Pitfalls in dermoscopy: “A sheep in the wolf`s clothing” = Pitfalls in dermoscopy: “A sheep in the wolf`s clothing”

다국어 초록 (Multilingual Abstract)

As a medical student, we always learned that it is of paramount importance not to miss one case of severe disease, even though mis-diagnosing thousands of minor diseases. In other words, motto in medical school is rather “OVER-diagnosis” than “MISS-diagnosis”. We are trained to find a wolf in the sheep`s clothing in the flock of sheep. In the realm of skin cancer, above-mentioned motto is more appealing than any other sub-field of dermatology. Thus, we learned and learned numerous signs suggestive of underlying malignancy. One of the most famous dermoscopic sign for acral melanoma is so-called parallel ridge pattern. In real world, however, doctors usually meet many cases of benign lesion masquerading under parallel ridge pattern. In this educational lecture, first I will try to review the anatomical background of parallel ridge/ furrow pattern, then introduce several benign conditions which show parallel ridge pattern on dermoscopic examination, discuss their clinical implications. In conclusion, I believe that a competent dermatologist should not miss a wolf in the sheep`s clothing, at the same time, not over-diagnose a sheep in the wolf`s clothing.