Shiny white streaks: a sign of malignancy at dermoscopy of pigmented skin lesions

Acta Derm Venereol. 2014 Mar;94(2):132-7. doi: 10.2340/00015555-1683.


The aim of this study was to evaluate the practical importance of the presence of shiny white streaks (SWS) (chrysalis or crystalline structures in polarized dermoscopy) for suspicion of malignancy, diagnosis of melanoma, and pre-operative estimation of Breslow thickness and its correlation with total dermoscopy score (TDS). SWS were present in 13.6% of 800 consecutive excised lesions. The presence of SWS was associated with malignancy (odds ratio (OR) 10.534, 95% confidence interval (95% CI) 6.357-17.455, p < 0.0005) in the context of melanocytic lesions with invasive melanoma (OR 10.333, 95% CI 3.812-28.014) and melanomas with high TDS (OR 6.286, 95% CI 1.673-23.619), but was also a factor in the diagnosis of featureless and some thin melanomas. These results corroborate the clinical applicability of SWS in aiding the diagnosis of malignancy and helping to raise the general dermatologist's awareness in cases of doubt and featureless lesions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Neuroendocrine / pathology
  • Carcinoma, Neuroendocrine / surgery
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Dermoscopy*
  • Humans
  • Melanoma / pathology
  • Melanoma / surgery
  • Retrospective Studies
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery