Umbilical Endometriosis: A New Dermoscopic Pattern

Jorge Juan Vega-Castillo, Jorge Juan Vega‐Castillo, Vega-Castillo JJ, Saenz-Guirado S, Soledad Saenz-Guirado, Soledad Sáenz‐Guirado, Maria Luisa Vega-Castillo, Vega-Castillo ML, Ricardo Ruíz‐Villaverde, Ricardo Ruiz-Villaverde
Dermatology practical & conceptual · 2022 · vol. 12(1) , pp. e2022023 · doi:10.5826/dpc.1201a23 · PMID:35223168 · PMC8824559 · W4210688021
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper describes a novel dermoscopic pattern observed in cases of umbilical endometriosis, characterized by specific visual features useful for diagnosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This paper describes umbilical endometriosis and introduces a new dermoscopic pattern, based on noninvasive dermatologic imaging findings. It focuses on characterizing visual dermoscopic features associated with primary umbilical endometriosis rather than studying underlying mechanisms, and it presents the pattern as a diagnostic description. A key limitation is that the evidence is based on a case-style report and therefore cannot establish sensitivity, specificity, or generalizability. This paper is centrally about endometriosis — specifically primary umbilical endometriosis and its dermoscopic pattern.

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Abstract

Citation: Vega-Castillo JJ, Saenz-Guirado S, Vega-Castillo M, Ruiz-Villaverde R. Umbilical endometriosis: a new dermoscopic pattern. Dermatol Pract Concept. 2022;12(1):e2022023. DOI: https://doi.org/10.5826/dpc.1201a23
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Case

A 45-year-old woman attended our dermatologic outpatient clinic complaining of a 4-months history of a solitary painless umbilical nodule. The bluish-green colored lesion had not appeared on a previous scar. Any recent bleeding episode was ruled out. A complete medical history revealed long-term dysmenorrhea as the only relevant clinical finding. On dermoscopy, a central white reticular pattern on a violet background was observed ( Figure 1A ). No vascular structures, points, globules, or structures suggestive of a melanocytic lesion were observed. Histopathological examination was consistent with cutaneous endometriosis ( Figure 1B ). Complementary tests, including abdominal-pelvic CT and determination of cancer antigen 125 offered results within normal ranges.

Intro

Endometriosis is defined as the growth of ectopic endometrial tissue outside the uterine cavity. Extra pelvic endometriosis occurs in 12% of women, and umbilical endometriosis, a rare presentation of extra pelvic endometriosis, occurs in 0.5%–1% of reported cases. Umbilical endometriosis is also known as Villar nodule as Villar first described the condition in 1886. Cutaneous endometriosis tends to settle on scars from surgical procedures (abdominal or pelvic surgery) such as hysterectomy, caesarean section, laparoscopy, or episiotomy. From a clinical point of view, it is necessary to establish a differential diagnosis with amelanotic melanoma, basal cell carcinoma, Sister Mary Joseph nodule, or pyogenic granuloma.

Conclusions

There are few dermoscopic descriptions in the literature of cutaneous endometriosis [ 1 , 2 ]. The main dermoscopic findings and histopathological correlation are reflected in Table 1 . There appears to be a difference in patterns depending on the phase of the hormonal cycle, as well as the depth of the lesion, histological subtype and phototype of the patient. White reticular pattern (negative pigment network) is due to elongated rete ridges and is characteristic of melanoma. Nevertheless, it has also been observed in Spitz/Reed nevi. The diffuse area of bluish color is likely related to hemosiderin deposits, unlike the referred deposits observed in other cases reported as small focused globules. Histopathological examination remains the diagnostic gold standard for endometriosis. It is considered mandatory in ruling out a neoplastic condition, as more than 60% of umbilical tumors are malignant. The description of new dermoscopic patterns and their histological correlations can be helpful in the diagnosis of this entity.

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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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