This research’s objective was to study 10 cases to find the dermoscopy and reflectance confocal microscopy of balloon cell nevi. Balloon cell nevus (BCN) is a rare histopathological entity. It is usually represented by an asymptomatic brown smooth or polypoid lesion, but no clinical features differentiate from other melanocytic nevi. The researchers evaluated ten patients who underwent a BCN surgical excision with the histological diagnosis were included in this study. Dermatoscopy and RCM were performed for each lesion, searching for the features described in the literature.

As a result of that, every nevus presented as an asymptomatic, smooth brownish lesion. Regarding dermoscopy, four balloon cell nevi showed yellow globules, eight white globules, eight a light‐brown network at the periphery, and eight a structureless central area; moreover, we found a hyperpigmented central blotch in four cases. RCM examination focused aggregates of dense nests at a superficial dermis level in all BCNs, characterized by a dark nucleus surrounded by vacuolized cytoplasm. Moreover, multiple melanophages were seen at the dermal-epidermal junction in one case and superficial epidermal dendritic cells. Hence, the study showed that all the 10 BCNs improved the dermoscopic and confocal microscopic knowledge of this rare entity.