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. 2022 Nov 30;58(12):1761.
doi: 10.3390/medicina58121761.

Vascular Diameter as Clue for the Diagnosis of Clinically and/or Dermoscopically Equivocal Pigmented and Non-Pigmented Basal Cell Carcinomas and Nodular Melanomas

Roberta Giuffrida  1 , Claudio Conforti  2 , Andreas Blum  3 , Marija Buljan  4   5 , Fabrizio Guarneri  1 , Rainer Hofmann-Wellenhof  6 , Caterina Longo  7   8 , John Paoli  9 , Cliff Rosendahl  10 , H Peter Soyer  11 , Ružica Jurakić Tončić  12 , Roberta Vezzoni  2 , Iris Zalaudek  2
Affiliations

Vascular Diameter as Clue for the Diagnosis of Clinically and/or Dermoscopically Equivocal Pigmented and Non-Pigmented Basal Cell Carcinomas and Nodular Melanomas

Roberta Giuffrida et al. Medicina (Kaunas). .

Abstract

Background and objectives: Dermoscopy is a useful tool for the early and non-invasive diagnosis of skin malignancies. Besides many progresses, heavily pigmented and amelanotic skin tumors remain still a challenge. We aimed to investigate by dermoscopy if distinctive morphologic characteristics of vessels may help the diagnosis of equivocal nodular lesions. Materials and Methods: A collage of 16 challenging clinical and dermoscopic images of 8 amelanotic and 8 heavily pigmented nodular melanomas and basal cell carcinomas was sent via e-mail to 8 expert dermoscopists. Results: Dermoscopy improved diagnostic accuracy in 40 cases. Vessels were considered the best clue in 71 cases. Focusing on the diameter of vessels improved diagnosis in 5 cases. Conclusions: vascular diameter in addition to morphology and arrangement may be a useful dermoscopic clue for the differential diagnosis of clinically equivocal nodular malignant tumors.

Keywords: basal cell carcinoma; dermoscopy; melanoma; skin cancer; vascular diameter; vessels.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Examples of clinical and dermoscopic images concerning challenging nodular lesions submitted for evaluation to the expert dermoscopists involved in the study. (a) Nodular amelanotic melanoma; (b) nodular non-pigmented basal cell carcinoma; (c) nodular heavily pigmented melanoma; (d) nodular pigmented basal cell carcinoma.
Figure 2
Figure 2
(a–d) Clinical and dermoscopic images of nodular amelanotic melanomas. Dermoscopy shows dense, short and fine polymorphic micro-vessels.
Figure 3
Figure 3
(a–d) Clinical and dermoscopic images of nodular non-pigmented basal cell carcinoma. Large superficial macro-vessels are easily visible on dermoscopy.
Figure 4
Figure 4
Clinical and dermoscopic images of nodular heavily pigmented melanoma. On dermoscopy, short polymorphous vessels can be seen at the periphery (a,b) or are hidden by heavy pigmentation (c,d).
Figure 5
Figure 5
(a–d) Clinical and dermoscopic images of nodular pigmented basal cell carcinoma. The heavy pigmentation does not completely hide the superficial large caliber vessels of BCC on dermoscopy.
See this image and copyright information in PMC

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