Dermoscopy of cutaneous smooth muscle neoplasms: a morphological study of 136 cases (original) (raw)
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Dermoscopy of Non-Melanocytic Skin Tumors: A Descriptive Study in a Tertiary Care Hospital
Nepal Journal of Dermatology, Venereology & Leprology
Introduction: Dermoscopy is a non-invasive technique that enhances visualization of morphological lesions invisible to naked eye examination and aids in clinical diagnosis. We study its role in non-melanocytic skin tumors. Objectives: The purpose of this study was to evaluate and compare the dermoscopic features of non-melanocyte skin tumors of skin Materials and Methods: A cross-sectional hospital-based study including patients clinically diagnosed as non-melanocytic epidermal tumors was conducted. All dermoscopic findings were studied using a handheld pocket dermoscope (Dermlite DL1) and recorded in a preset proforma. Results: A total of 100 patients were enrolled in the study with mean age of 37 (+/-18.34). There were 56 % females. The face was the commonest site of involvement (56%). Seborrheic keratosis was the commonest clinical diagnosis (55%), followed by pyogenic granuloma 8%, cherry angioma 7%, haemangioma 6%, basal cell carcinoma 5%, achrochordons 4%, xanthelasma, and seb...
Nonmelanoma skin cancer refers to a broad class of tumors, including actinic keratosis, basal cell carcinoma, and squamous cell carcinoma, and as a group these are the most frequent cancers occurring in light skinned humans. In contrast to the rarity of amelanotic melanoma, nonmelanoma skin cancer commonly lacks pigmentation. Although these tumors rarely cause death related to metastases, they commonly destroy underlying tissues and should be removed at the earliest possible stage. Dermoscopy improves the clinical diagnosis of nonpigmented skin tumors by allowing the visualization of specific vascular structures that are usually not visible to the naked eye. Dermoscopic vascular patterns of several nonmelanocytic nonpigmented skin tumors, such as sebaceous hyperplasia, seborrheic keratosis, clear cell acanthoma, Bowen disease, or nodular cystic basal cell carcinoma are highly specific, allowing a ready diagnosis in most cases. Others, such as actinic keratosis, pyogenic granuloma, or uncommon adnexal tumors, may be difficult to differentiate even with the aid of dermoscopy. For this reason, general guidelines have been established to assist in making the most appropriate management decision. In the second part of this review of dermoscopic vascular structures of nonpigmented skin tumors, the dermoscopic patterns associated with benign and malignant nonmelanocytic skin tumors and recommendations for the management of these tumors will be discussed. ( J Am Acad Dermatol 2010;63:377-86.) Learning objectives: After completing this learning activity, participants should be able to recognize the vascular morphology, architectural arrangement of vessels, and additional dermoscopic clues of nonmelanocytic nonpigmented skin tumors, recognize the diagnostic significance of vessels associated with benign and malignant nonmelanocytic tumors, and apply rules for the management of these tumors.
The limitations of dermoscopy: false-positive and false-negative tumours
Journal of the European Academy of Dermatology and Venereology, 2018
Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumors, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically "false positive" and "false negative" tumors do exist. False positive diagnosis usually leads to unnecessary excisions. False negative diagnosis is much more dangerous, since it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false negative tumors. The most frequent benign tumors that might acquire dermatoscopic characteristics suggestive of malignancy are seborrheic keratosis (SK), including solar lentigo, melanoacathoma, irritated, clonal and regressive SK, angioma (mainly thrombosed angioma and angiokeratoma), dermatofibroma, benign adnexal tumors and nevi (Clark, Spitz, recurrent, combined, sclerosing). The most useful clues to recognize these tumors are the following: solar lentigo-broad network; melanoacanthoma-sharp border; irritated SKregularly distributed white perivascular halos; clonal SK-classic SK criteria; regressive SK-remnants of SK; targetoid hemosiderotic angioma-dark center and reddish periphery; thrombosed angioma-sharp demarcation; angiokeratoma-dark lacunae; atypical dermatofibromas-palpation; follicular tumors-white color; sebaceous tumors-yellow color; Clark nevi-clinical context; Spitz/Reed nevi-age; combined nevi-blue central area; recurrent nevi-pigmentation within the scar; sclerosing nevi-age and location on the upper back; blue nevi-history Malignant tumors that might mimic benign ones and escape detection are melanoma (in-situ, nevoid, spitzoid, verroucous, regressive, amelanotic), squamous cell carcinoma (mainly well-differentiated variants) and rarely basal cell carcinoma (non-pigmented variants). The most useful clues to recognize the peculiar melanoma subtypes are: melanoma in situ-irregular hyperpigmented areas; nevoid melanoma-history of growth; spitzoid melanoma-age; verrucous melanoma: blue-black sign; regressive melanoma-peppering or scar-like depigmentation; amelanotic melanoma-pink color, linear irregular vessels, dotted vessels. In this paper we summarized the most frequent dermoscopic variations of common skin tumors that are often misinterpreted, aiming to assist clinicians to reduce the number of false diagnoses.
Dermoscopic-Pathologic Correlation: Apropos of Six Equivocal Cases
The increasing use of dermoscopy in preoperative diagnosis of melanocytic skin neoplasms is impacting on routine histopathology to a relevant extent. We herein present the dermoscopic-pathologic features of 6 cases of histopathologically controversial melanocytic skin neoplasms. By illustrating these cases, we emphasize at least 3 different fields of interest for a combined (clinico-)dermoscopic-pathologic diagnostic approach, namely, information about the evolution of lesions; detection of gross sampling errors; definition of peculiar clinicopathologic entities. The theoretic and practical aspects of a close interaction among dermoscopists and histopathologists are itemized in detail. Semin Cutan Med Surg 28:157-164
Dermoscopy of uncommon skin tumours
Australasian Journal of Dermatology, 2014
Abbreviations: AFX Atypical fibroxanthoma AS angiosarcoma of the head and scalp BCC basal cell carcinoma DFSP dermatofibrosarcoma protuberans LAS lymphoedema associated angiosarcoma MCC Merkel cell carcinoma MFH malignant fibrous histiocytoma RIA radiation induced angiosarcoma SCC squamous cell carcinoma
Dermatology practical & conceptual, 2017
The diagnosis of a single small pink papule poses a real challenge to the clinician, as the differential diagnosis of such lesions includes benign entities such as a neurofibroma or hemangioma, as well as aggressive and potentially fatal skin malignancies such as amelanotic melanoma or Merkel cell carcinoma (MCC). The absence of a benign vascular pattern and the presence of atypical vascular features under dermoscopy direct the clinician to proceed to histologic evaluation in order to rule out a malignant process in such lesions. The diagnosis of MCC is particularly problematic, given that this tumor usually lacks specific clinical diagnostic features. Low clinical suspicion for MCC may result in delayed diagnosis and poor outcomes. The dermoscopic features of MCC are also non-specific, most commonly including milky-red areas and linear irregular vessels. We report a patient who presented with two discrete pink papules on different digits that appeared three years apart. Dermoscopy ...
Exploring the Dermoscopic Spectrum and Examination of Non-Melanocytic Benign Skin Tumors in Humans
Texila International Journal of Public Health, 2024
Dermoscopy unveils distinctive features aiding non-melanocytic benign skin tumor identification. This study aimed to delineate and characterize these unique dermoscopic patterns, essential for precise diagnosis and tailored treatment. The study was conducted between December 2022 and June 2023, this descriptive study in a tertiary hospital assessed 96 patients with various benign skin tumors. Dermoscopic evaluations were blinded, ensuring rigorous data collection. Dermatofibroma displays a central white globule encircled by a peripheral pigmented network, while neurofibroma exhibits finger-print-like pigmentary lines. Mucosal neurofibroma stands out with its vascular reticulate network against a homogenous white background, contrasting with trichoepithelioma's structureless shiny white structures. Angiofibroma presents as unevenly distributed brown pigmentation, distinct from pyogenic granuloma's white collarette. Steatocystoma displays peripheral reticulate brown pigmentation, while keratoacanthoma showcases a central keratin mass. Cylindroma is characterized by a salmon pink-yellow color background with arborizing blood vessels at the periphery, whereas syringoma manifests multiple pigmented clusters. This study emphasizes dermoscopy's significance as a non-invasive tool enhancing diagnostic accuracy and guiding effective treatment modalities in dermatological practice.
How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy
Journal of the American Academy of Dermatology, 2010
Dermoscopy is a noninvasive tool that can be helpful in the diagnosis of nonpigmented skin tumors. This is because dermoscopy permits the visualization of key vascular structures that are usually not visible to the naked eye. Much work has concentrated on the identification of specific morphologic types of vessels that allow a classification into melanocytic versus nonmelanocytic and benign versus malignant nonpigmented skin tumors. Among a broad spectrum of different types of vascular patterns, six main morphologies can be identified. These are comma-like, dotted, linear-irregular, hairpin, glomerular, and arborizing vessels. With some exceptions, comma, dotted, and linear irregular vessels are associated with melanocytic tumors, while the latter three vascular types are generally indicative of keratinocytic tumors. Aside from vascular morphology, the architectural arrangement of vessels within the tumor and the presence of additional dermoscopic clues are equally important for the diagnosis. This article provides a general overview of the dermoscopic evaluation of nonpigmented skin tumors and is divided into two parts. Part I discusses the dermoscopic vascular patterns of benign and malignant melanocytic skin tumors. Part II discusses the dermoscopic vascular patterns of benign and malignant nonmelanocytic nonpigmented skin tumors. In each part, additional special management guidelines for melanocytic and nonmelanocytic nonpigmented skin tumors, respectively, will be discussed. ( J Am Acad Dermatol 2010;63:361-74.) Learning objectives: After completing this learning activity, participants should be able to categorize different vascular structures and the architectural arrangement of vessels within tumors and additional dermoscopic clues of nonpigmented skin tumors, recognize the diagnostic significance of vessels associated with nevi and melanoma, and appropriately manage nonpigmented melanocytic skin tumors.