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,
Claudio Conforti,
Andreas Blum,
Marija Buljan,
Fabrizio Guarneri,
Rainer Hofmann-Wellenhof,
Caterina Longo,
John Paoli,
Cliff Rosendahl,
H. Peter Soyer,
Ružica Jurakić Tončić,
Roberta Vezzoni,
Iris Zalaudek
Affiliations
Roberta Giuffrida
Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy
Claudio Conforti
Department of Dermatology and Venereology, Dermatology Clinic, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy
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.
