Nonmelanocytic lesions Flashcards
(193 cards)
1
Q
MC type of skin cancer?
A
BCC
2
Q
Two main dermoscopic categories of BCC
A
Pigmented
&
Nonpigmented BCC
3
Q
Criteria for pigmented BCC apply only when there is…?
A
Absence of pigment network
&
streaks(pseudopods)
(bcz presence of these structures are seen in melanocytic lesions)
4
Q
Dermoscopic structures of pBCC
A
- Large blue-gray ovoid nests
- Arborizing telangiectasie
- Multiple blue-gray globules
- Ulceration
- Leaf-like structures
- Spoke-wheel-like structures
Only if absence of pigment network and streaks
5
Q
Name 2 dermoscopic findings of pBCC that have 100% specificity
A
- Leaf-like structures
- Spoke-wheel-like structures
6
Q
Sensitivity & Specificity of Dermoscopic Structures for pBCC
A
7
Q
Difference of blue-gray ovoid nests vs globules
A
Nests > globules
Nests > globules > dots
8
Q
Leaf-like structures can be sometimes mistaken for…?
A
Streaks
( seen in melanocytic lesions)
9
Q
Features of leaf-like structures
A
- Leaf-like structures:
- Fuzzy
- May radiate towards tumor mass
- Tend to converge in focal area towards the periphery creating leaf-like structures
- Central part of lesion often HYPOPIGMENTED/white/ structureless
10
Q
Features of streaks( melanoma/CMN/Spitz)
A
- Streaks:
- Sharper in focus
- Always radiate away from tumor mass
- Tend to converge towards the geometric center of the lesion
- center of lesion usually pigmented, HYPERPIGMENTED, has a blue-white veil
11
Q
Leaf-like structures vs streaks (table)
A
12
Q
Globules seen in BCC vs melanoma/cmn/Spitz
A
13
Q
Arborizing telangiectasia features
A
- multiple branching blood vessels in a tree-like pattern
- often seen in non-pigmented BCC
- rarely seen in nevi/other benign pigmented lesions
14
Q
Ulceration is a valid BCC feature only if…?
A
Rule out a prior Hx of trauma
15
Q
Non-classic BCC dermoscopic features
A
- Short-fine telangiectasias
- Multiple small,shallow erosions +/- crust
- Concentric structures/globules (variant of spoke-wheel)
- Multiple in-focus brown to blue-gray dots
- Shiny white areas/ chrysaline structures (PD only)
Seen both in PD & NPD
16
Q
Non-pigmented BCC dermoscopic features
(other than arborizing vessels, ulceration)
A
- Scattered vascular global pattern
- Shiny white to red structureless and milky pink areas
- Small fine telangiectasia ( aka arborizing microvessels)
- Corkscrew vessels
17
Q
Name two main dermoscopic findings of superficial BCCs
A
- Scattered vascular global pattern (97%)
- Shiny white to red structureless & milky pink areas
18
Q
Small fine telangiectasia
vs
large arborizing vessels
seen in…?
A
superficial
vs
invasive BCC
19
Q
Describe the major dermoscopic finding in this lesion
Dx?
A
No pigment network
large blue-gray ovoid nests
multiple blue-gray globules
pBCC
20
Q
Describe the major dermoscopic findings in this lesion
Dx?
A
multiple blue-gray non-aggregated globules
BCC
21
Q
Describe the major dermoscopic findings in this lesion
Dx?
A
Multiple leaf-like structures
No pigment network
BCC
22
Q
Describe the major dermoscopic finding in this lesion
Dx?
A
Multiple leaf-like structures
Spoke-wheel-like structures
pBCC
23
Q
Describe the major dermoscopic findings in this lesion
Dx?
A
Spoke-wheel-like areas
pBCC
24
Q
Describe the major dermoscopic findings in this lesion
Dx?
A
leaf-like areas
blue-gray globules
brownish concentric globules
shallow ulcerations with an orange hue
superficial BCC
25
Describe the major dermoscopic finding in this lesion
Dx?
Arborizing telangiectasia
BCC
26
Describe the major dermoscopic finding in this lesion
Dx?
Arborizing telangiectasia
non-pigmented BCC
27
Describe the major dermoscopic finding in this lesion
Dx?
multiple shallow serous crusted ulcerations
leaf-like structures
BCC
28
Describe the major dermoscopic finding in this lesion
Dx?
multiple brown dots
BCC
29
Describe the major dermoscopic finding in these lesions
Dx?
a) multiple erosions
b) crystalline structures/ white shiny areas
c) vascular blush (commonly seen in malignancies)
BCC
30
Describe the major dermoscopic findings in this lesion
Dx?
large diameter arborizing blood vessels
shiny white areas
nodular non-pigmented BCC
31
Describe the major dermoscopic findings in this lesion
Dx?
shiny white chrysalis-like structures
pink blush
scattered global vascular pattern
BCC
32
Describe the major dermoscopic finding in this lesion
Dx?
shiny white areas / milky pink areas
Shallow ulcerations
small fine telangiectasias
superficial nonpigmented BCC
33
NPD image of BCC
Dull white structureless area in the center
PD image of the same lesion
reveals shiny white and pink areas
chrysalis-like structures
34
Describe the major dermoscopic finding in this lesion
Dx?
tortuous corkscrew blood vessels
BCC
35
Spectrum of premalignant & malignant keratizing tumors comprises...?
* Actinic keratosis (AK)
* Bowen's disease (BD)
* Keratoacanthoma (KA)
* Squamous cell carcinoma ( SCC)
Spectrum of keratinocyte dysplasia
36
Main benefit from the development of PD
Better examination of the cutaneous vascular architecture
- has eliminated the effect of pressure-induced compression of blood vessels
37
Dx of nonpigmented skin lesions is based on..?
* Clinical assessment (texture, firmness)
* Vascular morphology
* Architectural arrangement & distribution of vessels
* Assessment of additional criteria
38
Name the dermatoscopic criteria of nonpigmented AK
* Strawberry pattern:
1. Pink-to-red pseudonetwork, sparing hair follicles
2. White-to-yellow surface scale
3. Straight or coiled perifollicular vessels
4. Hair follicle openings filled with keratotic plug
5. Rosette sign
39
Rosette sign is seen mainly in..., Interpretation...?
Seen in AK
Optical effect of polarized light interacting with follicular openings that contain orthokeratosis and parakeratosis
40
Rosette sign, DDx
AK
Actinic damaged skin
BCC
Melanoma
SCC
41
Major DDx of pigmented AK?
Lentigo Maligna (LM)
42
Dermoscopic findings of pigmented AK
* Asymmetric pigmented follicular openings
* Annular-granular pattern
* Rhomboidal structures
* Pseudonetwork located btw keratin-filled ostial openings
43
How to clinically(not dermoscopically) differentiate a pigmented AK from LM?
pAK =\> rough texture
vs
LM =\> smooth texture
44
How to dermoscopically differentiate pAK from LM?
* pAK: Pseudonetwork
vs
* LM: Isobar sign ( darker dots located within ostial openings)
45
If DDx btw pAK & LM is not possible, where to perform biopsy?
* annular–granular structures
* asymmetric follicular openings
* dots within the ostial openings
* rhomboidal structures
These structures may provide the pathologist with the most diagnostically relevant tissue to examine
46
BD represents ...?
SCC in situ of the skin
aka intraepidermal carcinoma
47
Dermoscopic findings in nonpigmented BD
* Surface scale
* Glomerular (coiled) vessels
If these 2 signs are seen simultaneously =\>
98% diagnostic probability of BD
48
Limitations of glomerular vessels visualization are due to?
These vessels often appear as...?
* Small size
* Lack of contrast
* Camera resolution
vs
-- Globular structures or doted vessels
49
How to differentiate BD from other skin entities as spitzoid neoplasms?
Based on vascular morphology:
* BD: focal, clustered, asymmetric distribution of the vessels
vs
* Spitzoid neoplasms: Symmetric distribution
50
Dermoscopic features of pigmented Bowen disease (pBD)
* brown/grey dots (strong clue when arranged as linear radial lines at the periphery of the lesion)
* pink or skin colored eccentric structureless areas
* glomerular (coiled) vessels, arranged randomly, as clusters, or in radial lines
51
Dermoscopic DDx btw pBD & melanoma
* pBD:
1. brown/grey dots arranged in linear radial lines at the periphery
2. focal glomerular (coiled) vessels
vs
* Melanoma:
1. brown/grey dots with NO pattern
2. Dotted or polymorphous vessels
52
Define bowenoid AK
AK that nearly full thickness dysplasia of keratinocytes histologically
53
Bowenoid AK
vs
BD
dermoscopically
Both have glomerular vessels
* BoAK: regularly distributed
vs
* Classic BD: focal clusters
54
Clinical features of KA
* Well-differentiated variant of SCC
* Initial rapid growth followed by spontaneous involution over a period of a few months
55
Dermoscopic findings of KA
* Central yellowish to brownish structureless mass of keratin
* Elongated telangiectasias
* Hairpin or serpentine vessel morphology
* Pearl-like structures surrounded by white circle
56
Dermoscopic findings of invasive SCC
* Central mass of keratin
* Ulceration
* Hairpin vessels, linear-irregular vessels
* Targetoid hair follicles over a white structureless area
If SCC arises in ass/w AK =\> strawberry pattern, adjacent & contiguous with the SCC
57
Dermoscopic findings of invasive pSCC (rare)
DDx?
* diffuse, homogeneous blue pigmentation
* distinct, irregularly distributed, blue-gray granular structures
* NO vessels are visible due to pigmentation
* DDX: pBCC, Melanoma
58
Definitions of the different morphologic types of vessels ass/w keratinizing tumors
59
Describe the major dermoscopic finding in this lesion
Dx?
* Strawberry pattern:
1. Background erythema
2. Small keratin filled follicular ostia
3. Coiled perifollicular vessels (inset on the right)
Nonpigmented facial AK
60
Describe the major dermoscopic finding in this lesion
Dx?
* Red pseudonetwork
* Keratin-filled hair follicles ostia
61
Describe the major dermoscopic finding in this lesion
Dx?
Hyperkeratosis
AK not located on the face ( often present with nonspecific features)
62
Describe the major dermoscopic findings in this lesion
Dx?
* Superficial pseudonetwork
* Thickened brown short lines btw keratin-filled hair follicles of irregular size
Facial pAK
63
Describe the major dermoscopic findings in these lesions
A & B (different !!)
Dx?
Both tumors show multiple small gray dots (annular–granular pattern)
* A) facial pAK, hair follicle openings of the actinic keratosis lack the central black dot
* B) LM: hair follicle openings of the actinic keratosis with the central black dot (isobar sign!!!)
64
Describe the major dermoscopic findings in this lesion
Dx?
* Glomerular (coiled) vessels
* surface scale
BD
65
Describe the major dermoscopic findings in this lesion
Dx?
* Glomerular vessels
* Surface scale
BD
66
Describe the major dermoscopic findings in this lesion
Dx?
* Glomerular vessels arranged in focal structures
* Surface scale
BD
67
Describe the major dermoscopic findings in these lesions
A & B (different!!)
Dx?
* A) Spitz nevus:
1. Negative network (reticular depigmentation)
2. Chrysalis lines
3. Dotted vessels, HOMOGENEOUSLY distributed
* B) BD:
1. Surface scale
2. Dotted vessels, focal, clustered
68
Describe the major dermoscopic findings in this lesion
Dx?
* Clustered glomerular (coiled) vessels
* Small brown globules & dots at the periphery arranged in a radial (linear) configuration
* Homogenous light brown background
Partially pBD
69
Describe the major dermoscopic findings in this lesion
Dx?
* Brown dots arranged in radial lines
* eccentric pink structureless zone
* Monomorphic glomerular (coiled) vessels(!!!)
pBD
70
Describe the major dermoscopic finding in this lesion
Dx?
* Glomerular (coiled) vessels of irregular size that are UNIFORMLY distributed(!!!)
Bowenoid AK
71
Describe the major dermoscopic finding in this lesion
Dx?
* Central crust
* Large linear irregular vessels, aka serpentine branched
* Hairpin, aka looped, vessels (square) on a white background
KA
72
Describe the major dermoscopic findings in these lesions(same Dx)
* Central keratin crust surrounded by linear vessels
* Looped & serpentine vessels, dotted (red dots) or glomerular (coiled) vessels (D)
* Keratin pearl-like structures and white circles (B)
KA
73
Describe the major dermoscopic findings in this lesion
Dx?
* Hairpin or looped vessels (arrows)
* Glomerular or coiled vessels (circle)
* White-to-yellow structure- less background
Poorly differentiated invasive SCC
74
Describe the major dermoscopic findings in this lesion
Dx?
* Polymorphism of vascular structures
* Targetoid appearing keratin-filled follicular ostia
Minimal invasive SCC
75
Describe the major dermoscopic findings in this lesion
Dx?
* Elongated hairpin (looped) vessels
* Typical “strawberry” (white circles) pattern of AK
Minimally invasive SCC arising in ass/w AK
76
Common vascular structures and patterns encountered in keratinizing tumors
* hairpin (looped) vessels with a whitish halo
* glomerular (coiled) vessels
* linear–irregular(serpentine)
* dotted
* strawberry-red pseudonetwork (white circles on a red back- ground)
* polymorphous
77
Define solar lentigines
* sharply circumscribed, uniformly pigmented macules
* predominantly on the sun-exposed areas
* imduced by UV exposure
78
Solar lentigines are a result of...?
Hyperplasia of keratinocytes & melanocytes
with ^ accumulation of melanin in keratinocytes
79
Difference btw freckles & solar lentigo
Solar lentigines persist indefinitely
80
Name two variants of solar lentigo:
a) seen in old age ( \>60yrs)
b) color variant
lentigo senilis
vs
ink-spot lentigo
81
Solar lentigo is a benign lesion can evolve into..?
pigmented SK
82
Dermoscopic findings of solar lentigo
* Moth-eaten border
* Homogenous light brown pigmentation ( jelly sign)
* Pigment network
* Fingerprint-like areas
* Pseudonetwork
* Symmetric follicular pigmentation
83
Dermoscopic findings of ink-spot lentigo
* very prominent black pigmented network
* network ends abruptly at the edge of the lesion
84
Clinical features or SKs
* benign epithelial lesions that can appear on any part of the body
* except mucous membranes, palms & soles
* more frequent \> 30 yrs
* unclear etiology
85
Early vs "advanced" SK
* Early SK:
-- light-to-dark brown oval macules with sharply demarcated borders
* Advanced SK:
-- plaques with a waxy or stuck-on appear- ance
86
Dermoscopic features of SKs
* Milia-like cysts (image of cloudy sky)
* Comedo-like openings
* Fissures & ridges
* Network-like structures
* Cerebriform pattern
* Fat-fingers
*
87
Milia-like cysts histologically correspond to...
intraepidermal, keratin-filled cysts
88
Milia-like cysts DDx
* SKs ( cloudy sky)
* BCC
* Congenital nevi (starry sky)
* Melanoma (starry sky)
89
Milia-like cysts can be observed with...
NPD
90
How to clinically differentiate SK from other melanocytic lesions
Examine via slide lighting
makes cerebriform pattern & ridges more prominent
91
Cerebriform pattern is generally ass/w...?
Acanthotic SK
92
Wobble sign DDx
SK
Intradermal nevus
93
Wobble sign
SK
vs
intradermal nevi
* SK:
-- appear to stick to the glass plate and move en bloc
vs
* Intradermal nevi:
-- will not move en bloc but, rather roll back and forth
94
SK can mimick melanoma or SCC if..?
* Irritated
* Traumatized
95
**ALWAYS** remember for a SK that..
skin cancer can develop within a SK
96
Clinical features of lichen planus-like keratosis(LPLK)
* macular or slightly raised solitary lesion with sharply demarcated borders
* shares histological features of LP
* believed to be mediated by an immunologic or inflammatory response to a pre-existing lesion, such as SK, solar lentigo, AK
**Pink variant** of LPLK can mimick BCC
97
Key dermoscopic features of LPLK
● Diffuse granular pattern
● Localized granular pattern
● Crystalline structures
98
Describe the major dermoscopic findings in this lesion
Dx?
* Moth-eaten border
* Fingerprint-like structures
* Faint pn
Solar lentigo
99
Describe the major dermoscopic findings in this lesion
Dx?
* Prominent black pn
* Moth-eaten border
Ink-spot lentigo
100
Describe the major dermoscopic findings in this lesion
Dx?
* Moth-eaten border
* Fingerprint-like structures
* Raised papule centrally
* Milia-like cysts
Solar lentigo evolving into SK
101
Describe the major dermoscopic findings in this lesion
Dx?
* Moth-eaten border
* Irregular pn
Solar lentigo resembling melanoma
102
Describe the major dermoscopic finding in this lesion
Dx?
* Fingerprint-like structures
Solar lentigo
103
Describe the major dermoscopic finding in this lesion
Dx?
* light brown to tan color
* sharply demarcated border
* Moth-eaten appearance ( upper part)
* Jelly sign, pigment appears as if it has been smeared onto the skin
Solar lentigo
104
Schematic drawing of the criteria of solar lentigines/early SK
105
Describe the major dermoscopic finding in this lesion
Dx?
* Light brown to tan color
* Pseudonetwork
Solar lentigo
106
Describe the major dermoscopic finding in this lesion
Dx?
* Prominent black pn
* Moth-eaten border
Ink-spot lentigo
107
Dermoscopic criteria of pigmented SKs
108
Describe the major dermoscopic findings in this lesion
Dx?
* Multiple milia-like cysts
* Comedo-like openings
pSK
109
Describe the major dermoscopic findings in this lesion
Dx?
* Lack of network within the lesion =\> not of melanocytic origin
* Sharp border
* Comedo-like openings
* Milia-like cysts
pSK
110
Describe the major dermoscopic findings in this lesion
Dx?
* Hairpin blood vessels
* Milia-like cysts
SK
111
Which dermoscopic finding becomes less or more conspicuous in these images A,B.
Dx?
A) NPD image: more conspicuous milia-like cysts
vs
B) PD image: less conspicuous
SK
112
Describe the major dermoscopic findings in this lesion
Dx?
* Sharp borders
* Numerous comedo-like openings
SK
113
Describe the major dermoscopic findings in this lesion
Dx?
* Blue-white pigmentation
* Large comedo-like openings
* Fissures ( sulci)
SK
114
Describe the major dermoscopic findings in this lesion
Dx?
* Network-like structures, larger than one would expect from a pn
* Ridges
* Comedo-like openings
SK
115
Describe the major dermoscopic finding in this lesion
Dx?
Cerebriform pattern
SK
116
Describe the major dermoscopic finding in this lesion
Dx?
Fat-finger like structures, ( curvilinear pigmented ridges)
SK
117
Describe the major dermoscopic findings in this lesion
Dx?
* Multiple dark thrombosed capillaries
* Hairpin vessels with white halo (lower part)
SK
118
Describe the major dermoscopic findings in this lesion
Dx?
* Milia-like cysts
* Comedo-like openings
* Hairpin vessels with withish halo
SK
119
Describe the major dermoscopic findings in this lesion
Dx?
* Few comedo-like openings
* Blue-white veil
"Ugly duckling" SK, resembling melanoma
120
Describe the major dermoscopic findings in this lesion
Dx?
* Sharp border
* Milia-like cysts
* Hairpin vessels
pSK
121
Describe the major dermoscopic findings in this lesion
Dx?
* Regression structures
* Milia-like cysts
* Comedo-like openings
SK
122
Describe the major dermoscopic findings in this lesion
Dx?
* fingerprint-like areas
* fat-finger-like structures
* milia-like cyst
* Granularity (regression)
* Blue-white veil (regression)
Melanoma arising within a SK
123
Describe the major dermoscopic finding in this lesion
Dx?
* Diffuse clumped bluish-grey granules
LPLK
124
Describe the major dermoscopic finding in this lesion
Dx?
Diffuse granular pattern
LPLK
125
Describe the major dermoscopic findings in this lesion
Dx?
* Coarse granularity
* Milia-like cysts
* Comedo-like openings
SK undergoing regression
126
Describe the major dermoscopic findings in this lesion
Dx?
* Fine,coarse granularity
* 2 milia-like cysts (left half)
* Fingerprint-like areas
* Moth-eaten borders
Regressing solar lentigo/ SK
127
Vascular lesions are classified as
* Hemangiomas
* Malformations
128
Definition of hemangioma
Benign proliferation of blood vessels
129
MC vascular lesions in childhood vs adulthood
Hemangiomas of infancy
vs
Cherry hemangiomas ( Campbell de Morgan spots)
130
Dermoscopic hallmark of hemangiomas
Presence of red lacunae
131
Presence of red lacunae correspond istologically to...?
dilated, blood-filled vessels in the papillary dermis
132
Is presence of red lacunae, solely, a sufficient criterion for Dx of benign vascular lesions?
No
Absence of criteria of melanocytic lesions is required as well
133
When do hemangiomas acquire a blue-black or jet-black color?
Partially thrombosis (blue-black color)
vs
Total thrombosis ( jet-black)
134
Clinical features of angiokeratoma
* Acquired lesions
* Result from ectatic dilatation of pre-existing vessels in the papillary dermis in conjunction with overlying hyperkeratotic epidermis
* on lower extremities of young to middle-aged adults
135
Clinical feature of angiokeratomas
Can undergo sudden enlargement, darkening or spontaneous bleeding
136
Name the 4 clinical subtypes of angiokeratomas
* Solitary
* Angiokeratoma of Mibelli
* Angiokeratoma of Fordyce
* Angiokeratoma corporis diffusum
137
DDx of angiokeratomas
* Spitz/Reed nevus
* pBCC
* SK
* Pyogenic granuloma
* Hemangioma
138
MC dermoscopic pattern of solitary angiokeratoma
* Dark lacunae with whitish veil
* +/- Eyrthema, hemorrhagic crusts
Whitish veil corresponds to hyperkeratosis & acanthosis
139
Dx?
Angiokeratoma of Fordyce
* MC in elderly individuals, pregnant women, OCP use
* Ass/w inguinal hernias, varicoceles, thrombophlebitis, trauma and localized venous HTN
140
Dx?
Angiokeratoma of Mibelli
* MC in women
* appears in childhood or adolescence (ages 10-15)
* Ass/w cold temperatures & pernio (chilblains)
141
Dx?
Angiokeratoma corporis diffusum
Skin manifestation of Fabry dx
X-linked disorder, a-galactosidase deficiency
142
Clinical features of pyogenic granuloma (PG)
* benign, acquired, vascular lesion of the skin & mucous membranes
* rapidly growing, reddish papule or polyp with a glistening surface
* bleeds easily after minor trauma
* preferentially affects fingers, hands, face, lips, & oral mucous membranes
143
Triggers of PG
* Infective organisms
* penetrating injury
* hormonal factors
* retinoid therapy
* systemic medications (i.e., docetaxel)
Reactive hyperproliferative vascular response to a variety of stimuli
144
Dermoscopic pattern of PG
* red or red-whitish homogenous areas surrounded by a white collarette
* white lines resembling rails within the lesion
145
Clinical features of microvenular hemangioma
* acquired, slowly growing, asymptomatic, benign vascular tumor
* usually on upper limbs, forearms, or trunk of young to middle-aged adults
* sharply circumscribed, bright red, solitary lesions varying in size from 0.5 to 2cm
146
Dermoscopic pattern of microvenular hemangioma
* diffuse erythema
* multiple well-demarcated small red globules of differing sizes
* peripheral fine pigment network
147
Clinical features of angioma serpiginosum
* benign vascular disorder
* multiple minute, red-to-purple, grouped macules distributed in a serpiginous or gyrate pattern
148
Angioma serpiginosum
vs
Unilateral nevoid telangiectasia
149
Unilateral nevoid telangiectasia
150
Dermoscopic pattern of angioma serpiginosum
* numerous small, relatively well-demarcated, round-to-oval red lacunae
151
Purpuric dermatoses
vs
Angioma serpiginosum
Dermoscopically
* Purpuric dermatoses:
1. **IRREGULARLY** shaped, red to yellow-brown patches with clusters of petechial hemorrhages
2. +/- ill-defined **GLOBULAR** structures (not lacunae)
* Angioma ser. :
1. Small, **WELL-DEMARCATED** round-to-oval **LACUNAE**
152
Patient with multiple bluish oral,cutaneous and GI malformations
Dx?
Blue rubber vleb venus syndrome
Rare genodermatosis comprising multiple venous malformations of the skin,GI & frequently other sites
153
Dx?
Nevus flammeus ( Port-wine stain)
* capillary malformation
* present at birth
* persists throughout life
* localized or cover extensive areas of the skin surface
* predilection for head/neck, trunk, or limbs
154
Dermoscopic patterns of nevus flammeus
* Superficial:
1. red dotted and globular vessels
* Deep:
1. dilated linear and tortuous vessels
Unlike superficial port-wine stains, deep port-wine stains respond poorly to laser ablation
155
Dx?
Lymphangioma circumscriptum
* vascular malformation involving primarily the lymphatic vessels in dermis
* numerous small-vesicle-like lesions grouped in a plaque
156
Dermoscopic pattern of Lymphangioma circumscriptum
* lacunar pattern composed of clear to tan lacunae surrounded by pale septa
157
Dermoscopic pattern of targetoid hemosiderotic hemangioma
* central area with reddish dark lacunae
* surrounded by red-brown to violaceous homogenous pigmentation
158
Clinical features of Kaposi sarcoma
* low-grade malignant vascular tumor
* caused by HHV-8
* multifocal endothelial proliferation predominantly involving the skin
* reddish-blue macules or flat plaques that gradually enlarge and become nodular
159
Name the clinical subsets of Kaposi sarcoma
* Classic
* Endemic
* Iatrogenic
* HIV-related
160
Dermoscopic findings of Kaposi sarcoma
* homogenous pattern with differing colors (i.e., whitish, pink- ish, reddish, bluish, or violaceous)
* rainbow-like appearance
161
Schematic representation of the dermoscopic patterns for the 4 MC vascular lesions
162
Describe the major dermoscopic finding in this lesion
Dx?
multiple, well-demarcated, red lacunae
Cherry angioma
163
Describe the major dermoscopic finding in this lesion
Dx?
Tightly clustered multiple, well-demarcated red to blue-red lacunae
Cherry hemangioma
164
Describe the major dermoscopic finding in this lesion
Dx?
multiple dilated serpentine blood vessels
Cherry hemangioma
165
Describe the major dermoscopic findings in this lesion
Dx?
* numerous tortuous and serpentine blood vessels
* few red lacunae
Hemangioma of infancy
166
Describe the major dermoscopic findings in this lesion
Dx?
* violaceous lacunae with whitish veil (right)
* one dark lacuna (left)
Partially thrombosed hemangioma
167
Describe the major dermoscopic findings in this lesion
Dx?
* homogeneous, confluent, dark bluish-black pigment
* reddish halo
Entirely thrombosed hemangioma
168
Describe the major dermoscopic findings in this lesion
Dx?
* multiple dark lacunae
* whitish veil
Solitary angiokeratoma
169
Describe the major dermoscopic findings in this lesion
Dx?
* multiple dark lacunae
* whitish veil
* surface scale
Solitary angiokeratoma
170
Describe the major dermoscopic findings in this lesion
Dx?
* blue-red lacunae
* overlying whitish yellow hue
* surrounding red halo of erythema
Partially thrombosed angiokeratoma
171
Describe the major dermoscopic findings in this lesion
Dx?
* central red-whitish homogenous area
* white collarette
Pyogenic granuloma
172
Describe the major dermoscopic findings in this lesion
Dx?
* central red-white homogenous areas
* large hemorrhagic crust
* surface scale
* white collarette
Pyogenic granuloma
173
Describe the major dermoscopic findings in this lesion
Dx?
* reddish homogeneous area
* white veil
Atypical PG
174
Describe the major dermoscopic findings in this lesion
Dx?
* reddish homogenous areas
* whitish veil
* rail lines
* RAINBOW sign
PG
175
Describe the major dermoscopic findings in this lesion
Dx?
* yellowish-brown background color
* blurry reddish-brown dots and **globules**
Lichen aureus
176
Describe the major dermoscopic findings in this lesion
Dx?
* mixed pattern with
* red dotted and globular vessels (superficial pattern)
* dilated and tortuous vessels (deep pattern)
Nevus flammeus
177
Describe the major dermoscopic findings in this lesion
Dx?
Clustered clear to yellowish lacunae
Lymphangioma circumscriptum
178
Describe the major dermoscopic finding in this lesion
Dx?
Thrombosed lacunae
Angiokeratoma
179
Describe the major dermoscopic findings in this lesion
Dx?
* central area composed of dark lacunae, red lacunae
* whitish veil
* peripheral delicate pigment network
Targetoid hemosiderotic hemangioma
180
Clinical features of dermatofibroma
* Fibrosing cutaneous lesion
* increased number of fibrocytes in the dermis & subcutis
* epidermis overlying the tumor: acanthotic, papillomatous, hyperpigmented
* firm, single or multiple firm papules, or nodules that have a relatively smooth surface
* affects young to middle-aged adults, females \> males
* predilection for the lower extremities
* + dimple/Fitzpatrick sign
181
Typical dermoscopic pattern of dermatofibroma
* peripheral delicate pigment network
* central scar-like white patch
182
Schematics of the different dermoscopic patterns in dermatofibromas
183
Describe the major dermoscopic findings in this lesion
Dx?
* Peripheral delicate pigment network
* central white scar-like patch
Dermatofibroma ( typical pattern)
184
Describe the major dermoscopic finding in this lesion
Dx?
* Peripheral delicate pigment network
* central white **network**
Dermatofibroma
185
Describe the major dermoscopic finding in this lesion
Dx?
Delicate pigment network throughout
Dermatofibroma
186
Name 2 variants of dermatofibroma
* Hemosiderotic or aneurysmal
* Lipidized
187
Describe the major dermoscopic findings in this lesion
Dx?
* peripheral brown homogenous pigment
* central bright white areas
* chrysalis-like structures
* pink hue
* numerous irregular blood vessels
Dermatofibroma
188
Describe the major dermoscopic finding in this lesion
Dx?
fissures (sulci) and ridge
Dermatofibroma
189
Describe the major dermoscopic finding in this lesion
Dx?
foci of yellow coloration
Lipidized dermatofibroma
190
Describe the major dermoscopic findings in this lesion
Dx?
* peripheral delicate pigment network
* white network
* chrysalis- like structures
Lipidized Dermatofibroma
(yellow coloration in the right part of the lesion, corresponds histopathologically to areas of lipidization with lipophages & Touton giant cells)
191
Describe the major dermoscopic findings in this lesion
Dx?
* brownish homogenous area (right)
* white scar-like patch in the center
* red-bluish homogenous area
* white linear chrysalis- like structures
Aneurysmal dermatofibroma
192
Describe the major dermoscopic findings in this lesion
Dx?
* peripheral atypical pigment network
* central red-bluish homogenous area with white structures, including chrysalis
* surrounding erythema
Aneurysmal dermatofibroma
193
Describe the major dermoscopic findings in this lesion
Dx?
* Erythema, numerous dotted vessels
Non pigmented dermatofibroma
