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Nonmelanocytic lesions Flashcards

1
Q

MC type of skin cancer?

A

BCC

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2
Q

Two main dermoscopic categories of BCC

A

Pigmented

&

Nonpigmented BCC

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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)

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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

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5
Q

Name 2 dermoscopic findings of pBCC that have 100% specificity

A
  • Leaf-like structures
  • Spoke-wheel-like structures
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6
Q

Sensitivity & Specificity of Dermoscopic Structures for pBCC

A
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7
Q

Difference of blue-gray ovoid nests vs globules

A

Nests > globules

Nests > globules > dots

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8
Q

Leaf-like structures can be sometimes mistaken for…?

A

Streaks

( seen in melanocytic lesions)

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9
Q

Features of leaf-like structures

A
  • Leaf-like structures:
  1. Fuzzy
  2. May radiate towards tumor mass
  3. Tend to converge in focal area towards the periphery creating leaf-like structures
  4. Central part of lesion often HYPOPIGMENTED/white/ structureless
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10
Q

Features of streaks( melanoma/CMN/Spitz)

A
  • Streaks:
  1. Sharper in focus
  2. Always radiate away from tumor mass
  3. Tend to converge towards the geometric center of the lesion
  4. center of lesion usually pigmented, HYPERPIGMENTED, has a blue-white veil
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11
Q

Leaf-like structures vs streaks (table)

A
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12
Q

Globules seen in BCC vs melanoma/cmn/Spitz

A
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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
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14
Q

Ulceration is a valid BCC feature only if…?

A

Rule out a prior Hx of trauma

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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

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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
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17
Q

Name two main dermoscopic findings of superficial BCCs

A
  • Scattered vascular global pattern (97%)
  • Shiny white to red structureless & milky pink areas
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18
Q

Small fine telangiectasia

vs

large arborizing vessels

seen in…?

A

superficial

vs

invasive BCC

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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

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20
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

multiple blue-gray non-aggregated globules

BCC

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21
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

Multiple leaf-like structures

No pigment network

BCC

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22
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Multiple leaf-like structures

Spoke-wheel-like structures

pBCC

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23
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

Spoke-wheel-like areas

pBCC

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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

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25
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Arborizing telangiectasia

BCC

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26
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Arborizing telangiectasia

non-pigmented BCC

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27
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

multiple shallow serous crusted ulcerations

leaf-like structures

BCC

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28
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

multiple brown dots

BCC

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29
Q

Describe the major dermoscopic finding in these lesions

Dx?

A

a) multiple erosions
b) crystalline structures/ white shiny areas
c) vascular blush (commonly seen in malignancies)

BCC

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30
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

large diameter arborizing blood vessels

shiny white areas

nodular non-pigmented BCC

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31
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

shiny white chrysalis-like structures

pink blush

scattered global vascular pattern

BCC

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32
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

shiny white areas / milky pink areas

Shallow ulcerations

small fine telangiectasias

superficial nonpigmented BCC

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33
Q

NPD image of BCC

Dull white structureless area in the center

A

PD image of the same lesion

reveals shiny white and pink areas

chrysalis-like structures

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34
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

tortuous corkscrew blood vessels

BCC

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35
Q

Spectrum of premalignant & malignant keratizing tumors comprises…?

A
  • Actinic keratosis (AK)
  • Bowen’s disease (BD)
  • Keratoacanthoma (KA)
  • Squamous cell carcinoma ( SCC)

Spectrum of keratinocyte dysplasia

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36
Q

Main benefit from the development of PD

A

Better examination of the cutaneous vascular architecture

  • has eliminated the effect of pressure-induced compression of blood vessels
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37
Q

Dx of nonpigmented skin lesions is based on..?

A
  • Clinical assessment (texture, firmness)
  • Vascular morphology
  • Architectural arrangement & distribution of vessels
  • Assessment of additional criteria
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38
Q

Name the dermatoscopic criteria of nonpigmented AK

A
  • 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
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39
Q

Rosette sign is seen mainly in…, Interpretation…?

A

Seen in AK

Optical effect of polarized light interacting with follicular openings that contain orthokeratosis and parakeratosis

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40
Q

Rosette sign, DDx

A

AK

Actinic damaged skin

BCC

Melanoma

SCC

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41
Q

Major DDx of pigmented AK?

A

Lentigo Maligna (LM)

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42
Q

Dermoscopic findings of pigmented AK

A
  • Asymmetric pigmented follicular openings
  • Annular-granular pattern
  • Rhomboidal structures
  • Pseudonetwork located btw keratin-filled ostial openings
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43
Q

How to clinically(not dermoscopically) differentiate a pigmented AK from LM?

A

pAK => rough texture

vs

LM => smooth texture

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44
Q

How to dermoscopically differentiate pAK from LM?

A
  • pAK: Pseudonetwork

vs

  • LM: Isobar sign ( darker dots located within ostial openings)
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45
Q

If DDx btw pAK & LM is not possible, where to perform biopsy?

A
  • 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

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46
Q

BD represents …?

A

SCC in situ of the skin

aka intraepidermal carcinoma

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47
Q

Dermoscopic findings in nonpigmented BD

A
  • Surface scale
  • Glomerular (coiled) vessels

If these 2 signs are seen simultaneously =>

98% diagnostic probability of BD

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48
Q

Limitations of glomerular vessels visualization are due to?

These vessels often appear as…?

A
  • Small size
  • Lack of contrast
  • Camera resolution

vs

– Globular structures or doted vessels

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49
Q

How to differentiate BD from other skin entities as spitzoid neoplasms?

A

Based on vascular morphology:

  • BD: focal, clustered, asymmetric distribution of the vessels

vs

  • Spitzoid neoplasms: Symmetric distribution
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50
Q

Dermoscopic features of pigmented Bowen disease (pBD)

A
  • 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
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51
Q

Dermoscopic DDx btw pBD & melanoma

A
  • 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
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52
Q

Define bowenoid AK

A

AK that nearly full thickness dysplasia of keratinocytes histologically

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53
Q

Bowenoid AK

vs

BD

dermoscopically

A

Both have glomerular vessels

  • BoAK: regularly distributed

vs

  • Classic BD: focal clusters
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54
Q

Clinical features of KA

A
  • Well-differentiated variant of SCC
  • Initial rapid growth followed by spontaneous involution over a period of a few months
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55
Q

Dermoscopic findings of KA

A
  • Central yellowish to brownish structureless mass of keratin
  • Elongated telangiectasias
  • Hairpin or serpentine vessel morphology
  • Pearl-like structures surrounded by white circle
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56
Q

Dermoscopic findings of invasive SCC

A
  • 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

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57
Q

Dermoscopic findings of invasive pSCC (rare)

DDx?

A
  • diffuse, homogeneous blue pigmentation
  • distinct, irregularly distributed, blue-gray granular structures
  • NO vessels are visible due to pigmentation
  • DDX: pBCC, Melanoma
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58
Q

Definitions of the different morphologic types of vessels ass/w keratinizing tumors

A
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59
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Strawberry pattern:
  1. Background erythema
  2. Small keratin filled follicular ostia
  3. Coiled perifollicular vessels (inset on the right)

Nonpigmented facial AK

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60
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Red pseudonetwork
  • Keratin-filled hair follicles ostia
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61
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Hyperkeratosis

AK not located on the face ( often present with nonspecific features)

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62
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Superficial pseudonetwork
  • Thickened brown short lines btw keratin-filled hair follicles of irregular size

Facial pAK

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63
Q

Describe the major dermoscopic findings in these lesions

A & B (different !!)

Dx?

A

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!!!)
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64
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Glomerular (coiled) vessels
  • surface scale

BD

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65
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Glomerular vessels
  • Surface scale

BD

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66
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Glomerular vessels arranged in focal structures
  • Surface scale

BD

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67
Q

Describe the major dermoscopic findings in these lesions

A & B (different!!)

Dx?

A
  • 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
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68
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Clustered glomerular (coiled) vessels
  • Small brown globules & dots at the periphery arranged in a radial (linear) configuration
  • Homogenous light brown background

Partially pBD

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69
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Brown dots arranged in radial lines
  • eccentric pink structureless zone
  • Monomorphic glomerular (coiled) vessels(!!!)

pBD

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70
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Glomerular (coiled) vessels of irregular size that are UNIFORMLY distributed(!!!)

Bowenoid AK

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71
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Central crust
  • Large linear irregular vessels, aka serpentine branched
  • Hairpin, aka looped, vessels (square) on a white background

KA

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72
Q

Describe the major dermoscopic findings in these lesions(same Dx)

A
  • 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

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73
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Hairpin or looped vessels (arrows)
  • Glomerular or coiled vessels (circle)
  • White-to-yellow structure- less background

Poorly differentiated invasive SCC

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74
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Polymorphism of vascular structures
  • Targetoid appearing keratin-filled follicular ostia

Minimal invasive SCC

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75
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Elongated hairpin (looped) vessels
  • Typical “strawberry” (white circles) pattern of AK

Minimally invasive SCC arising in ass/w AK

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76
Q

Common vascular structures and patterns encountered in keratinizing tumors

A
  • ​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
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77
Q

Define solar lentigines

A
  • sharply circumscribed, uniformly pigmented macules
  • predominantly on the sun-exposed areas
  • imduced by UV exposure
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78
Q

Solar lentigines are a result of…?

A

Hyperplasia of keratinocytes & melanocytes

with ^ accumulation of melanin in keratinocytes

79
Q

Difference btw freckles & solar lentigo

A

Solar lentigines persist indefinitely

80
Q

Name two variants of solar lentigo:

a) seen in old age ( >60yrs)
b) color variant

A

lentigo senilis

vs

ink-spot lentigo

81
Q

Solar lentigo is a benign lesion can evolve into..?

A

pigmented SK

82
Q

Dermoscopic findings of solar lentigo

A
  • Moth-eaten border
  • Homogenous light brown pigmentation ( jelly sign)
  • Pigment network
  • Fingerprint-like areas
  • Pseudonetwork
  • Symmetric follicular pigmentation
83
Q

Dermoscopic findings of ink-spot lentigo

A
  • very prominent black pigmented network
  • network ends abruptly at the edge of the lesion
84
Q

Clinical features or SKs

A
  • benign epithelial lesions that can appear on any part of the body
  • except mucous membranes, palms & soles
  • more frequent > 30 yrs
  • unclear etiology
85
Q

Early vs “advanced” SK

A
  • Early SK:

– light-to-dark brown oval macules with sharply demarcated borders

  • Advanced SK:

– plaques with a waxy or stuck-on appear- ance

86
Q

Dermoscopic features of SKs

A
  • Milia-like cysts (image of cloudy sky)
  • Comedo-like openings
  • Fissures & ridges
  • Network-like structures
  • Cerebriform pattern
  • Fat-fingers
    *
87
Q

Milia-like cysts histologically correspond to…

A

intraepidermal, keratin-filled cysts

88
Q

Milia-like cysts DDx

A
  • SKs ( cloudy sky)
  • BCC
  • Congenital nevi (starry sky)
  • Melanoma (starry sky)
89
Q

Milia-like cysts can be observed with…

90
Q

How to clinically differentiate SK from other melanocytic lesions

A

Examine via slide lighting

makes cerebriform pattern & ridges more prominent

91
Q

Cerebriform pattern is generally ass/w…?

A

Acanthotic SK

92
Q

Wobble sign DDx

A

SK

Intradermal nevus

93
Q

Wobble sign

SK

vs

intradermal nevi

A
  • 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
Q

SK can mimick melanoma or SCC if..?

A
  • Irritated
  • Traumatized
95
Q

ALWAYS remember for a SK that..

A

skin cancer can develop within a SK

96
Q

Clinical features of lichen planus-like keratosis(LPLK)

A
  • 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
Q

Key dermoscopic features of LPLK

A

● Diffuse granular pattern
● Localized granular pattern
● Crystalline structures

98
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Moth-eaten border
  • Fingerprint-like structures
  • Faint pn

Solar lentigo

99
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Prominent black pn
  • Moth-eaten border

Ink-spot lentigo

100
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Moth-eaten border
  • Fingerprint-like structures
  • Raised papule centrally
  • Milia-like cysts

Solar lentigo evolving into SK

101
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Moth-eaten border
  • Irregular pn

Solar lentigo resembling melanoma

102
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Fingerprint-like structures

Solar lentigo

103
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • 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
Q

Schematic drawing of the criteria of solar lentigines/early SK

105
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Light brown to tan color
  • Pseudonetwork

Solar lentigo

106
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Prominent black pn
  • Moth-eaten border

Ink-spot lentigo

107
Q

Dermoscopic criteria of pigmented SKs

108
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Multiple milia-like cysts
  • Comedo-like openings

pSK

109
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Lack of network within the lesion => not of melanocytic origin
  • Sharp border
  • Comedo-like openings
  • Milia-like cysts

pSK

110
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Hairpin blood vessels
  • Milia-like cysts

SK

111
Q

Which dermoscopic finding becomes less or more conspicuous in these images A,B.

Dx?

A

A) NPD image: more conspicuous milia-like cysts

vs

B) PD image: less conspicuous

SK

112
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Sharp borders
  • Numerous comedo-like openings

SK

113
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Blue-white pigmentation
  • Large comedo-like openings
  • Fissures ( sulci)

SK

114
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Network-like structures, larger than one would expect from a pn
  • Ridges
  • Comedo-like openings

SK

115
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Cerebriform pattern

SK

116
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Fat-finger like structures, ( curvilinear pigmented ridges)

SK

117
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Multiple dark thrombosed capillaries
  • Hairpin vessels with white halo (lower part)

SK

118
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Milia-like cysts
  • Comedo-like openings
  • Hairpin vessels with withish halo

SK

119
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Few comedo-like openings
  • Blue-white veil

“Ugly duckling” SK, resembling melanoma

120
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Sharp border
  • Milia-like cysts
  • Hairpin vessels

pSK

121
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Regression structures
  • Milia-like cysts
  • Comedo-like openings

SK

122
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • fingerprint-like areas
  • fat-finger-like structures
  • milia-like cyst
  • Granularity (regression)
  • Blue-white veil (regression)

Melanoma arising within a SK

123
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Diffuse clumped bluish-grey granules

LPLK

124
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Diffuse granular pattern

LPLK

125
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Coarse granularity
  • Milia-like cysts
  • Comedo-like openings

SK undergoing regression

126
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Fine,coarse granularity
  • 2 milia-like cysts (left half)
  • Fingerprint-like areas
  • Moth-eaten borders

Regressing solar lentigo/ SK

127
Q

Vascular lesions are classified as

A
  • Hemangiomas
  • Malformations
128
Q

Definition of hemangioma

A

Benign proliferation of blood vessels

129
Q

MC vascular lesions in childhood vs adulthood

A

Hemangiomas of infancy

vs

Cherry hemangiomas ( Campbell de Morgan spots)

130
Q

Dermoscopic hallmark of hemangiomas

A

Presence of red lacunae

131
Q

Presence of red lacunae correspond istologically to…?

A

dilated, blood-filled vessels in the papillary dermis

132
Q

Is presence of red lacunae, solely, a sufficient criterion for Dx of benign vascular lesions?

A

No

Absence of criteria of melanocytic lesions is required as well

133
Q

When do hemangiomas acquire a blue-black or jet-black color?

A

Partially thrombosis (blue-black color)

vs

Total thrombosis ( jet-black)

134
Q

Clinical features of angiokeratoma

A
  • 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
Q

Clinical feature of angiokeratomas

A

Can undergo sudden enlargement, darkening or spontaneous bleeding

136
Q

Name the 4 clinical subtypes of angiokeratomas

A
  • Solitary
  • Angiokeratoma of Mibelli
  • Angiokeratoma of Fordyce
  • Angiokeratoma corporis diffusum
137
Q

DDx of angiokeratomas

A
  • Spitz/Reed nevus
  • pBCC
  • SK
  • Pyogenic granuloma
  • Hemangioma
138
Q

MC dermoscopic pattern of solitary angiokeratoma

A
  • Dark lacunae with whitish veil
  • +/- Eyrthema, hemorrhagic crusts

Whitish veil corresponds to hyperkeratosis & acanthosis

139
Q

Dx?

A

Angiokeratoma of Fordyce

  • MC in elderly individuals, pregnant women, OCP use
  • Ass/w inguinal hernias, varicoceles, thrombophlebitis, trauma and localized venous HTN
140
Q

Dx?

A

Angiokeratoma of Mibelli

  • MC in women
  • appears in childhood or adolescence (ages 10-15)
  • Ass/w cold temperatures & pernio (chilblains)
141
Q

Dx?

A

Angiokeratoma corporis diffusum

Skin manifestation of Fabry dx

X-linked disorder, a-galactosidase deficiency

142
Q

Clinical features of pyogenic granuloma (PG)

A
  • 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
Q

Triggers of PG

A
  • Infective organisms
  • penetrating injury
  • hormonal factors
  • retinoid therapy
  • systemic medications (i.e., docetaxel)

Reactive hyperproliferative vascular response to a variety of stimuli

144
Q

Dermoscopic pattern of PG

A
  • red or red-whitish homogenous areas surrounded by a white collarette
  • white lines resembling rails within the lesion
145
Q

Clinical features of microvenular hemangioma

A
  • 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
Q

Dermoscopic pattern of microvenular hemangioma

A
  • diffuse erythema
  • multiple well-demarcated small red globules of differing sizes
  • peripheral fine pigment network
147
Q

Clinical features of angioma serpiginosum

A
  • benign vascular disorder
  • multiple minute, red-to-purple, grouped macules distributed in a serpiginous or gyrate pattern
148
Q

Angioma serpiginosum

vs

Unilateral nevoid telangiectasia

149
Q

Unilateral nevoid telangiectasia

150
Q

Dermoscopic pattern of angioma serpiginosum

A
  • numerous small, relatively well-demarcated, round-to-oval red lacunae
151
Q

Purpuric dermatoses

vs

Angioma serpiginosum

Dermoscopically

A
  • 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
Q

Patient with multiple bluish oral,cutaneous and GI malformations

Dx?

A

Blue rubber vleb venus syndrome

Rare genodermatosis comprising multiple venous malformations of the skin,GI & frequently other sites

153
Q

Dx?

A

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
Q

Dermoscopic patterns of nevus flammeus

A
  • 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
Q

Dx?

A

Lymphangioma circumscriptum

  • vascular malformation involving primarily the lymphatic vessels in dermis
  • numerous small-vesicle-like lesions grouped in a plaque
156
Q

Dermoscopic pattern of Lymphangioma circumscriptum

A
  • lacunar pattern composed of clear to tan lacunae surrounded by pale septa
157
Q

Dermoscopic pattern of targetoid hemosiderotic hemangioma

A
  • central area with reddish dark lacunae
  • surrounded by red-brown to violaceous homogenous pigmentation
158
Q

Clinical features of Kaposi sarcoma

A
  • 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
Q

Name the clinical subsets of Kaposi sarcoma

A
  • Classic
  • Endemic
  • Iatrogenic
  • HIV-related
160
Q

Dermoscopic findings of Kaposi sarcoma

A
  • homogenous pattern with differing colors (i.e., whitish, pink- ish, reddish, bluish, or violaceous)
  • rainbow-like appearance
161
Q

Schematic representation of the dermoscopic patterns for the 4 MC vascular lesions

162
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

multiple, well-demarcated, red lacunae

Cherry angioma

163
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Tightly clustered multiple, well-demarcated red to blue-red lacunae

Cherry hemangioma

164
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

multiple dilated serpentine blood vessels

Cherry hemangioma

165
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • numerous tortuous and serpentine blood vessels
  • few red lacunae

Hemangioma of infancy

166
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • violaceous lacunae with whitish veil (right)
  • one dark lacuna (left)

Partially thrombosed hemangioma

167
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • homogeneous, confluent, dark bluish-black pigment
  • reddish halo

Entirely thrombosed hemangioma

168
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • multiple dark lacunae
  • whitish veil

Solitary angiokeratoma

169
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • multiple dark lacunae
  • whitish veil
  • surface scale

Solitary angiokeratoma

170
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • blue-red lacunae
  • overlying whitish yellow hue
  • surrounding red halo of erythema

Partially thrombosed angiokeratoma

171
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • central red-whitish homogenous area
  • white collarette

Pyogenic granuloma

172
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • central red-white homogenous areas
  • large hemorrhagic crust
  • surface scale
  • white collarette

Pyogenic granuloma

173
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • reddish homogeneous area
  • white veil

Atypical PG

174
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • reddish homogenous areas
  • whitish veil
  • rail lines
  • RAINBOW sign

PG

175
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • yellowish-brown background color
  • blurry reddish-brown dots and globules

Lichen aureus

176
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • mixed pattern with
  • red dotted and globular vessels (superficial pattern)
  • dilated and tortuous vessels (deep pattern)

Nevus flammeus

177
Q

Describe the major dermoscopic findings in this lesion

Dx?

A

Clustered clear to yellowish lacunae

Lymphangioma circumscriptum

178
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Thrombosed lacunae

Angiokeratoma

179
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • central area composed of dark lacunae, red lacunae
  • whitish veil
  • peripheral delicate pigment network

Targetoid hemosiderotic hemangioma

180
Q

Clinical features of dermatofibroma

A
  • 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
Q

Typical dermoscopic pattern of dermatofibroma

A
  • peripheral delicate pigment network
  • central scar-like white patch
182
Q

Schematics of the different dermoscopic patterns in dermatofibromas

183
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Peripheral delicate pigment network
  • central white scar-like patch

Dermatofibroma ( typical pattern)

184
Q

Describe the major dermoscopic finding in this lesion

Dx?

A
  • Peripheral delicate pigment network
  • central white network

Dermatofibroma

185
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

Delicate pigment network throughout

Dermatofibroma

186
Q

Name 2 variants of dermatofibroma

A
  • Hemosiderotic or aneurysmal
  • Lipidized
187
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • peripheral brown homogenous pigment
  • central bright white areas
  • chrysalis-like structures
  • pink hue
  • numerous irregular blood vessels

Dermatofibroma

188
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

fissures (sulci) and ridge

Dermatofibroma

189
Q

Describe the major dermoscopic finding in this lesion

Dx?

A

foci of yellow coloration

Lipidized dermatofibroma

190
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • 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
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • brownish homogenous area (right)
  • white scar-like patch in the center
  • red-bluish homogenous area
  • white linear chrysalis- like structures

Aneurysmal dermatofibroma

192
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • peripheral atypical pigment network
  • central red-bluish homogenous area with white structures, including chrysalis
  • surrounding erythema

Aneurysmal dermatofibroma

193
Q

Describe the major dermoscopic findings in this lesion

Dx?

A
  • Erythema, numerous dotted vessels

Non pigmented dermatofibroma

Δερματοσκόπηση (4 decks)

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