How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy

Zalaudek, Iris; Kreusch, Jürgen; Giacomel, Jason; Ferrara, Gerardo; Catricalà, Caterina; Argenziano, Giuseppe

doi:10.1016/j.jaad.2009.11.698

Cited by 218 publications

(228 citation statements)

References 45 publications

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“…Therefore dermoscopic examination should assess the morphology of vessels, their arrangement and the presence of additional dermoscopic criteria [12]. In our series, 3 cases of IFK showed hairpin vessels surrounded by a whitish halo, arranged in a radial pattern around a whitish amorphous central area.…”

Section: Discussionmentioning

confidence: 96%

“…The whitish halo surrounding vessels is a strong indicator of epithelial differentiation of a neoplasm, and it is normally absent in melanocytic tumors [13]. Hairpin vessels have been described in benign and malignant keratinizing lesions such as VW, SK and SCC, but they can also be seen in poromas and thick melanomas [12,14]. …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, they have also been observed in some adnexal tumors (angiohistiocytoma, hidradenoma, intraepidermal poroma), nodular melanoma and other thick tumors [12,13,16]. …”

Section: Discussionmentioning

confidence: 99%

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Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Armengot‐Carbó

Abrego²,

González³

et al. 2013

Dermatology

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Inverted follicular keratosis (IFK) is a rare benign tumor which usually appears as a firm papule on the face. The diagnosis is generally made by histopathology because the clinical appearance is difficult to differentiate from other lesions. Dermoscopic features of IFK have not been established to date. Herein we describe the dermoscopic findings of 4 cases of IFK. Radial peripheral hairpin vessels surrounded by a whitish halo arranged around a central white-yellowish amorphous area were observed in 3 cases, and glomerular vessels were present in the central area of one of them. The fourth case also presented a central white amorphous area but showed arborizing vessels. Reflectance confocal microscopy (available in 1 case) revealed a broadened honeycomb pattern, epidermal projections and hairpin and glomerular vessels. To our knowledge this is the first case series describing the dermoscopic features of inverted follicular keratosis and the first confocal microscopy description of this entity.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Armengot‐Carbó

Abrego²,

González³

et al. 2013

Dermatology

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“…However, skin lesions that lack visual or tactile criteria typically associated with malignancy may remain undiagnosed. [2][3][4] The diagnostic accuracy based on physical examination is considerably lower than the gold standard of biopsy with histopathological analysis. 5 Visual inspection is also associated with a high false positive rate for skin cancer, 6 and atypical or deeper cancerous lesions can be difficult to diagnose with physical examination alone.…”

Section: Introductionmentioning

confidence: 99%

Quantified ultrasound elastography in the assessment of cutaneous carcinoma

Dasgeb¹,

Morris

Mehregan³

et al. 2015

BJR

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Objective: To evaluate the feasibility of high-frequency ultrasound and ultrasound elastography (USE) in discriminating benign from malignant skin lesions in a prospective cohort study and to introduce the use of a "strain ratio" for evaluation of skin lesions. Methods: A commercial ultrasound system with a 14-MHz transducer was used to visualize skin lesions requiring biopsy on clinical evaluation. Anatomic ultrasound and USE imaging of the skin lesions was performed using 2-to 4-mm gel stand-off pads. A region of interest was manually selected over the area of each lesion with the lowest strain. The concept of a strain ratio of the compressibility of the normal skin at the corresponding layer to that of the least compressible region of a lesion in question was created and applied. This ratio was subsequently correlated with blind histopathological evaluation for malignancy. Results: 55 patients were included in the study with a total of 67 lesions evaluated. 29 lesions were malignant and 38 benign. All malignant lesions had strain ratios $3.9. All benign lesions had strain ratios #3.0. A diagnostic value between 3.0 and 3.9 would result in 100% sensitivity and specificity in the characterization of these lesions as malignant.Conclusion: This pilot study demonstrated that USE plus strain ratio appears to be a promising modality in providing diagnostic determination between cancerous and benign primary solitary skin lesions prior to biopsy. Advances in knowledge: This is the first reported study applying an original mathematical elastographic ratio, or strain ratio, to evaluate primary solitary skin lesions.

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“…It comprises a magnifying lens and a light source attached to a digital camera. This device allows the visualization of pigmented structures or vessels in the epidermis and superficial dermis (Zalaudek et al, 2010). Most dermoscopic structures are correlated with specific histopathological markers, therefore dermoscopy can be regarded as a link between clinical (macroscopic) and histopathological (microscopic) morphology (Zalaudek et al, 2006b).…”

Section: Introductionmentioning

confidence: 99%

On the geometric modulation of skin lesion growth: a mathematical model for melanoma

et al. 2016

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Introduction: Early detection of suspicious skin lesions is critical to prevent skin malignancies, particularly the melanoma, which is the most dangerous form of human skin cancer. In the last decade, image processing techniques have been an increasingly important tool for early detection and mathematical models play a relevant role in mapping the progression of lesions. Methods: This work presents an algorithm to describe the evolution of the border of the skin lesion based on two main measurable markers: the symmetry and the geometric growth path of the lesion. The proposed methodology involves two dermoscopic images of the same melanocytic lesion obtained at different moments in time. By applying a mathematical model based on planar linear transformations, measurable parameters related to symmetry and growth are extracted. Results: With this information one may compare the actual evolution in the lesion with the outcomes from the geometric model. First, this method was tested on predefined images whose growth was controlled and the symmetry known which were used for validation. Then the methodology was tested in real dermoscopic melanoma images in which the parameters of the mathematical model revealed symmetry and growth rates consistent with a typical melanoma behavior. Conclusions: The method developed proved to show very accurate information about the target growth markers (variation on the growth along the border, the deformation and the symmetry of the lesion trough the time). All the results, validated by the expected phantom outputs, were similar to the ones on the real images.

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How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy

Cited by 218 publications

References 45 publications

Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Quantified ultrasound elastography in the assessment of cutaneous carcinoma

On the geometric modulation of skin lesion growth: a mathematical model for melanoma

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