Objectives: To describe the different vascular structures seen by dermoscopy and to evaluate their association with various melanocytic and nonmelanocytic skin tumors in a large series of cases. Design: Digital dermos...
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Objectives: To describe the different vascular structures seen by dermoscopy and to evaluate their association with various melanocytic and nonmelanocytic skin tumors in a large series of cases. Design: Digital dermoscopic images of the lesions were evaluated for the presence of various morphologic types of vessels. Setting: Specialized university clinic. Patients: From a larger database, 531 excised lesions (from 517 patients) dermoscopically showing any type of vascular structures were included. Main Outcome Measures: The frequency and positive predictive value of the different vascular structures seen in various tumors were calculated, and the differences were evaluated by the χ2 or Fisher exact test. Results: Arborizing vessels were seen in 82.1%of basal cell carcinomas, with a 94.1%positivepredictive value (P < .001). Dotted vessels were generally predictive for a melanocytic lesion (90.0%, P < .001), and were especially seen in Spitz nevi (77.8%of lesions). In melanoma, linear-irregular, dotted, and polymorphous/atypical vessels were the most frequent vascular structures, whereas milky-red globules/areas were the most predictive ones (77.8%, P=.003). The presence of erythema was most predictive for Clark nevus, whereas comma, glomerular, crown, and hairpin vessels were significantly associated with dermal/congenital nevi, Bowen disease, sebaceous hyperplasia, and seborrheic keratosis, respectively (P < .001 for all). Conclusions: Different morphologic types of vessels are associated with different melanocytic or nonmelanocytic skin tumors. Therefore, the recognition of distinctive vascular structures may be helpful for diagnostic purposes, es-pecially when the classic pigmented dermoscopic structures are lacking.
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