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Journal of the American Academy of Dermatology
Volume 63, n° 3
pages 377-386 (septembre 2010)
Doi : 10.1016/j.jaad.2009.11.697
Continuing Medical Education

How to diagnose nonpigmented skin tumors: A review of vascular structures seen with dermoscopy : Part II. Nonmelanocytic skin tumors
 

Iris Zalaudek, MD a, , Jürgen Kreusch, MD, PhD b, Jason Giacomel, MBBS c, Gerardo Ferrara, MD d, Caterina Catricalà, MD e, Giuseppe Argenziano, MD, PhD f
a Division of Dermatology, Medical University of Graz, Graz, Austria 
b private practice, Lübeck, Germany 
c Mends St Medical Centre, South Perth, Australia 
d Pathologic-Anatomy Unit, Gaetano Rummo Hospital, Benevento, Italy 
e Department of Dermatologic Oncology, Santa Maria and San Gallicano Dermatologic Institute, Rome, Italy 
f Department of Dermatology, Second University of Naples, Naples, Italy 

Reprint requests: Iris Zalaudek, MD, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, 8036 Graz, Austria.
Abstract

Nonmelanoma skin cancer refers to a broad class of tumors, including actinic keratosis, basal cell carcinoma, and squamous cell carcinoma, and as a group these are the most frequent cancers occurring in light skinned humans. In contrast to the rarity of amelanotic melanoma, nonmelanoma skin cancer commonly lacks pigmentation. Although these tumors rarely cause death related to metastases, they commonly destroy underlying tissues and should be removed at the earliest possible stage. Dermoscopy improves the clinical diagnosis of nonpigmented skin tumors by allowing the visualization of specific vascular structures that are usually not visible to the naked eye. Dermoscopic vascular patterns of several nonmelanocytic nonpigmented skin tumors, such as sebaceous hyperplasia, seborrheic keratosis, clear cell acanthoma, Bowen disease, or nodular cystic basal cell carcinoma are highly specific, allowing a ready diagnosis in most cases. Others, such as actinic keratosis, pyogenic granuloma, or uncommon adnexal tumors, may be difficult to differentiate even with the aid of dermoscopy. For this reason, general guidelines have been established to assist in making the most appropriate management decision. In the second part of this review of dermoscopic vascular structures of nonpigmented skin tumors, the dermoscopic patterns associated with benign and malignant nonmelanocytic skin tumors and recommendations for the management of these tumors will be discussed.

Learning objectives

After completing this learning activity, participants should be able to recognize the vascular morphology, architectural arrangement of vessels, and additional dermoscopic clues of nonmelanocytic nonpigmented skin tumors, recognize the diagnostic significance of vessels associated with benign and malignant nonmelanocytic tumors, and apply rules for the management of these tumors.

The full text of this article is available in PDF format.

Key words : basal cell carcinoma, dermoscopy, nonpigmented skin tumors, seborrheic keratosis, squamous cell carcinoma, vessels

Abbreviations used : AHM, AK, BCC, BD, CCA, CMN, DM, IEC, KA, NPSL, NPST, PPV, PST, SCC, SH, SK



 Dr Zalaudek is supported by the Elise Richter Program (V9-B05) of the Austrian Science Fund (FWF).
 Conflicts of interest: The authors, editors, planners, and peer reviewers have no relevant financial relationships.



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