Vascular patterns in basal cell carcinoma

J Eur Acad Dermatol Venereol. 2011 Mar;25(3):358-61. doi: 10.1111/j.1468-3083.2010.03734.x.

Abstract

Background: Dermoscopy has been proved to increase the diagnostic accuracy of basal cell carcinoma (BCC).

Objective: To characterize the type and frequency of vascular patterns in superficial and nodular BCCs.

Methods: We retrospectively analysed the dermoscopic images of 504 histopathologically proven BCCs.

Results: The most common vascular pattern was represented by arborizing vessels (306/504; 60.7%), which were significantly more frequent in nodular BCCs (nBCCs) compared with superficial BCCs (sBCCs), and in pigmented sBCCs vs. non-pigmented sBCCs (P<0.0001). Short fine telangectasias (SFTs) were found in 33.1% (167/504) of cases and were significantly more frequent in sBCCs compared with nBCCs (P<0.0001). Hairpin vessels were detected in 52/504 (10.3%) BCCs. Minor vascular patterns included glomerular vessels (41/504; 8.1%), dotted (21/504; 4.2%), comma vessels (5/504; 1.0%) and polymorphous pattern (9/504; 1.8%).

Conclusions: Arborizing vessels are prototypic of nBCCs, whereas SFTs are characteristics of sBCCs. Differential diagnosis with squamous cell carcinoma or melanoma is mandatory when a polymorphous pattern is detected.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Basal Cell / blood supply*
  • Carcinoma, Basal Cell / diagnosis
  • Carcinoma, Basal Cell / pathology*
  • Carcinoma, Squamous Cell / diagnosis
  • Dermoscopy
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Melanoma / diagnosis
  • Middle Aged
  • Neovascularization, Pathologic / pathology*
  • Retrospective Studies
  • Skin Neoplasms / blood supply*
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology*
  • Young Adult