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March 2010

The Vasculature of Nonmelanocytic Skin Tumors in Reflectance Confocal Microscopy: Vascular Features of Basal Cell Carcinoma

Author Affiliations


Arch Dermatol. 2010;146(3):353-354. doi:10.1001/archdermatol.2009.380

Dermoscopy, particularly polarized dermoscopy, has become an important tool for the examination of vascular structures of pigmented and nonpigmented skin lesions. Branching (arborizing) vessels can be found in about 82% of basal cell carcinomas (BCCs).1 Small-diameter branching vessels are usually found in superficial BCCs (91.7%).2 Reflectance confocal microscopy (RCM) is a new noninvasive imaging technique with cellular-level resolution.3 Many of the structures seen on RCM correlate closely to dermoscopic and histopathologic findings.3 The principal features of BCCs on RCM imaging include dark silhouettes surrounded by collagen bundles and tumor islands delineated from the adjacent stroma by a dark cleft. Furthermore, the vasculature pattern has been demonstrated to play an important role in the diagnosis of BCC.4,5 The vessels in BCC that have been described as canalicular are branched and linear and run parallel to the horizontal (en face) plane of RCM imaging. We report 2 cases of BCC demonstrating these vascular features.

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