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February 2011February 21, 2011

The Vasculature of Nonmelanocytic Skin Tumors on Reflectance Confocal MicroscopyVascular Features of Squamous Cell Carcinoma In Situ

Author Affiliations

Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Dermatol. 2011;147(2):264. doi:10.1001/archdermatol.2010.416

We describe 2 cases of Squamous cell carcinoma (SCC) in situ showing distinctive vascular features. A 74-year old man presented with a 10-mm, pink-brown, scaly plaque on the left side of his chest (Figure 1A, circle). Dermoscopy revealed pink and light-brown structureless areas and dotted vessels in the center of the lesion (Figure 1B, arrows). On reflectance confocal microscopy (RCM), scaly surface areas and an atypical honeycomb pattern were seen (Figure 1C, circle). At the dermoepidermal junction, there was an abnormally increased density of dermal papillae with multiple round blood vessels (Figure 1C, arrows). The increased blood flow was readily observed in real-time video-mode RCM (video 1). On histopathologic examination, keratinocytes with atypical nuclei and abnormal maturation were seen throughout the epidermis (Figure 1D, arrows) (hematoxylin-eosin, original magnification ×40).