Sebaceous hyperplasia is the overgrowth of sebaceous glands. It can mimic BCC on the face. Sebaceous hyperplasia presents with multiple vessels in a crown-like arrangement that do not cross the center of the lesion. The sebaceous glands resemble popcorn (FIGURE 8).
Clear-cell acanthoma is a benign erythematous epidermal tumor usually found on the leg with a string-of-pearls pattern. This pattern is vascular so the pearls are red in color (FIGURE 9).
Malignant nonmelanocytic lesions
BCC is the most common type of skin cancer. Features often include:
- spoke-wheel-like structures or concentric structures (FIGURE 10A)
- leaf-like areas (FIGURE 10B)
- arborizing vessels (FIGURE 10b and 10C)large blue-gray ovoid nest (FIGURE 10A)
- multiple blue-gray non-aggregated globules
- ulceration or multiple small erosions
- shiny white structures and strands (FIGURE 10C).
Additional dermoscopic clues include short, fine, superficial telangiectasias and multiple in-focus dots in a buck-shot scatter distribution.
Squamous cell carcinomas (SCCs) of the skin are keratinizing malignant tumors. Each SCC generally has some of the following features (FIGURE 11):
- dotted and/or glomerular vessels, commonly distributed focally at the periphery. They can also be diffuse or aligned linearly within the lesion.
- scale (yellow or white)
- rosettes (seen with polarized light)
- white circles or keratin pearls
- brown circles
- brown dots or globules arranged in a linear configuration.
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