A whitish lesion

A 48-year-old woman consulted for a whitish scar-like lesion on her back.  

Clinical picture: whitish scar-like lesion with a pigmented border. Patient has a background of former heavy sun exposure.

At dermoscopy:

• no signs in favor of a melanocytic lesion
• a structureless  scar-like white pattern
• pinkish areas without any vascular structures
• a peripheral pigmentation (red square) in favor of leaf-like areas

Pathology revealed a superficial basal cell carcinoma

A temporal lesion

A 60-year-old woman consulted for this temporal  pigmented lesion

 Dermoscopy revealed:

• blue-gray dots / globules
• leaf-like areas

Pathology was in favor of a basal cell carcinoma

Basal cell carcinomas

A 75-year-old patient consulted for 3 lésions on her face and a lesion on her back with superficial ulcerations.

Dermoscopy 1: ulcerations, leaf-like areas

Dermoscopy 2: leaf-like areas, arborizing vessels, blue ovoid nest

Dermoscopy 3: leaf-like areas and arborizing vessels

Dermoscopy 4: leaf-like areas

All these lesions were superficial basal cell carcinomas

Leaves

A 48-year-old woman presented a pigmented lesion on her sternal area:

Dermoscopy revealed:

• a non melanocytic pattern
• typical leaf-like structures
• one spoke wheel-like structure

in favour of a basal cell carcinoma

Typical leaf-like areas (click on the picture above to see enlargement)

Leaf-like structures

A 92-year-old woman presented a red tumor on her neck.

Dermoscopy revealed many brown structures with a leaf-like configuration located at the periphery of the lesion. This was typical of leaf-like structures, also called maple leaf-like areas in the first publications.

Leaf-like structures are quite exclusively found in basal cell carcinomas but have also been reported in featureless melanomas.

Other cases of basal cell carcinomas: 

1 2 3 4 5 6 7 8 9  10 11 12 13 14 15 16 17 18 19 20 21

Basal cell carcinoma

A 72-year-old man consulted for a red tumor on his left leg.


Dermoscopy revealed arborizing blood vessels, leaf-like structures and crusts in favor of a basal cell carcinoma.

basal cell carcinoma (pigmented)

A 30-year-old man consulted for this pigmented lesion on his back.




















On dermoscopy: multi-component pattern with blue gray globules, blue-gray ovoïd nests, leaf-like areas (upper left quadrant) and arborizing vessels