A small lesion...

A 52-year-old woman consulted for a cutaneous check up.
Examination revealed this lesion.

Dermoscopy revealed:

• maple leaf-like areas (black arrow)
• blue ovoid nests (red circle)
• structureless area (red arrow)

This lesion was excised and pathology revealed a superficial basal cell carcinoma.

Plantar lesion

1 - clinical image

A 28-year-old woman consulted for a plantar  bluish ulcerated lesion on his left foot which was present for 6 months.

Clinically, a melanoma was suspected.

2 - Dermoscopic image

Dermoscopy revealed:

• blue hue
• ulceration
• blue ovoid nest

in favor of a basal cell carcinoma.

but this lesion was excised and pathology revealed an eccrine poroma (or eccrine acrospiroma).

Dermoscopic features of eccrine poroma have been described similar to basal cell carcinoma except the spoke-wheel areas and leaf-like structures (1)

1- A.Gatti, N. di Meo, G. Trevisan. Dermoscopy of eccrine acrospiroma masquerading as nodular malignant melanoma. ActaDermatoven APA Vol 19, 2010, No4, 23-25

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

A scalp tumour...

A 38-year-old woman presented since birth a localised parietal hairless orange-yellow plaque (1) This plaque was smooth and became verrucous during childhood.

The patient consulted because of the occurence of nodules (2) on the anterior part of the lesion.

Dermoscopy revealed yellow globular-like structures (1) on the posterior area.

On the nodules, arborizing tree vessels and blue ovoid nests were in favour of a basal cell carcinoma or a trichoblastoma

This lesion was biopsied  and pathology confirmed the diagnosis of basal cell carcinoma occuring on a Jadahsson nevus (nevus sebaceus)

Knowing that trichoblastomas are the tumors the most frequently reported as complication of nevus sebaceous  (2, 3) and that dermoscopy is not sufficently discriminative to distinguish a trichoblastoma from a basal cell carcinoma, we have to wait for the pathology result of the entire excision.

An update will be added within a month.

Litterature

1 -Nancy H. Kim et al.  The dermoscopic differential diagnosis of yellow lobularlike structures. Arch Dermatol 2008; 144 (7): 962.

2-Jaqueti et Al. Trichobastoma is the most common neoplasm debeloped in nevus sebaceus of Jadassohn: a clinicopathologic study of a series of 155 cases. Am J Dermatopathol 2000;22(2):108-18

3- Cribier et Al. Tumors arising in nevus sebaceus. A study of 596 cases. J Am Acad Dermatol 2000;42:263-8

Basal cell carcinoma

A 72-year-old woman consulted for this pigmented lesion on the left side of her nose.

Dermoscopy revealed a non melanocytic tumor with:

• large blue ovoïd nest
• arborizing vessels (in the blue ovoïd nest)
• blue gray globules
• leaf-like areas

in favor of a basal cell carcinoma.

leaf-like structures

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 59-year-old man consulted for this tumor on his nose.

Dermoscopy was typically in favor of a basal cell carcinoma:

• arborizing blood vessels
• blue ovoid nest
• blue gray globules
• ulceration with congealed blood
  

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 70-year-old woman consulted for a black ulcerated lesion on her left groin.


Dermoscopy displayed:
- absence of pigment network
- ulceration (white arrow)
- large blue gray ovoid nest (double arrow)
- delicate leaf-like areas (white circle)
in favor of a basal cell carcinoma

Basal cell carcinoma

A 69-year-old patient presented a pigmented tumor on his right temporal area.
Dermoscopy revealed blue ovoid nests in favour of a basal cell carcinoma.
The lesion was removed and pathology confirmed the dermoscopic diagnosis.

Blue ovoïd nests

A 73-year old woman consulted for this ulcerated tumor of her forehead. The main clinical diagnosis was a basal cell carcinoma.



Dermoscopy confirmed easily the diagnosis, showing ulceration and many blue ovoïd nests.



Blue ovoïd nests (or blue-gray ovoïd nests) are well circumscribed areas, larger than blue-gray globules and often associate. Their presence is a good dermoscopic sign for a basal cell carcinoma.

Basal cell carcinoma

A 75-year-old man with background of former heavy sun expositions consulted for a regular skin check-up. A suspicious lesion was detectected on his left scapular area. The clinical diagnosis was a basal cell carcinoma. Dermoscopy revealed arborizing vessels (*) and a blue gray ovoid nest (+).

Basal cell carcinoma

This 56-year-old man presented a basal cell carcinoma of his chest. The lesion had two parts: a red one at the left and a brown one at the right.
On the red part of the BCC, dermoscopy revealed arborizing vessels. On the brown part of the BCC, there were many polymorphous vessels and some blue-gray ovoid nests.

Basal cell carcinoma

A 72-year-old woman presented on her right leg a nodular tumor. Eight years before she had been operated on for a tumor but could not provide the pathology result. Dermoscopy revealed a blue ovoid nest and some arborizing blood vessels in favor of the recurrence of a basal cell carcinoma.

Pigmented basal cell carcinoma

A 67-year-old man consulted for a pigmented tumor on his right forearm. Dermoscopy revealed a central ulceration, arborizing blood vessels and blue ovoid nests. The lesion was excised and pathology confirmed the diagnosis of basal cell carcinoma.