Collision lesions

From dermoscopedia

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 Editor: Andreas Blum

 Author(s): Andreas Blum     ·  Rainer Hofmann     ·  Florentia Dimitriou
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Author(s) Andreas Blum · Rainer Hofmann · Florentia Dimitriou
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Status update July 5, 2018
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Detectable by dermoscopyThe examination of [skin lesions] with a 'dermatoscope'. This traditionally consists of a magnifier (typically x10), a non-polarised light source, a transparent plate and a liquid medium between the instrument and the skin, and allows inspection of skin lesions unobstructed by skin surface reflections. Modern dermatoscopes dispense with the use of liquid medium and instead use polarised light to cancel out skin surface reflections., Collision tumors/lesions of the skinThis glossary term has not yet been described. can occur in all possible combinations of the different growths of the epidermal and/or dermal cell layers (Table 1 & Figure 1)[1].

  • They are associated with advancing ageprocess of becoming older and cumulative UV-exposure[2].
  • Compared with combinations of epidermal-dermal collision tumors, epidermal-epidermal collision tumors are more likely to be found in older patients and on the head and neck areas. In addtion, Collision tumors with a basal cell carcinomais the most common skin cancer, and one of the most common cancers in the United States.[1] While BCC has a very low metastatic risk, this tumor can cause significant disfigurement by invading surrounding tissues component are more common on the head and neck compared to collision tumors with a melanocyticThis glossary term has not yet been described. component that are more common on the trunk[2].
  • Collision tumors pose a diagnostic challenge. To correctly diagnose any possible collision tumor/lesion, the dermoscopic analysis of colorsThis glossary term has not yet been described. and structuresThis glossary term has not yet been described. must be performed in all four "quadrants" of the inspected lesion[3].
  • Using both polarized and non-polarized dermoscopy may be helpful in the diagnosisis the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines with variations in the use of logic, analytics, and experience to determine "cause and effect". In systems engineering and computer science, it is typically used to determine the causes of symptoms, mitigations, and solutions of these lesions[4][5].



Table 1 - Skin lesions or tumors with their original cell types of the different skin layers (focused only on skin lesions detectable by dermoscopy).[2]
Layer of the SkinThis glossary term has not yet been described. Cell Type or Functional Structure Associated Proliferations / Neoplasms
Epidermis Keratinocytes Solar lentigoThis glossary term has not yet been described.

Seborrheic keratosisThis glossary term has not yet been described.
Actinic keratosisActinic keratosis (also called solar keratosis and senile keratosis; abbreviated as AK) is a pre-cancerous patch of thick, scaly, or crusty skin.
Bowen's diseaseThis glossary term has not yet been described.
KeratoacanthomaThis glossary term has not yet been described.
Squamous cell carcinomaThis glossary term has not yet been described.

Basal cell layer (non-differentiated folliculo-sebaceous-apocrine germ) Trichoblastoma

Basal cell carcinomais the most common skin cancer, and one of the most common cancers in the United States.[1] While BCC has a very low metastatic risk, this tumor can cause significant disfigurement by invading surrounding tissues

Melanocytes MelanocyticThis glossary term has not yet been described. nevusThis glossary term has not yet been described.

MelanomaThis glossary term has not yet been described.

Merkel cells Merkel cell carcinoma
Dermis Blood capillaries AngiomaAngiomas are benign tumors derived from cells of the vascular or lymphatic vessel walls (endothelium) or derived from cells of the tissues surrounding these vessels.[1][2] Angiomas are a frequent occurrence as patients age, but they might be an indicator of systemic problems such as liver disease. They are not commonly associated with malignancy.This glossary term has not yet been described.
Melanocytes Melanocytic (dermal or blue) nevus

Melanoma

Fibroblasts DermatofibromaDermatofibromas are hard solitary slow-growing papules (rounded bumps) that may appear in a variety of colours, usually brownish to tan; they are often elevated or pedunculated. A dermatofibroma is associated with the dimple sign; by applying lateral pressure, there is a central depression of the dermatofibroma.

Dermatofibrosarcoma protuberans

Non-Langerhans cells/histiocystes Xanthogranuloma
Infundibulo-follicular-sebaceous unit Sebaceous hyperplasiaThis glossary term has not yet been described.

Milia cyst
Pilomatrixoma
Trichoepithelioma
Adnexal (benignis any condition that is harmless in the long run or malignantThis glossary term has not yet been described.) tumor

Myocytes Kaposi sarcomaThis glossary term has not yet been described.


ReferencesThis is material contained in a footnote or bibliography holding further information.:
  1. An Atlas of Dermoscopy, Second Edition. Marghoob A. et al. CRC Press; 2012.
  2. 2.0 2.1 2.2 Blum et al.: Collision skin lesions-results of a multicenter study of the International Dermoscopy Society (IDS). Dermatol Pract Concept 2017;7:51-62. PMID: 29230351. DOI.
  3. Braga et al.: Melanoma mimicking seborrheic keratosis: an error of perception precluding correct dermoscopic diagnosis. J. Am. Acad. Dermatol. 2008;58:875-80. PMID: 18328596. DOI.
  4. Kittler et al.: Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy. J. Am. Acad. Dermatol. 2016;74:1093-106. PMID: 26896294. DOI.
  5. Wang et al.: Differences in dermoscopic images from nonpolarized dermoscope and polarized dermoscope influence the diagnostic accuracy and confidence level: a pilot study. Dermatol Surg 2008;34:1389-95. PMID: 18637816. DOI.