Comma vessels

From dermoscopedia

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 Editor: Ralph P. Braun

 Author(s): Ralph P. Braun
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Description This chapter covers the dermoscopy of comma vessels
Author(s) Ralph P. Braun
Responsible author Ralph Braun→ send e-mail
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Status update November 29, 2019
Status by Ralph P. Braun


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Comma vessels are slightly curved vessels that appear to take the shape of a comma[1]. These vessels tend to appear slightly out of focus, as their deeper location within the dermis does not allow for sharp visualization under dermoscopy.

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Differential diagnosis
Comma vessels are most commonly associated with dermal nevi. In a study of dermal/ congenital nevi, 66.3% exhibited this vascular pattern, with a PPV of 94% [2]. In another study, comma vessels, when distributed in an organized fashion and when they comprise the predominant observed vessel morphology, are predictive that the lesion in question is not a melanoma [3]. In other words, comma vessels are highly suggestive of benign nevi with dermal nevi being the most common, but they can also be seen in compound nevi.

File:Comma vessels1.jpgC600px
Comma vessels as they appear on an intradermal nevus



References

  1. Braun et al.: Dermoscopy: what's new?. Clin. Dermatol. 2009;27:26-34. PMID: 19095151. DOI.
  2. Argenziano et al.: Vascular structures in skin tumors: a dermoscopy study. Arch Dermatol 2004;140:1485-9. PMID: 15611426. DOI.
  3. Menzies et al.: Dermoscopic evaluation of amelanotic and hypomelanotic melanoma. Arch Dermatol 2008;144:1120-7. PMID: 18794455. DOI.