Glomerular vessels

From dermoscopedia

5.00
(2 votes)

 Editor: Ralph P. Braun

 Author(s): Ralph P. Braun
Annotations
Description Describes dermoscopy of glomerular vessels
Author(s) Ralph P. Braun
Responsible author Ralph Braun→ send e-mail
Status released
Status update June 29, 2019
Status by Ralph P. Braun


User=

Glomerular vessels are the dermoscopic manifestations of tortuous, dilated capillaries [1]. They are named as such because their morphology is reminiscent of the convoluted capillaries that comprise the glomerular apparatus of the kidney[2]. Glomerular vessels are larger than dotted vessels and can be positioned in clusters throughout the lesion. Histologically these vessels correlate to dilated capillaries in the dermal papillae and papillary dermis [3].

Glomerular vessels schematics.jpg



Differential diagnosis
Most commonly, glomerular vessels are associated with SCCs, in which the glomerular vessels are principally distributed focally in clusters and at the periphery of the lesion together with hyperkeratosis (i.e., scaly surface). In a study of Bowen’s disease (BD), 80% of pigmented BD and 100% of nonpigmented BD displayed glomerular vessels [4]. In another study, glomerular vessels were seen in 81.2% of BD cases with a PPV of 61.9%. In contrast, glomerular vessels were seen in only 1.3% of melanomas, 12.2% of SKs, and 7.1% of invasive SCCs [2]. Glomerular vessels can also be seen in clear cell acanthoma where the vessels will be arranged in a string of pearls distribution, in psoriasis where the vessels are distributed throughout the lesion in an organized pattern, and in stasis dermatitis where these vessels will be visible in normal appearing skin. Lastly, glomerular vessels can also be seen in melanoma, especially within metastatic foci.


Glomerular vessels appearing on a squamous cell carcinoma



References:

  1. Braun et al.: Dermoscopy: what's new?. Clin. Dermatol. 2009;27:26-34. PMID: 19095151. DOI.
  2. 2.02.1 Argenziano et al.: Vascular structures in skin tumors: a dermoscopy study. Arch Dermatol 2004;140:1485-9. PMID: 15611426. DOI.
  3. Felder et al.: Dermoscopic differentiation of a superficial basal cell carcinoma and squamous cell carcinoma in situ. Dermatol Surg 2006;32:423-5. PMID: 16640692. DOI.
  4. Zalaudek et al.: Dermoscopy of Bowen's disease. Br. J. Dermatol. 2004;150:1112-6. PMID: 15214896. DOI.