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Collision tumors/lesions of the skin, detectable with dermoscopy, can occur in all possible combinations of the different cells of the epidermal and/or dermal cell layers (Table 1, Figure 1) (1).
- Combinations of epidermal-epidermal collision tumors are more often found in UV-exposed skin areas in older patients than epidermal-dermal combinations.
- To diagnose correctly any possible collision tumor/lesion, the dermoscopic analysis of colors and differential structures must be perfomed in all four "quadrants" (2,3).
- The switch between polarized and non-polarized light might also be helpful (4,5).
Skin lesions or tumors with their original cell types of the different skin layers (focused only on skin lesions detectable by dermoscopy) (1).
|Layer of the Skin||Cell Type or Functional Structure||Associated Proliferations / Neoplasms|
|Epidermis||Keratinocytes|| Solar lentigo|
|Basal cell layer (non-differentiated folliculo-sebaceous-apocrine germ)|| Trichoblastoma|
Basal cell carcinoma
|Melanocytes|| Melanocytic nevus|
|Merkel cells||Merkel cell carcinoma|
|Melanocytes|| Melanocytic (dermal or blue) nevus|
|Infundibulo-follicular-sebaceous unit|| Sebaceous hyperplasia|
- An Atlas of Dermoscopy, Second Edition. Marghoob A. et al. CRC Press; 2012.
- Blum A, Siggs G, Marghoob AA, et al. (2017) Collision skin lesions-results of a multicenter study of the International Dermoscopy Society (IDS). Dermatol Pract Concept 2017;7(4):12;51-62
- Braga JC, Scope A, Klaz I, Mecca P, Spencer P, Marghoob AA. Melanoma mimicking seborrheic keratosis: an error of perception precluding correct dermoscopic diagnosis. J Am Acad Dermatol 2008:58:875-880
- Kittler H, Marghoob AA, Argenziano G, 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;74:1093-1106
- Wang SQ, Dusza SW, Scope A, Braun RP, Kopf AW, Marghoob AA. Differences in dermoscopic images from nonpolarized dermo¬scope and polarized dermoscope influence the diagnostic accuracy and confidence level: a pilot study. Dermatol Surg 2008;34:1389-1395
- Pan Y, Gareau DS, Scope A, Rajadhyaksha M, Mullani NA, Mar¬ghoob AA. Polarized and nonpolarized dermoscopy: the explana¬tion for the observed differences. Arch Dermatol 2008;144:828-829.
- Blum A, Maltagliati-Holzner P, Deinlein T, Hofmann-Wellenhof R. Collision tumors in dermoscopy : A new challenge. Hautarzt 2018 May 4. doi: 10.1007/s00105-018-4172-z.