Polymorphous vessels

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Main PageVascular structuresPolymorphous vessels
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 Editor: Ralph P. Braun

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


Polymorphous vessels are used to describe the vasculature of lesions in which two or more types of vessel morphologies are detected[1].

Polymorphous vessels schematics.jpg



Differential diagnosis
The presence of polymorphous vessels may suggest a diagnosis of melanoma[2]. The most common combination of vessel types seen in melanoma is the presence of both dotted vessels and linear–irregular vessels[3]. In a study of lesions with vascular features seen on dermoscopy, only 20% of the lesions contained polymorphous structures, which correlated with a PPV of 52.6% for melanoma[3]. More specifically, the combination of dotted and linear–irregular vessels was found in 18% of amelanotic/hypomelanotic melanomas but only extremely rarely in other nonmelanoma amelanotic/hypomelanotic lesions (1.8% of AHNML and 0% of AHBML)[4]. Polymorphous vessels in combinations other than dotted vessels and linear–irregular vessels may be observed in cutaneous melanoma metastases[5]. They can also be seen in papillomatous melanocytic nevi[6] and other tumors, such as eccrine poromas[7].




References:

  1. Marghoob & Braun: Proposal for a revised 2-step algorithm for the classification of lesions of the skin using dermoscopy. Arch Dermatol 2010;146:426-8. PMID: 20404234. DOI.
  2. Braun et al.: Dermoscopy: what's new?. Clin. Dermatol. 2009;27:26-34. PMID: 19095151. DOI.
  3. 3.03.1 Argenziano et al.: Vascular structures in skin tumors: a dermoscopy study. Arch Dermatol 2004;140:1485-9. PMID: 15611426. DOI.
  4. Pizzichetta et al.: Amelanotic/hypomelanotic melanoma: clinical and dermoscopic features. Br. J. Dermatol. 2004;150:1117-24. PMID: 15214897. DOI.
  5. Minagawa et al.: Dermoscopic and histopathological findings of polymorphous vessels in amelanotic cutaneous metastasis of pigmented cutaneous melanoma. Br. J. Dermatol. 2009;160:1134-6. PMID: 19302066. DOI.
  6. Niederkorn et al.: Frequency, clinical and dermoscopic features of benign papillomatous melanocytic naevi (Unna type). Br. J. Dermatol. 2009;161:510-4. PMID: 19466956. DOI.
  7. Ferrari et al.: Eccrine poroma: a clinical-dermoscopic study of seven cases. Acta Derm. Venereol. 2009;89:160-4. PMID: 19326001. DOI.