Polymorphous vessels

From dermoscopedia

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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 released
Status update June 29, 2019
Status by Ralph P. Braun


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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.