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The Dermoscopy of Gorlin Syndrome: Pursuit of the Pits Revisited

Rachael Jarrett, BMBCh; Lisa Walker, BMBCh, BSc, DPhil, MRCPCH; Jonathan Bowling, MBChB, MRCP
Arch Dermatol. 2010;146(5):582. doi:10.1001/archdermatol.2010.44.
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We describe 4 patients with known mutations in the PTCH gene (OMIM 233500) to illustrate the dermoscopic features of palmar lesions in Gorlin syndrome. Case 1 involved a 10-year-old boy with a discrete palmar depression measuring approximately 1 mm in diameter (Figure 1). Dermoscopy demonstrated well-defined, heterogeneous, pale and pigmented areas containing microarborizing vessels and blue dots, features typical of basal cell carcinoma (Figure 2). Case 2 involved an 11-year-old girl. Dermoscopy of a palmar lesion showed a solitary blue structure and a microvessel (Figure 3). Case 3 involved a 45-year-old woman with typical palmar pits on clinical examination (Figure 4). Dermoscopy showed prominent paired parallel lines of dotted vessels corresponding to the underlying dermatoglyph and an absence of blue structures and microvessels (Figure 5). Case 4 involved a 41-year-old woman with typical palmar pits on clinical examination (Figure 6). Dermoscopy showed prominent dotted vessels (Figure 7).

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