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The Vasculature of Nonmelanocytic Skin Tumors on Reflectance Confocal Microscopy Vascular Features of Squamous Cell Carcinoma In Situ

Verena Ahlgrimm-Siess, MD; Theresa Cao, DO; Margaret Oliviero, ARNP; Rainer Hofmann-Wellenhof, MD; Harold S. Rabinovitz, MD; Alon Scope, MD
Arch Dermatol. 2011;147(2):264. doi:10.1001/archdermatol.2010.416.
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We describe 2 cases of Squamous cell carcinoma (SCC) in situ showing distinctive vascular features. A 74-year old man presented with a 10-mm, pink-brown, scaly plaque on the left side of his chest (Figure 1A, circle). Dermoscopy revealed pink and light-brown structureless areas and dotted vessels in the center of the lesion (Figure 1B, arrows). On reflectance confocal microscopy (RCM), scaly surface areas and an atypical honeycomb pattern were seen (Figure 1C, circle). At the dermoepidermal junction, there was an abnormally increased density of dermal papillae with multiple round blood vessels (Figure 1C, arrows). The increased blood flow was readily observed in real-time video-mode RCM (video 1). On histopathologic examination, keratinocytes with atypical nuclei and abnormal maturation were seen throughout the epidermis (Figure 1D, arrows) (hematoxylin-eosin, original magnification ×40).

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