• Roberta Giuffrida, Claudio Conforti, Andreas Blum, Marija Buljan, Fabrizio Guarneri, Rainer Hofmann-Wellenhof, Caterina Longo, John Paoli, Cliff Rosendahl, H Peter Soyer, Ružica Jurakić Tončić, Roberta Vezzoni, and Iris Zalaudek.
• Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy.
• Medicina (Kaunas). 2022 Nov 30; 58 (12).

AbstractBackground and objectives: Dermoscopy is a useful tool for the early and non-invasive diagnosis of skin malignancies. Besides many progresses, heavily pigmented and amelanotic skin tumors remain still a challenge. We aimed to investigate by dermoscopy if distinctive morphologic characteristics of vessels may help the diagnosis of equivocal nodular lesions. Materials and Methods: A collage of 16 challenging clinical and dermoscopic images of 8 amelanotic and 8 heavily pigmented nodular melanomas and basal cell carcinomas was sent via e-mail to 8 expert dermoscopists. Results: Dermoscopy improved diagnostic accuracy in 40 cases. Vessels were considered the best clue in 71 cases. Focusing on the diameter of vessels improved diagnosis in 5 cases. Conclusions: vascular diameter in addition to morphology and arrangement may be a useful dermoscopic clue for the differential diagnosis of clinically equivocal nodular malignant tumors.

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