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Thread: Question regarding vessels in dermoscopy

  1. #1 Question regarding vessels in dermoscopy 
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    Jul 2014
    I've been trying to learn about diagnostic features in dermoscopy recently, and I've picked up some of the information via various websites. However, part of the stuff on vessels has really thrown me off.

    Namely, the terms "linear irregular" and "polymorphous."

    1. When I look at examples in pictures, sometimes I see what I perceive to be serpentine vessels described as "linear irregular," and vice-versa. I thought that "linear irregular" referred to weird/bizarre-looking vessels, such as corkscrews and other short, twisted shapes, and hence was often a sign of a malignancy? And that serpentine referred to vessels that bend in waves, and they are oftentimes branched (or as some refer to it, "arborized") tree branches or bolts of lightning? As I understand it, the latter would usually be a sign of basal cell carcinoma and very rarely melanoma.

    2. All of this has also made me wonder about one broader point - the term "linear irregular" seems to connote that these vessels are abnormal. So what exactly would NORMAL/REGULAR vessels look like in the skin? Or is it that the vessels wouldn't normally be visible unless there's some sort of lesion present, and therefore it's in some way abnormal by default?

    3. Additionally, a PDF I downloaded describes "polymorphous vessels" as "any combination of two more more different types of vascular structures." Does this mean that the different types themselves are separate (like a bunch of dots somewhere in the lesion, and then a bunch of serpentine vessels somewhere else...or a bunch of curved somewhere else...or corkscrew somewhere else...or whatever), or a blend of two different types....such as a vessel that looks like a dot attached to a wavy/serpentine vessel? Like a hybrid?

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