Reflectance Confocal Microscopy as an Aid to Dermoscopy to Improve Diagnosis on Equivocal Lesions: Evaluation of Three Bluish Nodules
Figure 3
Forehead of a 75-year-old woman. A bluish, ulcerated nodule (a). The dermoscopic images were characterized by the presence of blue-brown leaf-like structures (red arrows), with an area of ulceration in the center, surrounded by white bright lines, with a chrysalis structure aspect (white arrow) and some brownish and black globular-like structures all over the lesion (yellow asterisk) (b). Confocally, reflectant tumor islands with palisading cells at the periphery ((c) red arrows) and bright cells in their inner portion ((c) mosaic mm; (d) detail m; yellow arrow), were present, mixed to thickened collagen fibers ((d) white arrow head). Histopathology confirmed the diagnosis of a BCC with a high correspondence, showing tumor islands ((e) HH 10x magnification, red arrow) and numerous melanophages (yellow arrow).
