I took out a dermatoscope. I saw scaling and dotted vessels. Could abnormal vessels be a malignant specific structure? You bet. (Remember that dotted vessels are irregular vessels. An easier way to understand this is anything other than a comma vessel is irregular. Irregular vessels in and of themselves are melanoma specific structures. As I previously mentioned vascular structures are best seen on non contact highly polarized dermoscopy.)

Since dotted vessels and scales were present,  I also suspected eczema. 

I was not surprised then the clinical pathology report confirmed my dermatoscopic findings. However since melanoma might also be present with such dermatoscopic findings one must also biopsy. 

2 specimens were sent out (one in Michel's solution and one in Formalin). The vertical information obtained from a biopsy is used in addition to the horizontal information one obtains from dermoscopy. Ultimately podiatrists with dermatoscopes obtain a more accurate diagnosis. 

 

This is why I so much appreciate laboratories that attach dermatoscopic images I send them to their pathology reports. Please consider using a dermatoscope, sending dermatoscopic images to your dermatopathologist and request that they include such images in your pathology reports. 

 

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