<p>A 57 year old man presented with a slow growing asymptomatic lesion on the right cheek. There had been no bleeding. Based on the clinical and dermoscopic features what is the differential? </p>
Dermoscopy - Introduction, Terminology and Structures
A document to help you understand the dermoscopic descriptions used in this blog.
Dermoscopy Algorithm
To help you work through dermoscopic cases.
<p>Dermoscopically the lesion is structureless with a prominent blue area at the base. There is a very subtle hint of arborising vessels (arrows) but no more. The differential includes a BCC and one of the benign appendageal tumours such as an <a href="http://www.pcds.org.uk/clinical-guidance/appendage-tumours">apocrine hidrocystoma</a>, the latter are only diagnosed retrospectively once the histology has been reviewed. Given that most BCC have clearly identifiable dermoscopic features my usual practice is to excise them without a biopsy, however, as with this case if there is diagnostic uncertainty a biopsy is performed. The result of histology was ........... a BCC!</p>
<p>Image copied with kind permission from South Tees Hospitals NHS Foundation Trust.<br></p>
