![]() ![]() In nonmelanocytic lesions, dotted vessels are commonly seen in psoriasis, clear cell acanthomas (CCA), and squamous cell carcinoma ( SCC). In a study analyzing amelanotic/hypomelanotic benign melanocytic lesions (AHBML) and amelanotic/hypomelanotic nonmelanocytic lesions (AHNML) (tumors), dotted vessels were observed in 32.7% and 21.8% of lesions, respectively. The aforementioned data suggests that dotted vessels may be one of the first morphologic types of neoangiogenic vessels visible in melanoma because they appear to be more prevalent in thinner tumors. In another study, Bono and colleagues reported the presence of dotted vessels in 100% of thin amelanotic melanomas (<1mm) (n = 9). In a study of amelanotic and hypomelanotic melanomas ( AHM), dotted vessels were more commonly seen in melanomas 1 mm in thickness (20.0%) when evaluating purely amelanotic melanomas, dotted vessels were seen in 60% of cases. In melanoma, dotted vessels, which are frequently found in conjunction with other vessel types, can be seen anywhere within the lesion but tend to be present at a higher concentration toward the center of the lesion. In benign nevi, dotted vessels correspond to vessels at the tips of the dermal papillae and dermoscopically often appear to be situated within the holes of the pigment network. In melanocytic tumors, dotted vessels confer a PPV of 38% for melanoma, 16% for dermal/ congenital nevi, 21% for Clark nevi, and 16% for Spitz nevi. The presence of dotted vessels often implies that a lesion is melanocytic in one study, 90% of the lesions with dotted vessels were melanocytic. However, they can also be seen in cutaneous tumors. Dotted vessels can be seen in inflamed skin, traumatized skin, or in skin overlying stasis. ![]()
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