10.5826/dpc.1203a147
According. to the instructions for Authors, the Image Letter should not have an abstract
text/xml
2160-9381
2129
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Joanna Pogorzelska-Dyrbuś
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Loop vessels; basal cell carcinoma; dermoscopy; optical super-high magnification dermoscopy
“Oak-leaf-like” loop vessels in super-high magnification dermoscopy of basal cell carcinoma 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-07-28
2021-10-26
2022-07-28
2022-09-15
e2022147
Dermatol Pract Concept
According. to the instructions for Authors, the Image Letter should not have an abstract
Joanna Pogorzelska-Dyrbuś
2022/07/28
10.5826/dpc.1203a147
e2022147
“Estevita” Specialist Medical Practice, Tychy, Poland 
2160-9381
Loop vessels; basal cell carcinoma; dermoscopy; optical super-high magnification dermoscopy
en
e2022147
“Oak-leaf-like” loop vessels in super-high magnification dermoscopy of basal cell carcinoma 
https://dpcj.org/index.php/dpc/article/download/2129/1682
                    Dermatology Practical & Conceptual


   “Oak-leaf-like” Loop Vessels in Super-high
Magnification Dermoscopy of Basal Cell Carcinoma
                                                 Joanna Pogorzelska-Dyrbuś1


1“Estevita” Specialist Medical Practice, Tychy, Poland



Citation: Pogorzelska-Dyrbuś J. “Oak-leaf-like” loop vessels in super-high magnification dermoscopy of basal cell carcinoma.
Dermatol Pract Concept. 2022;12(3):e2022147. DOI: https://doi.org/10.5826/dpc.1203a147
Accepted: December 17, 2021; Published: July 2022
Copyright: ©2022 Pogorzelska-Dyrbuś. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Corresponding author: Joanna Pogorzelska-Dyrbuś MD, PhD Specjalistyczna Praktyka Lekarska “Estevita”, Pasaz Europejski 8/1 Street,
43-100 Tychy, Silesia, Poland, Telephone: +48604542643 E-mail: jpogorzelskadyrbus@gmail.com




Case Presentation                                                      established diagnosis was superficial BCC. The consent to
                                                                       publish data has been obtained from the patients.
An 81-year-old patient presented with a 5-mm red firm ul-
cerated nodule of the skin on his back. Dermoscopy revealed
ulceration in the center and linear irregular vessels distrib-
                                                                       Teaching point
uted on the lesion’s periphery (Figure 1A). Optical super-high         In some cases, the diagnosis of BCC can be challenging. There-
magnification dermoscopy (OSHMD) revealed looped vessels               fore, the detailed dermoscopy, including analysis of morphol-
with extremely branched loops resembling oak leaves, which             ogy of the vessels is of the greatest importance. According to
were distributed throughout the entire lesion (Figure 1B).             the literature, arborizing vessels are the most common type
The patient underwent excision of the lesion and diagnosis             of vessels followed by the short fine tele-angiectasias, while
of nodular basal cell carcinoma (BCC) was established.                 the looped vessels are a minor vascular feature of BCC [1,2].
    A 49-year-old patient presented with a 4-mm plaque on              I have found looped vessels and named them “oak-leaf-like”
the abdomen. Dermoscopy (Figure 1C) showed an image                    because of their striking similarity to an oak leaf. As each of
typical for BCC. OSHMD showed surprisingly numerous                    the images concerned a different subtype of BCC, it might be
loop vessels in form of “oak leaves“, distributed across the           presumed that such complicated vessels do not depend on
entire lesion as well as in the previous case (Figure 1D). The         the thickness of the lesion.




Image Letter | Dermatol Pract Concept. 2022;12(3):e2022147                                                                             1
Figure 1. Dermoscopy and super-high magnification dermoscopy images of basal cell carcinoma cases presented in the manuscript.
(A) Ulceration in the center of the lesion and linear irregular vessels distributed on the red homogenous background on the periphery of the lesion
(20x magnification). (B) Super high magnification dermoscopy (400x magnification) demonstrating looped vessels with extremely
branched loops resembling “oak leaves”. (C) Arborizing vessels and short fine telangiectasias with a blue-gray globule (20x magnification).
(D) Numerous loop vessels in the form of “oak leaves“ (400x magnification). All images taken by the Foto Finder GmBH.



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                                                                                tures in skin tumors: a dermoscopy study. Arch Dermatol.
 1. Micantonio T, Gulia A, Altobelli E, et al. Vascular patterns                2004;140(12):1485–1489.DOI:10.1001/archderm.140.12.1485.
    in basal cell carcinoma. J Eur Acad Dermatol Venereol.                      PMID: 15611426.
    2011;25(3):358–361. DOI:10.1111/j.1468–3083.2010.03734.x.
    PMID: 20561131.




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