Dermoscopy of Targetoid Hemosiderotic Hemangioma: A Morphological Study of 35 Cases

Abstract

Background: Targetoid hemosiderotic hemangioma is an uncommon, vascular, benign solitary lesion of lymphatic origin that can be misdiagnosed as other tumors including melanomas. Objectives: To evaluate the dermoscopic features of a large series of targetoid hemosiderotic hemangiomas. Methods: Digital dermoscopic images of 35 histopathologically confirmed cases of targetoid hemosiderotic hemangiomas collected from 7 hospitals in Spain and Italy were evaluated for the presence of dermoscopic structures and patterns. Results: The results of our study reveal that the presence of central red and dark lacunae and a peripheral circular reddish-violaceous homogeneous area is the most common dermoscopic pattern in targetoid hemosiderotic hemangioma (71.4%). The targetoid hemosiderotic hemangiomas of our study were correctly diagnosed in 77% of cases. Conclusion: Dermoscopy is helpful in improving the diagnosis of targetoid hemosiderotic hemangioma. However, attention must be paid to those cases that dermoscopically may show nontargetoid patterns, which often mimic other lesions, including melanoma.

Arborizing vessels in a targetoid hemosiderotic hemangioma: mistaken dermoscopic diagnosis of basal cell carcinoma

“…We highlight the series of 35 cases recently published by Zaballos et al [ 7 ] in which the authors were able to establish that the unequivocal dermoscopic pattern for HHT is only present in 52% of lesions and is represented by the presence of lagoons in the center, a yellowish circular intermediate area, and a purple or ecchymotic ring on the periphery.…”

“…Other vascular structures, such as points or polymorphous irregular vessels, have been described in HH in the central portion of the lesion, which have been linked to deeper vessels in the dermis [ 7 ].…”

Reflectance confocal microscopy in the evaluation of targetoid haemosiderotic haemangioma apropos two cases

“…Dermoscopy usually helps in limiting differential diagnosis and it is enough to reassure a patient with classic THH. However, dermoscopy of black lacunae may be misinterpreted as melanin blotches, prompting a melanoma diagnosis . RCM may further enhance our clinical diagnosis and may aid in ruling out melanoma, especially in cases in which dermoscopy is not sufficient; reducing patient anxiety and the number of biopsies.…”

“…It is based on the mechanism of backscattering the light, using a diode laser at 830 nm as a source of light. The dermoscopy of THH was recently described; however, to the best of our knowledge the RCM features have not been reported.…”

Red-Violaceous Lacunae With a Yellowish Ecchymotic Halo

“…Upon dermoscopy analysis, THH is characterised by the presence of red lacunae located at the center, an intermediate yellow circular homogeneous area, and a violaceous or ecchymotic homogeneous ring on the periphery (Figure 1B). 1,2 Discriminating these dermoscopic signs help to establish an accurate diagnosis of THH and will definitely reduce unnecessary biopsies for it.…”