Dermoscopy of a Squamous Cell Carcinoma of the Lower Lip Showing Multiple Rosettes.

Abstract

The term white shiny structures groups 3 well-defined morphologies including white shiny lines, white shiny areas, and rosettes. They all can be observed exclusively with polarized light dermoscopy. Rosettes are defined as 4 bright white circles arranged as a square resembling a 4-leaf clover, mainly localized in the follicular openings. Despite being well-described dermoscopically, their exact histology correlation is uncertain. The presence of white rosettes is suggestive of a diagnosis of actinic keratosis or squamous cell carcinoma (SCC), but they also can be seen in a range of skin conditions and in nonlesional photo-damaged skin [1]. SCC of the lip represents 20% of all oral carcinomas; its dermoscopic criteria were recently described, with the main dermoscopic features being the presence of ulceration, scales, polymorphous vessels, and white structures such as white structureless areas, white shiny lines, white circles, and perivascular white halos [2]. Herein we report a case showing multiple rosettes on an SCC of the lower lip.