Ultraviolet-Induced Fluorescence Dermoscopy for the Differentiation of Non-Pigmented Malignant and Benign Lesions on the Face.

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There is increasing evidence suggesting that ultraviolet-induced fluorescence dermoscopy (UVFD) may enhance the diagnostic accuracy of various skin entities. This study aimed to evaluate the utility of UVFD for visualizing the discriminative features of the most common non-pigmented tumors of the face, including basal cell carcinoma (BCC), dermal nevus (DN), sebaceous hyperplasia (SebH), and seborrheic keratosis (SebK). A total of 181 lesions were examined using polarized dermoscopy (PD) and UVFD. For assessment, established dermato-oncologic criteria for PD, as well as previously defined and newly observed features for UVFD, were used. The most common UVFD findings in BCCs were dark silhouettes (84.48%), interrupted follicle patterns (54.83%), arborizing vessels (54.83%), and well-demarcated borders (41.93%). DNs exhibited dark silhouettes (72.72%), interrupted follicle patterns (66.66%), and well-demarcated borders (54.54%). SebHs presented with punctate pink central fluorescence (43.63%) and 2-3 central plugs with or without fluorescence (36.36%). SebK showed well-defined borders (70.96%), white-blue fluorescence at the ridge edges (41.93%), and an interrupted follicle pattern (41.93%). Several UVFD features were indicative of specific entities, such as black globules, which are characteristic of BCC, central plugs or punctate pink central fluorescence (SebH), and white-blue fluorescence at the ridges or warty surface (SebK). However, other findings, such as an interrupted follicular pattern or absence of follicular fluorescence, were common across lesions and did not allow for differentiation. The study offers new insights into the presentation of non-pigmented facial lesions under UVFD, with several features indicative of particular entities. Incorporating this method into daily practice may improve diagnostic accuracy and reduce unnecessary biopsies.