Blood flow compared in benign melanocytic naevi, malignant melanomas and basal cell carcinomas

Histologically, increasing malignancy is reflected by increased tumour vascularization. We therefore assessed whether laser Doppler perfusion imaging might allow differentiation between different types of skin tumour. The perfusion patterns of 27 melanocytic naevi, 16 basal cell carcinomas and six malignant melanomas were examined with a laser Doppler perfusion imager before excision for precise diagnosis. Malignant melanomas were significantly more perfused than basal cell carcinomas and tended also to be more so than melanocytic naevi. Further, for the first time, the perfusion pattern of the entire tumour area was visualized two-dimensionally; it was higher in the centre of the tumours than at the periphery for malignant melanomas and melanocytic naevi but was the same throughout for basal cell carcinomas. Laser Doppler perfusion imaging can thus provide information to assist in the differential diagnosis of skin tumours. In addition, with increases in resolution of the technique such data may well become steadily more useful in the future.