TOPLINE:

Ultraviolet-induced fluorescence dermoscopy (UVFD) revealed distinct features in non-pigmented facial lesions, with basal cell carcinoma (BCC) showing dark silhouettes in 84.48% of cases and enhanced visualisation of characteristic features in sebaceous hyperplasia (SebH), dermal naevus, and seborrhoeic keratosis (SebK), potentially improving diagnostic accuracy.

METHODOLOGY:

• Researchers conducted a prospective study evaluating 181 patients with clinically non-pigmented facial nodules at the Department of Dermatology, Rzeszów, between March and October 2025.
• Overall, 62 cases of BCC, 33 cases of dermal naevus, 55 cases of SebH, and 31 cases of SebK were included.
• Researchers used a Dermlite DL5 dermatoscope for both polarised dermoscopy with an established dermato-oncologic criteria and UVFD with predefined terminology.

TAKEAWAY:

• In case of polarised dermoscopy, BCC was characterised by the presence of ulceration, focused and bright red arborising vessels, scales, and red-white homogeneous areas (P < .001 for all). Under UVFD, BCC exhibited dark silhouettes in most cases (84.48%) and also showed white-blue irregular confluent fluorescence, arborising vessels, white clods, and blue-fluorescent fibres (P < .001 for all) and black globules (P < .01).
• Dermal naevus showed distinct patterns depending on the light source. Under polarised dermoscopy, comma vessels, out-of-focus arborising vessels, tan structureless foci, and dark or light halos (P < .001 for all) and linear irregular vessels (P < .005) were significantly more frequent. Conversely, under UVFD, dermal naevus was characterised by dark or light halos (P < .001) and the lack of pink-orange follicular fluorescence (P = .03).
• SebH displayed distinctive characteristics; the cumulus sign, crown vessels, and the bonbon toffee sign (P < .001 for all) were identified under polarised dermoscopy, and punctate pink central fluorescence and two to three central plugs with or without fluorescence (P < .001 for both) were identified under UVFD.
• SebK exhibited some exclusive features: moth-eaten borders, flat fissures and sulci, cerebriform patterns, and fat fingers (P < .001 for all) under polarised dermoscopy. Under UVFD, a warty surface and white-blue fluorescence at the ridge edges (P < .001 for both) were distinct for these lesions.

IN PRACTICE:

"Our study offers new insights into the presentation of non-pigmented elevated facial lesions under UVFD. Novel observations may improve the diagnostic accuracy and diagnostic confidence for facial lesions and potentially reduce the number of unnecessary biopsies," the authors wrote.

SOURCE:

This study was led by Agnieszka Pszczółkowska, Department of Dermatology, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland. It was published online on January 09, 2026, in Dermatology and Therapy.

LIMITATIONS:

The single-centre design and the focus on Caucasian patients with low skin phototypes limited the generalisation of the results. Statistical analysis was potentially limited by the relatively small sample size of certain subgroups, particularly dermal naevus cases.

DISCLOSURES:

This study did not receive any funding. One author reported serving as an editorial board member of Dermatology and Therapy.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.