Dermoscopy differentiated superficial BCC from other BCC subtypes

Lallas A. J Am Acad Dermatol. 2013;doi:10.1016/j.jaad.2013.10.003.

  • December 11, 2013

Dermoscopy effectively distinguished superficial basal cell carcinomas from other subtypes of basal cell carcinoma, according to recent study results.

Researchers conducted a retrospective evaluation of dermoscopic images of histopathically confirmed basal cell carcinomas (BCC) for predefined criteria to differentiate superficial BCC (sBCC) from other BCC subtypes.

Three hundred thirteen patients (mean age, 67.1 years; 172 men), including 77 with sBCC and 236 with other types of BCC (controls), were included in the study. Upon reevaluation of histopathologic slides, BCC subtypes included nodular (n=154 patients), micronodular (n=19), morpheaform (n=8), mixed (n=15), infiltrating (n=32) and fibroepithelioma of Pinkus (n=8).

Strong predictors of sBCC were maple leaf–like areas, short fine superficial telangiectasia, multiple small erosions and shiny white-red structureless areas, with each making diagnoses greater than fivefold more likely. Diagnoses of non-sBCC were more likely when arborizing vessels (11-fold increased possibility), blue-gray ovoid nests (15-fold) and ulceration (threefold) were present.

“Based on the results of multivariate analysis, we propose a diagnostic algorithm that can predict the diagnosis of sBCC with a sensitivity of 81.9% and a specificity of 81.8%,” the researchers reported.

“Our study indicates that dermoscopy may be regarded as a reliable tool for predicting the diagnosis of sBCC,” the researchers concluded. “The detection of maple leaf–like areas and short fine superficial telangiectasias, in the absence of arborizing vessels, blue-gray ovoid nests and ulceration is strongly suggestive of sBCC. The presence of the latter features should exclude the diagnosis of sBCC, irrespectively of the co-existing dermoscopic findings, or the clinical appearance of the tumor.”

Disclosure: The researchers report no relevant financial disclosures.

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