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. 2023 Jan 1;13(1):e2023004.
doi: 10.5826/dpc.1301a4.

Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma

Yıldız Gürsel Ürün  1 , Sezin Fiçicioğlu  1 , Mustafa Ürün  1 , Nuray Can  2
Affiliations

Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma

Yıldız Gürsel Ürün et al. Dermatol Pract Concept. .

Abstract

Introduction: Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC).

Objectives: To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns.

Methods: Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis.

Results: The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%).

Conclusions: In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.

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Conflict of interest statement

Competing Interests: None.

Figures

Figure 1
Figure 1
The clinical aspect of basal cell carcinoma. (A) Pigmented, (B) Superficial, (C) Nodular, (D) Infiltrative, (E) Mixed, (F) Basosquamous.
Figure 2
Figure 2
Dermoscopic features of (A) Arborizing vessels, (B) Short fine telangiectasias, (C) Polymorphous vessels, (D) Looped (hairpin) vessels.
Figure 3
Figure 3
The different dermoscopic pigmentation patterns of basal cell carcinoma. (A) Multiple blue-grey dots, (B–C) Multiple blue-grey globules, Large blue-grey ovoid nests, (D) Brown dots, (E) Brown globules, (F) Brown nets, (G) Concentric structures, (H) Leaflike areas.
Figure 4
Figure 4
Dermoscopic features of (A) Shiny white streaks, (B) Shiny white blotches and strands, (C) Rosettes.
Figure 5
Figure 5
Other dermoscopic features of basal cell carcinoma. (A) Multiple small erosions, (B) Ulceration, (C) Shiny white-red structureless background, (D) Blue-whitish veil, (E) Keratin masses.
See this image and copyright information in PMC

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