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. 2025 Mar 17;317(1):586.
doi: 10.1007/s00403-025-04133-x.

Dermoscopy combined with reflectance confocal microscopy for basal cell carcinoma diagnosis

Xianhe Deng #  1   2 , Ziyu Guo #  2 , Ping Wang  2 , Yang Lu  2 , Weiwei Wu  3   4
Affiliations

Dermoscopy combined with reflectance confocal microscopy for basal cell carcinoma diagnosis

Xianhe Deng et al. Arch Dermatol Res. .

Abstract

Purpose: To investigate the characteristic manifestations of basal cell carcinoma (BCC) under dermoscopy and reflectance confocal microscopy (RCM) and explore the diagnostic value of dermoscopy combined with RCM for BCC.

Methods: A cohort of 71 patients with the suspected clinical diagnosis of BCC underwent dermoscopy, RCM, and histopathological examinations. The concordance of dermoscopy, RCM, and dermoscopy combined with RCM with histopathology was individually assessed. Receiver operating characteristic (ROC) curves were constructed to compare the diagnostic performance of these modalities.

Results: Using histopathology as the reference standard, the sensitivity, specificity, and overall agreement rate were 95%, 81.82%, and 92.96% for dermoscopy; 96.67%, 72.73%, and 92.96% for RCM; and 98.30%, 81.80%, and 95.80% for dermoscopy + RCM, respectively. Assessment of the concordance of dermoscopy, RCM, and dermoscopy + RCM with histopathology yielded kappa values of 0.741, 0.721, and 0.832, respectively. The area under the ROC curve for dermoscopy, RCM, and dermoscopy + RCM were 0.884, 0.847, and 0.901, respectively, with dermoscopy + RCM demonstrating the best diagnostic efficacy.

Conclusion: This study elucidated the common characteristic features of BCC, as visualized on dermoscopy and RCM, indicating the enhanced diagnostic efficacy of combining dermoscopy with RCM in BCC.

Keywords: Basal cell carcinoma; Combined; Dermoscopy; Diagnosis; Reflectance confocal microscopy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study has been approved by the Ethical Committee and was conducted according to the Declaration of Helsinki Principles. The patients in this manuscript have given written informed consent to publication of their case details. Competing interests: The authors declare no competing interests.

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