Dermatoscopic Pattern Variability in Basal Cell Carcinoma – Implications in Diagnosis, Preoperative Assessment, and Tumor Management

Abstract

Basal cell carcinoma is a slow growing non-melanoma skin cancer appearing as a non-healing, painless, and sometimes pruriginous sore, usually on sun-exposed areas. Although it rarely metastasizes, BCC diagnosis and treatment should not be delayed due to its local invasive potential. Currently, dermatoscopy is a well propagated and commonly employed tool in clinical practice, providing a fast and handy approach to clinical diagnosis, without the significant financial costs associated with other more sophisticated diagnostic means. Since the very first dermatoscopic descriptions of basal cell carcinoma, the list of dermatoscopic diagnostic criteria has been updated and renewed numerous times. Dermatoscopy significantly augments basal cell carcinoma detection by its capability of discriminating it from other skin lesions and inflammatory skin conditions. Moreover, current evidence suggests that this noninvasive, real-time imaging technique is also valuable in tumor management, seeing that it provides additional information related to histopathological subtype, presence or lack of pigmentation, lateral tumor extension, and tumor response to non-surgical treatments. In this paper, we aim to summarize time-honored as well as current knowledge on the value of dermatoscopy in the diagnosis, classification, and treatment of basal cell carcinoma.