Dermoscopic features of lower lip squamous cell carcinoma: A descriptive study

Abstract

Aim:Dermoscopic features of cutaneous squamous cell carcinoma (SCC) have been well described; however, there are a few studies focused on the dermoscopic aspect of lip SCC. In this study, we aimed to identify dermoscopic findings of lower lip SCC.Materials and Methods:The clinical and histopathologic features, dermoscopic images, and demographic data of the patients with histologically approved lip SCC were retrospectively evaluated.Results:A total of 10 lesions were enrolled in the study. Milky red structureless background (100%) and keratin scale (100%) were present in all the lesions. Blood spots on thick keratin scale were observed in eight lesions. Seven lesions showed white structureless areas. Two lesions exhibited ulceration and one of the lesions had structureless brown pigmentation. The most common vascular pattern observed was polymorphous vascular pattern (60%).Conclusion:White and milky red structureless areas, blood spots on thick keratin scale, and polymorphous vascular pattern are the main dermoscopic clues to lip SCC. The presence of these findings should direct the clinician to the possibility of SCC. The dermoscopic findings observed may also reflect histological grade of the lesion.

Mucoscopy of lip squamous cell carcinoma and correlation with skin phototype and histological differentiation: a multicentric retrospective observational study by the International Dermoscopy Society

“…Vascular findings observed in our analysis are different from that described in the largest dermoscopic study on lip SCC to date by Benati et al involving 22 patients, in which polymorphous pattern was stated as the most common (68%), followed by linear‐irregular and dotted in 27.0% and 5.0% of cases, respectively 6 . Elmas et al reported “polymorphous vascular pattern” in 6/10 (60%) of their cases 7 . This named pattern was also reported in the anecdotal reports of lip SCC by Güleç and Peralta et al 8,9 However, the concept or the frequency of the so‐called “polymorphous pattern” can neither be compared between our study with others nor among these studies themselves.…”

“…Regarding the “white‐colored structures,” we observed the presence of WSA, white halos, and white dots/globules, each feature in approximately one‐third (31‐36%) of the patients, with the majority observed in well‐differentiated followed by moderately‐differentiated histological variants. Note the relatively higher incidence of some of these white‐colored features reported by Benati et al and Elmas et al 6,7 with striking contrast with a lower frequency (comparable to our study) reported by Lallas et al in their 143 cases of cSCC. 5…”

“…This named pattern was also reported in the anecdotal reports of lip SCC by Güleç and Peralta et al 8,9 However, the concept or the frequency of the so‐called “polymorphous pattern” can neither be compared between our study with others nor among these studies themselves. Unlike the current study, where we have elaborately and clearly defined the two morphological patterns of vessels, with the special distinction of defining polymorphous vessels ( vide supra ; Table 1 & 2), the definition of this term has widely ranged in other publications ranging from “presence of nonfocused small‐sized vessels located both peripherally and throughout the lesion” without clearly stating the difference from the label of “linear irregular” and “dotted” pattern 6 ; to a “ combination of at least three different types ‐ looped, coiled, and dotted vessels” 7 (with the combination of any two types considered nonpolymorphous), to “quadruple combination of dotted, hairpin, arborizing, and coiled vessels ” 8 ; to “ telangiectatic, branching, hairpin, serpiginous, truncated, and dotted vessels ” 9 ; to no definition at all 10 . Moreover, the sample sizes of the studies by Benati et al and Elmas et al were 22 and 10, whereas our study included 60 cases that too were of different SPTs and histological grades.…”

“…in case of disagreement on any issue between AJ and MS. Of note, all three investigators were kept blinded to the clinical data and histological differentiation of the scoped lesions. The collected dermoscopic images of lip SCC were analyzed for the presence of certain dermoscopic features defined by us based on the features evaluated and mentioned by Lallas et al in their study on dermoscopy of cSCC 5 and in the papers on dermoscopy of lip SCC 6‐10 . Any additional previously unreported observations were also noted and recurring new observations were looked for, in all images.…”

“…In this regard, dermoscopy has been shown to play a useful role in assisting the early recognition of cutaneous SCC (cSCC), with consequent reduction of its morbidity and mortality 4,5 . However, while dermoscopic features of SCC of the skin have been extensively studied, 4,5 the evidence on dermoscopic morphology of lesions developing on the lips, has been relatively scarce; being limited to only two small case series 6,7 and three case reports 8‐10 . Further, no data or analysis exists on dermoscopic variability in lip SCC according to the degree of histological differentiation.…”