Dermoscopic Findings in the Presurgical Evaluation of Basal Cell Carcinoma. A Prospective Study

Abstract

BACKGROUND Surgery is the best treatment for basal cell carcinoma (BCC); however, incomplete excisions are possible. OBJECTIVE Assessment of the accurateness of dermoscopy and clinical evaluation in the detection of borders of BCC and description of dermoscopic findings in clinically healthy tissue surrounding BCC. MATERIALS AND METHODS Eighty-eight lesions with clinical dermoscopic diagnosis of BCC were examined clinically and dermoscopically, to delineate the correct site of surgical incision, demarcating the respective margins with colred dermographic pencils. Specific dermoscopic features were searched in the skin adjacent to the demarcated clinical margin. RESULTS In 29 of 88 lesions, clinical and dermoscopic margins of the tumor coincided. In the remaining 59 (67%), 10 (16.9%) presented, in the lesion area identified under dermoscopy, classical criteria for BCC and 57 (96.6%) nonclassical criteria. Differences between clinical and dermoscopic margins were significantly more frequent in superficial BCCs (p = .006). The frequency was not significantly different (p = .85) in relation to body sites. CONCLUSION Dermoscopy improves the identification of margins for surgical excision in BCC. The observation of nontraditional dermoscopic criteria of BCC, mainly pink–white areas and short telangiectasias in the area between clinically and dermoscopically detected margins, helps to define the actual tumoral margins and to achieve a really radical excision.

Dermoscopy accuracy for lateral margin assessment of distinct basal cell carcinoma subtypes treated by Mohs micrographic surgery in 368 cases

“…A recent study compared clinical and dermoscopic margin demarcation and showed that these findings were often missed on clinical assessment. 5 Our study has limitations. Initial margins were not the same for all tumors, and our findings are limited to head tumors referred for MMS, an area typically with more photodamage than the trunk.…”

The role of dermoscopy in dermato-oncological diagnostics – new trends and perspectives

“…Moreover, the preoperative dermoscopic assessment using non-classic BCC criteria including pink-white areas and short telangiectasias in the area between clinically and dermoscopically detected margins, helps define the neoplasm's margins and to achieve a really radical excision (fig. 4C) [32].…”

Noninvasive diagnostic techniques in the preoperative setting of Mohs micrographic surgery: A review of the literature

“…Particularly, basal cell carcinoma (BCC) dermoscopic patterns have been described both for pigmented and nonpigmented lesions, with histopathological correlation and diagnostic accuracy that ranges from 95% to 99%. 7,[13][14][15] During MMS procedure, dermoscopy and VDS can guide the excision by a better definition of neoplastic margins, sometimes identifying specific structures not clinically evident at naked eye. However, preoperative assessment of deep margins is difficult to achieve.…”