The dermatoscopic universe of basal cell carcinoma

Abstract

Following the first descriptions of the dermatoscopic pattern of basal cell carcinoma (BCC) that go back to the very early years of dermatoscopy, the list of dermatoscopic criteria associated with BCC has been several times updated and renewed. Up to date, dermatoscopy has been shown to enhance BCC detection, by facilitating its discrimination from other skin tumors and inflammatory skin diseases. Furthermore, upcoming evidence suggests that the method is also useful for the management of the tumor, since it provides valuable information about the histopathologic subtype, the presence of clinically undetectable pigmentation, the expansion of the tumor beyond clinically visible margins and the response to non-ablative treatments. In the current article, we provide a summary of the traditional and latest knowledge on the value of dermatoscopy for the diagnosis and management of BCC.

Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs: A Chameleon!

“…Interestingly, only a minority of BCCs were clinically pigmented in our study sample, which is in accordance with previous reports showing that pigmented BCCs are mostly located on the trunk [11]. Furthermore, even though dermoscopy is known to increase the number of pigmented BCCs by detecting clinically undetectable pigmented criteria, only few of our lesions displayed those criteria, which were mostly classified as melanoma-looking lesions [17,18]. Results of multivariate analysis showed that the following dermoscopic criteria were independently associated with malignant-looking BCCs: erosions/ulceration and vessels.…”

Dermoscopy of Malignant Skin Tumours: What's New?

“…Recent studies suggest that dermoscopy significantly facilitates the accurate management of this tumour [21]. In detail, the dermoscopic criteria associated with non-pigmented BCC include fine telangiectasias with few ramifications and/or multiple small erosions for the superficial subtype, and classical arborizing vessels and large ulceration/s for the nodular subtype (Fig.…”

“…Pigmented BCC is dermoscopically typified by brown-coloured structures, including leaf-like areas, spoke wheel areas, or concentric structures, predictive of pigmented superficial BCC, and large blue-grey ovoid nests predictive of a non-superficial (i.e., invasive, nodular) subtype [22]. BCC with an infiltrative component often exhibits fine scattered telangiectasias and white/red structureless areas, whereas morphoeic (sclerodermiform) BCC frequently displays a whitish background, corresponding histologically to the underlying dermal fibrosis [21,23]. …”

Dermoscopy of multiple radiation-induced basal cell carcinomas in a patient treated previously for pinealoma

“…These are known features of basal cell carcinoma. 6 However dermoscopy of basal cell carcinoma in radiation-exposed areas was not described previously. With the new and recent knowledge about dosage and appropriate radiotherapy management, fewer adverse effects would be expected, so that its benefits increasingly outweigh its risks.…”