Dermatoscopy of basal cell carcinoma: Morphologic variability of global and local features and accuracy of diagnosis

Early detection of basal cell carcinoma (BCC) is crucial to reduce the morbidity of this tumor. We sought to investigate the variability and diagnostic significance of dermatoscopic features of BCCs. We conducted retrospective dermatoscopic analysis of 609 BCCs and 200 melanocytic and nonmelanocytic...

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Vydáno v:Journal of the American Academy of Dermatology Ročník 62; číslo 1; s. 67 - 75
Hlavní autoři: Altamura, Davide, Menzies, Scott W., Argenziano, Giuseppe, Zalaudek, Iris, Soyer, H. Peter, Sera, Francesco, Avramidis, Michelle, DeAmbrosis, Kathryn, Fargnoli, Maria Concetta, Peris, Ketty
Médium: Journal Article
Jazyk:angličtina
Vydáno: New York, NY Elsevier Inc 01.01.2010
Elsevier
Témata:
Adolescent
Adult
Aged
Aged, 80 and over
basal cell carcinoma
Biological and medical sciences
Carcinoma, Basal Cell - diagnosis
Carcinoma, Basal Cell - pathology
Dermatology
dermatoscopy
Dermoscopy
early diagnosis of skin tumors
Female
Humans
Male
Medical sciences
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Skin Neoplasms - diagnosis
Skin Neoplasms - pathology
Tumors of the skin and soft tissue. Premalignant lesions
Young Adult
dermatoscopy
early diagnosis of skin tumors
basal cell carcinoma
Skin disease
Accuracy
Basal cell carcinoma
Dermatology
Malignant tumor
Diagnosis
Cancer
ISSN:0190-9622, 1097-6787, 1097-6787
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Shrnutí:Early detection of basal cell carcinoma (BCC) is crucial to reduce the morbidity of this tumor. We sought to investigate the variability and diagnostic significance of dermatoscopic features of BCCs. We conducted retrospective dermatoscopic analysis of 609 BCCs and 200 melanocytic and nonmelanocytic lesions, and assessment of interrater reliability of dermatoscopic BCC criteria. Lesions included nonpigmented (15.1%), lightly pigmented (33.2%), pigmented (42.7%), and heavily pigmented (9%) BCCs. Classic BCC patterns including arborizing telangiectasia (57.1%), blue/gray ovoid nests (47.5%), ulceration (39.2%), multiple blue/gray globules (26.1%), leaflike areas (15.9%), and spoke-wheel areas (9%) were significantly increased in pigmented BCCs compared with nonpigmented and heavily pigmented BCCs (P = .0001). Among nonclassic BCC patterns, we detected short fine superficial telangiectasia (10%) and multiple small erosions (8.5%), and described two new patterns named “concentric structures” (7.6%) and “multiple in-focus blue/gray dots” (5.1%). Dermatoscopic features suggestive of melanocytic lesions (eg, multiple brown to black dots/globules, blue/white veillike structures, and nonarborizing vessels) were observed in 40.6% BCCs and significantly increased in heavily pigmented BCCs (P < .0001). Expert observers provided an accurate (sensitivity: 97%) and reliable (K: 87%) dermatoscopic diagnosis of BCC, although a significant difference in terms of specificity (P = .0002) and positive predictive value (P = .0004) was found. Arborizing telangiectasia, leaflike areas, and large blue/gray ovoid nests represented reliable and robust diagnostic parameters. The study was retrospective. BCCs show a large spectrum of global and local dermatoscopic features; heavily pigmented BCCs show the most challenging combinations of dermatoscopic features.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0190-9622
1097-6787
1097-6787
DOI:10.1016/j.jaad.2009.05.035