Diagnosing basal cell carcinoma by dermatoscopy.
BACKGROUND
Dermatoscopy (DS) has been used primarily to evaluate pigmented skin lesions. Little information is available on DS findings of basal cell carcinoma (BCC). Dermatoscopy is a noninvasive technique that allows visualization of cutaneous features from the skin surface to the papillary dermis. Basal cell carcinoma, the most common cutaneous malignancy, is traditionally diagnosed clinically and confirmed with biopsy.


OBJECTIVE
To determine the dermatoscopic features of nonpigmented basal cell carcinomas.


METHODS
The dermatoscopic findings of 27 lesions that clinically were suspicious for BCC were analyzed.


RESULTS
Of these 27 clinically suspect lesions, the biopsies revealed BCC in 20 specimens and squamous cell carcinoma (SCC) in two specimens. Twenty of these 22 specimens had dermatoscopic findings of BCC: diffusely distributed, branching blood vessels, asymmetric, and narrow blood vessels distributed deeper in the dermis, or a milky-red corona with superficial wide blood vessels. One nodular BCC in our study showed no distinct findings.


CONCLUSIONS
Many BCCs have characteristic DS findings; however, dermatoscopic examination of some tumours will not demonstrate any known characteristic findings. As such, the DS criteria we propose for BCC are best utilized as an adjunctive study of clinical impressions. Biopsy remains the definitive diagnostic tool.
Carroll
D M
DM
Medical Student, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Billingsley
E M
EM
Helm
K F
KF
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D010784:Photomicrography; D012878:Skin Neoplasms / Q000473:pathology*