title: Accuracy of dermoscopic criteria for discriminating superficial from other subtypes of basal cell carcinoma.
abstract: BACKGROUND
  The management of basal cell carcinoma (BCC) depends, among other factors, on its histopathologic subtype. Although dermoscopic criteria of BCC have been investigated, the possible role of dermoscopy in predicting the tumor subtype remains unclear.
  
  
  OBJECTIVE
  We sought to assess the diagnostic accuracy of dermoscopic criteria for differentiating superficial BCC (sBCC) from other BCC subtypes.
  
  
  METHODS
  Dermoscopic images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver operating characteristic curves.
  
  
  RESULTS
  In all, 77 sBCCs and 258 non-sBCCs were included. Maple leaf-like areas, short fine superficial telangiectasia, multiple small erosions, and shiny white-red structureless areas were potent predictors of sBCC, each making its diagnosis over 5-fold more likely. Conversely, the presence of arborizing vessels, blue-gray ovoid nests, and ulceration gave 11-fold, 15-fold, and 3-fold increased possibility for the diagnosis of non-sBCCs, respectively. Based on the results of the multivariate analysis, we propose a diagnostic algorithm that can predict the diagnosis of sBCC with a sensitivity of 81.9% and a specificity of 81.8%.
  
  
  CONCLUSIONS
  The retrospective design and the inclusion of only Caucasian patients are limitations.
  
  
  CONCLUSIONS
  Dermoscopy is reliable in differentiating sBCC from other BCC subtypes.
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy. Electronic address: emlallas@gmail.com.
authors.forename: Aimilios
authors.initials: A
authors.lastname: Lallas
authors.affiliation: State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece.
authors.forename: Thrassivoulos
authors.initials: T
authors.lastname: Tzellos
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Medical School, Aristotle University, Thessaloniki, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kyrgidis
authors.affiliation: State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Apalla
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy; Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: Iris
authors.initials: I
authors.lastname: Zalaudek
authors.affiliation: Private practice, Volos, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Karatolias
authors.affiliation: Anatomic Pathology Unit, Department of Oncology, Gaetano Rummo General Hospital, Benevento, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.affiliation: Pathology Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Piana
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Moscarella
authors.affiliation: Department of Dermatology, Medical School, University of Athens, Andreas Sygros Hospital, Athens, Greece.
authors.forename: Alexander
authors.initials: A
authors.lastname: Stratigos
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000473:pathology*; D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology*
keywords: BCC; CI; RR; basal cell carcinoma; confidence interval; dermoscopy; diagnosis; nodular basal cell carcinoma; relative risk; sBCC; superficial basal cell carcinoma