title: History of laser ablation in pigmented basal cell carcinoma conceals classic dermoscopic patterns.
abstract: BACKGROUND
  Some patients with pigmented basal cell carcinoma (pBCC) had a history of laser ablation after misdiagnosis, which may conceal the dermoscopic clues of malignancy.
  
  
  OBJECTIVE
  The objective of this study was to investigate the question of whether the classic and nonclassic dermoscopic patterns of BCCs may be concealed by past laser ablation.
  
  
  METHODS
  Classic and nonclassic dermoscopic patterns were examined in 55 pBCC patients with a history of laser ablation and another 150 control pBCC patients.
  
  
  RESULTS
  All but 4 of the study patients (92.3%) showed at least 1 classic pattern of BCC, whereas every control patient showed more than 1 classic pattern (p = .995). Compared with the control group, the detection rate of large blue/gray ovoid nests, multiple blue/gray globules, and ulceration was found to be significantly decreased in the study group (p < .05). However, 4 patients who lacked classic patterns showed at least 1 nonclassic pattern.
  
  
  CONCLUSIONS
  Previous laser ablation in pBCC may conceal the classic dermoscopic patterns by reducing the detection rate. Therefore, more prudent and detailed dermoscopic monitoring is required in suspected cases of pBCC, especially in patients with a history of laser ablation.
authors.affiliation: *Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea; †Biomedical Research Institute, Pusan National University Hospital, Busan, Korea; and ‡Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Won-Jeong
authors.initials: WJ
authors.lastname: Kim
authors.forename: Margaret
authors.initials: M
authors.lastname: Song
authors.forename: Hoon-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Ko
authors.forename: Moon-Bum
authors.initials: MB
authors.lastname: Kim
authors.forename: Byung-Soo
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery*; D016022:Case-Control Studies; D003116:Color; D046169:Dermoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D012883:Skin Ulcer / Q000473:pathology