title: Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location.
abstract: BACKGROUND
  Correctly diagnosing basal cell carcinoma (BCC) clinical type is crucial for the therapeutic management. A systematic description of the variability of all reported BCC dermoscopic features according to clinical type and anatomic location is lacking.
  
  
  OBJECTIVE
  To describe the dermoscopic variability of BCC according to clinical type and anatomic location and to test the hypothesis of a clinical/dermoscopic continuum across superficial BCCs (sBCCs) with increasing palpability.
  
  
  METHODS
  Clinical/dermoscopic images of nodular BCCs (nBCCs) and sBCCs with different degrees of palpability were retrospectively evaluated for the presence of dermoscopic criteria including degree of pigmentation, BCC-associated patterns, diverse vascular patterns, melanocytic patterns and polarized light patterns.
  
  
  RESULTS
  We examined 501 histopathologically proven BCCs (66.9% sBCCs; 33.1% nBCCs), mainly located on trunk (46.7%; mostly sBCCs) and face (30.5%; mostly nBCCs). Short fine telangiectasias, leaf-like areas, spoke-wheel areas, small erosions and concentric structures were significantly associated with sBCC, whereas arborizing telangiectasias, blue-white veil-like structures, white shiny areas and rainbow pattern with nBCCs. Short fine telangiectasia, spoke-wheel areas and small erosions were independently associated with trunk location, whereas arborizing telangiectasias with facial location. Scalp BCCs had significantly more pigmentation and melanocytic criteria than BCCs located elsewhere. Multiple clinical/dermoscopic parameters displayed a significant linear trend across increasingly palpable sBCCs.
  
  
  CONCLUSIONS
  Particular dermoscopic criteria are independently associated with clinical type and anatomic location of BCC. Heavily pigmented, scalp BCCs are the most challenging to diagnose. A clinical/dermoscopic continuum across increasingly palpable sBCCs was detected and could be potentially important for the non-surgical management of the disease.
authors: Department of Dermatology, University of L'Aquila, L'Aquila, Italy.|Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors: M
authors: http://orcid.org/0000-0002-9266-0342
authors: M
authors: Suppa
authors: Department of Dermatology, University of L'Aquila, L'Aquila, Italy.
authors: T
authors: T
authors: Micantonio
authors: Division of Dermatology, Complesso Integrato Columbus, Rome, Italy.
authors: A
authors: A
authors: Di Stefani
authors: Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, QLD, Australia.
authors: H P
authors: HP
authors: Soyer
authors: Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
authors: S
authors: S
authors: Chimenti
authors: Department of Dermatology, University of L'Aquila, L'Aquila, Italy.
authors: M C
authors: MC
authors: Fargnoli
authors: Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
authors: K
authors: K
authors: Peris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology*; D046169:Dermoscopy / Q000379:methods*; D005145:Face / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D012535:Scalp / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult