Adjunct use of optical coherence tomography increases the detection of recurrent basal cell carcinoma over clinical and dermoscopic examination alone.
BACKGROUND
Basal cell carcinoma (BCC) is a locally destructive form of skin cancer, mainly affecting Caucasians. In the last few years non-surgical treatments of BCC have become widely used and non-invasive methods for treatment monitoring and follow-up are therefore becoming increasingly warranted. The objective of this study was to investigate the utility of adjunct use of non-invasive optical coherence tomography (OCT) imaging for the detection of recurrent BCC over clinical and dermoscopic examination alone, in a real-world setting.


METHODS
A total of 58 patients, previously treated with curettage and/or MAL-PDT for BCC, were included in the study. The patients were examined clinically and dermoscopically for recurrence by a dermatologist before joining the study. The included patients were then OCT scanned and if the OCT images raised suspicion of recurrent BCC the area was biopsied.


RESULTS
In 6 cases the clinical examination revealed suspicions recurrent lesions and OCT correctly identified all of these (6/6). In 49 cases the follow-up examinations showed no clinical or dermoscopic signs of recurrence, but in 12.2% (6/49) of these cases the subsequent OCT examination revealed a subclinical recurrent BCC lesion. These were all confirmed by histology. In 3 cases both the clinical and the OCT diagnosis was unclear and recurrent BCC could not be ruled out, but histology showed no sign of malignancy.


CONCLUSIONS
These results suggest that the adjunct use of OCT increases the detection rate of recurrent BCC over clinical/dermoscopy examination alone.
Zaeland University Hospital, Department of Dermatology, Roskilde, Denmark.
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AA
Hussain
Zaeland University Hospital, Department of Dermatology, Roskilde, Denmark. Electronic address: lotte.themstrup@gmail.com.
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L
Themstrup
Zealand University Hospital, Department of Pathology, Roskilde, Denmark.
B M
BM
Nürnberg
Zaeland University Hospital, Department of Dermatology, Roskilde, Denmark.
Gbe
G
Jemec
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000494:pharmacology; D012878:Skin Neoplasms / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000379:methods
D017319:Photosensitizing Agents
Basal cell carcinoma; Follow-up; Non-invasive treatments; Non-melanoma skin cancer; Optical coherence tomography; Skin imaging