Usefulness of Dermatoscopy for the Preoperative Assessment of the Histopathologic Aggressiveness of Basal Cell Carcinoma

作者:Kim Hoon Soo; Park Jung Min; Mun Je Ho; Song Margaret; Ko Hyun Chang; Kim Byung Soo; Kim Moon Bum*
来源:Annals of Dermatology, 2015, 27(6): 682-687.
DOI:10.5021/ad.2015.27.6.682

摘要

Background: Limited information is available regarding dermatoscopic differences between non-aggressive and aggressive types of basal cell carcinoma (BCC). Objective: To investigate dermatoscopic differences between non-aggressive and aggressive types. Methods: We evaluated 145 histopathologically confirmed BCCs from 141 patients. Histopathologic types and aggressiveness from 4 mm punch biopsy and their dermatoscopic findings were evaluated. We assessed the statistical significance of dermatoscopic differences between non-aggressive and aggressive types. To objectively predict aggressiveness, we created a "dermatoscopic index of BCC aggressiveness" in which 1 point was added and subtracted for each dermatoscopic finding significantly higher in aggressive and non-aggressive types, respectively. Results: Large blue-gray ovoid nests were found more frequently in non-aggressive type than aggressive one (85/105 [80.9%] vs. 21/40 [52.5%], p= 0.001). Compared to non-aggressive type, aggressive type had more multiple blue-gray globules (29/40 [72.5%] vs. 57/105 [54.3%], p=0.046), arborizing telangiectasia (29/40 [72.5%] vs. 48/105 [45.7%], p= 0.004), and concentric structure (11/40 [27.5%] vs. 12/105 [11.4%], p= 0.018). Regarding dermatoscopic index, cases of aggressive type with a score of 1 were most common (n =18, 45.0%), followed by a score of 2 (n =14, 35.0%). Limited number of aggressive type of BCCs and the effect of width on the determination of histopathologic aggressiveness. Conclusion: Aggressive type BCCs more often exhibited multiple blue-gray globules, arborizing telangiectasia, and concentric structure, while the non-aggressive type exhibited large blue-gray ovoid nests more frequently. Score exceeding 2 on the dermoscopic index can be screening criteria for aggressiveness. These dermatoscopic features and dermoscopic index could be useful for assessing aggressiveness of BCCs before surgery.

  • 出版日期2015-12

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