Original articleClassifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy
Section snippets
Methods
BCC cases were collected in 4 centers in Italy, Spain, Florida, and Australia. Ethics committee approval was waived because the study affected neither the routine diagnostic nor therapeutic management of these cases.
Inclusion criteria were a definite histopathologic diagnosis of BCC, including subtype classification, the availability of clinical, dermatoscopic, and confocal images of the tumor, and the availability of histopathologic slides. All lesions were classified histologically as pure
Results
Eighty-eight patients (mean age, 60.6 ± 14.5 years) with 88 histopathologically proven BCCs were included in the study. Our sample included 44 sBCCs, 22 nBCCs, and 22 iBCCs.
Clinically, sBCCs were flat in 37 of 44 cases (84.1%) and elevated in 7 (15.9%); nBCCs were elevated or nodular in the majority of cases (86.4%) and flat in 3 cases (13.6%); and iBCCs were flat in 20 (90.9%) of the cases and elevated in 2 (9.1%).
Concerning pigmentation, 30 of 44 sBCCs were hypopigmented; 8 cases (18.1%) were
Discussion
Our study revealed significant differences in the dermatoscopic and RCM characteristics among BCC subtypes, suggesting that a combination of the 2 diagnostic modalities might significantly enhance the preoperative subtype classification of the tumor. This is particularly relevant in clinical practice, because the treatment approach of BCC is mainly determined by the tumor subtype.
Several investigators have previously noted the dermatoscopic variability of different subtypes of BCCs.7, 8, 9, 13,
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Supported in part by the Italian Ministry of Health (RF-2010-2316524).
Conflicts of interest: None declared.
Reprints not available from the authors.