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Manca R, Dattolo A, Valenzano F, Castriota M, Martella A, Galdo G, Argenziano G, Abeni D, Fania L. Proposal of a new dermoscopic criterion for pigmented basal cell carcinoma: a multicentre retrospective study. Dermatol Reports 2024; 16:9691. [PMID: 38623374 PMCID: PMC11017719 DOI: 10.4081/dr.2023.9691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/24/2023] [Indexed: 04/17/2024] Open
Abstract
Dermoscopy is widely used for the diagnosis of skin cancer and it increases the accuracy of basal cell carcinoma (BCC) detection. BCC dermoscopic criteria have been updated and divided into vascular, pigment-related, and non-vascular/non-pigment-related. Our multicenter retrospective study tested a new dermoscopic pigment-related characteristic to detect pigmented BCC (pBCC) [brown homogeneous blotches (BHB)]. Cases of pBCC were collected from the databases of IDI-IRCCS of Rome and from three Italian private dermatology centers. BHB are confined patches of brown uniform pigmentation without dermoscopic features (net, fat fingers, etc.) or other internal dermoscopic structures, except for occasional vascular ones like arborizing vessels or globules/dots. Melanocytic and non-melanocytic controls were used. We reviewed photos of 270 pigmented lesions (female 145; 51.8%), including 90 histopathologically verified pBCC and 180 control cases (90 melanocytic and 90 non-melanocytic). BHB were found in 61 cases of 90 pBCC patients. The results showed a 67.8 sensitivity, 93.3 specificity, 83.6 positive and 85.3 negative predictive values, posLR 10.2, negLR 0.3, odds ratio 29.4, p<0.001. Our multicentre retrospective analysis suggested the BHB may be a novel dermoscopic pBCC diagnosis criterion.
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Affiliation(s)
| | - Anna Dattolo
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | | | | | - Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome
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Palmisano G, Orte Cano C, Fontaine M, Lenoir C, Cinotti E, Tognetti L, Rubegni P, Perez-Anker J, Puig S, Malvehy J, Perrot JL, Del Marmol V, Peris K, Suppa M. Dermoscopic criteria explained by LC-OCT: Negative maple leaf-like areas. J Eur Acad Dermatol Venereol 2024; 38:e271-e273. [PMID: 37876332 DOI: 10.1111/jdv.19588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Gerardo Palmisano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Carmen Orte Cano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Margot Fontaine
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Clément Lenoir
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Cinotti
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Véronique Del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Ketty Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
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Arias-Rodriguez C, Muñoz-Monsalve AM, Cuesta D, Mejia-Mesa S, Aluma-Tenorio MS. Dermoscopy of very small basal cell carcinoma (≤3mm). An Bras Dermatol 2023; 98:755-763. [PMID: 37422343 PMCID: PMC10589476 DOI: 10.1016/j.abd.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) dermoscopy is key to lower the biopsy threshold of suspicious lesions. There is a scarcity of published data on the dermoscopy of very small BCC (≤3mm) and its differences from larger BCCs. OBJECTIVE To describe and compare dermoscopic features of BCCs measuring ≤3mm, with those from 3 to 10mm. METHODS An analytical cross-sectional study, included biopsy-proven BCCs that had dermoscopic photographic images, between January 2017 and December 2022 in a Skin Cancer Center in Medellín, Colombia. Demographic, clinic-pathological and dermoscopic features were compared between very small BCCs (vsBCCs) and a reference group. RESULTS A total of 326 BCCs in 196 patients were included, of whom 60% were male. The most common Fitzpatrick phototype was III. vsBCCs accounted for 25% of the lesions (81/326). Face and neck were the most frequent locations (53%), especially in very small tumors. The nodular type was more common in very small tumors than in larger lesions, the superficial type was less frequent, and aggressive types were equally prevalent in both groups. On dermoscopy, very small tumors were statistically more likely to present pigmented structures than reference lesions, especially blue-gray dots (67% vs. 54%), vessels were less frequent, particularly short-fine telangiectasias (SFT) (52% vs. 66%), as were other structures such as shiny white structures (SWS), ulceration, micro-erosions, and scales. STUDY LIMITATIONS Latin-American sample, lacks information on dark phototypes CONCLUSIONS: Pigmented structures, especially blue-gray dots, were most common in vsBCCs when compared to larger lesions; SFT, SWS and other findings were less prevalent.
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Affiliation(s)
- Camilo Arias-Rodriguez
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia; Department of Dermatology, Aurora Center Specialized in Piel Cancer, Medellin, Colombia.
| | | | - Diana Cuesta
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
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Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, Bataille V, Brochez L, Del Marmol V, Dummer R, Forsea AM, Gaudy-Marqueste C, Harwood CA, Hauschild A, Höller C, Kandolf L, Kellerners-Smeets NWJ, Lallas A, Leiter U, Malvehy J, Marinović B, Mijuskovic Z, Moreno-Ramirez D, Nagore E, Nathan P, Stratigos AJ, Stockfleth E, Tagliaferri L, Trakatelli M, Vieira R, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023; 192:113254. [PMID: 37604067 DOI: 10.1016/j.ejca.2023.113254] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
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Affiliation(s)
- Ketty Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | | | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London SE1 7EH, UK
| | - Lieve Brochez
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich and University Zurich, Switzerland
| | - Ana-Marie Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | | | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - Christoph Höller
- Department of Dermatology, Medical University of Vienna, Austria
| | - Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Nicole W J Kellerners-Smeets
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands; Department of Dermatology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, Croatia
| | - Zeljko Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - David Moreno-Ramirez
- Dermatology. Medicine School, University of Seville, University Hospital Virgen Macarena, Seville-Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Eggert Stockfleth
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | - Myrto Trakatelli
- Second Department of Dermatology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ricardo Vieira
- Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
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Song Z, Wang Y, Meng R, Chen Z, Gao Y, An X, Yang J, Yin Y, Chen L, Xin L, Xia Y, Tao J, Yang L. Clinical and dermoscopic variation of basal cell carcinoma according to age of onset and anatomic location: a multicenter, retrospective study. Arch Dermatol Res 2023; 315:1655-1664. [PMID: 36780005 DOI: 10.1007/s00403-023-02556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/14/2023]
Abstract
Basal cell carcinoma (BCC) is rare in young individuals and reported to possess different pathogenetic, clinical and histological features from late-onset BCC. However, the dermoscopic variability of BCC according to age of onset has not been investigated. Anatomic location was revealed to be associated with dermoscopic variation of BCC in Western population, but whether it applies to Asian population remains unknown. We evaluated the clinical and dermoscopic features of 448 BCCs and compared each feature by age of onset (age < 50/ > 50 years) and anatomic location. Early-onset BCCs occurred more frequently on non-sun-exposed sites (OR 3.28, P = 0.001) and were less pigmented than late-onset BCCs (P = 0.003). Blue-gray globules (OR 1.74, P = 0.037) and no vessels (OR 2.04, P = 0.021) were independently associated with early-onset BCCs, whereas arborizing telangiectasia (OR 0.30, P < 0.001), large blue-gray ovoid nests (OR 0.38, P < 0.001) and ulceration (OR 0.33, P < 0.001) were less common in early-onset BCCs. Scalp BCCs were significantly more pigmented than BCCs located elsewhere (P = 0.022). Superficial subtype (OR 5.90, P < 0.001), spoke-wheel areas (OR 4.78, P = 0.034), superficial erosions (OR 4.69, P = 0.003) and polymorph vessels (OR 6.86, P = 0.001) were independently associated with trunk BCCs, whereas nodular subtype (OR 5.48, P < 0.001) and arborizing telangiectasias (OR 3.64, P < 0.001) with BCCs on face and neck. Our findings suggest that age of onset and anatomic location are independent factors affecting the dermoscopic appearance of BCC.
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Affiliation(s)
- Zexing Song
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Yifei Wang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Rusong Meng
- Department of Dermatology, Specialty Medical Center of the Air Force, Chinese People's Liberation Army, Beijing, 100142, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Yaoying Gao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Xiangjie An
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Jing Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Yue Yin
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Liuqing Chen
- Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, 430030, Hubei, China
| | - Linlin Xin
- Department of Dermatology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, China
| | - Ying Xia
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China.
- Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China.
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Di Brizzi EV, Argenziano G, Brancaccio G, Scharf C, Ronchi A, Moscarella E. The current clinical approach to difficult-to-treat basal cell carcinomas. Expert Rev Anticancer Ther 2023; 23:43-56. [PMID: 36579630 DOI: 10.1080/14737140.2023.2161517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is the most common malignant tumor in adult white populations. If BCCs are not treated for years, if they cause massive destruction of the surrounding tissues, if they are considered unresectable or not eligible for radiotherapy they become progressively 'locally advanced' (laBCC) or metastatic (mBCC). These tumors are defined as 'difficult-to-treat BCC.' AREAS COVERED A comprehensive search on PubMed was conducted to identify relevant literature about the several approved and recommended treatment options for the management of difficult-to-treat BCC published from January 2012 to July 2022. Surgical options, radiotherapy, hedgehog inhibitors, immunotherapy, and combined treatments are discussed. The keywords used were basal cell carcinoma; difficult-to-treat BCC; management of difficult-to-treat BCC; surgical therapy; radiotherapy; hedgehog inhibitors; immunotherapy. EXPERT OPINION Identifying the best approach to DTT BCCs is one of the main challenges for the dermato-oncologist. The introduction of HHI for the treatment of advanced BCCs has revolutionized the clinical management of DTT BCCs. The immune checkpoint inhibitor cemiplimab has been approved for the treatment of locally advanced or metastatic BCC refractory to HHI therapy or in patients intolerant to HHI therapy. Multidisciplinary teams (MDTs) play a key role in managing these complex patients.
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Affiliation(s)
| | | | | | - Camila Scharf
- Dermatology Unit, University of Campania, Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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Gürsel Ürün Y, Fiçicioğlu S, Ürün M, Can N. Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma. Dermatol Pract Concept 2023; 13:dpc.1301a4. [PMID: 36892362 PMCID: PMC9946123 DOI: 10.5826/dpc.1301a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC). OBJECTIVES To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns. METHODS Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis. RESULTS The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%). CONCLUSIONS In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.
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Affiliation(s)
- Yıldız Gürsel Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Sezin Fiçicioğlu
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Mustafa Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Nuray Can
- Departments of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Kamińska-winciorek G, Galwas K, Suchorzepka M, Ziółkowska B, Turska-d’amico M, Bal W, Conforti C, Toffoli L, Cybulska-stopa B, Zalaudek I. Characteristics of Giant Nodular Melanomas in Special Locations: a Case Series and Review of the Literature. Dermatol Ther (Heidelb) 2022. [DOI: 10.1007/s13555-022-00841-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
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Kim M, Kim JW, Shin JW, Na JI, Huh CH. Basal cell carcinoma of the scalp shows distinct features from the face in Asians. Sci Rep 2022; 12:10183. [PMID: 35715697 PMCID: PMC9205873 DOI: 10.1038/s41598-022-14533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Basal cell carcinoma (BCC) affecting different sites has been reported to have different clinicopathological features. In previous studies, the scalp was commonly classified to the head and neck region. However, the scalp has distinct characteristics from those of other parts of the skin. We retrospectively reviewed the medical records of patients who underwent surgical treatment for BCC. A total of 734 lesions were examined, and 13.2% originated from the scalp. The nodular type was the most common histologic subtype; however, the proportion of the superficial type was significantly higher than that of facial BCC (p < 0.001). Compared with facial BCC, younger age (p = 0.046) and larger tumor size (p < 0.001) were observed in scalp BCC. These characteristics were similar to those of truncal BCC in that they demonstrated a higher proportion of the superficial type (p < 0.001), younger age (p = 0.001), and larger tumor diameter (p < 0.001) compared with BCC in the head and neck region. Scalp BCC and truncal BCC were not significantly different in terms of age (p = 0.052) and tumor size (p = 0.230). In conclusion, despite the anatomical proximity, features of scalp BCC were similar to those of truncal lesions compared with facial lesions. Scalp BCC might be a separate entity from facial BCC.
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Affiliation(s)
- Minsu Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jee-Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea.
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoscopically narrowed surgical margins for head and neck basal cell carcinoma: A retrospective case-control study. J Dtsch Dermatol Ges 2022; 20:807-816. [PMID: 35581699 PMCID: PMC9321004 DOI: 10.1111/ddg.14757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) can cause extensive tissue damage if untreated. Complete surgical excision is the treatment of choice, but especially in the head-and neck area, defining both radical and healthy skin sparing surgical margins is complex. MATERIALS AND METHODS Excised, small (≤ 1 cm), BCCs of the head and neck were retrospectively analyzed, comparing histological properness of surgical margins after clinical-dermatoscopical preoperative evaluation (cases), vs. clinical evaluation only (controls) and recurrences. RESULTS Of 281 BCCs: 6 % (8/139) of cases and 8 % (12/142) of controls had unproper deep margins; 4 % (5/139) of cases, 20 % (29/142) of controls had unproper lateral margins (P < 0.001). Surgical 3 mm lateral margins were unproper in 0 % (15/66) of cases, 15 % (10/66) of controls (P > 0.005); surgical 1-2 mm lateral margins were unproper in 7 % (5/73) of cases, 25 % (19/76) of controls (P < 0.01). Of cases excised at 3 mm, 1-2 mm, and controls, 1.5 %, 0 %, and 7.7 % recurred, respectively. CONCLUSIONS BCC excision at 3 mm may be appropriate in the head and neck for small, dermatoscopically well-defined and non-aggressive BCCs, attaining surgical cure rates of 100 % and 1.5 % recurrences. Excision at 1-2 mm should be reserved only for BCCs in very difficult-to-treat areas, as the surgical cure rate was only 93 %.
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Affiliation(s)
- Astrid Herzum
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Martina Burlando
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Pietro Paolo Tavilla
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Claudia Micalizzi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Mattia Fabio Molle
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Emanuele Cozzani
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Aurora Parodi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoskopisch kontrollierte, schmalere Resektionsränder bei Basalzellkarzinomen an Kopf und Hals: Retrospektive Fallkontrollstudie. J Dtsch Dermatol Ges 2022; 20:807-817. [PMID: 35711047 DOI: 10.1111/ddg.14757_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund: Unbehandelt kann das Basalzellkarzinom (BCC) erhebliche Gewebezerstörungen verursachen. Die komplette chirurgische Exzision ist die Behandlung der Wahl. Allerdings stellt es besonders im Gesichts- und Halsbereich eine Herausforderung dar, den Tumor vollständig zu entfernen und möglichst viel gesundes Gewebe zu erhalten. Material und Methoden: Bereits exzidierte kleine BCC (≤ 1 cm) von Kopf oder Hals wurden retrospektiv analysiert. Verglichen wurde die histologisch kontrolliert angemessene Breite des Resektionsrandes nach präoperativer dermatoskopischer Untersuchung (Fälle) im Vergleich zur rein klinischen Untersuchung (Kontrollen), sowie die Rezidivrate. Ergebnisse: Bei 281 BCC: 6 % (8/139) der Fälle und 8 % (12/142) der Kontrollen zeigten inadäquate basale Resektionsränder; 4 % (5/139) der Fälle und 20 % (29/142) der Kontrollen zeigten inadäquate laterale Resektionsränder (P < 0.001). Laterale Resektionsränder von 3 mm waren in 0 % (15/66) der Fälle, jedoch in 15 % (10/66) der Kontrollen inadäquat (P >0.005); laterale Resektionsränder von 1-2 mm waren in 7 % (5/73) der Fälle und in 25 % (19/76) der Kontrollen inadäquat (P < 0.01). Rezidive traten in den Fällen mit 3 mm Resektionsrand in 1,5 % auf, in den Fällen mit 1-2 mm Resektionsrand bei 0 %, und bei den Kontrollen bei 7,7 %. Schlussfolgerung: Für BCC im Kopf- und Halsbereich erscheint ein Resektionsrand von 3 mm angemessen, sofern das BCC klein, dermatoskopisch gut definiert und wenig aggressiv ist. Hier zeigten sich operative Heilungsraten von 100 % mit 1,5 % Rezidiven. Resektionsränder von 1-2 mm sollten nur für BCC in sehr schwierig zu behandelnden Bereichen in Betracht gezogen werden, da die Heilungsrate hier nur bei 93 % lag.
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Affiliation(s)
- Astrid Herzum
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Martina Burlando
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Pietro Paolo Tavilla
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Claudia Micalizzi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Mattia Fabio Molle
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Emanuele Cozzani
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Aurora Parodi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
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12
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Popadić M, Brasanac D. The use of dermoscopy in distinguishing the histopathological subtypes of basal cell carcinoma: A retrospective, morphological study. Indian J Dermatol Venereol Leprol 2022; 88:598-607. [PMID: 35146979 DOI: 10.25259/ijdvl_1276_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The role of dermoscopy in distinguishing the histopathological subtypes of basal cell carcinoma (BCC) is not fully elucidated. AIMS To determine the accuracy of dermoscopy in diagnosing different BCC subtypes. METHODS The dermoscopic features of 102 histopathologically verified BCCs were studied retrospectively. The tumours were classified as superficial (n=33,32.3%), nodular (n=46,45.1%) and aggressive (n=23,22.6%) BCCs by histopathology. Statistical analysis included Cohen's kappa test, proportion of correlation, measures of diagnostic accuracy, diagnostic odds ratio and the credibility ratio of positive (LR+) and negative (LR-) tests. RESULTS The highest value in all performed tests was seen in superficial BCCs (kappa 0.85; proportion of correlation 93%; diagnostic accuracy 93.1%), good correlation was noted in nodular BCCs (kappa 0.62, proportion of correlation 80%; diagnostic accuracy 80.4%) but dermoscopic correlation with histopathology was low for aggressive BCCs (kappa 0.13; proportion of correlation 79%; diagnostic accuracy 78.4%). Short, fine telangiectasias (83.3%) showed the greatest importance for the diagnosis of superficial BCCs, blue-grey ovoid nests (61.8%) had the highest diagnostic accuracy in nodular BCCs, while arborising vessels (79.4%) was the most significant dermoscopic feature for the diagnosis of aggressive BCCs. LIMITATIONS This was a retrospective analysis and included only Caucasian patients from a single centre. CONCLUSION The highest agreement of dermoscopic features with the histologic type was found in superficial BCCs. We did not find any specific dermoscopic structure that could indicate a diagnosis of aggressive BCC. The presence of relevant dermoscopic features in the evaluated cases was determined by the depth of tumour invasion and not by its histology.
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Affiliation(s)
- Mirjana Popadić
- Faculty of Medicine, University of Belgrade, Clinic of Dermatovenereology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Dimitrije Brasanac
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Serbia
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Cerci FB, Tolkachjov SN, Werner B. “DerMohscopy”: utility of dermoscopy combined with Mohs micrographic surgery for the treatment of basal cell carcinoma. An Bras Dermatol 2022; 97:250-253. [PMID: 35012803 PMCID: PMC9073244 DOI: 10.1016/j.abd.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/24/2020] [Accepted: 11/11/2020] [Indexed: 11/22/2022] Open
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Ivkov-simic M, Gajic B, Ogorelica D, Gajinov Z. Diagnostic accuracy of basal cell carcinoma in dermatology setting in Serbia: A single-center study. VOJNOSANIT PREGL 2022; 79:599-604. [DOI: 10.2298/vsp201207012i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. The growing incidence of skin tumors requires an accurate diagnosis. Dermoscopy, especially in vivo, enhances the diagnosis of basal cell carcinoma (BCC). Total body skin examination (TBSE), a visual inspection of the patient?s total body surface, is considered a basic step in the dermatological exam, especially in skin cancer screening. However, TBSE is still a matter of debate regarding its expediency in a real clinical setting. The aim of this study was to analyze the diagnostic accuracy of BCC detected and treated by referred dermatologists. Methods. The retrospective analysis included a five-year period of BCC detection during TBSE by visual inspection and dermoscopy. We calculated sensitivity, specificity and positive predictive value for BCC using histopathological results as the correct diagnosis. Results. Out of 3,346 biopsied skin tumors, 49.58% were malignant and 50.42% benign. The most common malignant tumor was BCC, accounting for 84.09%. Localization of BCCs was mainly on the trunk (38.92%) and the H-zone of the face (37.63%). Other localizations were face (non-H-zone) (6.67%), neck (3.01%), scalp (3.37%), arms (6.88%) and limbs (3.51%). Of all BCCs, 0.83% were recurrent BCC. The sensitivity for the diagnosis of BCC was 97.71%, and the positive predictive value was 95.08%. Conclusion. In the dermatology setting, TBSE and visual inspection with in vivo dermoscopy result in a very good diagnostic performance of BCC.
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Behera B, Kumari R, Mohan Thappa D, Gochhait D, Hanuman Srinivas B, Ayyanar P. Dermoscopic features of primary cutaneous amyloidosis in skin of colour: A retrospective analysis of 48 patients from South India. Australas J Dermatol 2021; 62:370-374. [PMID: 34227687 DOI: 10.1111/ajd.13662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/26/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Biswanath Behera
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, India
| | - Rashmi Kumari
- Department of Dermatology, Venereology and Leprology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Devinder Mohan Thappa
- Department of Dermatology, Venereology and Leprology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Debasis Gochhait
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Bheemanathi Hanuman Srinivas
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Sgouros D, Rigopoulos D, Panayiotides I, Apalla Z, Arvanitis DK, Theofili M, Theotokoglou S, Syrmali A, Theodoropoulos K, Pappa G, Damaskou V, Stratigos A, Katoulis A. Novel Insights for Patients with Multiple Basal Cell Carcinomas and Tumors at High-Risk for Recurrence: Risk Factors, Clinical Morphology, and Dermatoscopy. Cancers (Basel) 2021; 13:3208. [PMID: 34198960 PMCID: PMC8269292 DOI: 10.3390/cancers13133208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Basal cell carcinoma (BCC) quite frequently presents as multiple tumors in individual patients. Neoplasm's risk factors for local recurrence have a critical impact on therapeutic management. OBJECTIVE To detect risk factors for multiple BCCs (mBCC) in individual patients and to describe clinical and dermatoscopic features of low- and high-risk tumors. MATERIALS & METHODS Our study included 225 patients with 304 surgically excised primary BCCs. All patients' medical history and demographics were recorded. Clinical and dermatoscopic images of BCCs were evaluated for predefined criteria and statistical analyses were performed. RESULTS Grade II-III sunburns before adulthood (OR 2.146, p = 0.031) and a personal history of BCC (OR 3.403, p < 0.001) were the major predisposing factors for mBCC. Clinically obvious white color (OR 3.168, p < 0.001) and dermatoscopic detection of white shiny lines (OR 2.085, p = 0.025) represented strongly prognostic variables of high-risk BCC. Similarly, extensive clinico-dermatoscopic ulceration (up to 9.2-fold) and nodular morphology (3.6-fold) raise the possibility for high-risk BCC. On the contrary, dermatoscopic evidence of blue-black coloration had a negative prognostic value for high-risk neoplasms (light OR 0.269, p < 0.001/partial OR 0.198, p = 0.001). CONCLUSIONS Profiling of mBCC patients and a thorough knowledge of high-risk tumors' clinico-dermatoscopic morphology could provide physicians with important information towards prevention of this neoplasm.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Ioannis Panayiotides
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Zoe Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, 54643 Thessaloniki, Greece;
| | - Dimitrios K. Arvanitis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Melpomeni Theofili
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Sofia Theotokoglou
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Anna Syrmali
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Konstantinos Theodoropoulos
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Georgia Pappa
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Vasileia Damaskou
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Alexander Katoulis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
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Behera B, Kumari R, Thappa DM, Gochhait D, Srinivas BH, Ayyanar P. Dermoscopic features of basal cell carcinoma in skin of color: A retrospective cross-sectional study from Puducherry, South India. Indian J Dermatol Venereol Leprol 2021; 89:254-260. [PMID: 33969659 DOI: 10.25259/ijdvl_420_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 01/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. AIMS The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. METHODS A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. RESULTS Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. LIMITATIONS The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. CONCLUSION We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.
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Affiliation(s)
- Biswanath Behera
- Department of Dermatology, and Venereology AIIMS, Bhubaneswar, Odisha, India
| | - Rashmi Kumari
- Department of Dermatology, Venereology and Leprology JIPMER, Puducherry, India
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Behera B, Chandrashekar L, Thappa DM, Gochhait D, Srinivas BH, Ayyanar P. Dermoscopic features of benign cutaneous adnexal tumours in dark skin: A retrospective study from South India. Australas J Dermatol 2021; 62:e249-e255. [PMID: 33797080 DOI: 10.1111/ajd.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Biswanath Behera
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, India
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Álvarez-Salafranca M, Ara M, Zaballos P. Dermoscopy in Basal Cell Carcinoma: An Updated Review. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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20
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Pampena R, Parisi G, Benati M, Borsari S, Lai M, Paolino G, Cesinaro AM, Ciardo S, Farnetani F, Bassoli S, Argenziano G, Pellacani G, Longo C. Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma. Front Oncol 2021; 10:630458. [PMID: 33680953 PMCID: PMC7933517 DOI: 10.3389/fonc.2020.630458] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023] Open
Abstract
Background Infiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce the risk of incomplete excision and recurrence. Objective The aim of this study is to define clinical and dermoscopic criteria that can differentiate infiltrative BCC from the most common low-aggressive superficial and nodular BCC. Methods Clinical and dermoscopic images of infiltrative, superficial, and nodular BCC were retrospectively retrieved from our database and jointly evaluated by two experienced dermoscopists, blinded for the histologic subtype. Pairwise comparisons between the three histologic subtypes were performed and multivariable logistic regression models were constructed in order to define clinical and dermoscopic factors independently associated with each subtype. To validate our findings, two experienced dermoscopists not previously involved in the study were asked to evaluate clinical and dermoscopic images from an external dataset, guessing the proper BCC subtype between infiltrative, nodular and superficial, before and after being provided with the study results. Result A total of 481 histopathologically proven BCCs (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were included. We found that infiltrative BCC mostly appeared on the head and neck as an amelanotic hypopigmented plaque or papule, displaying ulceration on dermoscopic examination, along with arborizing and fine superficial telangiectasia. Shiny white structures were also frequently observed. Multivariate regression analysis allowed us to define a clinical-dermoscopic profile of infiltrative BCC. Conclusions We defined the clinical-dermoscopic profile of infiltrative BCC, allowing to differentiate this variant from superficial and nodular BCC. This will improve pre-surgical recognition of infiltrative forms, reducing the risk for post-surgical recurrence.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gabriele Parisi
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Mattia Benati
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Borsari
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michela Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milano, Italy.,Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy
| | - Anna Maria Cesinaro
- Department of Pathological Anatomy, Modena University Hospital, Modena, Italy
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Sara Bassoli
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Álvarez-Salafranca M, Ara M, Zaballos P. Dermoscopy in Basal Cell Carcinoma: An Updated Review. Actas Dermosifiliogr (Engl Ed) 2020; 112:330-338. [PMID: 33259816 DOI: 10.1016/j.ad.2020.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
Dermoscopy is a noninvasive technique that has been demonstrated to improve diagnostic accuracy in basal cell carcinoma (BCC). The first dermoscopic model for the diagnosis of BCC, based mainly on the identification of pigmented structures, was described by Menzies et al., and since then dermoscopy has generated an abundance of literature useful to routine clinical practice. From a practical perspective, dermoscopic structures associated with BCC can be classified as pigmented, vascular, or nonpigmented/nonvascular. One of the most recent applications of dermoscopy in BCC is as an aid to predicting histologic subtype and essentially differentiating between superficial and nonsuperficial BCC. It can also, however, help raise suspicion of more aggressive variants with a higher risk of recurrence. A thorough dermoscopic examination during follow-up of patients with actinic damage or a history of multiple BCCs can facilitate the detection of very incipient lesions and significantly impact treatment and prognosis.
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Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - M Ara
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, España
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22
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Sabri AH, Cater Z, Gurnani P, Ogilvie J, Segal J, Scurr DJ, Marlow M. Intradermal delivery of imiquimod using polymeric microneedles for basal cell carcinoma. Int J Pharm 2020; 589:119808. [DOI: 10.1016/j.ijpharm.2020.119808] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/07/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023]
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Fania L, Didona D, Morese R, Campana I, Coco V, Di Pietro FR, Ricci F, Pallotta S, Candi E, Abeni D, Dellambra E. Basal Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines 2020; 8:biomedicines8110449. [PMID: 33113965 PMCID: PMC7690754 DOI: 10.3390/biomedicines8110449] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common human cancer worldwide, and is a subtype of nonmelanoma skin cancer, characterized by a constantly increasing incidence due to an aging population and widespread sun exposure. Although the mortality from BCC is negligible, this tumor can be associated with significant morbidity and cost. This review presents a literature overview of BCC from pathophysiology to novel therapeutic approaches. Several histopathological BCC subtypes with different prognostic values have been described. Dermoscopy and, more recently, reflectance confocal microscopy have largely improved BCC diagnosis. Although surgery is the first-line treatment for localized BCC, other nonsurgical local treatment options are available. BCC pathogenesis depends on the interaction between environmental and genetic characteristics of the patient. Specifically, an aberrant activation of Hedgehog signaling pathway is implicated in its pathogenesis. Notably, Hedgehog signaling inhibitors, such as vismodegib and sonidegib, are successfully used as targeted treatment for advanced or metastatic BCC. Furthermore, the implementation of prevention measures has demonstrated to be useful in the patient management.
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Affiliation(s)
- Luca Fania
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Correspondence:
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany;
| | - Roberto Morese
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Irene Campana
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Valeria Coco
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Romana Di Pietro
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Ricci
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Sabatino Pallotta
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Eleonora Candi
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Damiano Abeni
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Elena Dellambra
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
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Conforti C, Pizzichetta MA, Vichi S, Toffolutti F, Serraino D, Di Meo N, Giuffrida R, Deinlein T, Giacomel J, Rosendahl C, Gourhant JY, Zalaudek I. Sclerodermiform basal cell carcinomas vs. other histotypes: analysis of specific demographic, clinical and dermatoscopic features. J Eur Acad Dermatol Venereol 2020; 35:79-87. [PMID: 32401364 DOI: 10.1111/jdv.16597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/21/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Among the various types of basal cell carcinoma, the sclerodermiform variant has a high risk of recurrence and local invasiveness. A systematic description of the dermatoscopic features associated with specific body localization is lacking. OBJECTIVES To describe the clinical and dermoscopic features of sclerodermiform basal cell carcinoma (BCC) according to localization in the body confronting with superficial and nodular types. METHODS Clinical and dermoscopic images of sclerodermiform, nodular and superficial BCCs were retrospectively evaluated to study the location in the various body districts, maximum diameter, clinical appearance of the lesion, features of edges and presence or absence of specific dermatoscopic criteria of BCCs. RESULTS We examined 291 histopathologically proven BCCs showing that in nodular BCCs, classical arborizing vessels were more frequently found in the body macro-area (trunk and limbs; n = 46, 97.9%) than in the head/neck area (n = 43, 82.7%); within sclerodermiform BCCs, short arborizing vessels were found more frequently in the head/neck district (n = 35, 49.3%) than in the body (n = 6, 23.1%; P-value 0.02); within nodular BCCs, multiple blue-grey dots and globules were more frequently found on the trunk (n = 23, 48.9%) than in the head/neck district (n = 12, 23.1%; P-value 0.01). In sclerodermiform BCCs, ulceration was found more frequently in the head/neck district (n = 38, 53.5%) than in the body (n = 4, 15.4%; P-value > 0.01), and in superficial BCCs, ulceration was found more frequently in the head/neck district (n = 5, 38.5%) than in the body (n = 8, 9.8%; P-value 0.02). CONCLUSION Our study shows that superficial BCC are found frequently in the head/neck district dermoscopically characterized by ulceration and arborizing vessels; nodular BCCs are more frequently found in the body than in the head/neck district, and the dermoscopic pattern is characterized by the combination of three features: (i) classical arborizing vessels, (ii) multiple blue-grey dots and (iii) globules. Instead, sclerodermiform BCC is preferentially located in areas at high-moderate risk of recurrence; if pink-white areas and/or fine arborizing vessels are seen, clinicians should consider this diagnosis. Furthermore, location-specific dermatoscopic criteria have been described.
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Affiliation(s)
- C Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - M A Pizzichetta
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy.,Department of Medical Oncology-Preventive Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - S Vichi
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - F Toffolutti
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - D Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano, IRCCS, Aviano, Italy
| | - N Di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - R Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology Section, University of Messina, Messina, Italy
| | - T Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - J Giacomel
- Skin Spectrum Medical Services, Como, WA, Australia
| | - C Rosendahl
- School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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25
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Kaminska-Winciorek G, Zalaudek I, Wozniak Z, Baglaj M. An unusual case of compound naevus of the scalp with hair greying, suggesting melanoma in dermoscopy. Postepy Dermatol Alergol 2020; 37:274-6. [PMID: 32489367 DOI: 10.5114/ada.2020.94848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/25/2020] [Indexed: 11/24/2022] Open
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26
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Dika E, Patrizi A, Veronesi G, Manuelpillai N, Lambertini M. Malignant cutaneous tumours of the scalp: always remember to examine the head. J Eur Acad Dermatol Venereol 2020; 34:2208-2215. [DOI: 10.1111/jdv.16330] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022]
Affiliation(s)
- E. Dika
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - A. Patrizi
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - G. Veronesi
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - N. Manuelpillai
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - M. Lambertini
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
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Neagu N, Lallas K, Maskalane J, Salijuma E, Papageorgiou C, Gkentsidi T, Spyridis I, Morariu S, Apalla Z, Lallas A. Minimizing the dermatoscopic morphologic overlap between basal and squamous cell carcinoma: a retrospective analysis of initially misclassified tumours. J Eur Acad Dermatol Venereol 2020; 34:1999-2003. [DOI: 10.1111/jdv.16207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/31/2019] [Indexed: 01/05/2023]
Affiliation(s)
- N. Neagu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - K. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - J. Maskalane
- Postgraduate Study Program in Dermatology, Venereology University of Latvia Riga Latvia
| | - E. Salijuma
- Postgraduate Study Program in Dermatology, Venereology RigaStradiņš University Riga Latvia
| | - C. Papageorgiou
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - T. Gkentsidi
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - I. Spyridis
- First Department of Dermatology Aristotle University Thessaloniki Greece
| | - S.‐H. Morariu
- State Clinic of Dermatology Mureș County Hospital Tîrgu Mureș Romania
| | - Z. Apalla
- State Clinic of Dermatology Hippokration Hospital Thessaloniki Greece
| | - A. Lallas
- First Department of Dermatology Aristotle University Thessaloniki Greece
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Garcia-Souto F, Coronel-Perez IM, Sosa-Moreno F, Sanchez-Santos Y, Escudero-Ordoñez J. A Painless, Slow-growing Ulcer on the Scalp. Int J Trichology 2019; 11:223-225. [PMID: 31728107 PMCID: PMC6830033 DOI: 10.4103/ijt.ijt_54_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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29
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Reiter O, Mimouni I, Dusza S, Halpern AC, Leshem YA, Marghoob AA. Dermoscopic features of basal cell carcinoma and its subtypes: A systematic review. J Am Acad Dermatol 2021; 85:653-64. [PMID: 31706938 DOI: 10.1016/j.jaad.2019.11.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/07/2019] [Accepted: 11/04/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results. OBJECTIVE To systematically review the prevalence of dermoscopic structures in BCC and its subtypes. METHODS Databases and reference lists were searched for relevant trials according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for the relative proportion of BCC dermoscopic features. Random-effects models were used to estimate summary effect sizes. RESULTS Included were 31 studies consisting of 5950 BCCs. The most common dermoscopic features seen in BCC were arborizing vessels (59%), shiny white structures (49%), and large blue-grey ovoid nests (34%). Arborizing vessels, ulceration, and blue-grey ovoid nests and globules were most common in nodular BCC; short-fine telangiectasia, multiple small erosions, and leaf-like, spoke wheel and concentric structures in superficial BCC; porcelain white areas and arborizing vessels in morpheaform BCC; and arborizing vessels and ulceration in infiltrative BCC. LIMITATIONS Studies had significant heterogeneity. Studies reporting BCC histopathologic subtypes did not provide clinical data on pigmentation of lesions. CONCLUSION In addition to arborizing vessels, shiny white structures are a common feature of BCC. A constellation of dermoscopic features may aid in differentiating between BCC histopathologic subtypes.
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30
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Żychowska M. Dermoscopic rainbow pattern - now also in pyogenic granuloma. Int J Dermatol 2019; 59:369-370. [PMID: 31646626 DOI: 10.1111/ijd.14683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/01/2019] [Accepted: 09/10/2019] [Indexed: 11/26/2022]
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31
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Swoboda R, Kaminska-Winciorek G, Jaworska M, Giebel S. Dermoscopic follow-up of therapeutic response in mantle cell lymphoma with secondary involvement of the scalp. J Cosmet Dermatol 2019; 18:1438-1440. [PMID: 30520227 DOI: 10.1111/jocd.12826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 10/31/2018] [Indexed: 01/24/2023]
Abstract
The scalp is a potential location for both benign and malignant tumors. Lymphoproliferative diseases can involve the skin as a primary or secondary manifestation. Dermoscopy is a noninvasive diagnostic tool for rapid diagnosis, screening, and follow-up of the majority of skin tumors. Mantle cell lymphoma (MCL), a rare type of aggressive systemic lymphoma, usually occurs as a generalized lymphadenopathy, commonly with infiltration of the bone marrow, spleen, gastrointestinal tract, and Waldeyer's ring. In rare cases, it can also involve other structures, such as the lungs, central nervous system, liver, or skin. We report the case of a 74-year-old male patient suffering from MCL since 2015. Complete remission was obtained after R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) treatment. During maintenance therapy with rituximab, a solitary tumor occurred on the scalp. Dermoscopy of the lesion suggested relapse because of the presence of multiple chaotically distributed short linear vessels with multiple red dots within the hair follicles. Histological examination confirmed the diagnosis of MCL. After second-line therapy with rituximab and bendamustine (R-B), the tumor of the scalp completely disappeared and dermoscopy showed no abnormalities.
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Affiliation(s)
- Ryszard Swoboda
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Grazyna Kaminska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Magdalena Jaworska
- The Department of Tumor Pathology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Sebastian Giebel
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
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Lee KJ, Soyer HP. Cutaneous keratinocyte cancers of the head and neck: Epidemiology, risk factors and clinical, dermoscopic and reflectance confocal microscopic features. Oral Oncol 2019; 98:109-117. [PMID: 31585338 DOI: 10.1016/j.oraloncology.2019.09.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/18/2019] [Indexed: 01/13/2023]
Abstract
Keratinocyte cancers are the most common malignancy among people with European ancestry, and are very common on sun-exposed areas of the head and neck. Incidence is directly correlated with latitude and annual ultraviolet radiation incidence, although there are a number of other environmental, occupational and genetic risk factors, and keratinocyte cancers become more common at middle age. Basal cell carcinomas (BCC) are the most common, comprising 80% of keratinocyte cancers, but have a very low rate of metastases and low mortality. Squamous cell carcinomas (SCC) make up 20% of keratinocyte cancers, and have relatively infrequent metastases, at 5-16%. While there are no precursor lesions for BCC, SCC represents the final stage in a spectrum of cellular atypia and dysplasia, from actinic keratoses to in situ SCC to invasive SCC. Dermoscopy is a well-established diagnostic tool for keratinocyte cancers, and reflectance confocal microscopy is emerging as another useful diagnostic tool, particularly on functionally and cosmetically sensitive sites like the face.
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Affiliation(s)
- Katie J Lee
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, Australia; Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia.
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Peris K, Fargnoli MC, Garbe C, Kaufmann R, Bastholt L, Seguin NB, Bataille V, Marmol VD, Dummer R, Harwood CA, Hauschild A, Höller C, Haedersdal M, Malvehy J, Middleton MR, Morton CA, Nagore E, Stratigos AJ, Szeimies RM, Tagliaferri L, Trakatelli M, Zalaudek I, Eggermont A, Grob JJ. Diagnosis and treatment of basal cell carcinoma: European consensus–based interdisciplinary guidelines. Eur J Cancer 2019; 118:10-34. [DOI: 10.1016/j.ejca.2019.06.003] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
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Paoli J, Gyllencreutz JD, Fougelberg J, Backman EJ, Modin M, Polesie S, Zaar O. Nonsurgical Options for the Treatment of Basal Cell Carcinoma. Dermatol Pract Concept 2019; 9:75-81. [PMID: 31106008 DOI: 10.5826/dpc.0902a01] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2018] [Indexed: 01/04/2023] Open
Abstract
Objectives The aim of this review article is to summarize the effectiveness, potential adverse events, and indications of the main nonsurgical treatment alternatives for basal cell carcinoma. Methods An extensive literature review was carried out. The most relevant articles were discussed and selected by the authors in order to provide a brief but evidence-based overview of the most common nonsurgical methods used for treating basal cell carcinoma. Results Although surgery and Mohs micrographic surgery are often considered the optimal treatment options for basal cell carcinoma, these tumors can also be treated successfully with destructive techniques (eg, curettage alone, cryosurgery, or electrodesiccation), photodynamic therapy, topical drugs (eg, 5-fluorouracil, imiquimod, or ingenol mebutate), radiotherapy, or hedgehog pathway inhibitors. When choosing between these alternatives, physicians must take into consideration the tumor's size, location, and histopathological subtype. Special care should be taken when treating recurrent tumors. Furthermore, physician experience is of great importance when using destructive techniques. Finally, patient preference, potential adverse events, and cosmetic outcome should also be considered. Conclusions Dermatologists and physicians treating basal cell carcinoma should have knowledge of and experience with the large arsenal of therapeutic alternatives available for the successful, safe, and individualized management of patients with basal cell carcinoma.
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Affiliation(s)
- John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | | | - Julia Fougelberg
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Eva Johansson Backman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Maja Modin
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Sam Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Oscar Zaar
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
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35
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Yélamos O, Braun RP, Liopyris K, Wolner ZJ, Kerl K, Gerami P, Marghoob AA. Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019; 80:341-363. [DOI: 10.1016/j.jaad.2018.07.073] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/01/2018] [Accepted: 07/04/2018] [Indexed: 12/21/2022]
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Castanheira A, Soares P, Boaventura P. Scalp basal cell carcinoma: A different entity? Dermatol Ther 2019; 32:e12828. [PMID: 30659714 DOI: 10.1111/dth.12828] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/17/2018] [Accepted: 01/15/2019] [Indexed: 11/28/2022]
Abstract
Basal cell carcinoma is the most frequent malignant neoplasm in white-skinned individuals. It develops in different body areas, including in the scalp, which is a unique anatomical region due to the high number of pilosebaceous follicles; the scalp is protected from UV exposure, a main risk factor for basal cell carcinoma development. Moreover, scalp basal cell carcinoma has been described as more aggressive and difficult to treat than other forms of basal cell carcinoma. In this study, we reviewed the clinical and pathological characteristics, risk factors, genetics, and treatment options for scalp basal cell carcinoma to better understand this special type of cancer. Even though it is not yet clear whether scalp basal cell carcinomas represent a different entity, it seems important to give them special attention due to their potential aggressiveness, invasion capacities, tendency to relapse, and treatment difficulties.
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Affiliation(s)
- António Castanheira
- Department of Otorhinolaryngology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Paula Soares
- Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal.,IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Paula Boaventura
- Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal.,IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Peccerillo F, Mandel V, Di Tullio F, Ciardo S, Chester J, Kaleci S, de Carvalho N, Del Duca E, Giannetti L, Mazzoni L, Nisticò S, Stanganelli I, Pellacani G, Farnetani F. Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy. Dermatology 2018; 235:35-44. [DOI: 10.1159/000493727] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022] Open
Abstract
Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p < 0.001), tumor islands located in the epidermis (100%, p < 0.001), smaller vascular diameter (100%, p < 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p < 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p < 0.001) with a larger vascular diameter (50%, p < 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
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Papageorgiou C, Apalla Z, Variaah G, Matiaki FC, Sotiriou E, Vakirlis E, Lazaridou E, Ioannides D, Lallas A. Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease. J Eur Acad Dermatol Venereol 2018; 32:1914-1919. [PMID: 29633377 DOI: 10.1111/jdv.14995] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The dermoscopic features of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) have been extensively investigated, and dermoscopy was shown to significantly improve their recognition. However, incorrectly diagnosed cases still exist, with a considerable number of sBCCs dermoscopically interpreted as BD. Our aim was to investigate the dermoscopic variability in sBCC and BD on different anatomic sites, to identify potent dermoscopic predictors for each diagnosis and to investigate the potential source of the inaccurate clinico-dermoscopic diagnosis of some sBCCs. METHODS Dermoscopic images of histopathologically diagnosed sBCC and BD were evaluated by three independent investigators for the presence of predefined criteria. Subsequently, three independent investigators with expertise in dermoscopy classified the tumours as sBCC or BD based on the dermoscopic image. Diagnostic accuracy scores were calculated and crude and adjusted odds ratios, and 95% confidence intervals were calculated by univariate and conditional multivariate logistic regression, respectively. RESULTS A total of 283 lesions were included in the study (194 sBCCs and 89 BD). The main dermoscopic predictors of BD were dotted vessels (7.5-fold) and glomerular vessels (12.7-fold). The presence of leaf-like areas/spoke-wheel areas/concentric structures (OR = 0.027) and arborizing vessels (OR = 0.065) has predicted sBCC. Multivariate risk factors for sBCC misclassification were the location on lower extremities (OR = 5.5), the presence of dotted vessels (OR = 59.5) and the presence of large ulceration (OR = 6.4). In contrast, the presence of brown-coloured pigmentation was a protective predictor for misdiagnosis (OR = 0.007). Finally, a subgroup analysis of lesions located on lower extremities revealed two additional potent predictors of sBCC: superficial fine telangiectasia (SFT) and whity shiny blotches/strands. CONCLUSIONS Dotted and glomerular vessels are strong predictors of BD. When located on the lower extremities, sBCC may also display dotted vessels, rendering its recognition problematic. On the latter anatomic site, clinicians should consider SFT and whity shiny blotches/strands as additional sBCC predictors.
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Affiliation(s)
- C Papageorgiou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - G Variaah
- Department of Dermatology & Venereology, Medical University, Pleven, Bulgaria
| | - F C Matiaki
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Sotiriou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Vakirlis
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- Second Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
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Affiliation(s)
- Christine Maria Prodinger
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Josef Koller
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Martin Laimer
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
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40
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Prodinger CM, Koller J, Laimer M. Tumoren der Kopfhaut. J Dtsch Dermatol Ges 2018; 16:730-754. [DOI: 10.1111/ddg.13546_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Christine Maria Prodinger
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Josef Koller
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Martin Laimer
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
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41
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Affiliation(s)
- Nicola Di Meo
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Paola Corneli
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy -
| | | | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
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Abstract
Dermoscopy is widely used in dermatological practice. The method increases the accuracy of basal cell carcinoma (BCC) detection. Pigmented and nonpigmented variants of basal cell carcinoma present different dermoscopic features. Specific dermoscopy criteria have been recognized in different subtypes of BCC. Differentiation of superficial BCC from other subtypes is the most important issue, as it may determine further management decisions.
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Affiliation(s)
- A Wozniak-Rito
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - I Zalaudek
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.,Department of Neuropeptides, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
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Wolner ZJ, Bajaj S, Flores E, Carrera C, Navarrete-Dechent C, Dusza SW, Rabinovitz HS, Marchetti MA, Marghoob AA. Variation in dermoscopic features of basal cell carcinoma as a function of anatomical location and pigmentation status. Br J Dermatol 2018; 178:e136-e137. [PMID: 28886224 DOI: 10.1111/bjd.15964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Z J Wolner
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
| | - S Bajaj
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
| | - E Flores
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
| | - C Carrera
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A.,Dermatology Service, Melanoma Unit, Hospital Clínic Barcelona, CIBERER, University of Barcelona, Barcelona, Spain
| | - C Navarrete-Dechent
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A.,Melanoma and Skin Cancer Unit, Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - S W Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
| | - H S Rabinovitz
- Pigmented Lesion Clinic of Skin and Cancer Associates, Plantation, FL, U.S.A
| | - M A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
| | - A A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, U.S.A
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Couzan C, Cinotti E, Labeille B, Vercherin P, Rubegni P, Cambazard F, Perrot JL. Reflectance confocal microscopy identification of subclinical basal cell carcinomas during and after vismodegib treatment. J Eur Acad Dermatol Venereol 2017; 32:763-767. [PMID: 29055164 DOI: 10.1111/jdv.14650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/09/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Recently, it has been shown that reflectance confocal microscopy (RCM) could identify subclinical basal cell carcinoma (BCC) during vismodegib treatment of locally advanced BCC. OBJECTIVES To evaluate specificity and sensitivity of clinical, dermoscopic and RCM examination for BCC in patients with multiple BCCs treated by vismodegib. METHODS Ninety four BCCs had 710 clinical, dermoscopic and RCM examinations during 72 weeks of vismodegib treatment. Thirty-eight were biopsied at the end of the treatment. Sensitivity and specificity for these 38 lesions were calculated. BCC diagnoses of clinical, dermoscopic and RCM examination on all the 710 investigations were compared using chi-square test. RESULTS Reflectance confocal microscopy was extremely more sensitive than dermoscopy and clinical examination and slightly less specific (sensitivity of 95%, 35% and 33% and specificity of 81%, 88% and 86% for RCM, dermoscopy and clinical examination, respectively) for the identification of residual BCC in the 38 biopsied cases. Considering all the 710 observations, RCM correctly diagnosed more BCCs than dermoscopy and clinical examination. CONCLUSION Reflectance confocal microscopy is a non-invasive technique that can detect subclinical residual BCC during and after vismodegib treatment helping the clinician to identify incomplete tumour regression.
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Affiliation(s)
- C Couzan
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - E Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - B Labeille
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - P Vercherin
- Service de Santé Publique et de l'Information Médicale, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - P Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - F Cambazard
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - J L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
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Cheng HM, Lo S, Scolyer R, Meekings A, Carlos G, Guitera P. Accuracy of optical coherence tomography for the diagnosis of superficial basal cell carcinoma: a prospective, consecutive, cohort study of 168 cases. Br J Dermatol 2016; 175:1290-1300. [PMID: 27146027 DOI: 10.1111/bjd.14714] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Superficial basal cell carcinoma (sBCC) can be safely treated topically. Potentially noninvasive imaging techniques, such as optical coherence tomography (OCT), may be useful to diagnose and manage patients with sBCC and obviate the need for biopsy. OBJECTIVES To evaluate in OCT (i) the sensitivity and specificity for sBCC diagnosis, (ii) the accuracy in determining BCC depth and (iii) the role in management of sBCC mimickers. METHODS A prospective, consecutive cohort of lesions for which sBCC was considered in the differential diagnosis. These lesions underwent clinical, dermoscopic and OCT assessment. Diagnosis and its confidence were recorded for each modality and were correlated with the histopathological diagnosis (punch biopsy). Interpretation of the OCT images and assessment of individual features were performed blinded to the biopsy results. RESULTS In total, 168 lesions were recruited: 52% were sBCC, 26% were other BCC variants and the remaining lesions were actinic keratosis, squamous cell carcinoma in situ, other benign inflammatory processes and two other malignant tumours. The sensitivity and specificity of OCT for diagnosis of sBCC were 0·87 and 0·80, respectively. There was excellent correlation between OCT and biopsy for tumour depth amongst tumours ≤ 0·4 mm (Pearson correlation r = 0·86, P < 0·001), but the correlation was less as depth increased (Pearson correlation r = 0·71, P < 0·001 for all tumours < 1·0 mm). CONCLUSIONS OCT has good diagnostic accuracy for diagnosing sBCC and measuring depth in tumours ≤ 0·4 mm. Potentially OCT can reduce the need for biopsy in clinically suspected sBCCs. However, careful follow-up is required in such cases as there is a small risk (5%) of misdiagnosis.
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Affiliation(s)
- H M Cheng
- Melanoma Institute Australia, North Sydney, NSW, Australia.,University of Sydney, Sydney Medical School, Sydney, NSW, Australia
| | - S Lo
- Melanoma Institute Australia, North Sydney, NSW, Australia.,University of Sydney, Sydney Medical School, Sydney, NSW, Australia
| | - R Scolyer
- Melanoma Institute Australia, North Sydney, NSW, Australia.,University of Sydney, Sydney Medical School, Sydney, NSW, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - A Meekings
- Guy's and St Thomas' NHS Foundation Trust, Department of Medical Physics, London, U.K
| | - G Carlos
- Melanoma Institute Australia, North Sydney, NSW, Australia.,University of Sydney, Sydney Medical School, Sydney, NSW, Australia
| | - P Guitera
- Melanoma Institute Australia, North Sydney, NSW, Australia.,University of Sydney, Sydney Medical School, Sydney, NSW, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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Imbernón-Moya A, Sidro M, Malvehy J, Puig S. Negative maple-leaf-like areas: a new clue for basal cell carcinoma margin recognition. Br J Dermatol 2016; 175:818-20. [DOI: 10.1111/bjd.14620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Imbernón-Moya
- Dermatology Department; Hospital Severo Ochoa; Leganés Madrid Spain
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
| | - M. Sidro
- Hospital del Espiritu Santo; Santa Coloma de Gramenet; Barcelona Spain
| | - J. Malvehy
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
- Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Instituto de Salud Carlos III (ISCIII); Barcelona Spain
- Departament de Medicina; Universitat de Barcelona; Barcelona Spain
| | - S. Puig
- Melanoma Unit; Dermatology Department; Hospital Clínic & IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer); Barcelona Spain
- Centro Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Instituto de Salud Carlos III (ISCIII); Barcelona Spain
- Departament de Medicina; Universitat de Barcelona; Barcelona Spain
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47
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Boone M, Suppa M, Miyamoto M, Marneffe A, Jemec G, Del Marmol V. In vivo assessment of optical properties of basal cell carcinoma and differentiation of BCC subtypes by high-definition optical coherence tomography. Biomed Opt Express 2016; 7:2269-84. [PMID: 27375943 PMCID: PMC4918581 DOI: 10.1364/boe.7.002269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/15/2016] [Accepted: 05/15/2016] [Indexed: 05/11/2023]
Abstract
High-definition optical coherence tomography (HD-OCT) features of basal cell carcinoma (BCC) have recently been defined. We assessed in vivo optical properties (IV-OP) of BCC, by HD-OCT. Moreover their critical values for BCC subtype differentiation were determined. The technique of semi-log plot whereby an exponential function becomes linear has been implemented on HD-OCT signals. The relative attenuation factor (µraf ) at different skin layers could be assessed.. IV-OP of superficial BCC with high diagnostic accuracy (DA) and high negative predictive values (NPV) were (i) decreased µraf in lower part of epidermis and (ii) increased epidermal thickness (E-T). IV-OP of nodular BCC with good to high DA and NPV were (i) less negative µraf in papillary dermis compared to normal adjacent skin and (ii) significantly decreased E-T and papillary dermal thickness (PD-T). In infiltrative BCC (i) high µraf in reticular dermis compared to normal adjacent skin and (ii) presence of peaks and falls in reticular dermis had good DA and high NPV. HD-OCT seems to enable the combination of in vivo morphological analysis of cellular and 3-D micro-architectural structures with IV-OP analysis of BCC. This permits BCC sub-differentiation with higher accuracy than in vivo HD-OCT analysis of morphology alone.
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Affiliation(s)
- Marc Boone
- Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Belgium
| | - Mariano Suppa
- Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Belgium
| | - Makiko Miyamoto
- Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Belgium
| | - Alice Marneffe
- Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Belgium
| | - Gregor Jemec
- Department of Dermatology, Roskilde Hospital, University of Copenhagen, Denmark
| | - Veronique Del Marmol
- Department of Dermatology, Université Libre de Bruxelles, Hôpital Erasme, Belgium
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48
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Boone M, Suppa M, Pellacani G, Marneffe A, Miyamoto M, Alarcon I, Ruini C, Hofmann-Wellenhof R, Malvehy J, Jemec G, Del Marmol V. High-definition optical coherence tomography algorithm for discrimination of basal cell carcinoma from clinical BCC imitators and differentiation between common subtypes. J Eur Acad Dermatol Venereol 2015; 29:1771-80. [DOI: 10.1111/jdv.13003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 01/07/2015] [Indexed: 12/11/2022]
Affiliation(s)
- M.A.L.M. Boone
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - M. Suppa
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - G. Pellacani
- Department of Dermatology; University of Modena; Modena Italy
| | - A. Marneffe
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - M. Miyamoto
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
| | - I. Alarcon
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | - C. Ruini
- Department of Dermatology; University of Modena; Modena Italy
| | | | - J. Malvehy
- Department of Dermatology; University of Barcelona; Barcelona Spain
| | - G.B.E. Jemec
- Department of Dermatology; Health Sciences Faculty; Roskilde Hospital; University of Copenhagen; Roskilde Denmark
| | - V. Del Marmol
- Department of Dermatology; Université Libre de Bruxelles; Hôpital Erasme Brussels Belgium
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