Dermoscopic features in the diagnosis of different types of basal cell carcinoma: a prospective analysis

Hippokratia. 2012; 16(1):29-34

A. Trigoni, E. Lazaridou, Z. Apalla, E. Vakirlis, F. Chrysomallis, D. Varytimiadis, D. Ioannides


Background: There is limited data on dermoscopic features of basal cell carcinomas (BCCs). We evaluated the presence of dermoscopic features in superficial (sBCCs), nodular (nBCCs), pigmented and non-pigmented BCCs in order to evaluate the role of dermoscopy in the diagnosis of different subtypes of BCCs.
Patients and Methods: We conducted a retrospective study to evaluate the presence of dermoscopic features in superficial, nodular, pigmented and non – pigmented BCCs. One hundred thirty eight lesions (42 superficial, 96 nodular, 102 pigmented and 36 non-pigmented) were assessed by dermoscopy.
Results: The most significant features in all categories, were a scattered vascular pattern, featureless areas, atypical red vessels, arborizing vessels, comma vessels, background of white-red structureless areas and telangiectasias. Haemorrhage-ulceration, hypopigmented areas and blue-grey ovoid nests were all more likely to be observed in sBCCs, than in nBCCs (p < 0.0001). Arborizing and atypical red vessels in addition to featureless areas, were more frequent in nodular than in sBCCs (p < 0.0001). Telangectasias, white-red structureless areas, red dots and red globules were more common in non- pigmented than in pigmented BCCs (p < 0.0001). In addition, a significant difference of arborizing vessels was detected in pigmented lesions in comparison to non-pigmented (p < 0.0001).
Conclusions: Dermoscopic hallmarks of all BCCs may be the scattered atypical vessels, featureless areas and the whitered structureless background. Superficial BCCs are also characterized by comma vessels, haemorrhage, small ulcerations, hypopigmented areas, telangiectasias and blue-gray ovoid nests while nBCCs by arborizing vessels. Dermoscopy was found to be a valuable tool for the diagnosis of specific subtypes of BCCs.