Dermatoscopy of basal cell carcinoma: Morphologic variability of global and local features and accuracy of diagnosis

Altamura, D., Menzies, S. W., Argenziano, G., Zalaudek, I., Soyer, H. P., Sera, F., Avramidis, M., DeAmbrosis, K., Fargnoli, M. C. and Peris, K. (2009) Dermatoscopy of basal cell carcinoma: Morphologic variability of global and local features and accuracy of diagnosis. Journal of the American Academy of Dermatology, 62 1: 67-75. doi:10.1016/j.jaad.2009.05.035

Author Altamura, D.
Menzies, S. W.
Argenziano, G.
Zalaudek, I.
Soyer, H. P.
Sera, F.
Avramidis, M.
DeAmbrosis, K.
Fargnoli, M. C.
Peris, K.
Title Dermatoscopy of basal cell carcinoma: Morphologic variability of global and local features and accuracy of diagnosis
Journal name Journal of the American Academy of Dermatology   Check publisher's open access policy
ISSN 0190-9622
Publication date 2009-10-13
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jaad.2009.05.035
Volume 62
Issue 1
Start page 67
End page 75
Total pages 9
Editor Bruce H. Thiers
Place of publication United States
Publisher Mosby Inc.
Language eng
Subject C1
920117 Skin and Related Disorders
110304 Dermatology
Abstract Background Early detection of basal cell carcinoma (BCC) is crucial to reduce the morbidity of this tumor. Objective We sought to investigate the variability and diagnostic significance of dermatoscopic features of BCCs. Methods We conducted retrospective dermatoscopic analysis of 609 BCCs and 200 melanocytic and nonmelanocytic lesions, and assessment of interrater reliability of dermatoscopic BCC criteria. Results Lesions included nonpigmented (15.1%), lightly pigmented (33.2%), pigmented (42.7%), and heavily pigmented (9%) BCCs. Classic BCC patterns including arborizing telangiectasia (57.1%), blue/gray ovoid nests (47.5%), ulceration (39.2%), multiple blue/gray globules (26.1%), leaflike areas (15.9%), and spoke-wheel areas (9%) were significantly increased in pigmented BCCs compared with nonpigmented and heavily pigmented BCCs (P = .0001). Among nonclassic BCC patterns, we detected short fine superficial telangiectasia (10%) and multiple small erosions (8.5%), and described two new patterns named “concentric structures” (7.6%) and “multiple in-focus blue/gray dots” (5.1%). Dermatoscopic features suggestive of melanocytic lesions (eg, multiple brown to black dots/globules, blue/white veillike structures, and nonarborizing vessels) were observed in 40.6% BCCs and significantly increased in heavily pigmented BCCs (P < .0001). Expert observers provided an accurate (sensitivity: 97%) and reliable (K: 87%) dermatoscopic diagnosis of BCC, although a significant difference in terms of specificity (P = .0002) and positive predictive value (P = .0004) was found. Arborizing telangiectasia, leaflike areas, and large blue/gray ovoid nests represented reliable and robust diagnostic parameters. Limitation The study was retrospective. Conclusion BCCs show a large spectrum of global and local dermatoscopic features; heavily pigmented BCCs show the most challenging combinations of dermatoscopic features.
Keyword Basal cell carcinoma
Early diagnosis of skin tumors
Nonmelanoma Skin Cancer (nmsc)
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 112 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 07 Feb 2010, 10:02:48 EST