Difference between pigmented and nonpigmented basal cell carcinoma treated with Mohs micrographic surgery

Area of Science:

• Dermatology
• Surgical Oncology
• Pathology

Background:

• Previous research characterized pigmented basal cell carcinoma (PBCC) and its histologic patterns.
• Limited studies have investigated the subclinical extension and surgical margins specific to PBCC.

Purpose of the Study:

• To prospectively analyze the surgical margins and subclinical extension of PBCC.
• To compare surgical outcomes between PBCC and nonpigmented basal cell carcinoma (NPBCC).

Main Methods:

• A prospective study included 345 Mohs micrographic surgery cases for basal cell carcinoma (BCC).
• 67 PBCC cases were identified and analyzed for patient demographics, lesion site, histology, tumor size, and surgical margin.
• Data on the number of stages for tumor clearance and pigment presence were collected.

Main Results:

• The mean surgical margin for PBCC was significantly smaller (3.89 mm) than for NPBCC (5.85 mm).
• This difference was more pronounced in lesions <2 cm and in nonaggressive histologic subtypes.
• Smaller margins were observed for PBCC in aggressive vs. nonaggressive histologic groups (3.13 mm vs. 5.01 mm).

Conclusions:

• PBCC necessitates smaller surgical margins for complete excision compared to NPBCC.
• Smaller tumors and nonaggressive histologic subtypes of PBCC particularly benefit from reduced margin requirements.
• Early-stage PBCC treatment involves less subclinical invasion and smaller surgical margins.