Dermoscopic features in different morphologic types of basal cell carcinoma

Many different phenotypic presentations of basal cell carcinoma (BCC) are possible.

This study aims to highlight the similarities and differences in dermoscopic features between different morphologic types of BCC.

A prospective observational study was performed using contact polarized dermoscopy to evaluate the presence of various dermoscopic features. Images were evaluated for a range of dermoscopic colors, structures, and vessels. Features were compared according to the histopathologic subtype.

Of the 151 BCCs, 39.7% were nodular, 37.7% superficial, 13.9% ulcerated, 3.97% pigmented, 2.65% morpheaform, and 1.99% infiltrative BCCs. The dermoscopic features that showed a highly significant difference (p < .001) in distribution between various histologic groups were large blue-gray ovoid nests, leaf-like areas, arborizing vessels, short fine telangiectasias, annular distribution of telangiectatic vessels, structureless hypopigmentation, annular hypopigmentation, translucency, multiple erosions, and ulceration. A significant difference (p < .05) between evaluated groups was found in structureless hyperpigmentation, arborizing microvessels, milky red background, and pigment network.

The results of the study indicate that the combination of relevant dermoscopic features in different morphologic types of BCC depends on the thickness of the tumor, and not on its histologic nature. In addition, dermoscopy was shown to be not particularly useful in identifying which BCCs are more aggressive.