Usefulness of margin detection by digital dermoscopy in the traditional surgical excision of basal cell carcinomas of the head and neck including infiltrative/morpheaform type.

Incomplete or suboptimal surgical excision of basal cell carcinoma of the head and neck is a relatively frequent occurrence. Methods of preoperative assessment of tumoral margins are therefore of paramount importance. The aim of this study was to compare the preoperative evaluation of margins with digital dermoscopy and clinical definition. One hundred and 12 patients with histologically confirmed basal cell carcinoma were selected for surgical excision. Subsequently, the margin of excision was determined by either clinical (45 patients) or dermoscopic evaluation (67 patients). After pre-surgical clinical evaluation, 22% of histological specimens of excised basal cell carcinoma showed suboptimal margins of excision. Pre-surgical dermoscopic evaluation had only 7% suboptimal excision. Preoperative digital dermoscopy is a better method to determine tumoral margins than clinical evaluation alone. Indeed, preoperative digital dermoscopy is an effective, simple, non-invasive procedure for the pre-surgical determination of margins.