Aimilios Lallas1, Thrassivoulos Tzellos2, Athanasios Kyrgidis3, Zoe Apalla2, Iris Zalaudek4, Athanasios Karatolias5, Gerardo Ferrara6, Simonetta Piana7, Caterina Longo8, Elvira Moscarella8, Alexander Stratigos9, Giuseppe Argenziano8. 1. Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy. Electronic address: emlallas@gmail.com. 2. State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece. 3. Department of Otolaryngology Head and Neck Surgery, Medical School, Aristotle University, Thessaloniki, Greece. 4. Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy; Department of Dermatology, Medical University of Graz, Graz, Austria. 5. Private practice, Volos, Greece. 6. Anatomic Pathology Unit, Department of Oncology, Gaetano Rummo General Hospital, Benevento, Italy. 7. Pathology Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy. 8. Skin Cancer Unit, Arcispedale Santa Maria Nuova (IRCCS), Reggio Emilia, Italy. 9. Department of Dermatology, Medical School, University of Athens, Andreas Sygros Hospital, Athens, Greece.
Abstract
BACKGROUND: The management of basal cell carcinoma (BCC) depends, among other factors, on its histopathologic subtype. Although dermoscopic criteria of BCC have been investigated, the possible role of dermoscopy in predicting the tumor subtype remains unclear. OBJECTIVES: We sought to assess the diagnostic accuracy of dermoscopic criteria for differentiating superficial BCC (sBCC) from other BCC subtypes. METHODS: Dermoscopic images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver operating characteristic curves. RESULTS: In all, 77 sBCCs and 258 non-sBCCs were included. Maple leaf-like areas, short fine superficial telangiectasia, multiple small erosions, and shiny white-red structureless areas were potent predictors of sBCC, each making its diagnosis over 5-fold more likely. Conversely, the presence of arborizing vessels, blue-gray ovoid nests, and ulceration gave 11-fold, 15-fold, and 3-fold increased possibility for the diagnosis of non-sBCCs, respectively. Based on the results of the multivariate analysis, we propose a diagnostic algorithm that can predict the diagnosis of sBCC with a sensitivity of 81.9% and a specificity of 81.8%. LIMITATIONS: The retrospective design and the inclusion of only Caucasian patients are limitations. CONCLUSION: Dermoscopy is reliable in differentiating sBCC from other BCC subtypes.
BACKGROUND: The management of basal cell carcinoma (BCC) depends, among other factors, on its histopathologic subtype. Although dermoscopic criteria of BCC have been investigated, the possible role of dermoscopy in predicting the tumor subtype remains unclear. OBJECTIVES: We sought to assess the diagnostic accuracy of dermoscopic criteria for differentiating superficial BCC (sBCC) from other BCC subtypes. METHODS: Dermoscopic images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver operating characteristic curves. RESULTS: In all, 77 sBCCs and 258 non-sBCCs were included. Maple leaf-like areas, short fine superficial telangiectasia, multiple small erosions, and shiny white-red structureless areas were potent predictors of sBCC, each making its diagnosis over 5-fold more likely. Conversely, the presence of arborizing vessels, blue-gray ovoid nests, and ulceration gave 11-fold, 15-fold, and 3-fold increased possibility for the diagnosis of non-sBCCs, respectively. Based on the results of the multivariate analysis, we propose a diagnostic algorithm that can predict the diagnosis of sBCC with a sensitivity of 81.9% and a specificity of 81.8%. LIMITATIONS: The retrospective design and the inclusion of only Caucasian patients are limitations. CONCLUSION: Dermoscopy is reliable in differentiating sBCC from other BCC subtypes.
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