The Evaluation of Dermoscopic Findings in Basal Cell Carcinoma

Introduction: Many surface microscopy features of pigmented BCCs have been described. The purpose of this study was to review dermoscopic findings of BCC and to investigate their incidence in different dermatopathological subtypes. Material and Methods: Dermoscopic examination of 130 skin lesions in 113 patients with the preliminary diagnosis of BCC, without knowledge of the dermatopathological diagnosis was performed. For all lesions, macroscopic clinical photographs and documentation of the dermoscopic findings were performed. Routine biopsy procedures were carried out and haematoxylin and eosin stained sections were examined for dermatopathologic diagnosis and evalulation of dermatopathologic subtypes. Results: Preoperative diagnostic accuracy rate of dermoscopy in the diagnosis of BCC was found to be 95.3%. A total of 14 morphological dermoscopic criteria were identified. The most common dermoscopic finding was vascular structures (87.7%) with arborising vessels (78%). Vascular structures and ulceration were observed in all dermatopathological subtypes but except fibrosing BCC. Blue globules, mapple leaf like pattern, blue-gray ovoid nests and blue-grey areas were more commonly seen in pigmented BCC. Comedo like openings without a collision of seborrheic keratosis was observed in 3,2% of the BCCs which was not reported in association with BCC, previously. Conclusions: In our study dermoscopy maintained 95.3% preoperative diagnostic accuracy rate in BCC. In this way dermoscopy hinders unnecessary surgical procedures which might be carried out. Our study indicated that the six morphological findings that had already been reported for pigmented BCC can be seen in other dermatopathologic subtypes as well.