Dermoscopy in the differential diagnosis of basal cell carcinoma: a preliminary study
10.3760/cma.j.issn.0412-4030.2013.07.009
- VernacularTitle:皮肤镜对基底细胞癌鉴别诊断价值的初步研究
- Author:
Weiwei LI
;
Ping TU
;
Shuxia YANG
;
Hang LI
;
Yang WANG
- Publication Type:Journal Article
- Keywords:
Dermoscopy;
Carcinoma,basal cell;
Diagnosis,differential
- From:
Chinese Journal of Dermatology
2013;46(7):480-484
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the application value of dermoscopy in the differential diagnosis of basal cell carcinoma (BCC).Methods Patients who underwent dermoscopic examination and had been definitely diagnosed by pathological examination in the Peking University First Hospital were enrolled in this study.In a blind study,dermoscopic images of 86 BCC lesions from 81 patients (case group) and 68 non-BCC hyperpigmented lesions with similar degree of hyperpigmentation and location from 61 patients (control group) were evaluated for features suggestive of BCC and melanocytic lesions.The diagnostic capability of dermoscopy in patients with BCC was evaluated by diagnostic test.Pathology served as the gold standard method for diagnosis.The frequency of features suggestive of melanocytic lesions was calculated in BCC lesions,and dermatoscopic findings were compared between heavily and lightly pigmented BCC lesions.Results The sensitivity,specificity,positive predictive value,negative predictive value of the classic dermoscopic pattern for the diagnosis of BCC were 98.84％,89.71％,92.39％,98.39％ respectively,with a Youden index of 0.88.The coincidence rate was 94.81％ between pathologic and microscopic diagnosis.Pigment network,multiple brown to black globules/dots,pigmentation around hair follicle openings were observed more frequently in melanocytic lesions compared with BCC lesions (all P ＜0.05).Blue-whitish veil-like structures were observed in 61.63％ of the BCC lesions.The presence of blue-black blotch and blue-whitish veil-like structures was significantly more frequent in heavily pigmented BCC lesions than in lightly pigmented BCC lesions (both P ＜0.01).Conclusions The classic dermoscopic pattern of BCC shows a favorable diagnostic capacity in Chinese population.Large-scale studies are needed to estimate the value of some features proposed in this study,such as peripheral pigment in palisade arrangement,peripheral hyperpigmentation and hypo-or hyperpigrnentation around hair follicle openings,in the differential diagnosis of pigmented diseases.
