Application of high-frequency ultrasound and dermoscopy in precise preoperative evaluation of basal cell carcinoma
- VernacularTitle: 皮肤高频超声和皮肤镜在基底细胞癌术前精确评估中的应用
- Author:
Shiqi WANG
1
;
Jie LIU
1
;
Qingli ZHU
2
;
Chenyang ZHAO
2
;
Tao QU
1
;
Hongzhong JIN
1
Author Information
- Publication Type:Case Reports
- Keywords: Carcinoma, basal cell; Ultrasonography; Dermoscopy; Neoplasm recurrence, local; Preoperative evaluation
- From: Chinese Journal of Dermatology 2020;53(1):51-55
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the application value of ultrasound and dermoscopy in the precise preoperative evaluation of basal cell carcinoma (BCC) , and to analyze the association of high-frequency ultrasound and dermoscopic findings with pathological recurrence risk of BCC.
Methods:Clinical data were collected from 33 outpatients with confirmed BCC in the Department of Dermatology, Peking Union Medical College Hospital between April 2016 and December 2018, and high-frequency ultrasonographic and dermoscopic findings from 36 BCC lesions were analyzed. The lesions were classified into high-risk and low-risk groups based on pathological findings. Statistical differences in ultrasound and dermoscopic characteristics between high-risk and low-risk BCC groups were analyzed by using Fisher′s exact test, and the correspondence between high-frequency ultrasonographic and dermoscopic features of BCC was analyzed by calculating the simple matching coefficient.
Results:Of the 36 BCC skin lesions, 4 were high-risk lesions and 32 were low-risk lesions. Ultrasonographic features of the high-risk and low-risk lesions overlapped markedly, and no significant differences were observed between the high-risk and low-risk lesions with regard to the shape, boundary, internal echo, hyperechoic spots, or posterior echo (allP > 0.05) . However, 24 (75.0%) low-risk lesions were confined to the dermis, whereas 4 high-risk lesions involved the subcutaneous tissue, and there was a significant difference between the high-risk and low-risk BCC groups with regard to the distribution of BCC (P = 0.008) . In 5 BCC lesions, ultrasound could identify small easy-to-ignore lesions or deep and invisible lesions besides obvious lesions. There were no significant differences in dermoscopic features between high-risk and low-risk groups. However, none of spoke-wheel area, milky-red structureless area, milia-like cysts, comedo-like openings and rainbow pattern was observed in 4 high-risk BCC lesions. The simple matching coefficient between enhanced hyperechoic spots in the lesion observed by ultrasound and milia-like cysts under a dermoscope was 36.1%, and the simple matching coefficient between discontinuous hyperechoic echo in the epidermis on ultrasonography and ulcer/erosion under a dermoscope was 75.0%.
Conclusion:High-frequency ultrasound and dermoscopy both provide important information for preoperative evaluation of risk of BCC lesions, and high-frequency ultrasound can identify easy-to-ignore hidden lesions in clinical practice.
