Dermoscopic Findings of Pigmented Basal Cell Carcinomas in Koreans / 대한피부과학회지

ABSTRACT

BACKGROUND: Pigmented basal cell carcinomas (PBCC) may be confused with melanoma and other benign pigmented skin lesions. Dermoscopy is a noninvasive technique that is known to increase the diagnostic accuracy of benign versus malignant pigmented skin lesions. Menzies et al recently proposed a simple dermoscopic model for the diagnosis of PBCCs. OBJECTIVE: To demonstrate whether this criteria was adequate for Korean PBCC patients and seek other characteristic dermoscopic findings in Korean PBCCs. METHODS: Dermoscopic images of 50 biopsy-proven PBCCs were examined. RESULTS: Negative features such as a pigment network were not observed in all PBCCs. Positive features-ulceration, large blue-gray ovoid nests, multiple blue-gray globules, maple leaf-like areas, spoke wheel areas and arborizing (treelike) telangiectasia were present in 39 (78.0%), 41 (82.0%), 33 (66.0%), 21 (42.0%), 1 (2.0%) and 32 (64.0%) of 50 PBCCs respectively. All PBCCs satisfied the dermoscopic criteria for diagnosis of PBCC suggested by Menzies et al. Other dermoscopic features were as follows; multiple blue-gray dots (28.0%), milia-like cysts (8.0%), granules (6.0%), diffuse blue-white area (6.0%) and hairpin vessels (2%). Forty-four % of lesions had less than 50% pigmentation of the area and 38.0% of lesions had more than 75% pigmentation. CONCLUSION: The criteria of PBCC proposed by Menzies et al was useful for dermoscopic diagnosis of Korean PBCCs. Ulceration and pigmentary features such as large blue-gray ovoid nests, multiple blue-gray globules, maple leaf-like areas, multiple blue-gray dots, granules and larger pigmented areas were more frequently observed in Korean PBCCs. However, other specific dermoscopic findings for diagnosis of PBCC in Koreans were not present.