A Clinical and Histologic Study of Pigmented Basal Cell Carcinoma / 대한피부과학회지

ABSTRACT

BACKGROUND: Pigmented basal cell carcinoma(PBCC) is a clinical and histological variant of BCC, which is known to show better prognosis than non-PBCC. There has been no report about the PBCC among Korean patients. OBJECTIVE: Our purpose was to identify the clinical and histologic characteristics of PBCC and to determine whether this correlated with prognosis. METHODS: A clinical and histological survey was done with 62 lesions of 56 cases of PBCC that visited the Department of Dermatology, Presbyterian Medical Center during the last 10 years(1988 - 1998). Some results were then compared with results of non-PBCC. RESULTS: 1. The frequency of BCC in the total number of new outpatients was 0.34%, and 83.6% of BCC contained pigment histologically. 2. The male-female ratio was 1.241, and 92.9% of the patients with PBCC were older than the age of 40 years with the mean age of 62.9 years. 3. 88.7% of the PBCC occurred on the face, especially on the nose(38.7%), cheek(19.4%), and eyelid(17.7%). Clinically, most of the tumors were noduloulcerative(77.4%) and diffuse pigmentation was more common than dotted. 4. The most frequent histologic types were nodulocystic(43.6%) and mixed(43.6%) type followed by superficial(6.4%), micronodular(1.6%), adenoid (1.6%), infiltrative(1.6%), basosquamous(1.6%) types. Histologically 51.6% of the tumors were associated with ulceration, and 71% of the tumors were associated with infiltration of inflammatory cells. 5. Fontana-Masson stains showed pigment is melanin and it was found in both tumor nests and surrounding dermis in most cases(95.0%). Hypertrophic melanocytes with prominent dendrites were seen in the tumor nodule(77.8%) and in the normal epidermis overlying tumor(22.2%). 6. Margins were examined for evidence of residual tumor in 48 lesions that were excised. In 4 lesions(8.3%) were the margin positive for tumor. This was statistically not significant (p>0.05) compared with 10 excisions of non-PBCC in which 2(20%) showed positive margins. CONCLUSION: High incidence of PBCC is a characteristic feature in Korean patients, and PBCC showed better prognosis than non-PBCC because it is more frequently excised with adequate margins.