Line-field confocal optical coherence tomography of basal cell carcinoma: a descriptive study.

BACKGROUND: Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT. OBJECTIVES: To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes. METHODS: Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes. RESULTS: Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules. CONCLUSIONS: This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.

Height, whole Body Surface Area, gender, working outdoors, and sunbathing in previous summer are important determinants of serum 25-hydroxyvitamin D levels.

OBJECTIVE: To investigate if serum 25-hydroxyvitamin D (25(OH)D) is related to the whole Body Surface Area (BSA), and to several other anthropometric and environmental factors. MATERIALS/METHODS: Serum 25(OH)D was determined in 489 apparently healthy subjects (346 women and 143 men, mean age 43.9 years) in April and May. From all subjects the following data were available: height, body weight, waist to hip ratio, BSA, BMI, environment of work (indoors vs. outdoors), habit of regularly sunbathing during previous summer(s), fear of sun, dwelling in city or village, and skin color. RESULTS: Approximately 43% of the participants had serum 25(OH)D levels between 10 and 20 ng/ml, 44% had values between 20.1 and 30 ng/ml, whereas about 5% had values below 10 ng/ml and only 9% had values above 30 ng/ml. There was a significant positive relationship between 25(OH)D, height and BSA, which was more pronounced for BSA in obese subjects even after adjustment for work outdoors and sunbathing during previous summer(s). Outdoor workers and sunbathers had higher 25(OH)D compared to indoor workers and non-sunbathers respectively. Men when compared to women had higher 25(OH)D regardless of BMI and this difference was apparently due to the fact that men were taller, had greater BSA, and worked more often outdoors. CONCLUSIONS: Height, whole BSA, gender, working outdoors and sunbathing in previous summer(s) proved to be significant determinants of serum 25(OH)D. Vitamin D status is higher in taller individuals with greater BSA, and in men when compared to women.