Dermoscopic Findings of Pigmented Basal Cell Carcinomas in Koreans

Jwa, Seung Wook; Kim, Moon Bum; Ko, Hyun Chang; Kim, Byung Soo; Kim, Sung Jun; Oh, Chang Keun; Kwon, Kyung Sool

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.