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Soo Park, MD
Soo Park, MD
Posted: Monday, September 16, 2024
Hannah Ceder, MD, of Sahlgrenska University Hospital, Gothenburg, Sweden, and colleagues aimed to determine whether dermoscopic and clinical criteria may predict subtypes of facial basal cell carcinoma. The investigators’ overarching goal was to develop a diagnostic algorithm capable of predicting high-risk histopathologic subtypes of basal cell carcinoma, with an eye toward fewer inappropriate treatments and incomplete excisions. The results of their trial were published in Dermatology Practical & Conceptual.
“Integration of both clinical and dermoscopic features are essential to improve subtype prediction of facial basal cell carcinomas and management decisions,” concluded the study authors. “It is desirable to develop simple preoperative methods that help [physicians] in identifying these high-risk tumors. Therefore, our clinical algorithm is relevant and important.”
This retrospective study enrolled six independent readers to evaluate predefined dermoscopic and clinical criteria in 297 images of primary facial basal cell carcinomas that were verified by histology. Criteria included vessels; ulceration; topography; shiny, white blotches and strands; pigmented structures and vessels within ulceration; and border demarcation.
High-risk subtypes appeared to be associated with features such as ill-defined borders (odds ratio [OR] = 3.4), vessels within ulceration (OR = 3.1), “bumpy” topography (OR = 3.8), and white porcelain area (OR = 3.5). Additionally, predominantly focused vessels appeared to represent a positive diagnostic criterion for either high-risk (OR = 2.0) or nodular (OR = 1.7) subtypes, as well as a strong diagnostic criterion for superficial basal cell carcinoma (OR = 14.0). Of note, the diagnostic algorithm established from these findings yielded a sensitivity and specificity to predict a high-risk subtype of basal cell carcinoma of 81.4% and 53.3%, respectively.
Disclosure: Disclosure information was not provided.
Dermatology Practical & Conceptual
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