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Clinical-Dermoscopic Profile of Infiltrative Basal Cell Carcinoma: A Potential Diagnostic Tool

By: Julia Fiederlein
Posted: Monday, March 22, 2021

Caterina Longo, MD, PhD, of the University of Modena and Reggio Emilia, Italy, and colleagues defined clinical and dermoscopic criteria to differentiate infiltrative basal cell carcinoma from the more common, less aggressive superficial and nodular diseases. The profile constructed during this retrospective analysis was published in Frontiers in Oncology.  

“The definition of a specific dermoscopic profile for infiltrative, superficial, and nodular basal cell carcinoma allowed external readers to increase their diagnostic accuracy in differentiating these histotypes after being provided with our study results. In particular, they were able to correctly identify a higher number of infiltrative basal cell carcinomas, with a reduction of infiltrative basal cell carcinomas misdiagnosed as superficial or nodular basal cell carcinomas,” the investigators commented. “In clinical practice, this would improve presurgical recognition of infiltrative basal cell carcinoma, allowing the surgeon to keep wider margins and reducing the risk of recurrence.”

Two dermoscopists evaluated clinical and dermoscopic images of basal cell carcinomas from the digital databases of the University of Modena and Reggio Emilia; they were blinded for the histologic subtype. The investigators performed pairwise comparisons and constructed multivariable logistic regression models to define the factors independently associated with each subtype. Two additional dermoscopists evaluated images from an external data set before and after being provided with the study results to validate their findings. A total of 481 basal cell carcinomas (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were assessed.

Infiltrative basal cell carcinoma most frequently appeared on the head and neck as an amelanotic hypopigmented plaque or papule. The infiltrative disease commonly displayed ulceration and a mix of arborizing and superficial fine telangiectasia based on the dermoscopic examination. Shiny, white structures, such as short white streaks and red-white structureless areas, were also frequently observed. Using multivariate regression analysis, a clinical-dermoscopic profile of infiltrative basal cell carcinoma was defined.

Disclosure: The study authors reported no conflicts of interest.

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