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Multiple Aggregated, Yellow-White Globules: Indicator of Basal Cell Carcinoma?

By: Kayci Reyer
Posted: Monday, July 6, 2020

According to research published in JAMA Dermatology, the presence of multiple aggregated yellow-white globules in patients with basal cell carcinoma may be linked with a diagnosis of nonpigmented basal cell carcinoma and high-risk histologic subtypes of this type of skin cancer. The case-controlled study sourced nonpigmented skin tumors from a database of lesions biopsied between January 1, 2009 and December 31, 2015.

“[Multiple aggregated yellow-white] globules were negatively associated with superficial [basal cell carcinoma] and positively associated with deeper-seated, histologic, higher-grade tumor subtypes,” concluded Cristian Navarrete-Dechent, MD, of Pontificia Universidad Católica de Chile, and colleagues.

The study included 656 nonpigmented lesions from a total of 643 patients, with 291 lesions (44.4%) confirmed to be basal cell carcinomas. Of these basal cell carcinoma cases, 61 of them (21%) had evidence of multiple aggregated yellow-white globules. The globules were also present in 3 out of 365 cases with other diagnoses (0.8%). The odds ratio of a lesion positive for multiple aggregated yellow-white globules being basal cell carcinoma was 32.

The mean patient age was 63.1 years. The majority of patients (58.1%; n = 381) were male. Overall, 194 lesions (29.6%) were located on the head and neck; within the basal cell carcinoma subgroup, 124 patients (42.6%) had lesions located on the head and neck, whereas 167 patients (57.4%) had lesions located on the trunk or extremities.

“Although this dermoscopic feature was seen in only 21% of the nonpigmented basal cell carcinomas evaluated,” explained the study authors, “its frequency is within the range of other basal cell carcinoma–specific criteria, such as spoke-wheel structures, concentric structures, and leaf-like areas, with reported prevalence ranging from 8% to 20%.”

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.



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