Division of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan.
J Dermatol. 2011 Jan;38(1):59-65. doi: 10.1111/j.1346-8138.2010.01093.x.
Basal cell carcinoma (BCC) and seborrheic keratosis (SK) are representative pigmented skin tumors, and they are differentiated as non-melanocytic lesions in the two-step dermoscopy algorithm proposed by the Consensus Net Meeting on Dermoscopy. Because most BCC in Japanese patients are pigmented clinically, dermoscopy plays an important role in their differential diagnosis. The dermoscopic criteria for BCC include the lack of a pigment network and the presence of at least one positive feature for BCC, such as large blue-gray ovoid nests, multiple blue-gray globules, leaf-like areas, spoke wheel areas, arborizing vessels and ulceration. Whereas various dermoscopic features are seen in SK, comedo-like openings, milia-like cysts, and fissures and ridges are especially important features. It is necessary for clinicians to consider the pathological conditions causing the dermoscopic features of BCC and SK. In addition, the sensitivity and specificity of each feature should be taken into consideration to ensure an accurate dermoscopic diagnosis.
基底细胞癌（BCC）和脂溢性角化病（SK）是具有代表性的色素性皮肤肿瘤，在共识网络会议提出的两步式皮肤镜算法中被分为非黑素细胞病变。由于大多数日本患者的 BCC 在临床上呈色素性，因此皮肤镜在其鉴别诊断中发挥着重要作用。BCC 的皮肤镜标准包括缺乏色素网和至少存在一个 BCC 的阳性特征，如大的蓝灰色卵圆形巢、多个蓝灰色小球、叶状区域、辐轮状区域、树枝状血管和溃疡。而 SK 则可见各种皮肤镜特征，其中最重要的特征是粉刺样开口、粟粒样囊肿、裂隙和脊。临床医生有必要考虑导致 BCC 和 SK 皮肤镜特征的病理情况。此外，还应考虑每个特征的敏感性和特异性，以确保准确的皮肤镜诊断。
