State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece.
Br J Dermatol. 2014 Apr;170(4):809-15. doi: 10.1111/bjd.12749.
Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell carcinoma (sBCC) after nonablative therapies has not been sufficiently assessed.
Certain dermoscopic criteria, namely pigmented structures, ulceration and arborizing vessels, have been suggested to predict the presence of residual disease [residual disease-associated dermoscopic criteria (RDADC)]. We aimed to assess this hypothesis.
Lesions exhibiting RDADC 3 months after treatment were biopsied and in the case of histopathological confirmation were excised. Lesions characterized by white/red structureless areas, superficial fine telangiectasias, or lacking any dermoscopic criterion, were monitored for 12 months.
At the 3-month evaluation, one or more of the RDADC were detected in 25/98 (25·5%) sBCCs, in which histology confirmed tumour persistence. In 45 (61·6%) of the 73 remaining lesions, dermoscopy showed white/red structureless areas and/or superficial fine telangiectasias. Twenty-eight lacked any dermoscopic criterion of sBCC. The two latter groups entered follow-up. In total, disease recurred in 13 (17·8%) of the 73 lesions.
RDADC accurately predict residual disease. Absence of dermoscopic criteria of sBCC safely predicts complete histopathological clearance. Detection of white/red structureless areas and/or superficial fine telangiectasias warrants close monitoring to recognize early recurrence.
非消融性治疗后评估浅表基底细胞癌（sBCC）结局和监测时，皮肤镜的适用性尚未得到充分评估。
某些皮肤镜标准，即色素性结构、溃疡和树枝状血管，已被建议用于预测残留疾病[与残留疾病相关的皮肤镜标准（RDADC）]。我们旨在评估这一假设。
治疗后 3 个月出现 RDADC 的病变进行活检，如果组织病理学证实存在肿瘤，则进行切除。表现为白色/红色无结构区域、浅表细毛细血管扩张或缺乏任何皮肤镜标准的病变，进行 12 个月的监测。
在 3 个月的评估中，25/98（25.5%）例 sBCC 中检测到一个或多个 RDADC，其中组织学证实肿瘤持续存在。在其余 73 例中，45 例（61.6%）的病变表现为白色/红色无结构区域和/或浅表细毛细血管扩张。28 例缺乏任何 sBCC 的皮肤镜标准。后两组进入随访。总共有 73 例病变中有 13 例（17.8%）复发。
RDADC 可准确预测残留疾病。缺乏 sBCC 的皮肤镜标准可安全预测完全组织病理学清除。检测到白色/红色无结构区域和/或浅表细毛细血管扩张需要密切监测以识别早期复发。
