Kim Hoon-Soo, Park Jung-Min, Mun Je-Ho, Song Margaret, Ko Hyun-Chang, Kim Byung-Soo, Kim Moon-Bum
Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Ann Dermatol. 2015 Dec;27(6):682-7. doi: 10.5021/ad.2015.27.6.682. Epub 2015 Dec 7.
Limited information is available regarding dermatoscopic differences between non-aggressive and aggressive types of basal cell carcinoma (BCC).
To investigate dermatoscopic differences between non-aggressive and aggressive types.
We evaluated 145 histopathologically confirmed BCCs from 141 patients. Histopathologic types and aggressiveness from 4 mm punch biopsy and their dermatoscopic findings were evaluated. We assessed the statistical significance of dermatoscopic differences between non-aggressive and aggressive types. To objectively predict aggressiveness, we created a "dermatoscopic index of BCC aggressiveness" in which 1 point was added and subtracted for each dermatoscopic finding significantly higher in aggressive and non-aggressive types, respectively.
Large blue-gray ovoid nests were found more frequently in non-aggressive type than aggressive one (85/105 [80.9%] vs. 21/40 [52.5%], p=0.001). Compared to non-aggressive type, aggressive type had more multiple blue-gray globules (29/40 [72.5%] vs. 57/105 [54.3%], p=0.046), arborizing telangiectasia (29/40 [72.5%] vs. 48/105 [45.7%], p=0.004), and concentric structure (11/40 [27.5%] vs. 12/105 [11.4%], p=0.018). Regarding dermatoscopic index, cases of aggressive type with a score of 1 were most common (n=18, 45.0%), followed by a score of 2 (n=14, 35.0%). Limited number of aggressive type of BCCs and the effect of width on the determination of histopathologic aggressiveness.
Aggressive type BCCs more often exhibited multiple blue-gray globules, arborizing telangiectasia, and concentric structure, while the non-aggressive type exhibited large blue-gray ovoid nests more frequently. Score exceeding 2 on the dermoscopic index can be screening criteria for aggressiveness. These dermatoscopic features and dermoscopic index could be useful for assessing aggressiveness of BCCs before surgery.
关于非侵袭性和侵袭性基底细胞癌（BCC）的皮肤镜差异，现有信息有限。
研究非侵袭性和侵袭性基底细胞癌的皮肤镜差异。
我们评估了141例患者的145个经组织病理学确诊的基底细胞癌。评估了4毫米钻孔活检的组织病理学类型和侵袭性及其皮肤镜表现。我们评估了非侵袭性和侵袭性类型之间皮肤镜差异的统计学意义。为了客观预测侵袭性，我们创建了一个“基底细胞癌侵袭性皮肤镜指数”，其中对于侵袭性类型中显著更高的每个皮肤镜表现分别加1分，对于非侵袭性类型中显著更高的每个皮肤镜表现分别减1分。
大的蓝灰色卵圆形巢在非侵袭性类型中比侵袭性类型中更常见（85/105 [80.9%] 对 21/40 [52.5%]，p = 0.001）。与非侵袭性类型相比，侵袭性类型有更多的多个蓝灰色小球（29/40 [72.5%] 对 57/105 [54.3%]，p = 0.046）、树枝状毛细血管扩张（29/40 [72.5%] 对 48/105 [45.7%]，p = 0.004）和同心结构（11/40 [27.5%] 对 12/105 [11.4%]，p = 0.018）。关于皮肤镜指数，得分1分的侵袭性类型病例最常见（n = 18，45.0%），其次是得分2分（n = 14，35.0%）。侵袭性基底细胞癌数量有限以及宽度对组织病理学侵袭性判定的影响。
侵袭性基底细胞癌更常表现出多个蓝灰色小球、树枝状毛细血管扩张和同心结构，而非侵袭性类型更常表现出大的蓝灰色卵圆形巢。皮肤镜指数超过2分可作为侵袭性的筛查标准。这些皮肤镜特征和皮肤镜指数可能有助于在手术前评估基底细胞癌的侵袭性。
