EsteDerm Private Dermatolgy Clinic, Tychy, Poland.
Department of Biophysics, Medical University of Silesia, Zabrze, Poland.
In Vivo. 2021 Jan-Feb;35(1):423-427. doi: 10.21873/invivo.12274.
BACKGROUND/AIM: Basal cell carcinoma (BCC) is a common skin cancer, especially in the elderly population. The probability of BCC development increases past the age of 55. Dermoscopy and reflectance confocal microscopy (RCM) are two modern tools useful in the diagnosis of BCC.
This is a retrospective study conducted on a group of 21 patients with a confirmed diagnosis of BCC. All patients were examined by dermoscopy and RCM. Dermoscopic images were taken using a videodermoscope. RCM was performed in three layers: epidermal, dermoepidermal junction (DEJ), and superficial dermal layer. In each layer, a few RCM criteria of basal cell carcinoma diagnosis were taken into consideration.
Dermoscopy of pigmented BCCs revealed blue globules of pigment (p<0.05), gray and blue ovoid nests, which were absent in the entire non-pigmented carcinomas group. In RCM, the epidermis showed no differences between pigmented and non-pigmented carcinomas, however, significant differences were observed at the DEJ. In pigmented BCCs, cordlike structures and plump atypical cells were observed (p<0.05), while in non-pigmented carcinomas, dark silhouettes were present (p<0.05).
To our knowledge, that is the first study comparing features between pigmented and non-pigmented BCC by RCM. Pigmented and non-pigmented BCCs presented different features in both dermoscopy and RCM. Furthermore, RCM revealed more discriminating features at the DEJ than dermoscopy, thus can be more efficient in the differential diagnosis of difficult BCC.
背景/目的：基底细胞癌（BCC）是一种常见的皮肤癌，尤其在老年人群中更为常见。BCC 的发病概率随着年龄的增长而增加，超过 55 岁后概率明显上升。皮肤镜和反射共聚焦显微镜（RCM）是两种有助于 BCC 诊断的现代工具。
这是一项回顾性研究，共纳入了 21 例经病理证实的 BCC 患者。所有患者均接受了皮肤镜和 RCM 检查。皮肤镜图像由视频皮肤镜拍摄。RCM 在表皮、表皮-真皮连接（DEJ）和真皮浅层三个层面进行，每个层面都考虑了一些诊断 BCC 的 RCM 标准。
色素性 BCC 的皮肤镜显示蓝色色素球（p<0.05）、灰色和蓝色的椭圆形巢，而整个非色素性 BCC 组均未出现这些特征。在 RCM 中，色素性和非色素性 BCC 的表皮无差异，但在 DEJ 处存在显著差异。在色素性 BCC 中，观察到条索状结构和肿胀的非典型细胞（p<0.05），而非色素性 BCC 中存在暗轮廓（p<0.05）。
据我们所知，这是第一项通过 RCM 比较色素性和非色素性 BCC 特征的研究。色素性和非色素性 BCC 在皮肤镜和 RCM 中均呈现出不同的特征。此外，RCM 在 DEJ 处比皮肤镜显示出更多的鉴别特征，因此在 BCC 的鉴别诊断中可能更为有效。
