Litaiem Noureddine, Hayder Faten, Benlagha Imene, Karray Manel, Dziri Chadli, Zeglaoui Faten
Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.
University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia.
Dermatol Pract Concept. 2022 Oct 1;12(4):e2022176. doi: 10.5826/dpc.1204a176. eCollection 2022 Nov.
Several studies investigated the use of dermoscopy in the delineation of basal cell carcinoma (BCC) for Mohs micrographic surgery (MMS) with conflicting results.
The purpose of this systematic review with meta-analysis was to evaluate the effectiveness of the use of dermoscopy-guided MMS in the treatment of BCC.
We included all comparative studies. Cases of BCC treated using dermoscopy-guided MMS (or slow MMS) were compared to those treated with curettage-guided MMS or "standard" MMS.
A total of 6 studies including 508 BCCs were reviewed. There was no statistically significant difference in the proportion of total margin clearance on the first MMS stage between BCCs removed using dermoscopy-guided MMS and those that had curettage or visual inspection. However, lateral margin involvement was significantly lower in BCCs that had dermoscopy-guided MMS.
Dermoscopy allows visualization of structures up to 1mm into the dermis. Therefore, it is rational to use it for lateral margin evaluation. Currently, there are two comparative studies showing the efficacy of dermoscopy for lateral margin evaluation during MMS. Future studies are required to develop an evidence-based recommendation regarding the utility of dermoscopy in MMS.
多项研究调查了皮肤镜在Mohs显微外科手术（MMS）中用于界定基底细胞癌（BCC）的情况，但结果相互矛盾。
本系统评价及荟萃分析的目的是评估皮肤镜引导下的MMS治疗BCC的有效性。
我们纳入了所有比较性研究。将使用皮肤镜引导下的MMS（或慢速MMS）治疗的BCC病例与刮除引导下的MMS或“标准”MMS治疗的病例进行比较。
共回顾了6项研究，包括508例BCC。在第一个MMS阶段，使用皮肤镜引导下的MMS切除的BCC与刮除或目视检查切除的BCC在总切缘清除率方面无统计学显著差异。然而，皮肤镜引导下的MMS治疗的BCC侧缘受累情况明显更低。
皮肤镜可观察到真皮内1mm深处的结构。因此，将其用于侧缘评估是合理的。目前，有两项比较性研究显示了皮肤镜在MMS期间进行侧缘评估的有效性。未来需要开展研究，以制定关于皮肤镜在MMS中效用的循证推荐。
