头颈部H区和非H区基底细胞癌的偏振皮肤镜检查及紫外线诱导荧光皮肤镜检查

Polarized Dermoscopy and Ultraviolet-Induced Fluorescence Dermoscopy of Basal Cell Carcinomas in the H- and Non-H-Zones of the Head and Neck.

作者信息

Wojtowicz Irena M, Reich Adam A, Żychowska Magdalena

机构信息

Department of Dermatology, Faculty of Medicine, Collegium Medicum, University of Rzeszów, Ul. Szopena 2, 35-055, Rzeszów, Poland.

出版信息

Dermatol Ther (Heidelb). 2025 Jun;15(6):1507-1522. doi: 10.1007/s13555-025-01432-z. Epub 2025 Apr 28.

DOI:10.1007/s13555-025-01432-z

PMID:40293692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12092849/

Abstract

INTRODUCTION

Basal cell carcinoma (BCC) is the most common skin cancer, primarily affecting the head and neck region. This study aimed to evaluate the characteristics of BCCs in different facial areas using polarized dermoscopy (PD) and ultraviolet-induced fluorescence dermoscopy (UVFD).

METHODS

BCCs were examined using a Dermlite DL5 dermatoscope in polarized and UVFD modes. The tumors were categorized based on their location within the high-risk H-zone (ear and periauricular region, temple, eyes and periorbital area, nose and paranasal region, oral region, chin) and non-H-zone (forehead, cheek, rest of the face, scalp, neck). PD features were characterized according to standard dermoscopic criteria for skin cancer assessment. UVFD characteristics included dark silhouettes, interrupted follicle patterns, ulcerations/erosions, white-blue scales, arborizing vessels, absence of pink-orange or blue-green fluorescence, blue-fluorescent fibers, pink-orange fluorescence, black globules, white depigmentation, white clods, and well-defined margins.

RESULTS

A total of 151 BCCs were analyzed, with 61.6% located in the H-zone, where the nose and paranasal region were the most affected area (37.6%). Nodular (65.6%) and nonpigmented (86%) subtypes predominated in the H-zone. PD most commonly revealed arborizing vessels (52.7%), short fine telangiectasias (46.2%), red-white homogeneous areas (40.9%), and ulcerations/micro-ulcerations (40.9%). Under UVFD, BCCs in the H-zone frequently exhibited dark silhouettes (77.4%), interrupted follicle patterns (51.6%), absence of blue-green (51.6%) or pink-orange fluorescence (44%), and well-defined lesion borders (43%). Compared to non-H-zone tumors, BCCs in the H-zone were significantly more likely to display ulcerations/micro-ulcerations under PD (p = 0.021), and erosions/ulcerations (p = 0.019), blue-fluorescent fibers (p = 0.009), and absence of blue-green fluorescence (p = 0.019) under UVFD.

CONCLUSION

BCCs in the head and neck exhibit distinct characteristics under UVFD, with certain findings more commonly observed in H-zone tumors. The addition of UVFD to PD serves as a valuable, noninvasive diagnostic tool that enhances early detection of BCCs in this anatomically and cosmetically significant region.

摘要

引言

基底细胞癌（BCC）是最常见的皮肤癌，主要影响头颈部区域。本研究旨在使用偏振皮肤镜检查（PD）和紫外线诱导荧光皮肤镜检查（UVFD）评估不同面部区域BCC的特征。

方法

使用Dermlite DL5皮肤镜在偏振和UVFD模式下检查BCC。根据肿瘤在高风险H区（耳部及耳周区域、颞部、眼及眶周区域、鼻及鼻旁区域、口腔区域、下巴）和非H区（额头、脸颊、面部其他部位、头皮、颈部）的位置进行分类。PD特征根据皮肤癌评估的标准皮肤镜标准进行描述。UVFD特征包括深色轮廓、中断的毛囊模式、溃疡/糜烂、白蓝色鳞屑、树枝状血管、无橙粉色或蓝绿色荧光、蓝色荧光纤维、橙粉色荧光、黑色小球、白色色素脱失、白色团块以及边界清晰。

结果

共分析了151例BCC，其中61.6%位于H区，鼻及鼻旁区域是受影响最严重的区域（37.6%）。结节型（65.6%）和无色素型（86%）亚型在H区占主导。PD最常显示树枝状血管（52.7%）、短细毛细血管扩张（46.2%）、红白均匀区域（40.9%）和溃疡/微溃疡（40.9%）。在UVFD下，H区的BCC常表现出深色轮廓（77.4%）、中断的毛囊模式（51.6%）、无蓝绿色（51.6%）或橙粉色荧光（44%）以及边界清晰的病变（43%）。与非H区肿瘤相比，H区的BCC在PD下更易出现溃疡/微溃疡（p = 0.021），在UVFD下更易出现糜烂/溃疡（p = 0.019）、蓝色荧光纤维（p = 0.009）和无蓝绿色荧光（p = 0.019）。