Dermoscopy of Basal Cell Carcinoma Part 1: Dermoscopic Findings and Diagnostic Accuracy-A Systematic Literature Review.

introductionBasal cell carcinoma (BCC) is the most common malignant skin tumor. While rarely fatal, it can cause local tissue damage. Part I of the review summarizes the dermoscopic features of BCC and the diagnostic accuracy of dermoscopy in the diagnosis of BCC.

methodsA search of the PubMed database was performed for studies reporting on the diagnostic accuracy of dermoscopy or dermoscopic findings in BCC, either pigmented or non-pigmented, located anywhere on the body, of any histopathologic subtype, size and at any age of onset.

resultsBCC was found to present with a wide range of dermoscopic features, including white structures (shiny white lines, shiny white areas, rosettes), yellow structures (milia-like cysts, yellow lobular-like structures), multiple aggregated yellow-white globules (MAY globules), blue structures (blue ovoid nests), vascular structures (arborizing vessels, short fine telangiectasias), multiple small erosions/ulcerations, features of regression (pepper-like structures, white scar-like areas) and pigmented structures (spoke-wheel areas, maple leaf-like areas (MLLAs), blue/gray dots). Dermoscopy showed a sensitivity of 67.6-98.6% and a positive predictive value (PPV) of 85.9-97% in identifying BCC. The physician's experience and training improve the accuracy, however, BCCs on the trunk and extremities, particularly of superficial subtypes, may still constitute a challenge.

conclusionsDermoscopy, especially when performed by a trained physician, increases the accuracy of early BCC detection.