Dermoscopic Features of Basal Cell Carcinoma and Their Association with Histological Types in A Chinese Population: A Perspective Study

Abstract

Objective: The treatments and prognoses of high-risk and low-risk basal cell carcinomas are quite different. This study aimed to examine the dermoscopic features of basal cell carcinomas and assess the association between the features and basal cell carcinomas recurrence risks in a Chinese population. Methods: Patients with histopathologically confirmed basal cell carcinomas examined from March 2016 to April 2020 were enrolled. The dermoscopic features were evaluated, and the correlations between these features and the histological types and recurrence risks were assessed. Results: The study cohort comprised 119 Chinese patients with a total of 119 skin lesions. The most common dermoscopic feature of basal cell carcinomas was the absence of a pigment network (119/119, 100%), followed by shiny white streaks (105/119, 88.24%), blue-gray ovoid nests (99/119, 83.19%), multiple blue globules (78/119, 65.55%), and arborizing vessels (78/119, 65.55%); yellow-white structures were present in 29/119 lesions (24.37%). Leaf-like and spoke-wheel areas were significantly associated with superficial basal cell carcinomas (P<0.001), while arborizing vessels (P<0.001), blue-gray ovoid nests (P<0.001), and ulceration (P<0.05) were significantly associated with nonsuperficial basal cell carcinomas subtypes. The dermoscopic features of the high-risk and low-risk groups exhibited considerable overlap; however, the respective independent predictive factors for a high and low risk of basal cell carcinomas recurrence were short fine telangiectases (P<0.05) and blue-gray ovoid nests (P<0.05). Conclusion: Dermoscopy provides important information about basal cell carcinomas and is helpful in differentiating superficial basal cell carcinomas from other subtypes. The dermoscopic vascular structures and blue-gray ovoid nests play a crucial role in evaluating the basal cell carcinomas risks preoperatively.