Supervisors info:
Δημήτριος Ρηγόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Στρατηγός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Κατούλης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Basal cell carcinoma (BCC) is the most common type of skin cancer in the world and accounts for approximately 80% of all skin cancer but for less than 0.1% of patient deaths due to cancer. Its incidence has doubled over the past 25 years. The estimated lifetime risk for BCC in the caucasians is 35–40% for men and 20–30% for women, with a male to-female ratio is of 2.1:1. Although mortality related to BCC is negligible, BCCs can be associated with significant morbidity, especially if left untreated and/or if discovered when they have attained relatively large diameters. Clinically, BCC can present with a variety of morphologies, ranging from erythematous patches to ulcerated nodules. There are multiple histopathologic subtypes of BCC including superficial, nodular, morpheaform/ sclerosing/ infiltrative, fibroepithelioma of Pinkus and baso-squamous cell BCC. Each subtype can be clinically pigmented or non-pigmented.
Dermoscopy is an in vivo, non-invasive technique utilized when examining the skin. A dermatoscope is a handheld device, which allows illumination and a 10–14 times magnification of the area being analyzed. The dermatoscope allows clinicians not only to magnify skin lesions, but also helps visualize subsurface features. Dermoscopy has become an integrative part of the clinical examination of skin tumors. This is because it improves significantly the early diagnosis of melanoma and non-melanoma skin cancer (NMSC) including basal cell carcinoma compared with the unaided eye. Besides its value in the noninvasive diagnosis of skin cancer, dermoscopy has also gained increased interest in the management of BCC. Dermoscopy has been used in the preoperative evaluation of tumor margins, monitoring of the outcomes of topical treatments, post-treatment follow-up and is also useful for the management of the tumor, since it provides valuable information about the istopathologic subtype, the presence of clinically undetectable pigmentation and the expansion of the tumor beyond clinically visible margins. Based on the degree of pigmentation, some BCCs can mimic melanomas or other pigmented skin lesions. Depending on the subtype of BCC and the degree of pigmentation, the clinical differential diagnosis can be quite broad ranging from benign inflammatory lesions to melanoma. Fortunately, the use of dermoscopy has dramatically improved the diagnostic accuracy and diagnostic confidence of clinicians for both pigmented and non-pigmented BCCs. In addition, dermoscopy permits for the diagnosis of clinically tiny BCCs since the dermoscopic criteria for BCC are visible irrespective of the size of the tumor. In the current article, we provide a summary of the traditional and latest knowledge on the value of dermatoscopy for the diagnosis and management of BCC
