Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Sgouros Dimitrios
Dissertation committee:
Αλέξανδρος Κατούλης, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Ρηγόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Παναγιωτίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αλέξανδρος Στρατηγός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ηλέκτρα Νικολαΐδου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σταμάτιος Γρηγορίου, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Διαμάντω Ψυρρή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη συσχέτισης επιδημιολογικών, κλινικών, δερματοσκοπικών χαρακτηριστικών και ιστοπαθολογικών κριτηρίων του βασικοκυτταρικού καρκινώματος δέρματος
Translated title:
Study on correlations of epidemiological, clinical, dermatoscopic characteristics and histo-pathologic criteria of cutaneous basal cell carcinoma
Summary:
Introduction: Basal Cell Carcinoma (BCC) quite frequently presents as multiple tumors in individual patients. Neoplasm’s risk factors for local recurrence have a critical impact on therapeutic management. Basosquamous carcinoma (BSC) is a relatively rare type of neoplasm originating from Basal Cell Carcinoma with features of squamous differentiation. BSC has an aggressive local behavior with a tendency for recurrence and a less frequent metastatic potential.
Objective: To detect risk factors for multiple BCCs (mBCC) in individual patients and to describe clinical and dermatoscopic features of low and high-risk tumors. The secondary goal was to describe the clinic-dermatoscopic features of BSC and to evaluate possible dermatoscopic and histopathologic correlations.
Materials & Methods: Our study included 225 patients with 304 surgically excised primary BCCs. All patients’ medical history and demographics were recorded. Clinical and dermatoscopic images of BCC were evaluated for pre-defined criteria and statistical analyses were performed. As a subgroup analysis 22 pateints with BSC were enrolled in parallel and as a separate sample from the basic population of the study.
Results: Grade II-III sunburns before adulthood (OR 2.146, p=0.031) and personal history of BCC (OR 3.403, p <0.001) were the major predisposing factors for mBCC. Clinically obvious white color (OR 3.168, p<0.001) and dermatoscopically detected white shiny lines (OR 2.085, p=0.025) represented strongly prognostic variables of high-risk BCC. Similarly, extensive clinico-dermatoscopic ulceration (up-to 9.2-fold) and nodular morphology (3.6-fold) raise the possibility for high-risk BCC. On the contrary, dermatoscopically evident blue-black coloration had a negative prognostic value for high-risk neoplasms (light OR 0.269, p<0.001 / partial OR 0.198, p=0.001). Dermatoscopically, 92% of BSC showed prominent vasculature and monomorphous arborizing vessels with a diffuse arrangement were the most frequently observed type. Ulceration (88%), SCC dermatoscopic criteria (56%), white strands/blotches (56%) and features of pigmentation (40%) were also detected.
Conclusions: mBCC patients’ profiling and thorough knowledge of high-risk tumors’ clinico-dermatoscopic morphology could provide physicians with important information towards prevention of this neoplasm. We suggest that the most common prototype of BSC is an ulcerated, facial nodule in elderly males with photo-damaged skin, dermatoscopically displaying combined features of mostly nodular BCC and less of SCC.
Main subject category:
Health Sciences
Keywords:
Basal cell carcinoma, Skin cancer, Multiple basal cell carcinomas, Non-melanoma skin cancer, Basosquamous carcinoma, Dermatoscopy
Number of references:
227
