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To describe the relevant morphologic features and to create a simple diagnostic method for pigmented basal cell carcinoma (BCC) using in vivo cutaneous surface microscopy (ie, dermoscopy, dermatoscopy, or oil epiluminescence microscopy).Design: Pigmented skin lesions were photographed in vivo using immersion oil (surface microscopy). All pigmented skin lesions were excised and reviewed for histological diagnosis. Photographs of 142 pigmented BCCs, 142 invasive melanomas, and 142 benign pigmented skin lesions were randomly divided into 2 equally sized training and test sets. Images from the training set were scored for 45 surface microscopy features. From this a model was derived and tested on the independent test set.

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Patients with large congenital melanocytic nevi are at increased risk for developing melanomas. There is also a significant increased risk for developing NCM. The high incidence of CNS involvement may influence decisions concerning treatment of the large congenital melanocytic nevi.

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This is the third report in a series that reviews the experience in the Skin and Cancer Unit, from 1955 through 1982, with the treatment of basal cell carcinomas (BCCs). It concerns 588 previously untreated (primary) BCCs removed by surgical excision. The cumulative 5-year recurrence rate was 4.8%. This is a statistically significant lower recurrence rate (P = .034) than 135 previously treated BCCs that had a re-recurrence rate of 11.6%. For the primary BCCs, multivariate analysis showed that location on the head (P = .010) and being male (P = .004) were independent risk factors for recurrence. The patient's age, the duration of the BCC, its maximum diameter, or the time span (1955-1963, 1964-1972, 1973-1982) in which it was treated did not significantly affect the recurrence rate. The 5-year recurrence rate for BCCs excised from various anatomic sites were as follows: 1) neck, trunk, and extremities = 0.7%; 2) head--less than 6 mm in diameter = 3.2%; 3) head--6 to 9 mm in diameter = 8.0% (treated since 1964 = 5.2%); and 4) head--10 mm or more in diameter = 9.0%. Surgical excision is a highly effective method for removal of BCCs, and achieved a good to excellent cosmetic outcome in about 85% of the recurrence-free treatment sites.