Clinical management of very small pigmented lesions: Improved clinical outcome through dermoscopy and reflectance confocal microscopy combination

Persechino, Flavia; Franceschini, Chiara; Iorio, Alessandra; Carbone, Anna; Ferrari, Ângela; Buccini, Pierluigi; Piemonte, Paolo; Eibenschutz, Laura; Sperduti, Isabella; Cota, Carlo; Frascione, Pasquale; Ardigò, Marco

doi:10.1111/srt.12863

Cited by 2 publications

(5 citation statements)

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“…RCM imaging revealed an irregular epidermal architecture with enlarged keratinocytes, predominantly the combination of RCM and dermoscopy is the "correct" way to screen microscopic pigmented lesions. 12 We utilized these two imaging modalities to detect pigmented small-sized BCC in three cases, each with a lesion diameter of 2 mm or less. Each of the three cases exhibited different dermoscopic features, reinforcing the dermoscopic variability of pigmented small-sized BCC.…”

Section: Casementioning

confidence: 99%

“…Moreover, the application of additional imaging modalities, such as reflectance confocal microscopy (RCM), further characterizes these diseases to aid in their early detection. [11][12][13] Previous publications have illustrated clinical features of small-sized BCCs, typically 5 mm in diameter or smaller. There is a paucity of literature demonstrating dermoscopic and RCM features of BCCs measuring 2 mm or less, (which we refer to as micro-BCCs) that are also pigmented.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dermoscopy and reflectance confocal microscopy‐augmented characterization of pigmented micro‐basal cell carcinoma (less than 2 mm diameter)

Foltz

Łudzik

Witkowski

2022

Skin Research and Technology

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BackgroundBasal cell carcinoma (BCC) is the most common skin cancer, accounting for approximately 80% of nonmelanoma skin cancer diagnoses each year. Among other factors, the staging of BCC is influenced by its measured diameter. Stage 1 BCC is defined as a lesion measuring 2 cm across or less. Of note, there have been increasing publications reporting features of “small‐sized” BCCs, which can present smaller than 1 mm. However, few of these studies have characterized features of pigmented small‐sized BCC. The application of in‐vivo imaging such as dermoscopy and reflectance confocal microscopy (RCM) allows for the non‐invasive distinction of these lesions from benign and malignant melanocytic neoplasms, thereby reducing unnecessary biopsies.MethodsWithin one year, three patients presented to Oregon Health and Science University's dermatology clinic with pigmented lesions of concern measuring less than 2 mm that were histologically confirmed as pigmented BCC. We sought to characterize the features of these lesions in a case series with the non‐invasive imaging modalities of dermoscopy and RCM.ResultsAll cases presented clinically as a small, brown, macule on the face. Each of the three cases exhibited differing features on dermoscopy. With the application of RCM, we were able to visualize characteristic BCC features, prompting removal by shave biopsy.ConclusionTo our knowledge, no other study has reported dermoscopic and RCM features of a cohort of pigmented BCCs 2 mm in diameter or smaller. We propose to define BCCs of this size as micro‐BCCs. The variability of dermoscopic findings observed in our study, combined with the small size of these pigmented lesions, shows the utility of RCM as a non‐invasive diagnostic tool for pigmented micro‐BCCs.

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Section: Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dermoscopy and reflectance confocal microscopy‐augmented characterization of pigmented micro‐basal cell carcinoma (less than 2 mm diameter)

Foltz

Łudzik

Witkowski

2022

Skin Research and Technology

View full text Add to dashboard Cite

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“…Small BCCs have been defined by some authors as those measuring less than 5 mm, while BCCs lower than 3 mm have been denominated very small BCCs. 10 , 11 , 12 , 13 , 14 , 15 Regarding clinical presentation, small BCCs are more prevalent in younger men, prevail on the face, are often pigmented, and their most common histological subtype is nodular. 11 Detection of initial tumoral stages is related to an easier treatment, with better cosmetic outcomes and less functional impact.…”

Section: Introductionmentioning

confidence: 99%

“…Very small BCCs (vsBCCs) are even more incipient lesions, that could display different features due to an early phase of tumoral growth. 14 , 15 , 16 , 17 , 18 Dermoscopy on these tumors has not been widely studied, therefore, there is a scarcity of medical literature reporting and comparing dermoscopic characteristics with larger BCCs. The aim of this study was to describe and compare dermoscopic features of BCCs measuring ≤3 mm, with those from 3 to 10 mm in diameter.…”

Section: Introductionmentioning

confidence: 99%