Dermatoscopic Criteria of Non-Pigmented Basal Cell Carcinoma

Abstract

Introduction. Basal cell skin cancer (BCC) is one of the most common human cancers, it constitutes about 70,0 % of keratinocyte tumors that comprise 90,0 % of all malignant skin diseases [2,7]. The risk for Caucasian race individual to develop BCC varies between 33,0 and 39,0 % for men and 23,0 and 28,0 % for women. As a rule, the tumor grows slowly and is characterized by non-aggressive behavior, usually occurs in elderly patients, especially those who were frequently and intensively exposed to solar radiation. The tumor has slow progression and metastases are found in only 0,5 % of the cases [5], but it can result in considerable local destruction and disfigurement when treatment is neglected or inadequate. The BCC affects mainly photo exposed areas, in about 80 % of patients it appears on the head, and in half of them it affects the skin of cheeks and the nose [2]. Other photo exposed areas such as the trunk and the limbs are less affected and in about 4,0 % of patients lesions may appear on genitals and perianal area. Non-melanoma skin tumors are not included into the analysis of the International Agency for Research on Cancer (IARC) and are often not taken into account in routine analyses of cancer registers. The evaluation of the incidence is based on statistical data from different countries. Characteristics differ significantly from low in the regions with low level exposure to extremely high in tropical countries. BCC is the most common neoplasm in humans. Moreover, due to the long and non-aggressive trend the real incidence of this type of tumor is, probably, more than registered [6]. BCC has different clinical varieties and commonly lacks pigmentation that often causes diagnostic difficulty. Dermatoscopy as a simple non-invasive investigation technique for a long time takes an important place in the diagnosis not only of melanocytic tumors, but different non-pigmented neoplasms as well. Nevertheless, the dermatoscopic criteria for determining of non-pigmented basal cell carcinoma are promiscuous and require detalization and systematization. Another problem is metaphorical and subjective language for description of dermatoscopic picture.

Dermatoscopic predictors of the risk of recurrence of basal cell carcinoma of the skin

“…-Древовидные сосуды -неравномерно ветвящиеся ярко-красного цвета сосуды большого диаметра, расположенные на поверхности опухоли [12]. При патоморфологическом исследовании этот признак соответствует растянутым сосудам в дерме -неоангиогенезу, что часто сопровождает опухолевый процесс [13]. Древовидные сосуды чаще встречаются при узловой форме, но также и при других формах БКРК.…”

“…-Концентрические структуры определяются как неправильной формы глобулы разного цвета (синий, серый, коричневый, черный) с более темным центральным участком, которые, возможно, представляют собой вариацию или «предшественник» структур по типу «спицы колеса» [13]. Этот дерматоскопический признак может быть представлен при всех формах БКРК, чаще при поверхностной, и может быть отнесен к факторам низкого риска рецидивирования.…”

“…-Белесовато-розовые бесструктурные области встречаются при поверхностной форме БКРК и патоморфологически представляют собой диффузный дермальный фиброз или фиброзную опухолевую строму [13].…”