Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma
BackgroundInfiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recogniti...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.630458/full |
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| author | Riccardo Pampena Gabriele Parisi Mattia Benati Stefania Borsari Michela Lai Michela Lai Giovanni Paolino Giovanni Paolino Anna Maria Cesinaro Silvana Ciardo Francesca Farnetani Sara Bassoli Giuseppe Argenziano Giovanni Pellacani Caterina Longo Caterina Longo |
| author_facet | Riccardo Pampena Gabriele Parisi Mattia Benati Stefania Borsari Michela Lai Michela Lai Giovanni Paolino Giovanni Paolino Anna Maria Cesinaro Silvana Ciardo Francesca Farnetani Sara Bassoli Giuseppe Argenziano Giovanni Pellacani Caterina Longo Caterina Longo |
| author_sort | Riccardo Pampena |
| collection | DOAJ |
| description | BackgroundInfiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce the risk of incomplete excision and recurrence.ObjectiveThe aim of this study is to define clinical and dermoscopic criteria that can differentiate infiltrative BCC from the most common low-aggressive superficial and nodular BCC.MethodsClinical and dermoscopic images of infiltrative, superficial, and nodular BCC were retrospectively retrieved from our database and jointly evaluated by two experienced dermoscopists, blinded for the histologic subtype. Pairwise comparisons between the three histologic subtypes were performed and multivariable logistic regression models were constructed in order to define clinical and dermoscopic factors independently associated with each subtype. To validate our findings, two experienced dermoscopists not previously involved in the study were asked to evaluate clinical and dermoscopic images from an external dataset, guessing the proper BCC subtype between infiltrative, nodular and superficial, before and after being provided with the study results.ResultA total of 481 histopathologically proven BCCs (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were included. We found that infiltrative BCC mostly appeared on the head and neck as an amelanotic hypopigmented plaque or papule, displaying ulceration on dermoscopic examination, along with arborizing and fine superficial telangiectasia. Shiny white structures were also frequently observed. Multivariate regression analysis allowed us to define a clinical-dermoscopic profile of infiltrative BCC.ConclusionsWe defined the clinical-dermoscopic profile of infiltrative BCC, allowing to differentiate this variant from superficial and nodular BCC. This will improve pre-surgical recognition of infiltrative forms, reducing the risk for post-surgical recurrence. |
| first_indexed | 2024-12-24T05:09:51Z |
| format | Article |
| id | doaj.art-e7d354bac1214ee780b067cfbf430db2 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-24T05:09:51Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e7d354bac1214ee780b067cfbf430db22022-12-21T17:13:44ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-02-011010.3389/fonc.2020.630458630458Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell CarcinomaRiccardo Pampena0Gabriele Parisi1Mattia Benati2Stefania Borsari3Michela Lai4Michela Lai5Giovanni Paolino6Giovanni Paolino7Anna Maria Cesinaro8Silvana Ciardo9Francesca Farnetani10Sara Bassoli11Giuseppe Argenziano12Giovanni Pellacani13Caterina Longo14Caterina Longo15Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyCentro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyCentro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyUnit of Dermatology, IRCCS Ospedale San Raffaele, Milano, ItalyClinica Dermatologica, La Sapienza University of Rome, Rome, ItalyDepartment of Pathological Anatomy, Modena University Hospital, Modena, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyDermatology Unit, University of Campania Luigi Vanvitelli, Naples, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyCentro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyBackgroundInfiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce the risk of incomplete excision and recurrence.ObjectiveThe aim of this study is to define clinical and dermoscopic criteria that can differentiate infiltrative BCC from the most common low-aggressive superficial and nodular BCC.MethodsClinical and dermoscopic images of infiltrative, superficial, and nodular BCC were retrospectively retrieved from our database and jointly evaluated by two experienced dermoscopists, blinded for the histologic subtype. Pairwise comparisons between the three histologic subtypes were performed and multivariable logistic regression models were constructed in order to define clinical and dermoscopic factors independently associated with each subtype. To validate our findings, two experienced dermoscopists not previously involved in the study were asked to evaluate clinical and dermoscopic images from an external dataset, guessing the proper BCC subtype between infiltrative, nodular and superficial, before and after being provided with the study results.ResultA total of 481 histopathologically proven BCCs (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were included. We found that infiltrative BCC mostly appeared on the head and neck as an amelanotic hypopigmented plaque or papule, displaying ulceration on dermoscopic examination, along with arborizing and fine superficial telangiectasia. Shiny white structures were also frequently observed. Multivariate regression analysis allowed us to define a clinical-dermoscopic profile of infiltrative BCC.ConclusionsWe defined the clinical-dermoscopic profile of infiltrative BCC, allowing to differentiate this variant from superficial and nodular BCC. This will improve pre-surgical recognition of infiltrative forms, reducing the risk for post-surgical recurrence.https://www.frontiersin.org/articles/10.3389/fonc.2020.630458/fullbasal cell carcinomasubtypeinfiltrativesuperficialnodulardermoscopy |
| spellingShingle | Riccardo Pampena Gabriele Parisi Mattia Benati Stefania Borsari Michela Lai Michela Lai Giovanni Paolino Giovanni Paolino Anna Maria Cesinaro Silvana Ciardo Francesca Farnetani Sara Bassoli Giuseppe Argenziano Giovanni Pellacani Caterina Longo Caterina Longo Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma Frontiers in Oncology basal cell carcinoma subtype infiltrative superficial nodular dermoscopy |
| title | Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma |
| title_full | Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma |
| title_fullStr | Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma |
| title_full_unstemmed | Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma |
| title_short | Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma |
| title_sort | clinical and dermoscopic factors for the identification of aggressive histologic subtypes of basal cell carcinoma |
| topic | basal cell carcinoma subtype infiltrative superficial nodular dermoscopy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.630458/full |
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