Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy

• DOI: 10.1159/000493727
• Publication Date: 2018-11-07T22:01:17Z
• Authors: Francesca Peccerillo; Victor Desmond Ma...; Francesca Di Tullio; Silvana Ciardo; Johanna Chester; Shaniko Kaleci; Nathalie de Carvalho; Ester Del Duca; Luca Giannetti; Laura Mazzoni; Steven Paul Nisticò; Ignazio Stanganelli; Giovanni Pellacani; Francesca Farnetani
• Keywords: Histopathology; Actinic keratosis

Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution.To evaluate with RCM atypical melanocytic lesions identified dermoscopy, according common criteria for the differential diagnosis BCC, and identify representative parameters superficial (sBCCs) nonsuperficial (nsBCCs) carcinomas (BCCs).A retrospective analysis consecutive patients evaluated RCM, selecting excised classified dermoscopy ≥1 score from re visited 7-point checklist, mimicking melanoma, registered between 2010 2016. Cluster BCC subclassifications.Of 178 lesions, 34 were diagnosed as BCCs RCM. Lesions confirmed histopathology. Dermoscopic included network (55.9%) regression structures (35.5%) associated sBCCs, an vascular pattern (58.8%) irregular blotches nsBCCs. Hierarchical cluster 2 clusters: 1 (100% sBCCs) was presence cords connected epidermis (90%, p < 0.001), tumor islands located (100%, smaller diameter 0.001) solar elastosis = 0.017), (nsBCCs 85%) defined dermic location (87.5%, branch-like (70.8%, 0.007) surrounding collagen (83.3%, 0.012), peripheral palisading 0.012) coiled morphology (79.2%, a larger (50%, 0.001).RCM is able diagnose seems sBCCs