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Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma

BACKGROUND: Infiltrative 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 recogni...

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Autores principales: Pampena, Riccardo, Parisi, Gabriele, Benati, Mattia, Borsari, Stefania, Lai, Michela, Paolino, Giovanni, Cesinaro, Anna Maria, Ciardo, Silvana, Farnetani, Francesca, Bassoli, Sara, Argenziano, Giuseppe, Pellacani, Giovanni, Longo, Caterina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933517/
https://www.ncbi.nlm.nih.gov/pubmed/33680953
http://dx.doi.org/10.3389/fonc.2020.630458
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author Pampena, Riccardo
Parisi, Gabriele
Benati, Mattia
Borsari, Stefania
Lai, Michela
Paolino, Giovanni
Cesinaro, Anna Maria
Ciardo, Silvana
Farnetani, Francesca
Bassoli, Sara
Argenziano, Giuseppe
Pellacani, Giovanni
Longo, Caterina
author_facet Pampena, Riccardo
Parisi, Gabriele
Benati, Mattia
Borsari, Stefania
Lai, Michela
Paolino, Giovanni
Cesinaro, Anna Maria
Ciardo, Silvana
Farnetani, Francesca
Bassoli, Sara
Argenziano, Giuseppe
Pellacani, Giovanni
Longo, Caterina
author_sort Pampena, Riccardo
collection PubMed
description BACKGROUND: Infiltrative 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. OBJECTIVE: The 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. METHODS: Clinical 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. RESULT: A 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. CONCLUSIONS: We 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.
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spelling pubmed-79335172021-03-06 Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma Pampena, Riccardo Parisi, Gabriele Benati, Mattia Borsari, Stefania Lai, Michela Paolino, Giovanni Cesinaro, Anna Maria Ciardo, Silvana Farnetani, Francesca Bassoli, Sara Argenziano, Giuseppe Pellacani, Giovanni Longo, Caterina Front Oncol Oncology BACKGROUND: Infiltrative 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. OBJECTIVE: The 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. METHODS: Clinical 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. RESULT: A 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. CONCLUSIONS: We 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. Frontiers Media S.A. 2021-02-19 /pmc/articles/PMC7933517/ /pubmed/33680953 http://dx.doi.org/10.3389/fonc.2020.630458 Text en Copyright © 2021 Pampena, Parisi, Benati, Borsari, Lai, Paolino, Cesinaro, Ciardo, Farnetani, Bassoli, Argenziano, Pellacani and Longo http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Pampena, Riccardo
Parisi, Gabriele
Benati, Mattia
Borsari, Stefania
Lai, Michela
Paolino, Giovanni
Cesinaro, Anna Maria
Ciardo, Silvana
Farnetani, Francesca
Bassoli, Sara
Argenziano, Giuseppe
Pellacani, Giovanni
Longo, Caterina
Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma
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 Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933517/
https://www.ncbi.nlm.nih.gov/pubmed/33680953
http://dx.doi.org/10.3389/fonc.2020.630458
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