Infiltrating basal cell carcinoma: a stellate peri-tumor dermatoscopy pattern as a clue to diagnosis

Background: Infiltrating basal cell carcinoma (BCC) has associated features that may be readily identified using dermatoscopy. Objective: Investigate a stellate dermatoscopy pattern extending from the peripheral margin of infiltrating BCC. Methods: A total of 741 consecutive cases of BCC were assessed retrospectively using non-polarized dermatoscopy. Following histopathologic examination, cases were categorized into six different BCC subtypes. Infiltrating cases numbered 107. This stellate feature was defined as a geometric star shaped pattern extending outwards from the circumferential peripheral edge of the tumor, and identified by white lines, vessels or uneven skin surface morphology. The percentages of infiltrating subtype within the tumor mass and tumor depth were compared, with and without the stellate pattern. Results: Infiltrating BCC displayed the stellate pattern more than other BCC subtypes. Concordance between the two observers was almost perfect for white lines: Kappa coefficient of 0.87 (95% CI: 0.0.79-0.95) P<0.01 and substantial for vessels: Kappa coefficient of 0.71 95% CI: 0.59-0.84) P<0.01. Folds were only recorded in infiltrating cases (n=3). Compared to other BCC subtypes the stellate pattern had a sensitivity of 31.7% and specificity of 94.1%. A higher mean fraction of the tumor mass containing infiltrating subtype was found when comparing stellate pattern observed to stellate pattern not observed (P<0.01). No statistically significant association was found between the tumor depth with and without the stellate pattern. Conclusion: This study found a higher incidence of the stellate pattern within infiltrating BCC compared to the other BCC subtypes. As the percentage of the infiltrating subtype within the tumors increased the incidence of the stellate pattern also increased.

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CD10, TDAG51, CK20, AR, INSM1, and Nestin Expression in the Differential Diagnosis of Trichoblastoma and Basal Cell Carcinoma

International Journal of Surgical Pathology ◽

10.1177/1066896918781719 ◽

2018 ◽

Vol 27 (1) ◽

pp. 19-27 ◽

Cited By ~ 8

Author(s):

Cem Leblebici ◽

Buket Bambul Sığırcı ◽

Canan Kelten Talu ◽

Sevim Baykal Koca ◽

Gülben Erdem Huq

Keyword(s):

Differential Diagnosis ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

The Other ◽

Cytokeratin 20 ◽

Nestin Expression ◽

The Difference ◽

Nevus Sebaceous ◽

Sensitive Marker

Background. Trichoblastoma (TB) and basal cell carcinoma (BCC) are 2 different neoplasms composed of basaloid cells and have overlapping histopathological features. We compared the immunoexpression of CD10, T-cell death-associated gene 51 (TDAG51), cytokeratin 20 (CK20), androgen receptor (AR), insulinoma-associated protein 1 (INSM1), and nestin for the differential diagnosis of these tumors. Materials and Methods. We assessed a total of 27 BCC and 27 TB cases, including 4 TB lesions in nevus sebaceous and 3 malignant TB lesions for CD10, TDAG51, CK20, AR, INSM1, and nestin expression. Results. Staining for CK20, TDAG51, INSM1, and stromal CD10 was significantly more common in TB cases than in BCC cases ( P < .001). Epithelial CD10 and AR staining was significantly more common in BCC cases than in TB cases ( P < .001). The difference between the groups for nestin staining was not significant ( P > .05). Stromal CD10 staining was the most sensitive marker (96.3%) and INSM1 the least sensitive (55.6%) marker for TB. TDAG51 showed 100% specificity for TB. A larger number of CK20 positive cells was found in the cases associated with nevus sebaceous than in the other TBs. Conclusion. All the selected markers except nestin were useful for the differential diagnosis between TB and BCC. CD10 and TDAG51 were more useful than the other markers. The use of CK20 could be preferred in nevus sebaceous lesions. INSM1 was less effective in highlighting Merkel cells within the lesion than CK20.

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Diagnosing Basal Cell Carcinoma by Dermatoscopy

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347549800300202 ◽

1998 ◽

Vol 3 (2) ◽

pp. 62-67 ◽

Cited By ~ 7

Author(s):

David M. Carroll ◽

Elizabeth M. Billingsley ◽

Klaus F. Helm

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Blood Vessels ◽

Basal Cell ◽

Skin Surface ◽

Skin Lesions ◽

Noninvasive Technique ◽

Cutaneous Malignancy ◽

Basal Cell Carcinomas ◽

Pigmented Skin Lesions

Background: Dermatoscopy (DS) has been used primarily to evaluate pigmented skin lesions. Little information is available on DS findings of basal cell carcinoma (BCC). Dermatoscopy is a noninvasive technique that allows visualization of cutaneous features from the skin surface to the papillary dermis. Basal cell carcinoma, the most common cutaneous malignancy, is traditionally diagnosed clinically and confirmed with biopsy. Objective: To determine the dermatoscopic features of non-pigmented basal cell carcinomas. Methods: The dermatoscopic findings of 27 lesions that clinically were suspicious for BCC were analyzed. Results: Of these 27 clinically suspect lesions, the biopsies revealed BCC in 20 specimens and squamous cell carcinoma (SCC) in two specimens. Twenty of these 22 specimens had dermatoscopic findings of BCC: diffusely distributed, branching blood vessels, asymmetric, and narrow blood vessels distributed deeper in the dermis, or a milky-red corona with superficial wide blood vessels. One nodular BCC in our study showed no distinct findings. Conclusions: Many BCCs have characteristic DS findings; however, dermatoscopic examination of some tumours will not demonstrate any known characteristic findings. As such, the DS criteria we propose for BCC are best utilized as an adjunctive study of clinical impressions. Biopsy remains the definitive diagnostic tool.

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The other skin cancers (non-melanoma, non-basal cell carcinoma, non-squamous cell carcinoma)

Current Problems in Dermatology ◽

10.1016/s1040-0486(01)70044-0 ◽

2001 ◽

Vol 13 (2) ◽

pp. 123-129 ◽

Cited By ~ 3

Author(s):

Henry W. Randle

Keyword(s):

Squamous Cell Carcinoma ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Basal Cell ◽

The Other ◽

Skin Cancers

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Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence

Biomedicine Hub ◽

10.1159/000508208 ◽

2020 ◽

Vol 5 (2) ◽

pp. 1-8

Author(s):

Philip R. Cohen ◽

Christof P. Erickson ◽

Nathan S. Uebelhoer ◽

Antoanella Calame

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

The Other ◽

Medical Complications ◽

Supporting Evidence ◽

The Sun ◽

Native State ◽

Exposed Skin ◽

Left Scapula

Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injection-associated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.

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Ultrastructure of Mouse Basal Cell Carcinoma Exhibiting Sebaceous Differentiation

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s1431927600003214 ◽

1980 ◽

Vol 38 ◽

pp. 738-739

Author(s):

Victoria L. Wade ◽

Winslow G. Sheldon ◽

James W. Townsend ◽

William Allaben

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Topical Application ◽

Basal Cell ◽

Sebaceous Gland ◽

Rats And Mice ◽

Mixed Tumors

Sebaceous gland tumors and other tumors exhibiting sebaceous differentiation have been described in humans (1,2,3). Tumors of the sebaceous gland can be induced in rats and mice following topical application of carcinogens (4), but spontaneous mixed tumors of basal cell origin rarely occur in mice.

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