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DERMATOSCOPY IN PREDICTING BASAL CELL CARCINOMA MARGINS

IVANA MANOLA ; Manola Polyclinic, Zagreb, Croatia
ANA MATAIĆ orcid.org/0000-0001-9118-464X ; Clinical Department of Pathology and Cytology, Zagreb University Hospital Center, Zagreb, Croatia
MILAN MILOŠEVIĆ orcid.org/0000-0001-9008-7645 ; Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
DANIJELA LEDIĆ DRVAR ; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Dermatology and Venereology, Zagreb University Hospital Center, Zagreb, Croatia
ANDREJA PETROVIĆ ; Clinical Department of Pathology and Cytology, Merkur University Hospital, Zagreb, Croatia
BOŽO KRUŠLIN orcid.org/0000-0002-0480-1687 ; School of Medicine, University of Zagreb, Zagreb, Croatia; Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

Abstract

Introduction: Basal cell carcinoma (BCC) is a slow-growing epithelial tumor that rarely metastasizes, and has the rising incidence in the last decades. Complete surgical removal to reduce local recurrence is the therapy goal. Aim: To investigate the effi cacy of dermatoscopy in distinguishing superfi cial from other histopathologic BCC subtypes and in predicting the required surgical margins to reduce recurrence rate. Methods: We conducted a single-center, retrospective study in the period between January 1, 2011 and December 31, 2020. After BCC diagnosis was established, skin lesions were evaluated using dermatoscopy. After surgical excision, histopathologic analysis of the tumor and peritumoral tissue was performed by an experienced pathologist. Correlation between dermatoscopy and histopathology fi ndings were evaluated. Results: All tumors were up to 20 mm in largest diameter with head and neck being the most affected skin site (56%). There was an absolute correlation between dermatoscopy and histopathology in superfi cial BCC subtype (kappa coeffi cient 1.000; p<0.001), lower in nodular (kappa 0.847; p<0.001) and infi ltrative subtype (kappa value 0.846, p<0.001). A large majority of tumors were 1-2 mm from the inked margins (81%), belonging to pT1 category. Regarding the recurrence rate, there was no statistically signifi cant relationship with tumor size, margin or base status or tumor thickness; 8.8% of patients had recurrence in the median follow-up period of 120 months. There was a signifi cantly poorer survival period regarding recurrence in infi ltrative BCC subtype when compared to superfi cial (51 vs. 108 months; p<0.001) and nodular subtype (51 vs. 72 months, p<0.001). Conclusion: Dermatoscopic evaluation of the BCC margins could be helpful in preoperative assessment, with emphasis on inking of surgical specimen margins.

Keywords

basal cell carcinoma; dermatoscopy; margins; inking

Hrčak ID:

294442

URI

https://hrcak.srce.hr/294442

Publication date:

27.2.2023.

Article data in other languages: croatian

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