The Value Of Dermoscopy In The Diagnosis Of Basal Cell Carcinoma

Objective:The purpose of the study is to explore the value of dermoscopy in the diagnosis of basal cell carcinoma(BCC)and its dermoscopic features.Methods:The retrospective study was performed on the complete clinical data of 54 patients with suspected BCC.These patients derived from the dermatology department of the Forth Affliated Hospital of Hebei Medical University from January to December 2019.Using histopathology as the gold standard,we compared the diagnosis of dermoscopy and histopathology,and investigated the dermoscopic features among different clinical subtypes of BCC.Results:Compared with histopathology,the sensitivity,specificity,accuracy,misdiagnosis,missed diagnosis,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,negative likelihood ratio,Youden index,area under the ROC curve and Kappa value of dermoscopy in the diagnosis of BCC were 97.78%,77.78%,94.44%,22.22%,2.22%,95.65%,87.50%,4.40,0.03,75.56%,0.878 and 0.791,respectively.There was no statistical difference between the two diagnostic methods(P > 0.05).45 cases were confirmed by histopathology,including three clinical subtypes: ulcerated nodular,pigmented and superficial type.The ulcerated nodular BCC typically showed arborizing vessels,blue-gray oval nests and multiple blue-gray globules.The pigmented BCC were typified by the presence of arborizing vessels,blue-gray oval nests and maple leaf-like structures.The superficial BCC had a greater frequency of maple leaf-like structures,shiny white structureless areas and spoke-wheel-like structures.There were statistically significant differences in arborizing vessels,maple leaf-like structures,blue-gray oval nests,spoke-wheel-like structures and shiny white structureless areas among different clinical subtypes of BCC(P < 0.05).Conclusions:1.There is a good consistency between dermoscopy and histopathology in the diagnosis of BCC.2.The dermoscopic features of different clinical subtypes of BCC are various.It is suggested that dermoscopy could improve the diagnostic accuracy for BCC by allowing the visualization of these specific structures.