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 Table of Contents  
THROUGH THE DERMOSCOPE
Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 123-124

Dermoscopy of pigmented basal cell carcinoma


Department of Dermatology, Venereology and Leprosy, Government Medical College, Nagpur, Maharashtra, India

Date of Web Publication14-Dec-2018

Correspondence Address:
Dr. Kinjal D Rambhia
H. No. 574, Gulati Bhavan, Mukundraj Lane, Walker Road, Mahal, Nagpur, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/Pigmentinternational.Pigmentinternational_

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How to cite this article:
Rambhia KD, Shah VH, Singh RP. Dermoscopy of pigmented basal cell carcinoma. Pigment Int 2018;5:123-4

How to cite this URL:
Rambhia KD, Shah VH, Singh RP. Dermoscopy of pigmented basal cell carcinoma. Pigment Int [serial online] 2018 [cited 2019 Dec 14];5:123-4. Available from: http://www.pigmentinternational.com/text.asp?2018/5/2/123/247501



Sir,

A 42-year-old male presented with single asymptomatic dark-colored lesion on left side of forehead which erupted 10 months ago. Examination revealed single, well-defined, hyperpigmented, waxy nodule with central depression over the left temporal region [Figure 1]. Dermoscopy (eScope, magnification 10×, polarized light) revealed absence of pigment network, blue-gray structureless areas, linear telangiectasia, and shiny white chrysalis-like structures [Figure 2]. Histopathology revealed multiple well-demarcated islands of basaloid cells with peripheral palisading, with clumps of pigment [Figure 3]. The diagnosis of pigmented basal cell carcinoma (BCC) was made on clinical, dermoscopic, and histopathological findings.
Figure 1: Single well-defined hyperpigmented waxy nodule with central depression over the left temporal region

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Figure 2: Dermoscopy (eScope, magnification 10×) showing absence of pigment network, blue-gray structureless area (red arrow), linear telangiectasia (green arrow), shiny white chrysalis-like structures (yellow arrow)

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Figure 3: Multiple well-demarcated islands of basaloid cells with peripheral palisading, with clumps of pigment (hematoxylin and eosin, ×10)

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BCC is the most common skin cancer and presents as a pigmented lesion in 6.7% to 8.5% of the cases.[1] Pigmentation is seen in more than 50% of the tumors in Asian population, whereas less than 10% of BCCs are pigmented in fair skinned individuals.[2]

Dermoscopy has greatly enhanced clinical diagnosis of pigmented skin tumors.[1] The diagnosis of pigmented BCC is made on the dermatoscopic absence of pigment network and the detection of one of six positive criteria: arborizing vessels, large blue-gray ovoid nests, ulceration, maple-leaf-like areas, spoke wheel areas, or multiple blue-gray dots/globules.[2] Chrysalis-like structures are shiny, white, orthogonal linear streaks which are prominent under polarized dermoscopy.[3] On dermoscopy, pigmented BCCs are always asymmetric in pattern, and because of their irregularity, the differential diagnosis of pigmented BCCs includes both invasive melanoma and benign pigmented lesions. Dermoscopic findings of melanoma are atypical pigment network, presence of four or more colors, blue-white veil, atypical vascular pattern, irregular dots/globules, irregular streaks, irregular blotches, regression structures, and peripheral radial lines or pseudopods. Benign nevi patterns include presence of pigment network, homogenous color, diffuse reticular, patchy reticular, and globular (regular). Thus, dermoscopy is a useful tool in differentiating between pigmented BCC and melanoma and nevi.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Trigoni A, Lazaridou E, Apalla Z, Vakirlis E, Chrysomallis F, Varytimiadis D et al. Dermoscopic features in the diagnosis of different types of basal cell carcinoma: A prospective analysis. Hippokratia 2012;16:29-34.  Back to cited text no. 1
    
2.
Lallas A, Apalla Z, Argenziano G, Longo C, Moscarella E, Specchio F et al. The dermatoscopic universe of basal cell carcinoma. Dermatol Pract Concept 2014;4:2.  Back to cited text no. 2
    
3.
Marghoob AA, Cowell L, Kopf AW, Scope A. Observation of chrysalis structures with polarized dermoscopy. Arch Dermatol 2009;145:618.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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