Dermatoscopic Features of Basal Cell Carcinoma

Basal cell carcinoma is the most common type of non-melanoma skin cancers, frequently observed in fair-skinned individuals. The major risk factors for developing basal cell carcinoma are environmental exposures, phenotypic and genetic traits, and immunosuppression. The diagnosis of basal cell carcinoma is based upon clinical examination and dermatoscopy findings and finally confirmed by histopathological analysis. There are five main clinicopathologic types of basal cell carcinoma, specifically, superficial, nodular, pigmented, morpheaform, and fibroepithelial variant. The dermatoscopic feature of all BCC is the absence of a pigment network. Dermatoscopy structures are further classified as vascular, pigment-related, and non-vascular/non-pigment-related structures. Vascular structures include arborizing vessels and short fine telangiectasias, while pigmented structures comprise maple leaf-like areas, spoke-wheel areas, multiple blue-gray globules, in-focus dots, and concentric structures. Additional structures such as ulcerations, multiple small erosions, multiple aggregated yellow-white globules, shiny white-red structureless areas, and white streaks are considered non-vascular/non-pigmented structures. As treatment options highly depend on the type of BCC, dermatoscopy is of great value in management strategy, assessment of margins, and evaluation of response to non-ablative therapies