I thought this is a very interesting study.
Applicability of dermoscopy for evaluation of patients’ response to non-ablative therapies for the treatment of superficial basal cell carcinoma.
State Clinic of Dermatology, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece.
Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell carcinoma (sBCC) after non-ablative therapies has not been sufficiently assessed.
Certain dermoscopic criteria, namely pigmented structures, ulceration and arborizing vessels have been suggested to predict presence of residual disease (residual disease-associated dermoscopic criteria-RDADC). We aimed to assess this hypothesis.
Lesions exhibiting RDADC 3 months after treatment were biopsied and in case of histopathologic confirmation were excised. Lesions characterized by white/red structureless areas, superficial fine telangiectasias, or lacking any dermoscopic criterion, were monitored for 12 months.
At the 3-month evaluation, one or more of the RDADC were detected in 25/98 (25.5%) sBCCs, in which histology confirmed tumor persistence. In 45(61.6%) of the 73 remaining lesions, dermoscopy showed red/white structureless areas and/or superficial fine telangiectasias. Twenty-eight lacked any dermoscopic criterion of sBCC. The two latter groups entered follow-up. In total, disease recurred in 13 (17.8%) of the 73 lesions.
RDADC accurately predict residual disease. Absence of dermoscopic criteria of sBCC safely predicts complete histopathologic clearance. Detection of red/white structureless areas and/or superficial fine telangiectasias warrants close monitoring to recognize early recurrence.