The value of skin endoscopy in the diagnosis of pigmented basal cell carcinoma of the head and face

Abstract

Objective To evaluate and analysis the value of skin endoscopy in the diagnosis of pigmented basal cell carcinoma of the head and face. Methods A retrospective study was performed on 36 cases of patients(male 20 cases, female 16 cases, aged from 34~66 years old)with suspected pigmented basal cell from January to December 2014.The lesions mainly located in the head and neck, all patients received skin lesion endoscopy, and by 2 senior physicians from department of dermatology, according to the pathological characteristics of mirror skin pigmented basal cell carcinoma, independent of disease diagnosis, the pathological lesion diagnosis as the 'gold standard’, compared and studied the consistency of skin biopsy with pathological findings in the diagnosis of head to head facial pigmented basal cell carcinoma, and analyzed the sensitivity and specificity of diagnosis method. Results Among 36 cases of suspected patients, 25 cases of pigmented basal cell carcinoma were confirmed by histopathology; 27 cases of pigmented basal cell carcinoma were confirmed by A physician, the accuracy, misdiagnosis rate, the rate of missed diagnosis, sensitivity, specificity and Youden index were 92.6%, 27.3%, 4.0%, 87.5%, 33.3% and 68.7%, respectively, A physician diagnosed Kappa index was 0.965, P=0.326, and there was no statistically significant difference between the detection rate of basal cell carcinoma by A physician and pathological examination(P>0.05); 28 cases of pigmented basal cell carcinoma were confirmed by B physician, the accuracy, misdiagnosis rate, the rate of missed diagnosis, sensitivity, specificity and Youden index were 89.3%, 36.4%, 4.0%, 90.6%, 25.0% and 59.6%, respectively, B physician diagnosed Kappa index was 0.465, P=0.496, and there was no statistically significant difference between the detection rate of basal cell carcinoma by A physician and pathological examination(P>0.05). Conclusion Dermoscopic diagnosis of head facial pigmented basal cell carcinoma can achieve examination consistent with pathology; the diagnostic is speedy, convenient and noninvasive, which has important clinical value. Key words: Dermoscopic; Pigmented basal cell carcinoma; Diagnostic methods; Pathological examination