Features Of Basal Cell Carcinoma Research Articles

Correlation of Clinical, Dermoscopical and Histopathological Features of Basal Cell Carcinoma

Correlation of Clinical, Dermoscopical and Histopathological Features of Basal Cell Carcinoma

Application of Ultraviolet-Enhanced Fluorescence Dermoscopy in Basal Cell Carcinoma.

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The aim of the current study was to analyze the ultraviolet-enhanced fluorescence dermoscopy (UVFD) characteristics of BCCs. BCCs were evaluated under polarized dermoscopy (PD) and UVFD. The findings in PD were described using predefined parameters for dermoscopic evaluation in dermato-oncology. UVFD characteristics were determined based on personal observations, and included interrupted follicle pattern, absence of pink-orange or blue-green fluorescence, well-demarcated borders, and dark silhouettes. In total, 163 BCCs were analyzed. Under UVFD, the interrupted follicle pattern (p < 0.001), absence of pink-orange fluorescence (p = 0.005) and well-demarcated borders (p = 0.031) were more frequently noted in BCCs < 5 mm than in bigger tumors. Lesions on the face showed clearly defined borders (p = 0.031) and interrupted follicle pattern (p < 0.001) more frequently than tumors located beyond the face. Nodular BCCs displayed interrupted follicle pattern (p = 0.001) and absence of pink-orange fluorescence (p < 0.001) more commonly than superficial subtypes. Non-pigmented BCCs more frequently showed lack of blue-green fluorescence (p = 0.007) and interrupted follicle pattern (p = 0.018) compared to pigmented variants. UVFD may be a valuable, complementary to PD, tool in the diagnosis of BCC, particularly in small tumors, lesions located on the face and nodular or non-pigmented subtypes.

THE EPIDEMIOLOGY OF BASAL CELL CARCINOMA AT THE NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY IN THE PERIOD 2017-2022

Objectives: To examine the situation and characteristics of basal cell carcinoma (BCC) and to follow up on and evaluate the effectiveness of treatment methods at the National Hospital of Dermatology and Venereology (NHDV) during the period 2017-2022. Material and methods: Cross-sectional study using data from all patients diagnosed with BCC and treated at NHDV from January 2017 to December 2022. Results: In the six years from 2017 to 2022, 1133 patients with skin cancer were treated at NHDV, of whom 765 patients had BCC, accounting for 67.5%. The mean age of BCC patients gradually decreased from 65.01 years old in 2017 to 60.2 years old in 2022, and the proportion of patients under 60 years old increased statistically over the years (p &lt; 0.01). Among the 387 BCC patients treated at NHDV from January 2020 to December 2022, 317 patients underwent Mohs surgery, accounting for 81.9%, and no recurrence was recorded. Meanwhile, 70 patients underwent wide-local excision (18.1%), and five cases of recurrence were recorded during follow-up. Conclusion: Basal cell carcinoma is the most common among skin cancers, and patients tend to be younger. Mohs surgery yields good results with the highest cure rate, optimizing the preservation of surrounding healthy skin tissue, maintaining function and aesthetics, and minimizing the recurrence rate. Received 02 July 2023Revised 20 September 2023Accepted 26 November 2023

Clinical Characteristics of Basal Cell Carcinomas of the Scrotum: An Institutional Retrospective Review

Objective. To analyse the clinical and pathologic features, discuss therapeutic strategies, and possibly cause and identify prognostic factors of scrotal basal cell carcinoma (BCC) in Chinese patients. Materials and Methods. Between January 2012 and December 2022, 12 patients with scrotal BCC were diagnosed and treated at our institution. A review was conducted based on the clinical characteristics, pathology slides, and tissues of these patients. Results. The median patient age was 69.26 ± 11.23 years. The skin lesions presented as red papules, blue-grey polypoid nodules, erythematous patches, brownish plaques, and so on. All patients were treated using wide excision, but the margins varied from 0.5 cm to 2 cm. HPV infection was checked in all lesions, with 4 out of 12 testing positive for P16 and 1 for HPV16 DNA. We found mottled positive expression of P16 in the cytoplasm and membrane. One patient developed left inguinal lymph node metastasis and was successfully treated using bilateral inguinal lymphadenectomy. The rest recovered well without relapse. Conclusions. BCC of the scrotum is rare, but long-term surveillance is recommended for BCC patients, and whether genital HPV infection is a noteworthy feature for these patients remains under investigation.

Differentiation and risk stratification of basal cell carcinoma with deep learning on histopathologic images and measuring nuclei and tumor microenvironment features.

Nuclear pleomorphism and tumor microenvironment (TME) play a critical role in cancer development and progression. Identifying most predictive nuclei and TME features of basal cell carcinoma (BCC) may provide insights into which characteristics pathologists can use to distinguish and stratify this entity. To develop an automated workflow based on nuclei and TME features from basaloid cell tumor regions to differentiate BCC from trichoepithelioma (TE) and stratify BCC into high-risk (HR) and low-risk (LR) subtypes, and to identify the nuclear and TME characteristics profile of different basaloid cell tumors. The deep learning systems were trained on 161 H&E -stained sections which contained 51 sections of HR-BCC, 50 sections of LR-BCC and 60 sections of TE from one institution (D1), and externally and independently validated on D2 (46 sections) and D3 (76 sections), from 2015 to 2022. 60%, 20% and 20% of D1 data were randomly splitted for training, validation and testing, respectively. The framework comprised four stages: tumor regions identification by multi-head self-attention (MSA) U-Net, nuclei segmentation by HoVer-Net, quantitative feature by handcrafted extraction, and differentiation and risk stratification classifier construction. Pixel accuracy, precision, recall, dice score, intersection over union (IoU) and area under the curve (AUC) were used to evaluate the performance of tumor segmentation model and classifiers. MSA-U-Net model detected tumor regions with 0.910 precision, 0.869 recall, 0.889 dice score and 0.800 IoU. The differentiation classifier achieved 0.977±0.0159, 0.955±0.0181, 0.885±0.0237 AUC in D1, D2 and D3, respectively. The most discriminative features between BCC and TE contained Homogeneity, Elongation, T-T_meanEdgeLength, T-T_Nsubgraph, S-T_HarmonicCentrality, S-S_Degrees. The risk stratification model can well predict HR-BCC and LR-BCC with 0.920±0.0579, 0.839±0.0176, 0.825±0.0153 AUC in D1, D2 and D3, respectively. The most discriminative features between HR-BCC and LR-BCC comprised IntensityMin, Solidity, T-T_minEdgeLength, T-T_Coreness, T-T_Degrees, T-T_Betweenness, S-T_Degrees. This framework hold potential for future use as a second opinion helping inform diagnosis of BCC, and identify nuclei and TME features related with malignancy and tumor risk stratification.

Role of ultra-high-frequency ultrasound in the diagnosis and management of basal cell carcinoma: pilot study based on 117 cases.

Ultrasound imaging has recently benefited from the introduction of a new 70 MHz transducer able to provide high-resolution images, i.e. ultra-high-frequency ultrasound (UHFUS). To study the morphological features of basal cell carcinomas (BCCs) and measure BCC thickness by means of UHFUS examination. In this retrospective multicentric study, 171 consecutive patients underwent UHFUS examination between November 2018 and May 2019 for suspected BCC. Diagnosis was confirmed by histopathology. A series of morphological parameters including echogenicity, structure, borders, shape composition (presence of intralesional structures) were investigated along with objective measurements such as thickness (maximum distance between the surface of the epidermis and the deepest part of the tumour) and width. In total, 117 BCCs from 93 patients were examined, including superficial (n = 13; 11.1%), nodular (n = 64; 54.7%), infiltrative (n = 18; 15.4%), mixed subtypes (n = 20; 17.1%) and other subtypes (n = 2; 1.7%). The most frequently observed UHFUS parameters included: hypoechoic signal (n = 80; 68.4%, P < 0.001), homogeneous structure (n = 76, 65.0%, P = 0.01), well-defined borders (n = 77, 65.8%, P < 0.001) and elongated shape (n = 71, 60.7%, P < 0.001). An excellent correlation was found between the BCC thickness measured by UHFUS and the value estimated by histology (interclass correlation ≥ 0.80). UHFUS is a new rapid and easy noninvasive skin imaging technique able to provide data on the dimensions and morphology of BCCs in real time and at the bedside. These characteristics mean UHFUS has a number of possible applications, ranging from presurgical mapping to the detection of disease recurrence and treatment monitoring.

Clinical Characteristics of Basal Cell Carcinomas of the Vulva: An Institutional Retrospective Review.

There are limited data on the etiology, clinical characteristics, and optimal treatment of vulvar basal cell carcinoma (BCC). This retrospective review may aid in treatment decisions for vulvar BCC. A retrospective review of our institutional CoPath database was performed, using search terms to identify cases of vulvar BCCs from 2000 to 2018. A total of 35 cases of vulvar BCC were included. Patient age ranged from 33 to 97 years with a mean age of 70 years. Of the 35 cases, 28 (80%) involved the cutaneous vulva, 6 (17%) involved the suprapubic area, and 1 (3%) involved the clitoris. Most vulvar BCCs were treated by wide local excision (46%) and vulvectomies (37%), with 3 cases treated with Mohs (11%) and 2 with electrodesiccation and curettage (6%). Preoperative tumor sizes were 0.86 cm2 for Mohs, 0.94 cm2 for excision, and 1.54 cm2 for vulvectomy. The mean margins were 3 mm for Mohs, 4.4 mm for wide local excision, and 6 mm for vulvectomy. Most cases (77%) were identified and treated by gynecology. Mohs micrographic surgery should be considered for the advantages of being tissue sparing, evaluating the complete peripheral and deep margin, and avoiding the costs and risks of general anesthesia.

Dermatoscopic “Mimickers” of Basal Cell Carcinoma - Adnexal Skin Tumors

Background: Adnexal skin tumors (AST) are numerous and various, and in their appearance give dermoscopic and clinical features similar to basal cell carcinoma (BCC). Differential diagnosis is difficult, as clinical alteration seems insufficient to distinguish between BCC and many skin lesions that mimic BCC. However, the validity and usefulness of dermatoscopic criteria enable differentiation between BCC and AST. The purpose of this paper was to present the basic dermatoscopic criteria for diagnosis of BCC as well as minimally invasive methods for treatment and clinical management, with a better aesthetic outcome. Methods and Results: This study consisted of a retrospective review of 50 skin lesions collected in our institution over a 3-year period. We analyzed the dermoscopic images of 29 skin lesions with a clinical diagnosis of BCC and 21 cases with a clinical diagnosis of AST. All lesions were assessed for the presence of various dermatoscopic criteria using a manual photo dermatoscopy system DermLite (DermLite 3, Gen). Each case was evaluated by the presence of dermatoscopic features. We compared dermatoscopic and clinical features between the BCC and AST groups. In the AST group, there were 5(23.8%) premalignant and 16(76.2%) benign lesions. Compared to the AST group, the BCC group had a significantly higher frequency of dermatoscopic features (vascular pattern, ulceration, and additional dermatoscopic features). All lesions included in this study showed more than one of the following characteristics of BCC: arborizing vessels, short fine telangiectasia, translucency, ulceration, blue-gray globules, flecked pigmentation, and rolled borders. Cutaneous lesions with 2 or fewer dermatoscopic features of BCC were much more likely to be an adnexal tumor. Conclusion: The results of this study could be valuable for the differential diagnosis of BCC and BCC-mimicking cutaneous lesions, because dermatoscopy can be especially helpful in better describing, recognizing, and differentiating these lesions.

Clinicopathological features of head and neck cutaneous basal cell carcinoma observed at the Centro Hospitalar de Trás-os-Montes e Alto Douro ENT Department.

Cutaneous basal cell carcinoma (cBCC) incidence has been increasing, but there are no available data on its epidemiological, clinical, and pathological patterns in Northeast Portugal. cBCC is mainly located in the head and neck, where the ear, neck, and throat (ENT) surgeon may have a major role. We aimed to verify the clinicopathological characteristics of basal cell carcinomas diagnosed in an ENT department. We performed a retrospective clinicopathological evaluation of the head and neck cBCC cases followed up at the Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD) ENT Department between January 2007 and April 2021. One hundred seventy-four patients with 293 cBCCs were included in this retrospective study. We observed that about one-third of the patients had multiple cBCCs (30.5%) and an infiltrative-type growth pattern (39.3%), both features considered as patterns that are more aggressive. Infiltrative-type growth pattern cBCCs were significantly larger when compared with the indolent-type growth pattern (16.2 mm vs 10.8 mm). To the best of our knowledge, this is the first study about cBCC in a patient population followed up at an ENT hospital department. This study has shown that these patients had cBCCs with more aggressive features, making these tumors an important issue for the ENT surgeon.

Characteristics of Malignant Eyelid Basal Cell Carcinoma in Dr. Mohammad Hoesin General Hospital: A Retrospective Study

Introduction: Incidence rates of skin cancer have risen significantly over the last two decades. Most tumors develop in sun-exposed areas of the head and neck. Basal cell carcinoma (BCC) rarely metastasizes but can cause significant morbidity and death due to direct spread to the orbit, head, and neck and frequent recurrence. In addition, approximately 40% of BCC patients have other lesions after 5 years. Although there has been a lot of epidemiological data regarding the characteristics of BCC in developed countries, reports of BCC in Asia, especially in Southern Sumatra, are still at a minimum rate.&#x0D; Methods: This study retrospectively reviewed the medical records specific to periocular BCC. Data were collected from the patient register book recorded from January 2021 to May 2022. The clinical characteristics of patients with BCC, such as gender and age, clinicopathological findings of BCC lesions, and BCC management, were reviewed retrospectively. This study aims to determine the epidemiological profile of the malignant eyelid BCC patient, the BCC lesion characteristics, and the management of BCC cases at Mohammad Hoesin General Hospital Palembang.&#x0D; Results: From 16 BCC patients recruited for this study, most of them were 51–60 years old and 71–80 years old, each with 5 patients (31.3%). The female preponderance of 56.3%. Occulus dextra (56.3%), lower eyelid (62.5%), T1 (87.5%), nodular BCC (75,0%), and primary lesion (75,0%) were the most side, periocular site, size, histopathological subtype and recurrence, respectively. Most therapy done is excision (93,8%), while the leading reconstructive technique was Tenzel’s flap (50,0%).&#x0D; Conclusion: There is a slight preponderance of females as BCC patients. BCC is commonly found in elderly people. The lower eyelid and right side are the most frequent anatomical locations. Nodular is the most common histological subtype. In addition, lesions often present in T1 size and primary lesions. Lastly, the treatment is mainly surgical (excision), with Tenzel's flap as the most used reconstruction technique option.

An Up-to-Date Correlation of Epidemiological and Histopathological Characteristics of Basal Cell Carcinoma of the Skin in a County Hospital in Romania.

Background and Objectives: Basal carcinoma of the skin (BCC) is part of the nonmelanoma skin cancer (NMSC) family and is the most frequently occurring type of skin cancer in humans. A combination of clinical and histopathological approaches is necessary in order to establish the best treatment regime for patients who have been diagnosed with this type of cancer. The objective of the present study was to establish the statistical value of prediction for certain sociodemographic characteristics (age category and environment of origin) and histopathological parameters of the subjects that could be related to the incidence of diagnosis with certain histopathological subtypes of BCC. Materials and Methods: In order to verify the veracity of the established research hypotheses, we conducted a retrospective study based on the histopathological reports of 216 patients who were treated at the Pathology Department of Mureș Clinical County Hospital. Results: Cystic BCC is higher in patients who are older than 71 years of age, and the superficial multicentric and keratotic subtypes are more frequently diagnosed in urban areas. Patients who have been diagnosed with the superficial multicentric BCC subtype are not usually very old in contrast to the patients who tend to be diagnosed with the cystic BCC subtype. The nodular BCC subtype is positively associated with ulceration (p = 0.004); the superficial multicentric BCC subtype is positively associated with intra- and peritumoral inflammatory infiltrate (p = 0.022, p = 0.034) and negatively associated with ulceration (r = −0.218, p = 0.001). The infiltrative BCC subtype is positively associated with ulceration (p = 0.021), and the keratotic BCC subtype is positively associated with peritumoral inflammatory infiltrate (p = 0.02). Conclusions: Depending on each patient’s epidemiological and sociodemographic data, a pattern can be established regarding the appropriate clinical and treatment approaches for that patient, which can be supported based on the implications of the histopathological diagnostic. This can lead to an improvement in the patient’s quality of life and increased satisfaction with the provided medical services.

Line-field confocal optical coherence tomography of basosquamous carcinoma: a case series with histopathological correlation.

Basosquamous carcinoma (BSC) is a rare and potentially aggressive cutaneous neoplasm combining histopathological features of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Line-field confocal optical coherence tomography (LC-OCT) is a new, non-invasive imaging technique featuring excellent resolution and penetration. To date, studies about the use of LC-OCT in the BCC and SCC fields are available, but similar investigations are lacking in the BSC field. The goal of the present study was to identify/describe LC-OCT criteria of BSC. Consecutively enrolled BSCs were imaged with dermoscopy and LC-OCT prior to surgical excision. Dermoscopic and LC-OCT images were evaluated, and histopathological slides were reviewed. Six BSCs from six patients [four (66.7%) males and two (33.3%) females; mean age 76.5 (62-96) years] were included. Identified LC-OCT criteria for BSC included BCC-associated (dermal lobules with millefeuille pattern, dilated vessels, bright cells within the epidermis, bright cells within lobules, stromal stretching, stromal brightness) and SCC-associated features (acanthosis, hyperkeratosis, disarranged epidermal architecture, broad strands, elastosis and glomerular vessels). Interruption of the dermal-epidermal junction and ulceration represented overlapping criteria. Line-field confocal-OCT is a new promising technique that may support the non-invasive recognition of BSC through the simultaneous detection of BCC-associated and SCC-associated features. We hypothesize that the use of LC-OCT might be helpful not only in the diagnostic setting but also in the follow-up surveillance for an early identification of recurrences. Further larger studies are needed to prove this hypothesis.

2021 international consensus statement on optical coherence tomography for basal cell carcinoma: image characteristics, terminology and educational needs.

Despite the widespread use of optical coherence tomography (OCT) for imaging of keratinocyte carcinoma, we lack an expert consensus on the characteristic OCT features of basal cell carcinoma (BCC), aninternationally vetted set of OCT terms to describe various BCC subtypes, and an educational needs assessment. To identify relevant BCC features in OCT images, propose terminology based on inputs from an expert panel and identify content for a BCC-specific curriculum for OCT trainees. Over three rounds, we conducted a Delphi consensus study on BCC features and terminology between March and September 2020. In the first round, experts were asked to propose BCC subtypes discriminable by OCT, provide OCT image features for each proposed BCC subtypes and suggest content for a BCC-specific OCT training curriculum. If agreement on a BCC-OCT feature exceeded 67%, the feature was accepted and included in a final review. In the second round, experts had to re-evaluate features with less than 67% agreement and rank the ten most relevant BCC OCT image features for superficial BCC, nodular BCC and infiltrative and morpheaphorm BCC subtypes. In the final round, experts received the OCT-BCC consensus list for a final review, comments and confirmation. The Delphi included six key opinion leaders and 22 experts. Consensus was found on terminology for three OCT BCC image features: (i) hyporeflective areas, (ii) hyperreflective areas and (iii) ovoid structures. Further, the participants ranked the ten most relevant image features for nodular, superficial, infiltrative and morpheaform BCC. The target group and the key components for a curriculum for OCT imaging of BCC have been defined. We have established a set of OCT image features for BCC and preferred terminology. A comprehensive curriculum based on the expert suggestions will help implement OCT imaging of BCC in clinical and research settings.

Basal Cell Carcinoma Treated with High Dose Rate (HDR) Brachytherapy-Early Evaluation of Clinical and Dermoscopic Patterns during Irradiation.

Simple SummaryBasal cell carcinoma (BCC) is the most frequent malignancy of the Caucasian population. High dose rate (HDR) brachytherapy is a re-emerging treatment method for various skin cancers. Dermoscopy is an acknowledged and widely used diagnostic tool providing the bridge between histopathology and clinical examination. Current literature lacks data reporting on the dermoscopic observation of basal cell carcinomas undergoing brachytherapy. In this article, the authors describe clinical and dermoscopic patterns of basal cell carcinomas from 23 patients treated with HDR brachytherapy, and analyse the evolution of BCC structures.Basal cell carcinoma (BCC) is the most frequent malignancy of the Caucasian population. Dermoscopy is an established diagnostic method providing the bridge between clinical and pathological examination. Surface skin high dose rate (HDR) brachytherapy is an organ sparing treatment method used for non-surgical candidates. This prospective study aimed to observe clinical and dermoscopic features and their evolution in 23 patients with pathologically confirmed BCC that have been treated with HDR brachytherapy. In all cases, custom-made surface moulds were used. HDR brachytherapy was performed with 192Ir, dose 45Gy was delivered to the tumour in nine fractions of 5Gy, three times a week. The evolution of clinical and dermoscopic features was followed up at the beginning of treatment, and on the day of every fraction (t1–t9). Dermoscopic evaluation of neoplastic and non-neoplastic structures was based on current diagnostic criteria according to current literature. Univariate logistic regression showed a decreasing number of clinical and pathological features of basal cell carcinoma with every treatment fraction. The effect was more strongly pronounced for cancer-related dermoscopic structures compared with non-neoplastic features. We used multivariate ordinal logistic regression with random effects to prove that the patients’ age corresponds with the tumour’s response to radiation—which may implicate a better response to treatment among older patients. High dose rate brachytherapy decreases the number of clinical and dermoscopic features typical for basal cell carcinoma. The effect is more pronounced among older patients.

Dermoscopic Features of Basal Cell Carcinoma and Their Association with Histological Types in A Chinese Population: A Perspective Study

Abstract Objective: The treatments and prognoses of high-risk and low-risk basal cell carcinomas are quite different. This study aimed to examine the dermoscopic features of basal cell carcinomas and assess the association between the features and basal cell carcinomas recurrence risks in a Chinese population. Methods: Patients with histopathologically confirmed basal cell carcinomas examined from March 2016 to April 2020 were enrolled. The dermoscopic features were evaluated, and the correlations between these features and the histological types and recurrence risks were assessed. Results: The study cohort comprised 119 Chinese patients with a total of 119 skin lesions. The most common dermoscopic feature of basal cell carcinomas was the absence of a pigment network (119/119, 100%), followed by shiny white streaks (105/119, 88.24%), blue-gray ovoid nests (99/119, 83.19%), multiple blue globules (78/119, 65.55%), and arborizing vessels (78/119, 65.55%); yellow-white structures were present in 29/119 lesions (24.37%). Leaf-like and spoke-wheel areas were significantly associated with superficial basal cell carcinomas (P &lt; 0.001), while arborizing vessels (P &lt; 0.001), blue-gray ovoid nests (P &lt; 0.001), and ulceration (P &lt; 0.05) were significantly associated with nonsuperficial basal cell carcinomas subtypes. The dermoscopic features of the high-risk and low-risk groups exhibited considerable overlap; however, the respective independent predictive factors for a high and low risk of basal cell carcinomas recurrence were short fine telangiectases (P &lt; 0.05) and blue-gray ovoid nests (P &lt; 0.05). Conclusion: Dermoscopy provides important information about basal cell carcinomas and is helpful in differentiating superficial basal cell carcinomas from other subtypes. The dermoscopic vascular structures and blue-gray ovoid nests play a crucial role in evaluating the basal cell carcinomas risks preoperatively.

Comparison of Demographic and Clinicopathological Characteristics of Basal Cell Carcinoma on the Nose and Other Sites of the Face: A Cross-Sectional Study.

Introduction:The clinicopathological characteristics of basal cell carcinoma (BCC) in different areas of the face, including the nose, are important and may be different. Accurate recognition of these characteristics may be necessary for the planning and selection of appropriate treatment.Materials and Methods:This cross-sectional study was conducted on 328 patients (131 females and 197 males) with 371 documented facial BCC in the West of Iran within 2013-2018. The demographic and clinicopathological data of the patients in the nose area were compared with other sites of the face by appropriate statistical methods.Results:Out of 371 lesions, 38.8% of the cases were on the nose, 75.8% were primary lesions, 97.8% had no perineural invasion, 89.2% were nodular, and 65.8% were of nodular clinical and pathologic type, which were the most common variables of patients. It was revealed that early-onset (P<0.001), smaller size (P<0.001), high-risk pathologic type (P=0.01), and recurrent lesions (P=0.013) were significantly higher in the nasal BCC. However, there was no significant difference between BCC in the nose and other sites of the face in terms of gender (P=0.654), high-risk clinical type (P=0.06), and perineural invasion (P=0.275). Conclusion:Considering the nasal site as an important cosmetic unit, more limitation of the nose in performing any procedure, and presence of the more risk factors in the nose than in other areas of the face, the definite treatment of nasal BCC requires special attention, expertise, and experience.

Manually scanned single fiber optical coherence tomography for skin cancer characterization

Optical coherence tomography (OCT) is a cross-sectional imaging modality based on low coherence light interferometry. Within dermatology, it has found applications for in vivo diagnostic imaging purposes, as well as to guide Mohs micrographic surgery (MMS), due to its ability to visualize skin morphology up to several millimeters in depth. However, standard OCT probes have a large footprint and capture an extended area of the skin, making it difficult to precisely pinpoint clinically relevant location being imaged. Mohs surgeons stand to benefit from a handheld in vivo imaging device that can accurately trace surgical margins. In this study, we demonstrate the use of a single fiber OCT (sfOCT) instrument. Our imaging system features a miniature common path single fiber probe, and a novel speckle decorrelation technique that generates distortion free 2D images from manual scanning.By manually moving the single-fiber probe across the region of interest, the user can perform a lateral OCT scan while visualizing the location of the probe during data acquisition. Using the sfOCT, we have identified normal skin morphology, qualitatively correlated features of basal cell carcinoma and squamous cell carcinoma with histopathology, and quantified the disruption of the dermo-epidermal junction OCT pattern in skin tumors—each demonstrating the potential of utilizing sfOCT to differentiate tumor from normal skin. Using this imaging tool, a Mohs surgeon can enhance determination of surgical margins for the first stage of MMS, potentially decreasing the time and number of stages required for complete tumor removal.

CLINICOPATHOLOGIC STUDY OF BASAL CELL CARCINOMA: A SINGLE-CENTRE RETROSPECTIVE STUDY

Background: Basal cell carcinoma (BCC) is the most common malignant neoplasm in fair-skinned individuals and accounts for about two-thirds of all skin cancers in Caucasians. BCC rarely metastasizes or causes death, but it can result in extensive morbidity through local invasion and tissue destruction. Objective: To evaluate the clinicopathologic features of basal cell carcinoma in Egyptian population. Patients and methods: Our study included 80 patients with BCCs from January 2015 to December 2019. A retrospective analysis of baseline clinical and histopathological data was for all subjects incorporated in the study. Data needed for the study were obtained from the case files. Patients were histologically diagnosed at Dermatopathology unit of Department of Dermatology and Venereology, Al-Hussein University Hospital, Cairo, Egypt. Results: The present study showed that the clinical types of BCC of the involved patients were 41 lesions (39%) of ulcerative type, 39 lesions (37.1%) of nodular non pigmented type, 13 lesions (12.4%) of nodular pigmented type, 9 lesions (8.6%) of superficial type, and 3 lesions (2.9%) of advanced type. As regards the histological subtypes, 52 lesions (49.5%) were nodular, 11 lesions (15.9%) were pigmented, 9 lesions (8.6%) were adenoid, 9 lesions (8.6%) were superficial, 8 lesions (7.67%) were infiltrative, 7 lesions (6.7%) were micro-nodular, 6 lesions (5.7%) were nodulo-cystic and 3 lesions (4.3%) were baso-squamous. Conclusion: Based on our findings, BCC was strongly associated with exposure to ultraviolet (UV) radiations. Tumors developed mainly on the sun-exposed skin of elderly individuals. Nodular BCC was the most common clinical and histological subtype.

Topical Application of Glycerol Increases Penetration Depth of Optical Coherence Tomography in Diagnosis of Basal Cell Carcinoma.

Optical coherence tomography is a non-invasive imaging technique that enables high-resolution in vivo imaging of skin. Although optical coherence tomography is promising for diagnosing basal cell carcinoma, its limited penetration depth may impede basal cell carcinoma subtyping. This study evaluated whether topical application of glycerol can increase penetration depth and improve the image quality and visibility of characteristic features of basal cell carcinoma. A total of 61 patients with a total of 72 basal cell carcinomas were included. Optical coherence tomography scans were obtained before and after application of an 85% glycerol solution. The mean penetration depth of each optical coherence tomography scan was acquired by automatically tracing both skin surface and the point of signal loss using a custom-made MATLAB program. Mean±standard deviation penetration depth increased from 883 ± 108 to 904 ± 88 μm before and after glycerol application, respectively (p = 0.005). Topical application of glycerol leads to a significant 2.4% increase in penetration depth. However, no significant differences in image quality and visibility of basal cell carcinoma features were found.

Early-Onset Basal Cell Carcinoma; Wide Case Series At A Single Tertiary Center In Middle Anatolia

OBJECTIVEAlthough basal cell carcinoma (BCC) is prevalent in the older population, it can be rarely seen in younger people. This study aims to investigate the risk factors and characteristics of BCC in young patients.METHODSPathology reports in a single tertiary care institution between 2010 and 2020 were retrospectively reviewed. Patients under the age of 35 who were diagnosed with BCC were included for the analysis. Data were gathered from medical records and pathology reports. Demographic characteristics, accompanying pathologies, and clinical findings of these patients were analyzed.RESULTSThere were a total of 32 patients in our cohort. Out of 32 patients, 20 were female and 12 were male. One male patient and five female patients were younger than 18. An accompanying risk factor (Gorlin syndrome, XP, renal transplantation, etc.) was present in six patients. There were no known additional diseases or risk factors in 26 patients. Metastasis and recurrence were not reported in any of our patients. Contrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study.CONCLUSIONContrary to the information in the literature, the patients with BCC at a young age were not found more aggressive in our study. Understanding the risk factors associated with BCC is essential for designing prevention strategies and favoring early diagnosis. Awareness of early-onset BCC aids in early diagnosis and treatment of the disease. Therefore, BCC should be in the differential diagnosis of skin lesions in the young population. In addition, when we encounter early-onset BCC, we should not forget the accompanying risk factors and syndromes.