الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
Abstract
Summary
Basal cell carcinoma (BCC) occurs primarily on sunexposed
skin and is regarded as the most common cutaneous
malignancy. It constitutes approximately 75% of nonmelanoma
skin cancer and is traditionally considered as lowgrade,
indolent tumor. Whilst not life threatening, BCC can
cause substantial morbidity.
Frequency of BCC has been increasing in many countries
around the world. Because of its high frequency, the disease
has been accepted to be a public health issue. Despite low
mortality rates and the rare occurrence of metastases, the tumor
may be locally invasive and relapse after treatment, causing
significant morbidity. In BCC, knowledge of risk factors, early
diagnosis and treatment are the major points.
Dermatoscopy is a noninvasive method that aids in the
early diagnosis of pigmented skin lesions by giving physicians
more detailed view of the skin that is possible with the naked
eye. Dermatoscopy allows physicians to visualize structures
underneath the stratum corneum and has been shown to
increase diagnostic facilities for malignant melanoma and other
pigmented and non-pigmented skin lesions.
Although histopathology is recognized as the reference
standard in the diagnosis of BCC, on some occasions
histopathology services are not accessible or a more expedited
result is needed.
Summary
165
The purpose of this study was to establish the
dermatoscopic criteria of different histopathologic variants of
BCC and to correlate these findings with the histopathological
features of the tumor.
Our study was carried out on 20 patients with
histopathologically confirmed BCC. By the end of the study,
we had 24 BCC lesions. We classified the BCC lesions in the
current study, according to the histological growth pattern.
Seven BCC histopathologic types were observed: nodular;
pigmented; superficial; micronodular; infiltrative; morphoeic
and metatypical BCC.
As regards to the dermatoscopic criteria of nodular BCC,
our study showed that the most frequent dermatoscopic criteria
were arborizing vessels and blue /grey ovoid nests. They
correlated histologically with dilated dermal vessels and large
nests of basaloid cells in the dermis containing melanin
aggregates consecutively.
The main dermatoscopic findings in pigmented BCC
were blue/gray ovoid nests and blue/gray ovoid globules.
Furthermore, maple leaf areas were observed in pigmented
BCC and were corresponded histologically to melanin
deposition in the upper dermal nests at the tumor periphery.
Interestingly, we detected blue white veil in pigmented BCC
lesions that resulted from the presence of a large quantity of
melanin present in the dermis.
Summary
166
Concerning superficial BCC, short fine telangiectasia
was the predominant vascular pattern. Spoke wheel area and
concentric structure were more frequent in superficial BCC
compared with other BCC types. Histologically, they correlated
to basaloid cells arranged in cords with radial growth from a
central core or irregular basaloid nests in the superficial tumor
nests. Furthermore, superficial erosions were detected more
commonly in superficial BCC compared with other types.
Additionally, micronodular BCC showed predominance of
blue/ gray ovoid globules that corresponded to small size
basaloid nests in the dermis.
We described a single case of morphoeic BCC that
showed on dermatoscopy a characteristic stem arborizing vessel
crossing the tumor from the periphery to the adjacent side and
short fine telangiectasia. Furthermore, there were blue gray
ovoid nests and structurless white areas that corresponded
histopathologically to dermal infiltrating radiating stellate
islands of basaloid cells with prominent fibrotic stroma.
The main dermatoscopic findings of metatypical BCC
were short fine telangiectasia, blue/gray ovoid nest, ulceration,
haemorrhagic crust, blue/gray globules, structurless white
areas, and scales.
Of interest, in the current study, we detected for the first
time a unique dermatoscopic finding in all the infiltrative BCC
lesions and referred to as blue/gray radiating streaks. We
Summary
167
believe it corresponded histologically to infiltrating elongated
nests and strands of basaloid cells in the dermis.
Finally this study confirms that a handheld dermatoscope
is a very efficient and simple diagnostic tool for BCC. It could
be used for the diagnosis of different types of BCC.
Thus we recommend the use of dermatoscopy as a
routine investigation to improve our diagnostic capabilities for
BCC patients.