Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs: A Chameleon!

Mara Lombardi, Riccardo Pampena, Stefania Borsari, Caterina Bombonato, Elisa Benati, Giovanni Pellacani, Caterina Longo

Research output: Contribution to journalArticle

Abstract

Background: Lower limbs represent an uncommon location for basal cell carcinoma (BCC) and only few reports have described dermoscopic features of BCC in this body site. Since BCCs of the lower limbs frequently display nonclassic BCC dermoscopic criteria, they can simulate other benign or malignant lesions. Objective: Our aim was to describe the dermoscopic features of BCC located on lower limbs and to define which criteria were more associated with their benign-or malignant-looking appearance. Methods: We conducted a retrospective study enrolling consecutive patients with histologically confirmed BCCs of the lower limbs. Lesions were classified in 7 categories according to the clinical and dermoscopic global appearance. Clear BCC, squamous cell carcinoma (SCC) or Bowen disease-like, Kaposi disease-like, melanoma-like, and aspecific pattern were considered malignant-looking lesions; however, seborrheic keratosis-like and dermatofibroma-like were considered benign-looking. To define which dermoscopic criteria were independently associated with benign-or malignant-looking appearance, we conducted a multivariate logistic regression analysis. Results: A total of 81 BCCs were enrolled: 18 (22%) were benign-looking lesions (of which 11 were seborrheic keratosis-like and 7 dermatofibroma-like) and 63 (78%) were malignant-looking BCCs (of which 24 were clear-cut BCCs, 23 SCC-like, 2 Kaposi disease-like, 9 melanoma-like, and 5 had aspecific pattern). Multivariate regression analysis showed that erosions/ulceration and vessels were independently associated with malignant-looking appearance. The most represented vessels were glomerular and polymorphic, which are more frequently encountered in SCC, together with ulceration. Conclusion: BCC of the lower legs frequently simulates other benign or malignant lesions, with SCC being the main differential diagnosis.

Original languageEnglish
Pages (from-to)482-488
Number of pages7
JournalDermatology
Volume233
Issue number6
DOIs
Publication statusPublished - Apr 1 2018

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Lizards
Basal Cell Carcinoma
Lower Extremity
Squamous Cell Carcinoma
Seborrheic Keratosis
Benign Fibrous Histiocytoma
Xeroderma Pigmentosum
Melanoma
Regression Analysis
Bowen's Disease
Leg
Differential Diagnosis
Multivariate Analysis
Retrospective Studies
Logistic Models

Keywords

  • Basal cell carcinoma
  • Dermoscopy
  • Lower limbs

ASJC Scopus subject areas

  • Dermatology

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Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs : A Chameleon! / Lombardi, Mara; Pampena, Riccardo; Borsari, Stefania; Bombonato, Caterina; Benati, Elisa; Pellacani, Giovanni; Longo, Caterina.

In: Dermatology, Vol. 233, No. 6, 01.04.2018, p. 482-488.

Research output: Contribution to journalArticle

Lombardi, M, Pampena, R, Borsari, S, Bombonato, C, Benati, E, Pellacani, G & Longo, C 2018, 'Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs: A Chameleon!', Dermatology, vol. 233, no. 6, pp. 482-488. https://doi.org/10.1159/000487300
Lombardi M, Pampena R, Borsari S, Bombonato C, Benati E, Pellacani G et al. Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs: A Chameleon! Dermatology. 2018 Apr 1;233(6):482-488. https://doi.org/10.1159/000487300
Lombardi, Mara ; Pampena, Riccardo ; Borsari, Stefania ; Bombonato, Caterina ; Benati, Elisa ; Pellacani, Giovanni ; Longo, Caterina. / Dermoscopic Features of Basal Cell Carcinoma on the Lower Limbs : A Chameleon!. In: Dermatology. 2018 ; Vol. 233, No. 6. pp. 482-488.
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abstract = "Background: Lower limbs represent an uncommon location for basal cell carcinoma (BCC) and only few reports have described dermoscopic features of BCC in this body site. Since BCCs of the lower limbs frequently display nonclassic BCC dermoscopic criteria, they can simulate other benign or malignant lesions. Objective: Our aim was to describe the dermoscopic features of BCC located on lower limbs and to define which criteria were more associated with their benign-or malignant-looking appearance. Methods: We conducted a retrospective study enrolling consecutive patients with histologically confirmed BCCs of the lower limbs. Lesions were classified in 7 categories according to the clinical and dermoscopic global appearance. Clear BCC, squamous cell carcinoma (SCC) or Bowen disease-like, Kaposi disease-like, melanoma-like, and aspecific pattern were considered malignant-looking lesions; however, seborrheic keratosis-like and dermatofibroma-like were considered benign-looking. To define which dermoscopic criteria were independently associated with benign-or malignant-looking appearance, we conducted a multivariate logistic regression analysis. Results: A total of 81 BCCs were enrolled: 18 (22{\%}) were benign-looking lesions (of which 11 were seborrheic keratosis-like and 7 dermatofibroma-like) and 63 (78{\%}) were malignant-looking BCCs (of which 24 were clear-cut BCCs, 23 SCC-like, 2 Kaposi disease-like, 9 melanoma-like, and 5 had aspecific pattern). Multivariate regression analysis showed that erosions/ulceration and vessels were independently associated with malignant-looking appearance. The most represented vessels were glomerular and polymorphic, which are more frequently encountered in SCC, together with ulceration. Conclusion: BCC of the lower legs frequently simulates other benign or malignant lesions, with SCC being the main differential diagnosis.",
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AU - Benati, Elisa

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AU - Longo, Caterina

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N2 - Background: Lower limbs represent an uncommon location for basal cell carcinoma (BCC) and only few reports have described dermoscopic features of BCC in this body site. Since BCCs of the lower limbs frequently display nonclassic BCC dermoscopic criteria, they can simulate other benign or malignant lesions. Objective: Our aim was to describe the dermoscopic features of BCC located on lower limbs and to define which criteria were more associated with their benign-or malignant-looking appearance. Methods: We conducted a retrospective study enrolling consecutive patients with histologically confirmed BCCs of the lower limbs. Lesions were classified in 7 categories according to the clinical and dermoscopic global appearance. Clear BCC, squamous cell carcinoma (SCC) or Bowen disease-like, Kaposi disease-like, melanoma-like, and aspecific pattern were considered malignant-looking lesions; however, seborrheic keratosis-like and dermatofibroma-like were considered benign-looking. To define which dermoscopic criteria were independently associated with benign-or malignant-looking appearance, we conducted a multivariate logistic regression analysis. Results: A total of 81 BCCs were enrolled: 18 (22%) were benign-looking lesions (of which 11 were seborrheic keratosis-like and 7 dermatofibroma-like) and 63 (78%) were malignant-looking BCCs (of which 24 were clear-cut BCCs, 23 SCC-like, 2 Kaposi disease-like, 9 melanoma-like, and 5 had aspecific pattern). Multivariate regression analysis showed that erosions/ulceration and vessels were independently associated with malignant-looking appearance. The most represented vessels were glomerular and polymorphic, which are more frequently encountered in SCC, together with ulceration. Conclusion: BCC of the lower legs frequently simulates other benign or malignant lesions, with SCC being the main differential diagnosis.

AB - Background: Lower limbs represent an uncommon location for basal cell carcinoma (BCC) and only few reports have described dermoscopic features of BCC in this body site. Since BCCs of the lower limbs frequently display nonclassic BCC dermoscopic criteria, they can simulate other benign or malignant lesions. Objective: Our aim was to describe the dermoscopic features of BCC located on lower limbs and to define which criteria were more associated with their benign-or malignant-looking appearance. Methods: We conducted a retrospective study enrolling consecutive patients with histologically confirmed BCCs of the lower limbs. Lesions were classified in 7 categories according to the clinical and dermoscopic global appearance. Clear BCC, squamous cell carcinoma (SCC) or Bowen disease-like, Kaposi disease-like, melanoma-like, and aspecific pattern were considered malignant-looking lesions; however, seborrheic keratosis-like and dermatofibroma-like were considered benign-looking. To define which dermoscopic criteria were independently associated with benign-or malignant-looking appearance, we conducted a multivariate logistic regression analysis. Results: A total of 81 BCCs were enrolled: 18 (22%) were benign-looking lesions (of which 11 were seborrheic keratosis-like and 7 dermatofibroma-like) and 63 (78%) were malignant-looking BCCs (of which 24 were clear-cut BCCs, 23 SCC-like, 2 Kaposi disease-like, 9 melanoma-like, and 5 had aspecific pattern). Multivariate regression analysis showed that erosions/ulceration and vessels were independently associated with malignant-looking appearance. The most represented vessels were glomerular and polymorphic, which are more frequently encountered in SCC, together with ulceration. Conclusion: BCC of the lower legs frequently simulates other benign or malignant lesions, with SCC being the main differential diagnosis.

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