1
|
Karampinis E, Georgopoulou KE, Kampra E, Zafiriou E, Lallas A, Lazaridou E, Apalla Z, Behera B, Errichetti E. Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1386. [PMID: 39336428 PMCID: PMC11434363 DOI: 10.3390/medicina60091386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/13/2024] [Accepted: 08/22/2024] [Indexed: 09/30/2024]
Abstract
The diagnosis of basal cell carcinoma (BCC) in dark phototypes can be a challenging task due to the lack of relevant clues and its variable presentation. In this regard, there is growing evidence that dermoscopy may benefit the recognition of BCC even for skin of color (SoC). The objective of this review is to provide an up-to-date overview on clinical and dermoscopic patterns of BCC in SoC, also comparing such findings with those of the main clinical mimickers reported in the literature. A comprehensive search of the literature through the PubMed electronic database was carried out in order to identify papers describing the clinical and dermoscopic features of BCC in dark phototypes (IV-VI). By finding macroscopic clinical presentations of BCCs in SoC patients and any possible clinical mimickers considered in the retrieved papers, we built a differential diagnosis list and analyzed the dermoscopic findings of such conditions to facilitate the diagnosis of BCC. BCC in darker skin may present as pigmented nodular lesions, pigmented patches or plaques, ulcers, erythematous nodular lesions, erythematous plaques or patches, or scar-like lesions, depending on its subtype and body site. The differential diagnosis for BCC in patients with SoC includes squamous cell carcinoma, melanoma, nevi, adnexal tumors and sebaceous keratosis. Additionally, it differs from that of Caucasians, as it also includes lesions less common in fair skin, such as dermatosis papulosa nigra, melanotrichoblastoma, and pigmented dermatofibrosarcoma protuberans, and excludes conditions like actinic keratosis and keratoacanthoma, which rarely appear in darker skin. The resulting differences also include infectious diseases such as deep cutaneous mycosis and inflammatory dermatoses. The most prevalent differentiating dermoscopic feature for BCC includes blue, black and gray dots, though arborizing vessels still remain the predominant BCC feature, even in dark phototypes. Diagnostic approach to BCC in dark-skinned patients varies due to the prevalence of dermoscopy findings associated with hyperpigmented structures. Clinicians should be aware of such points of differentiation for a proper management of this tumor in SoC.
Collapse
Affiliation(s)
- Emmanouil Karampinis
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece
| | | | - Elli Kampra
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece
| | - Aimilios Lallas
- First Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Elizabeth Lazaridou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Zoe Apalla
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Biswanath Behera
- Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, Odisha, India
| | - Enzo Errichetti
- Institute of Dermatology, Department of Medical Area, University of Udine, 33100 Udine, Italy
| |
Collapse
|
2
|
Nouri K, Romanelli P, Trent JT, Javid R, Jimenez G. Rare Presentations of Basal Cell Carcinoma. J Cutan Med Surg 2016. [DOI: 10.1177/120347540200600306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Even though basal cell carcinomas (BCC) are the most common skin cancers in the world, they rarely appear in the African–American, Hispanic, and Asian populations. BCCs most commonly present on the head and neck of elderly, light-skinned individuals who have received an excessive amount of sun exposure. However, it has been hypothesized that the development of BCCs in unusual populations is a result of an alteration in tumor surveillance or an impairment in cellular immunity. Objective: We present two cases of BCC, one in an Asian woman and one in an African–American woman. Neither of these patients had any history of genodermatoses or were immunocompromised. Conclusion: BCCs can occur in Asian and African–American patients. Clinicians should include the diagnosis of BCC in their differential for these patients despite their rare presentations.
Collapse
Affiliation(s)
- Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA
| | - Paolo Romanelli
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA
| | - Jennifer T. Trent
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA
| | - Roya Javid
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA
| | - Gloria Jimenez
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, USA
| |
Collapse
|
3
|
Abstract
Basal cell carcinoma (BCC) is the most common malignant neoplasm of humans. Rising dramatically in incidence in North America, as likely reflects changing habits of the population and a move from more northerly climes to the sunbelt of the Southern and Southwestern United States, the incidence is surely to rise even higher in the future. The last decade has seen significant advances in our understanding of BCC biology and novel approaches to therapy, which hinge upon accurate diagnosis and subclassification by pathologists. The purpose of this review article is to summate the research advances in our understanding of BCC biology and to acquaint pathologists and clinicians to the practical issues in BCC diagnosis and subclassification which flow there from.
Collapse
Affiliation(s)
- A Neil Crowson
- Department of Dermatology, Pathology and Surgery, University of Oklahoma, Tulsa, OK 74114-4109, USA.
| |
Collapse
|