Table 2.
Clinical and dermoscopic features of BCC and keratinocytic lesions and potential therapies
Lesion | Clinical features | Dermoscopic features | Potential therapy |
---|---|---|---|
BCC subtypes | |||
Nodular | Nodular | Arborizing telangiectasias, ulceration Ovoid nests, other pigmented structures |
Nonsurgical therapy could be considered for thin and small lesions, but PDT should be avoided for pigmented lesions |
Superficial | Flat/scaly | Superficial fine telangiectasias, multiple erosions Pigmented structures (but not ovoid nests) |
Nonsurgical therapy could be considered, but PDT should be avoided for pigmented lesions |
Infiltrative | Plaque (ill-defined borders) | Arborizing vessels (finer and scattered), ulceration Ovoid nests, blue-gray dots |
Surgery |
Keratinocytic lesion subtypes | |||
AK | Erythematosquamous plaques | Facial AK: ‘strawberry’, granular pattern Nonfacial AK: white scales and erythema |
Nonsurgical methods are recommended for facial and nonfacial AKs and can be combined with surgical ablationa for nonfacial AKs |
Intraepidermal carcinoma or Bowen’s disease | Erythematosquamous plaques | Unpigmented variant: glomerular vessels + yellowish scales Pigmented variant (up to 6% of cases in the study by Cameron et al. [31]): linear pigmented structures |
Nonsurgical methods could be considered, but PDT should be avoided for pigmented lesions |
Invasive SCC/keratoacanthoma | Nodular | White circles, white color polymorphic/thrombosed vessels | Surgery |
AK actinic keratosis, BCC basal cell carcinoma, PDT photodynamic therapy, SCC squamous cell carcinoma
aSurgical ablation such as curettage or cryotherapy