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. 2018 Dec 4;2018(12):CD011901. doi: 10.1002/14651858.CD011901.pub2
Menzies algorithm for pigmented BCC
Menzies 2000
Menzies (revised; pigmented and non‐pigmented BCC)
Altamura 2010
Two‐step algorithm (Marghoob 2010); non‐pigmented BCC
Markowitz 2015
3‐point checklist plus dermoscopic criteria (pigmented BCC)
Amirnia 2016
Shiny White Structures (SWSs); non‐pigmented BCC
Navarrete Dechent 2016
No pigment network (Negative feature absent)
> 1 positive feature present
1. Spoke wheel areas (well‐circumscribed radial projections)
2. Large grey‐blue ovoid nests (well circumscribed, confluent or near confluent pigmented ovoid or elongated areas, larger than globules, not intimately connected to a pigmented tumor body
3. Arborizing telangiectasia (telangiectasia with distinct treelike branching)
4. Multiple grey‐blue globules (as opposed to multiple grey‐blue dots)
5. Maple leaflike areas (brown to grey‐blue discrete bulbous extensions forming leaflike pattern
6. Ulceration (absence of epidermis often associated with congealed blood; not due to recent trauma).
'Classic' BCC patterns for pigmented BCC (Menzies 2000)
1. ulceration,
2. multiple blue/grey globules,
3. leaflike areas,
4. large blue/grey ovoid nests,
5. spoke‐wheel areas,
6. arborizing telangiectasia
Plus 'Non‐classic' patterns
  • short fine superficial telangiectasia,

  • multiple small erosions,

  • concentric structures,

  • multiple in‐focus blue/grey dots

Dermoscopic features consistent with BCC:
  • arborized vessels,

  • pink white shiny background,

  • blue/grey ovoid nests,

  • ash leaf pattern,

  • dot‐globular‐like pattern,

  • spoke wheel, and

  • crystalline‐like structures

1. Asymmetry in colour or structure in one or two orthogonal axis asymmetric
2. Pigment network with irregular holes and thick lines atypical network
3. Any kind of blue or white colour Blue ‐ white structures
Dermoscopic criteria of BCC
  • tree‐like arteries

  • blue‐grey points

SWSs were classified as
1. blotches (clods; discrete, small or large structure‐less areas);
2. strands (long thick or thin lines, randomly distributed or parallel, not orthogonally oriented);
3. rosettes (cluster of 4 white dots in a 4‐leaf clover–like arrangement); and
4. short white lines (crystalline structures and chrysalis; fine lines that intersect or are oriented orthogonally to each other)
5. non‐specified.
All lesions also evaluated for Menzies 2000 criteria; ‘featureless’ lesions further evaluated for:
  • short fine telangiectasias;

  • multiple in‐focus, blue‐grey dots;

  • multiple small erosions;and

  • concentric structures

BCC ‐ basal cell carcinoma