Dermatoscopic “Mimickers” of Basal Cell Carcinoma - Adnexal Skin Tumors

Background: Adnexal skin tumors (AST) are numerous and various, and in their appearance give dermoscopic and clinical features similar to basal cell carcinoma (BCC). Differential diagnosis is difficult, as clinical alteration seems insufficient to distinguish between BCC and many skin lesions that mimic BCC. However, the validity and usefulness of dermatoscopic criteria enable differentiation between BCC and AST. The purpose of this paper was to present the basic dermatoscopic criteria for diagnosis of BCC as well as minimally invasive methods for treatment and clinical management, with a better aesthetic outcome. Methods and Results: This study consisted of a retrospective review of 50 skin lesions collected in our institution over a 3-year period. We analyzed the dermoscopic images of 29 skin lesions with a clinical diagnosis of BCC and 21 cases with a clinical diagnosis of AST. All lesions were assessed for the presence of various dermatoscopic criteria using a manual photo dermatoscopy system DermLite (DermLite 3, Gen). Each case was evaluated by the presence of dermatoscopic features. We compared dermatoscopic and clinical features between the BCC and AST groups. In the AST group, there were 5(23.8%) premalignant and 16(76.2%) benign lesions. Compared to the AST group, the BCC group had a significantly higher frequency of dermatoscopic features (vascular pattern, ulceration, and additional dermatoscopic features). All lesions included in this study showed more than one of the following characteristics of BCC: arborizing vessels, short fine telangiectasia, translucency, ulceration, blue-gray globules, flecked pigmentation, and rolled borders. Cutaneous lesions with 2 or fewer dermatoscopic features of BCC were much more likely to be an adnexal tumor. Conclusion: The results of this study could be valuable for the differential diagnosis of BCC and BCC-mimicking cutaneous lesions, because dermatoscopy can be especially helpful in better describing, recognizing, and differentiating these lesions.