Importance of Both Clinical and Dermoscopic Findings in Predicting High-Risk Histopathological Subtype in Facial Basal Cell Carcinomas
dc.contributor.author | Ceder, Hannah | |
dc.contributor.author | Backman, Eva | |
dc.contributor.author | Marghoob, Ashfaq | |
dc.contributor.author | Navarrete-Dechent, Cristian | |
dc.contributor.author | Polesie, Sam | |
dc.contributor.author | Reiter, Ofer | |
dc.contributor.author | Paoli, John | |
dc.date.accessioned | 2025-01-20T16:10:47Z | |
dc.date.available | 2025-01-20T16:10:47Z | |
dc.date.issued | 2024 | |
dc.description.abstract | Introduction: Being able to recognize high-risk facial basal cell carcinoma (BCC) may lead to fewer incomplete excisions and inappropriate treatments. Objectives: We sought to investigate clinical and dermoscopic criteria for predicting facial BCC subtypes, analyze the interobserver agreement between readers, and develop a diagnostic algorithm to predict high-risk histopathological subtype. Methods: In this single-center, retrospective investigation, 6 independent readers evaluated predefined clinical and dermoscopic criteria in images of histopathologically verified primary facial BCCs including: topography, border demarcation, vessels, ulceration, white porcelain areas, shiny white blotches and strands, and pigmented structures and vessels within ulceration. Results: Overall, 297 clinical and dermoscopic image pairs were analyzed. The strongest associations with high-risk subtype were: "bumpy" topography (OR 3.8, 95% CI, 3.1-4.7), ill-defined borders (OR 3.4, 95% CI 3.1-4.7), white porcelain area (OR 3.5, 95% CI 2.8-4.5), and vessels within ulceration (OR 3.1, 95% CI 2.4-4.1). Predominantly focused vessels were a positive diagnostic criterium for either nodular (OR 1.7, 95% CI 1.3-2.2) or high-risk (OR 2.0, 95% CI 1.6-2.5) subtypes and a strong negative diagnostic criterium for superficial BCC (OR 14.0, 95% CI 9.6-20.8). Interobserver agreement ranged from fair to substantial (kappa = 0.36 to 0.72). A diagnostic algorithm based on these findings demonstrated a sensitivity of 81.4% (95% CI, 78.9-83.7%) and a specificity of 53.3% (95% CI, 49.7-56.9%) for predicting high-risk BCC subtype. Conclusions: Integration of both clinical and dermoscopic features (including novel features such as topography and vessels within ulceration) are essential to improve subtype prediction of facial BCCs and management decisions. | |
dc.fuente.origen | WOS | |
dc.identifier.doi | 10.5826/dpc.1403a212 | |
dc.identifier.issn | 2160-9381 | |
dc.identifier.uri | https://doi.org/10.5826/dpc.1403a212 | |
dc.identifier.uri | https://repositorio.uc.cl/handle/11534/90230 | |
dc.identifier.wosid | WOS:001286343700001 | |
dc.issue.numero | 3 | |
dc.language.iso | en | |
dc.revista | Dermatology practical & conceptual | |
dc.rights | acceso restringido | |
dc.subject | basal cell carcinoma | |
dc.subject | dermoscopy | |
dc.subject | clinical decision-making | |
dc.subject | interobserver agreement | |
dc.subject | Mohs micrographic surgery | |
dc.subject | algorithm | |
dc.subject.ods | 03 Good Health and Well-being | |
dc.subject.odspa | 03 Salud y bienestar | |
dc.title | Importance of Both Clinical and Dermoscopic Findings in Predicting High-Risk Histopathological Subtype in Facial Basal Cell Carcinomas | |
dc.type | artículo | |
dc.volumen | 14 | |
sipa.index | WOS | |
sipa.trazabilidad | WOS;2025-01-12 |