Dermatoscopy in the early detection, control and surgical planning of basal cell carcinomas

Introduction: Dermatoscopy can help practitioners analyze details that are imperceptible to the naked eye, such as basal cell carcinoma arboriform vascularization patterns, which can b e linked to the tumoral limit. Clinical examinations might yet fail in the early detection and demarcation of the extension of such lesions.
Objective: To study the use of dermatoscopy in basal cell carcinomas, aiming at early detection and delimitation of their extension. Method: Basal cell carcinomas (n = 123) were studied prospectively and not randomly, using dermatoscopy, at the author''''''''s private practice. Suspect areas, mainly the nose, underwent dermatoscopic scanning. If the vascular pattern was identified, the tumor was delimited by dermatoscopy, and the incision was carried out using that marking. Surgical margins were checked using conventional cuts, cross sections or micrographic surgery.
Results:The vast majority of the tumors (92%) were located in the face, of which 59% were not well delimited, 21% were well delimited, and 20% were clinically undetectable. Although the vascular pattern was not observed in 18% of the tumors, in cases with a positive identification, it correctly delimited the tumors in 84% of cases (of which 44% were verified with conventional sampling, 48% with micrographic surgery and 8% with cross sections).
Conclusion: Dermatoscopy is an important tool in the early detection and delimitation of the superficial extension of basal cell carcinomas, and is helpful in the surgical planning and clinical control of such lesions.

Keywords: DERMOSCOPY, CARCINOMA, BASAL CELL, MOHS SURGERY, BLOOD VESSELS, CAPILLARIES