Abstract:
Basal cell carcinoma (BCC) is rare in young individuals and reported to possess different pathogenetic, clinical and histological features from late-onset BCC. However, the dermoscopic variability of BCC according to age of onset has not been investigated. Anatomic location was revealed to be associated with dermoscopic variation of BCC in Western population, but whether it applies to Asian population remains unknown. We evaluated the clinical and dermoscopic features of 448 BCCs and compared each feature by age of onset (age < 50/ > 50 years) and anatomic location. Early-onset BCCs occurred more frequently on non-sun-exposed sites (OR 3.28, P = 0.001) and were less pigmented than late-onset BCCs (P = 0.003). Blue-gray globules (OR 1.74, P = 0.037) and no vessels (OR 2.04, P = 0.021) were independently associated with early-onset BCCs, whereas arborizing telangiectasia (OR 0.30, P < 0.001), large blue-gray ovoid nests (OR 0.38, P < 0.001) and ulceration (OR 0.33, P < 0.001) were less common in early-onset BCCs. Scalp BCCs were significantly more pigmented than BCCs located elsewhere (P = 0.022). Superficial subtype (OR 5.90, P < 0.001), spoke-wheel areas (OR 4.78, P = 0.034), superficial erosions (OR 4.69, P = 0.003) and polymorph vessels (OR 6.86, P = 0.001) were independently associated with trunk BCCs, whereas nodular subtype (OR 5.48, P < 0.001) and arborizing telangiectasias (OR 3.64, P < 0.001) with BCCs on face and neck. Our findings suggest that age of onset and anatomic location are independent factors affecting the dermoscopic appearance of BCC.
摘要:
基底细胞癌(BCC)在年轻人中很少见,据报道具有不同的病因,晚发性BCC的临床和组织学特征。然而,尚未研究BCC根据发病年龄的皮肤镜下变异性。在西方人群中,解剖位置被发现与BCC的皮肤镜变化有关,但它是否适用于亚洲人口仍然未知。我们评估了448例BCC的临床和皮肤镜特征,并根据发病年龄(年龄<50/>50岁)和解剖位置比较了每个特征。早发性BCC在非阳光照射部位的发生频率更高(OR3.28,P=0.001),并且比晚发性BCC的色素沉着更少(P=0.003)。蓝灰色小球(OR1.74,P=0.037)和无血管(OR2.04,P=0.021)与早发性BCC独立相关,而使毛细血管扩张症(OR0.30,P<0.001),在早发性BCC中,大的蓝灰色卵形巢(OR0.38,P<0.001)和溃疡(OR0.33,P<0.001)较少见。头皮BCC的色素明显高于其他地方的BCC(P=0.022)。浅表亚型(OR5.90,P<0.001),轮辐区(OR4.78,P=0.034),浅表糜烂(OR4.69,P=0.003)和多晶型血管(OR6.86,P=0.001)与主干BCC独立相关,而结节亚型(OR5.48,P<0.001)和乔化毛细血管扩张(OR3.64,P<0.001)与面部和颈部的BCC。我们的发现表明,发病年龄和解剖位置是影响BCC皮肤镜外观的独立因素。