Diagnóstico de carcinoma basocelular por observadores no experimentados mediante dermatoscopía.

Abstract

Background: Basal cell carcinoma (BCC) is a fully described cancer which frequency has increased. Dermoscopy is a tool that in recent years has given great leaps, becoming more important as a diagnostic aid in lesions difficult to categorize. For an early diagnosis, multiple dermoscopic findings associated with BCC have been described. Materials and methods: Twenty dermoscopic images of melanocytic and non-melanocytic lesions with histopathological study were analyzed by ten non-experienced observers. In order to report the presence or absence of 14 classic and non-classical dermoscopic patterns associated with BCC, which were corroborated by an experienced observer. In addition, they were asked to indicate if the diagnosis corresponded or not to BCC, which was previously determined by histopathology. Results: The majority of non-experienced observers presented good or discrete concordance in the diagnosis of BCC. It was found that large blue / gray ovoid nests, arborizing vessels, superficial (short) fine telangiectasias, multiple small erosions and shiny white-red structureless areas were in good agreement. The non-classical criteria had better agreement than the classic ones among non-experienced observers. The shiny white-red structureless areas, arborizing vessels and ulceration were found to be in good relation with the expert observer´s findings. Conclusions: Dermoscopy is a useful tool in BCC´s diagnosis, also the diagnostic accuracy and adequate recognition of the different patterns increases with the experience of the observer in dermoscopy.