Características dermatoscópicas do carcinoma basocelular nos pacientes de fototipos IV e V

Abstract

BACKGROUND: basal cell carcinoma (BCC) is the most common skin neoplasm, and its incidence is increasing. However, the majority of the scientific literature is on fair-skinned populations and the usage of current scientific data in dark-skinned patients can lead to misdiagnosis. OBJECTIVE: to characterize BCC epidemiological, clinical, histopathological and dermoscopic features in dark-skinned patients (phototypes IV, V and IV). METHODS: this is an observational, cross-sectional study, where images of BCCs from patients with higher phototypes were evaluated regarding their epidemiological, clinical and dermoscopic characteristics. These data were statistically analyzed for differences between histological subtypes and compared to the literature. RESULTS: a total of 76 BCCs were evaluated, 47 (62%) were diagnosed in patients with phototype IV and 29 (38%) in phototype V, there no phototype VI patients. Among the participants, 33 were male and 30 were female, with a mean age of 70 years. Head/neck was the most affected anatomical site, with 60 lesions (79%), 11 were located on the trunk (14%), two on the lower limbs (3%) and three on the upper limbs (4%). Most BCCs were of the nodular (49%) and superficial (25%) histological subtypes. In nodular BCCs, there was a higher proportion of ovoid nests and arboriform telangiectasias. In the superficial BCCs, multiple small erosions, leaf structures, wheel spoke structures and white/pink structureless background were more frequent. Dermoscopically, 34 (45%) lesions were highly pigmented, 17 (22%) were pigmented, 24 (31%) were poorly pigmented and one (1%) was not pigmented. Diffuse pigmentation was found in 19 lesions (25%) and leaf-like structures in 44 (58%). Arboriform telangiectasias were present in 24 BCCs (32%) and short fine telangiectasias in five (7%). CONCLUSION: dark-skinned patients have a higher proportion of pigmented BCCs and this pigmentation occupies a larger area of the tumor. These patients also show a higher number of tumors with leaf structures and a lower proportion of vessels than BCCs from light-skinned patients.