The Study Of The Dermoscopic Features Of Some Non-melanocytic Skin Cancers

Background:Besides its relevance for evaluating pigmented structures, dermoscopy enables the recognition of vascular structures and other subtle features that usually are less visible to the naked eye. Consequently,in the last years dermoscopy has been employed also for the evaluation of non-pigmented skin disorders, such as non-pigmented skin tumors, and inflammatory and infectious diseases. even for monitoring skin reactions to various treatments. Seborrheic Keratosis, Basal Cell Carcinoma, Acticic Keratosis and Bowen Disease are four clinically frequent non-melanocytic skin cancers. It is difficult to diagnosis by clinical appearance and they are different in harm and treatment.Objective:To summarize the dermoscopic features in a series of Seborrheic Keratosis, Basal Cell Carcinoma, Acticic Keratosis and Bowen Disease in order to provide the basis for differential diagnosis of pigmented dermatoses with dermoscopy. Methods:Dermoscopic images of histopathologically proven Seborrheic Keratosis(70 patients), Basal Cell Carcinoma(71 patients).Acticic Keratosis(51 patients) and Bowen Disease(14 patients) were summarized for the presence of various dermoscopic features. Each lesion Was photographed using the Heine Delta 20 at 10-fold magnification,which Was combined with the Digital Single Lens Reflex (Nkion D70, Nkion Japan)。Results:The majority of cases of Seborrheic Keratosis revealed a peculiar dermoscopic pattern characterized by pseudofollicular openings(78.6%)and horn pseudocysts(65.7%). Additional dermoscopic criteria in Seborrheic Keratosis include gyri and sulci(44.2%), scale(77.1%), hairpin vascular(25.7%)etc. Of the 71 patients of BCC, the main dermoscopic features of BCC by frequency,from high to low is. Large blue-gray ovoid nests 78.9%、scatter pattern of vessels 74.6%、Multiple blue-gray non-aggregated globules 61.9%、ulceration 57.7%、Leaf-like areas 21.1%。 In Our study we observed, all(100%)of facial non-pigmented Aks(17 lesions), repetitive dermoscopic features of strawberry’pattern, produced by a background erythema that, surrounding follicles with whitish halos(74.5), Structureless red areas which, intermingled with evident, targetoid inner yellowand outer white round structures (43.1%), a whitish-yellowish’targetoid’ appearance (64.7%), resembled the surface of a strawberry; Erythema could also be seen(90%). Dermoscopic characteristics of pigmented AK(19 lesions) include multiple slategray to dark-brown dots and globules around the follicular ostia(10 lesions), the annular-granular pattern(6 lesions)andbrown to gray pseudonetwork(7 lesions). The most of cases of Bowen Disease revealed a peculiar dermoscopic pattern characterized by a scaly surface(78.6%)and glomerular vessels(57.1%). In addition, small brown dots regularly packed in a patchy distribution(50%), and structureless white areas(35.7%)were observed.Conclusions:Dermoscopy call improve the diagnostic accuracy of Seborrheic Keratosis, Basal Cell Carcinoma, Acticic Keratosis and Bowen Disease because of the presence of repetitive morphological findings, thus call be helpful in the differential diagnosis of non-melanocytic skin cancers. A limitation of our study is that we did not assess the specificity of the described dermoscopic criteria,in differentiating from other non-melanocytic skin cancers and filrther study is needed to assess the specificity and sensitivity of these criteria. Furthermore, dermoscopy cannot succeed over the clinical information including the patients’history,clinical features, or typical laboratory, radiographic and cannot substitute the established histopathologic diagnosis to perform diagnosis.