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Review

Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary

by
Emmanouil Karampinis
1,2,*,
Konstantina-Eirini Georgopoulou
1,
Elli Kampra
2,
Efterpi Zafiriou
2,
Aimilios Lallas
3,
Elizabeth Lazaridou
1,
Zoe Apalla
1,
Biswanath Behera
4 and
Enzo Errichetti
5
1
Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
2
Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece
3
First Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
4
Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, Odisha, India
5
Institute of Dermatology, Department of Medical Area, University of Udine, 33100 Udine, Italy
*
Author to whom correspondence should be addressed.
Medicina 2024, 60(9), 1386; https://doi.org/10.3390/medicina60091386
Submission received: 2 August 2024 / Revised: 13 August 2024 / Accepted: 22 August 2024 / Published: 24 August 2024
(This article belongs to the Special Issue Inflammatory Skin Diseases and Comorbidities)

Abstract

The diagnosis of basal cell carcinoma (BCC) in dark phototypes can be a challenging task due to the lack of relevant clues and its variable presentation. In this regard, there is growing evidence that dermoscopy may benefit the recognition of BCC even for skin of color (SoC). The objective of this review is to provide an up-to-date overview on clinical and dermoscopic patterns of BCC in SoC, also comparing such findings with those of the main clinical mimickers reported in the literature. A comprehensive search of the literature through the PubMed electronic database was carried out in order to identify papers describing the clinical and dermoscopic features of BCC in dark phototypes (IV–VI). By finding macroscopic clinical presentations of BCCs in SoC patients and any possible clinical mimickers considered in the retrieved papers, we built a differential diagnosis list and analyzed the dermoscopic findings of such conditions to facilitate the diagnosis of BCC. BCC in darker skin may present as pigmented nodular lesions, pigmented patches or plaques, ulcers, erythematous nodular lesions, erythematous plaques or patches, or scar-like lesions, depending on its subtype and body site. The differential diagnosis for BCC in patients with SoC includes squamous cell carcinoma, melanoma, nevi, adnexal tumors and sebaceous keratosis. Additionally, it differs from that of Caucasians, as it also includes lesions less common in fair skin, such as dermatosis papulosa nigra, melanotrichoblastoma, and pigmented dermatofibrosarcoma protuberans, and excludes conditions like actinic keratosis and keratoacanthoma, which rarely appear in darker skin. The resulting differences also include infectious diseases such as deep cutaneous mycosis and inflammatory dermatoses. The most prevalent differentiating dermoscopic feature for BCC includes blue, black and gray dots, though arborizing vessels still remain the predominant BCC feature, even in dark phototypes. Diagnostic approach to BCC in dark-skinned patients varies due to the prevalence of dermoscopy findings associated with hyperpigmented structures. Clinicians should be aware of such points of differentiation for a proper management of this tumor in SoC.
Keywords: dermoscopy; skin of color; basal cell carcinoma; skin cancer; cutaneous neoplasms; skin infections; cutaneous dermatoses dermoscopy; skin of color; basal cell carcinoma; skin cancer; cutaneous neoplasms; skin infections; cutaneous dermatoses

Share and Cite

MDPI and ACS Style

Karampinis, E.; Georgopoulou, K.-E.; Kampra, E.; Zafiriou, E.; Lallas, A.; Lazaridou, E.; Apalla, Z.; Behera, B.; Errichetti, E. Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary. Medicina 2024, 60, 1386. https://doi.org/10.3390/medicina60091386

AMA Style

Karampinis E, Georgopoulou K-E, Kampra E, Zafiriou E, Lallas A, Lazaridou E, Apalla Z, Behera B, Errichetti E. Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary. Medicina. 2024; 60(9):1386. https://doi.org/10.3390/medicina60091386

Chicago/Turabian Style

Karampinis, Emmanouil, Konstantina-Eirini Georgopoulou, Elli Kampra, Efterpi Zafiriou, Aimilios Lallas, Elizabeth Lazaridou, Zoe Apalla, Biswanath Behera, and Enzo Errichetti. 2024. "Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary" Medicina 60, no. 9: 1386. https://doi.org/10.3390/medicina60091386

APA Style

Karampinis, E., Georgopoulou, K.-E., Kampra, E., Zafiriou, E., Lallas, A., Lazaridou, E., Apalla, Z., Behera, B., & Errichetti, E. (2024). Clinical and Dermoscopic Patterns of Basal Cell Carcinoma and Its Mimickers in Skin of Color: A Practical Summary. Medicina, 60(9), 1386. https://doi.org/10.3390/medicina60091386

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