Dermatoscopy of basal cell carcinoma subtypes


THERE are several different subtypes of basal cell carcinoma  (BCC) with variable biological behaviour. This variation in behaviour is characterised by superficial and nodular subtypes behaving less aggressively, whereas infiltrating, micronodular, morphoeic subtypes and subtypes with squamous differentiation all behave in a more aggressive manner. 

More aggressive BCC subtypes are prone to higher rates of recurrence following surgical excision. They should therefore not be treated with topical or ablative treatments. 

Rare cases of perineural invasion by BCC can result in death via spread to the cerebral cortex by invasion along cranial nerves. More aggressive subtypes are more prone to neural invasion. 

Squamous differentiation in BCC is an indicator to treat a lesion as if it were a squamous cell carcinoma (SCC) rather than a BCC. In order to optimise management decisions when treating