[开放获取]    中国基底细胞癌皮肤镜特征专家共识（2019）

doi:10.3760/cma.j.issn.0412-4030.2019.06.001

中华皮肤科杂志 ›› 2019, Vol. 52 ›› Issue (6): 371-377.doi: 10.3760/cma.j.issn.0412-4030.2019.06.001

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[开放获取] 中国基底细胞癌皮肤镜特征专家共识（2019）

中国中西医结合学会皮肤性病专业委员会皮肤影像学组#br# 中国医疗保健国际交流促进会皮肤科分会皮肤影像学组#br# 中华医学会皮肤性病学分会皮肤病数字化诊断亚学组#br# 中国医师协会皮肤科医师分会皮肤外科亚专业委员会#br# 中国医学装备协会皮肤病与皮肤美容分会皮肤影像装备学组#br#

中国中西医结合学会皮肤性病专业委员会皮肤影像学组
中国医疗保健国际交流促进会皮肤科分会皮肤影像学组
中华医学会皮肤性病学分会皮肤病数字化诊断亚学组
中国医师协会皮肤科医师分会皮肤外科亚专业委员会
中国医学装备协会皮肤病与皮肤美容分会皮肤影像装备学组

收稿日期:2018-12-21 修回日期:2019-03-23 发布日期:2019-06-03
通讯作者: 邹先彪 E-mail:xbzou@126.com

Dermoscopic characteristics of basal cell carcinoma: a Chinese expert consensus statement （2019）

^{Skin Imaging Group, Committee on Dermatology and Venereology, Chinese Association of Integrative Medicine; Skin Imaging Group, Dermatology Branch of China International Exchange and Promotion Association for Medical and Healthcare; Subgroup of Digital Diagnosis of Skin Diseases, Chinese Society of Dermatology; Subcommittee on Dermatologic Surgery, China Dermatologist Association; Skin Imaging Equipment Group, Skin and Beauty Branch of Medical Equipment Association#br#}

#br#

Skin Imaging Group, Committee on Dermatology and Venereology, Chinese Association of Integrative Medicine; Skin Imaging Group, Dermatology Branch of China International Exchange and Promotion Association for Medical and Healthcare; Subgroup of Digital Diagnosis of Skin Diseases, Chinese Society of Dermatology; Subcommittee on Dermatologic Surgery, China Dermatologist Association; Skin Imaging Equipment Group, Skin and Beauty Branch of Medical Equipment Association

Received:2018-12-21 Revised:2019-03-23 Published:2019-06-03
Contact: xian-biao ZOU E-mail:xbzou@126.com

摘要/Abstract

摘要： 【摘要】基底细胞癌是皮肤科较为常见的皮肤肿瘤之一，临床及病理均有特殊表现，皮肤镜在基底细胞癌诊断中的应用也越来越多，但各型基底细胞癌的皮肤镜诊断标准繁多，国内尚无统一的标准与共识。本共识为部分皮肤镜专家结合国内外相关研究成果撰写而成，总结了基底细胞癌皮肤镜模式及特征性血管结构，描述了各种类型基底细胞癌皮肤镜表现，旨在统一国内基底细胞癌皮肤镜诊断标准，为临床医师提供诊断思路。

关键词: 肿瘤, 基底细胞；皮肤镜检查；诊断

Abstract: 【Abstract】 Basal cell carcinoma （BCC） is one of the most common neoplasms in dermatology, with specific clinical and pathological manifestations. Dermoscopy has been increasingly applied to the diagnosis of BCC. However, there are various diagnostic criteria for various types of BCC, and there is still no unified standard and consensus in China. This consensus is written by some Chinese experts in dermoscopy according to domestic and overseas related research findings, which summarizes dermoscopic patterns and characteristic dermoscopic vascular structures of BCC, and describes dermoscopic features of various types of BCC. The consensus on dermoscopic characteristics of BCC is aiming to unify the dermoscopic criteria for the diagnosis of BCC and provide diagnostic ideas for clinicians.

Key words: Neoplasms, basal cell, Dermoscopy, Diagnosis

中国中西医结合学会皮肤性病专业委员会皮肤影像学组中国医疗保健国际交流促进会皮肤科分会皮肤影像学组中华医学会皮肤性病学分会皮肤病数字化诊断亚学组中国医师协会皮肤科医师分会皮肤外科亚专业委员会中国医学装备协会皮肤病与皮肤美容分会皮肤影像装备学组. [开放获取] 中国基底细胞癌皮肤镜特征专家共识（2019）[J]. 中华皮肤科杂志, 2019,52(6):371-377. doi:10.3760/cma.j.issn.0412-4030.2019.06.001

Skin Imaging Group, Committee on Dermatology and Venereology, Chinese Association of Integrative Medicine, Skin Imaging Group, Dermatology Branch of China International Exchange and Promotion Association for Medical and Healthcare, Subgroup of Digital Diagnosis of Skin Diseases, Chinese Society of Dermatology, Subcommittee on Dermatologic Surgery, China Dermatologist Association, Skin Imaging Equipment Group, Skin and Beauty Branch of Medical Equipment Association. Dermoscopic characteristics of basal cell carcinoma: a Chinese expert consensus statement （2019）[J]. Chinese Journal of Dermatology, 2019, 52(6): 371-377.doi:10.3760/cma.j.issn.0412-4030.2019.06.001

参考文献 53

［1］	Marzuka AG, Book SE. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management［J］. Yale J Biol Med, 2015,88（2）:167⁃179.
［2］	Fargnoli MC, Kostaki D, Piccioni A, et al. Dermoscopy in the diagnosis and management of non⁃melanoma skin cancers［J］. Eur J Dermatol, 2012,22（4）:456⁃463. doi: 10.1684/ejd.2012. 1727.
［3］	Buljan M, Bulat V, Situm M, et al. Variations in clinical presentation of basal cell carcinoma［J］. Acta Clin Croat, 2008,47（1）:25⁃30.
［4］	Marghoob AA， Malvehy J, Braun RP. Atlas of dermoscopy（皮肤镜图谱）［M］. 徐峰, 周城, 译. 2版. 上海: 复旦大学出版社, 2016.
［5］	Puig S, Cecilia N, Malvehy J. Dermoscopic criteria and basal cell carcinoma［J］. G Ital Dermatol Venereol, 2012,147（2）:135⁃140.
［6］	Lallas A, Apalla Z, Argenziano G, et al. The dermatoscopic universe of basal cell carcinoma［J］. Dermatol Pract Concept, 2014,4（3）:11⁃24. doi: 10.5826/dpc.0403a02.
［7］	Lallas A, Apalla Z, Ioannides D, et al. Dermoscopy in the diagnosis and management of basal cell carcinoma［J］. Future Oncol, 2015,11（22）:2975⁃2984. doi: 10.2217/fon.15.193.
［8］	Nakayama M, Tabuchi K, Nakamura Y, et al. Basal cell carcinoma of the head and neck［J］. J Skin Cancer, 2011,2011:496910. doi: 10.1155/2011/496910.
［9］	Mogensen M, Jemec GB. Diagnosis of nonmelanoma skin cancer/keratinocyte carcinoma: a review of diagnostic accuracy of nonmelanoma skin cancer diagnostic tests and technologies［J］. Dermatol Surg, 2007,33（10）:1158⁃1174. doi: 10.1111/j.1524⁃4725.2007.33251.x.
［10］	吴晓琰, 陈晓栋, 顾黎雄. 皮肤镜在微小色素型基底细胞癌诊断中的初步研究［J］. 中华皮肤科杂志, 2011,44（12）:847⁃850. doi: 10.3760/cma.j.issn.0412⁃4030.2011.12.007.
［11］	尤艳, 孙桂珍, 刘厚广, 等. 皮肤镜在诊断色素性疾病方面的研究［J］. 哈尔滨医科大学学报, 2012,46（1）:52⁃55. doi: 10. 3969/j.issn.1000⁃1905.2012.01.014.
［12］	李琨, 边培雯, 张雪洁, 等. 皮肤镜诊断头面部色素型基底细胞癌的临床研究［J］. 中华临床医师杂志（电子版）, 2014,（3）:434⁃438. doi: 10.3877/cma.j.issn.1674⁃0785.2014.03.017.
［13］	孟如松, 胡博, 刘海军, 等. 临床易误诊基底细胞癌的皮肤镜和组织病理观察及其鉴别诊断［J］. 中国体视学与图像分析, 2015,20（4）:347⁃355.
［14］	Chan GJ, Ho HHF. A study of dermoscopic features of pigmented basal cell carcinoma in Hong Kong Chinese［J］. Hong Kong J Dermatol Venereol, 2008,16:189⁃196.
［15］	Bengü NA, Cengizhan E. The evaluation of dermoscopic findings in basal cell carcinoma［J］. J Turk Acad Dermatol, 2010,4（3）:04301a.
［16］	Lallas A, Apalla Z, Argenziano G, et al. The dermatoscopic universe of basal cell carcinoma［J］. Dermatol Pract Concept, 2014,4（3）:11⁃24. doi: 10.5826/dpc.0403a02.
［17］	Navarrete⁃Dechent C, Bajaj S, Marchetti MA, et al. Association of shiny white blotches and strands with nonpigmented basal cell carcinoma: evaluation of an additional dermoscopic diagnostic criterion［J］. JAMA Dermatol, 2016,152（5）:546⁃552. doi: 10.1001/jamadermatol.2015.5731.
［18］	Liebman TN, Jaimes⁃Lopez N, Balagula Y, et al. Dermoscopic features of basal cell carcinomas: differences in appearance under non⁃polarized and polarized light［J］. Dermatol Surg, 2012,38（3）:392⁃399. doi: 10.1111/j.1524⁃4725.2011.02205.x.
［19］	Lallas A, Tzellos T, Kyrgidis A, et al. Accuracy of dermoscopic criteria for discriminating superficial from other subtypes of basal cell carcinoma［J］. J Am Acad Dermatol, 2014,70（2）:303⁃311. doi: 10.1016/j.jaad.2013.10.003.
［20］	Altamura D, Menzies SW, Argenziano G, et al. Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis［J］. J Am Acad Dermatol, 2010,62（1）:67⁃75. doi: 10.1016/j.jaad.2009.05.035.
［21］	Zalaudek I, Kreusch J, Giacomel J, et al. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: partII. Nonmelanocytic skin tumors［J］. J Am Acad Dermatol, 2010,63（3）:377⁃386. doi: 10.1016/j.jaad.2009. 11.697.
［22］	Lallas A, Apalla Z, Ioannides D, et al. Dermoscopy in the diagnosis and management of basal cell carcinoma［J］. Future Oncol, 2015,11（22）:2975⁃2984. doi: 10.2217/fon.15.193.
［23］	Micantonio T, Gulia A, Altobelli E, et al. Vascular patterns in basal cell carcinoma［J］. J Eur Acad Dermatol Venereol, 2011,25（3）:358⁃361. doi: 10.1111/j.1468⁃3083.2010.03734.x.
［24］	Wozniak⁃Rito A, Zalaudek I, Rudnicka L. Dermoscopy of basal cell carcinoma［J］. Clin Exp Dermatol, 2018,43（3）:241⁃247. doi: 10.1111/ced.13387.
［25］	Altamura D, Menzies SW, Argenziano G, et al. Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis［J］. J Am Acad Dermatol, 2010,62（1）:67⁃75. doi: 10.1016/j.jaad.2009.05.035.
［26］	Mackiewicz⁃Wysocka M, Bowszyc⁃Dmochowska M, Strzelecka⁃Węklar D, et al. Basal cell carcinoma ⁃ diagnosis［J］. Contemp Oncol （Pozn）, 2013,17（4）:337⁃342. doi: 10.5114/wo.2013. 35684.
［27］	Menzies SW, Westerhoff K, Rabinovitz H, et al. Surface microscopy of pigmented basal cell carcinoma［J］. Arch Dermatol, 2000,136（8）:1012⁃1016.
［28］	Suppa M, Micantonio T, Di SA, et al. Dermoscopic variability of basal cell carcinoma according to clinical type and anatomic location［J］. J Eur Acad Dermatol Venereol, 2015,29（9）:1732⁃1741. doi: 10.1111/jdv.12980.
［29］	Lallas A, Argenziano G, Zendri E, et al. Update on non⁃melanoma skin cancer and the value of dermoscopy in its diagnosis and treatment monitoring［J］. Expert Rev Anticancer Ther, 2013,13（5）:541⁃558. doi: 10.1586/era.13.38.
［30］	Verduzco⁃Martínez AP, Quiñones⁃Venegas R, Guevara⁃Gutiérrez E, et al. Correlation of dermoscopic findings with histopathologic variants of basal cell carcinoma［J］. Int J Dermatol, 2013,52（6）:718⁃721. doi: 10.1111/j.1365⁃4632.2012.05816.x.
［31］	Lallas A, Argenziano G, Kyrgidis A, et al. Dermoscopy uncovers clinically undetectable pigmentation in basal cell carcinoma［J］. Br J Dermatol, 2014,170（1）:192⁃195. doi: 10.1111/bjd.12634.
［32］	Akay BN, Saral S, Heper AO, et al. Basosquamous carcinoma: Dermoscopic clues to diagnosis［J］. J Dermatol, 2017,44（2）:127⁃134. doi: 10.1111/1346⁃8138.13563.
［33］	Lallas A, Apalla Z, Argenziano G, et al. The dermatoscopic universe of basal cell carcinoma［J］. Dermatol Pract Concept, 2014,4（3）:11⁃24. doi: 10.5826/dpc.0403a02.
［34］	Jin H, Yang MY, Kim JM, et al. Arborizing vessels on dermoscopy in various skin diseases other than basal cell carcinoma［J］. Ann Dermatol, 2017,29（3）:288⁃294. doi: 10. 5021/ad.2017.29.3.288.
［35］	Braun RP, Rabinovitz HS, Krischer J, et al. Dermoscopy of pigmented seborrheic keratosis: a morphological study［J］. Arch Dermatol, 2002,138（12）:1556⁃1560.
［36］	Zalaudek I, Giacomel J, Argenziano G, et al. Dermoscopy of facial nonpigmented actinic keratosis［J］. Br J Dermatol, 2006,155（5）:951⁃956. doi: 10.1111/j.1365⁃2133.2006.07426.x.
［37］	Bugatti L, Filosa G, De Angelis R. Dermoscopic observation of Bowen′s disease［J］. J Eur Acad Dermatol Venereol, 2004,18（5）:572⁃574. doi: 10.1111/j.1468⁃3083.2004.01008.x.
［38］	Cameron A, Rosendahl C, Tschandl P, et al. Dermatoscopy of pigmented Bowen′s disease［J］. J Am Acad Dermatol, 2010,62（4）:597⁃604. doi: 10.1016/j.jaad.2009.06.008.
［39］	中国医疗保健国际交流促进会皮肤科分会皮肤影像学组, 中华医学会皮肤性病学分会皮肤病数字化诊断亚学组, 中国中西医结合学会皮肤性病专业委员会皮肤影像学组, 等. 鳞状细胞肿瘤皮肤镜特征专家共识（2017）［J］. 中华皮肤科杂志, 2018,51（2）:87⁃91. doi: 10.3760/cma.j.issn.0412⁃4030.2018.02. 001.
［40］	Menzies SW, Kreusch J, Byth K, et al. Dermoscopic evaluation of amelanotic and hypomelanotic melanoma［J］. Arch Dermatol, 2008,144（9）:1120⁃1127. doi: 10.1001/archderm.144.9.1120.
［41］	Altamura D, Menzies SW, Argenziano G, et al. Dermatoscopy of basal cell carcinoma: morphologic variability of global and local features and accuracy of diagnosis［J］. J Am Acad Dermatol, 2010,62（1）:67⁃75. doi: 10.1016/j.jaad.2009.05.035.
［42］	李薇薇, 涂平, 杨淑霞, 等. 皮肤镜对基底细胞癌鉴别诊断价值的初步研究［J］. 中华皮肤科杂志, 2013,46（7）:480⁃484. doi: 10.3760/cma.j.issn.0412⁃4030.2013.07.009.
［43］	Mueller CK, Nicolaus K, Thorwarth M, et al. Multivariate analysis of the influence of patient⁃, tumor⁃, and management⁃related factors on the outcome of surgical therapy for facial basal⁃cell carcinoma［J］. Oral Maxillofac Surg, 2010,14（3）:163⁃168. doi: 10.1007/s10006⁃010⁃0215⁃z.
［44］	Roldán⁃Marín R, Toussaint⁃Caire S. Imiquimod 5 as adjuvant therapy for incompletely excised infiltrative nodular basal cell carcinoma and dermoscopy to monitor treatment response［J］. Dermatol Ther （Heidelb）, 2015,5（4）:265⁃272. doi: 10.1007/s13555⁃015⁃0088⁃z.
［45］	Carducci M, Bozzetti M, Foscolo AM, et al. Margin detection using digital dermatoscopy improves the performance of traditional surgical excision of basal cell carcinomas of the head and neck［J］. Dermatol Surg, 2011,37（2）:280⁃285. doi: 10.1111/ j.1524⁃4725.2010.01870.x.
［46］	Griffiths RW, Suvarna SK, Stone J. Do basal cell carcinomas recur after complete conventional surgical excision?［J］. Br J Plast Surg, 2005,58（6）:795⁃805. doi: 10.1016/j.bjps.2005.02. 010.
［47］	Lara F, Santamaría JR, Garbers LE. Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors［J］. An Bras Dermatol, 2017,92（1）:58⁃62. doi: 10.1590/abd1806⁃4841.20174867.
［48］	Husein⁃ElAhmed H, Fernandez⁃Pugnaire MA. Dermatoscopy⁃guided therapy of pigmented basal cell carcinoma with imiquimod［J］. An Bras Dermatol, 2016,91（6）:764⁃769. doi: 10.1590/abd1806⁃4841.20165255.
［49］	Mun JH, Jwa SW, Song M, et al. Pitfalls of using dermatoscopy in defining surgical margins of basal cell carcinoma［J］. Dermatol Surg, 2011,37（11）:1704⁃1705. doi: 10.1111/j.1524⁃4725.2011.02153.x.
［50］	Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma［J］. Br J Dermatol, 2008,159（1）:35⁃48. doi: 10.1111/j.1365⁃2133.2008.08666.x.
［51］	Christensen E, Warloe T, Kroon S, et al. Guidelines for practical use of MAL⁃PDT in non⁃melanoma skin cancer［J］. J Eur Acad Dermatol Venereol, 2010,24（5）:505⁃512. doi: 10.1111/j.1468⁃3083.2009.03430.x.
［52］	Morton CA, Szeimies RM, Sidoroff A, et al. European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications ⁃ actinic keratoses, Bowen′s disease, basal cell carcinoma［J］. J Eur Acad Dermatol Venereol, 2013,27（5）:536⁃544. doi: 10.1111/jdv.12031.
［53］	Geisse J, Caro I, Lindholm J, et al. Imiquimod 5 cream for the treatment of superficial basal cell carcinoma: results from two phase III, randomized, vehicle⁃controlled studies［J］. J Am Acad Dermatol, 2004,50（5）:722⁃733. doi: 10.1016/j.jaad.2003. 11.066.

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[开放获取] 中国基底细胞癌皮肤镜特征专家共识（2019）

Dermoscopic characteristics of basal cell carcinoma: a Chinese expert consensus statement （2019）

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