ABSTRACT
Basosquamous carcinoma is an aggressive variant of basal cell carcinoma (BCC), characterized by clinical and pathologic features of both BCC and squamous cell carcinoma (SCC). It has a nonspecific clinical presentation, and the diagnosis is generally made only after biopsy. It occurs predominantly in men older than 50 years and is usually located on the head and neck. It has a higher risk of local recurrence and lymph node or distant metastasis as compared to BCC. Complete surgical removal, possibly with Mohs micrographic surgery, is recommended.
On dermoscopy, basosquamous carcinoma usually shows unfocused arborizing vessels, alone or in combination with dotted, straight, coiled, looped and/or focused arborizing vessels. Keratin masses, whitish structureless areas, superficial scales, blue-gray ovoid nests, white structures, ulceration and blood spots in keratin masses, are the most common dermoscopic features reported.
The identification of at least one feature of both invasive SCC and BCC should raise suspicion for basosquamous carcinoma.
