ABSTRACT

There are several histologic variants of BCC, including nodular, superfi cial, and infi ltrative. Each of these BCC subtypes can present as amelanotic lesions or they can present with pigment. BCCs that are amelanotic can be identifi ed based on the presence of arborizing vessels, shiny white areas, crystalline structures, and/or ulceration. Pigmented BCCs (pBCC), which may clinically mimic melanoma, contain specifi c dermoscopic structures that aid in their proper diagnosis (see chap. 5a, “Basal cell carcinoma”). Menzies model for dermoscopic diagnosis of pBCCs (sensitivity of 93% and specifi city of 89-92%) includes arborizing vessels as an important diagnostic feature (Menzies, 2002; Menzies et al., 2000). Arborizing vessels were observed in 52% of pBCCs, compared with 23% of melanomas and only 8% of benign skin lesions (Menzies et al., 2000).