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Cancers
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Dermoscopy in Skin Cancer
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Dermoscopy in Skin Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 14 February 2025 | Viewed by 6571

Special Issue Editors

Dr. Elisa Zavattaro

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Guest Editor
Department of Health Science, University of Eastern Piedmont, 13100 Novara, Italy
Interests: non-melanoma skin cancer; field cancerization; organ transplant recipients; melanoma
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Paola Savoia

E-Mail Website
Guest Editor
Dermatology Unit, Department of Health Sciences (DiSS), School of Medicine, Università del Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy
Interests: melanoma; non-melanoma skin cancer; photoaging; cutaneous lymphomas
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Skin cancers are very frequent worldwide and account for a large number of clinical issues requiring dermatological evaluations. Despite the fact that some of these neoplasms can be easily diagnosed, dermoscopy examination is mandatory in order to properly recognize and classify cutaneous lesions.

The development of dermoscopy has led to the identification of a large number of different pathognomonic patterns, many of which have already been published. Interestingly, dermoscopy might provide a useful tool to differentiate between certain skin tumors and even between their diverse types; moreover, it can also be of help in the follow-up after surgery and medical treatment.

Of note, numerous methods of automatic and AI-based readings of dermoscopy have been recently developed, with controversial results. On the other hand, comparisons between dermoscopy and other non-invasive diagnostic tools have been reported, and we are strongly convinced of their importance.

This Special Issue will discuss the latest updates on the usefulness of dermoscopy, both in the diagnostic process and in the follow-up of skin tumors, and it is also focused on reporting novel developments in the field of dermatology.

You may choose our Joint Special Issue in Dermato.

Dr. Elisa Zavattaro
Prof. Dr. Paola Savoia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dermoscopy
  • skin cancer
  • differential diagnosis
  • dermoscopy patterns
  • non-invasive diagnostic tool

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Published Papers (6 papers)

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Research

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12 pages, 440 KiB  
Article
The Importance of Early Detection and Prevention of Atypical Skin Lesions and Other Melanoma Risk Factors in a Younger Population
by Paulina Karp, Katarzyna Karp, Marcelina Kądziela, Radosław Zajdel and Agnieszka Żebrowska
Cancers 2024, 16(24), 4264; https://doi.org/10.3390/cancers16244264 - 22 Dec 2024
Viewed by 608
Abstract
Background/Objectives: Skin cancer is becoming increasingly common due to increasing risk factors such as excessive ultraviolet (UV) radiation, genetic predisposition, fair skin, and a history of sunburn. Melanoma accounts for only 1% of cases but causes most skin cancer deaths. Dysplastic nevi (DN) [...] Read more.
Background/Objectives: Skin cancer is becoming increasingly common due to increasing risk factors such as excessive ultraviolet (UV) radiation, genetic predisposition, fair skin, and a history of sunburn. Melanoma accounts for only 1% of cases but causes most skin cancer deaths. Dysplastic nevi (DN) are important precursors of melanoma. The aim of this study was to investigate the influence of these risk factors on the incidence and stage of skin cancer. Methods: The study included 591 patients aged 18 to 64 who visited the Department of Dermatology and Venereology in 2022–2023 for skin examinations. Each patient completed a questionnaire regarding the risk factors for melanoma and atypical melanocytic nevi and then underwent a dermatoscopic examination of the whole body using a digital videodermatoscope. Results: Dermatoscopic examination revealed a lesion suggestive of melanoma in 1.69% of the patients. Risk factors for developing melanoma included male gender, family history of melanoma, number of skin moles, sunburn in childhood, sun-dependent hobby, using a tanning bed, using low sun protection factor (SPF) cream, not avoiding sun exposure, and co-occurrence of actinic keratosis. Conclusions: Risk factors for melanoma and dysplastic nevi are still common among patients, but the situation has been improving over the years. Early intervention and education on sun safety can play pivotal roles in reducing the incidence of atypical moles and potentially preventing malignant transformations. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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15 pages, 2741 KiB  
Article
Application of Ultraviolet-Enhanced Fluorescence Dermoscopy in Basal Cell Carcinoma
by Irena Wojtowicz and Magdalena Żychowska
Cancers 2024, 16(15), 2685; https://doi.org/10.3390/cancers16152685 - 28 Jul 2024
Cited by 1 | Viewed by 1626
Abstract
Introduction: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The aim of the current study was to analyze the ultraviolet-enhanced fluorescence dermoscopy (UVFD) characteristics of BCCs. Methods: BCCs were evaluated under polarized dermoscopy (PD) and UVFD. The findings in PD [...] Read more.
Introduction: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The aim of the current study was to analyze the ultraviolet-enhanced fluorescence dermoscopy (UVFD) characteristics of BCCs. Methods: BCCs were evaluated under polarized dermoscopy (PD) and UVFD. The findings in PD were described using predefined parameters for dermoscopic evaluation in dermato-oncology. UVFD characteristics were determined based on personal observations, and included interrupted follicle pattern, absence of pink-orange or blue-green fluorescence, well-demarcated borders, and dark silhouettes. Results: In total, 163 BCCs were analyzed. Under UVFD, the interrupted follicle pattern (p < 0.001), absence of pink-orange fluorescence (p = 0.005) and well-demarcated borders (p = 0.031) were more frequently noted in BCCs < 5 mm than in bigger tumors. Lesions on the face showed clearly defined borders (p = 0.031) and interrupted follicle pattern (p < 0.001) more frequently than tumors located beyond the face. Nodular BCCs displayed interrupted follicle pattern (p = 0.001) and absence of pink-orange fluorescence (p < 0.001) more commonly than superficial subtypes. Non-pigmented BCCs more frequently showed lack of blue-green fluorescence (p = 0.007) and interrupted follicle pattern (p = 0.018) compared to pigmented variants. Conclusions: UVFD may be a valuable, complementary to PD, tool in the diagnosis of BCC, particularly in small tumors, lesions located on the face and nodular or non-pigmented subtypes. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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11 pages, 3804 KiB  
Article
Reflectance Confocal Microscopy and Dermoscopy of Facial Pigmented and Non-Pigmented Actinic Keratosis Features before and after Photodynamic Therapy Treatment
by Ewelina Mazur, Dominika Kwiatkowska and Adam Reich
Cancers 2023, 15(23), 5598; https://doi.org/10.3390/cancers15235598 - 27 Nov 2023
Cited by 3 | Viewed by 1496
Abstract
Actinic keratosis (AK), due to its widespread prevalence, as well as the possibility of progression to an invasive form of squamous cell carcinoma, requires treatment regardless of the clinical stage. New imaging techniques, such as in vivo reflectance confocal microscopy (RCM), significantly increase [...] Read more.
Actinic keratosis (AK), due to its widespread prevalence, as well as the possibility of progression to an invasive form of squamous cell carcinoma, requires treatment regardless of the clinical stage. New imaging techniques, such as in vivo reflectance confocal microscopy (RCM), significantly increase the accuracy of diagnosis and allow noninvasive evaluation of the therapeutic efficacy of the ongoing treatment. Our objective was to evaluate the prevalence of specific (video)dermoscopy and RCM features of pigmented and classical subtypes of AK before and after photodynamic therapy (PDT) treatment. We included patients with facial grade II AKs (25 pigmented, 275 non-pigmented) were included in the study. Skin lesions were evaluated by (video)dermoscopy and RCM at the baseline and three months after PDT. In classic AK, the most frequent dermoscopic findings were fine wavy vessels (96%), scale (92%), microerosions (48%), and “strawberry” pattern (36%), while pigmented AK was characterized mostly by “rhomboidal pattern” (80%), scale (60%), white globules (48%), “jelly sign”, and superficial pigmentation (40%). RCM’s most characteristic classic AK findings were abnormal honeycomb pattern in the spinous layer, epidermal inflammatory infiltrate, and solar elastosis that were present in 96% of lesions. Pigmented AKs presented mostly with dark central areas of parakeratosis (72%), mottled pigmentation (72%), dermal inflammatory infiltrate (64%), solar elastosis (60%), and abnormal honeycomb pattern in the spinous layer (56%). Dermoscopically, PDT resulted in complete disappearance of the “rhomboidal pattern” in both classical and pigmented AKs, “starburst pattern” and “jelly sign” in classical AKs, and inner gray halo, “rosette sign” and central crust in pigmented AKs. Three months after one PDT session, RCM evaluation showed mostly solar elastosis in both classical and pigmented AK subtypes, epidermal inflammatory infiltrate in classical AKs, and dermal inflammatory infiltrate in pigmented AKs. New noninvasive imaging techniques such as RCM and (video)dermoscopy can help practitioners better visualize the efficacy of the ongoing PDT treatment in either classical or pigmented AK subtypes. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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Review

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21 pages, 4995 KiB  
Review
Dermoscopy of Basal Cell Carcinoma Part 1: Dermoscopic Findings and Diagnostic Accuracy—A Systematic Literature Review
by Irena Wojtowicz and Magdalena Żychowska
Cancers 2025, 17(3), 493; https://doi.org/10.3390/cancers17030493 - 1 Feb 2025
Viewed by 379
Abstract
Introduction: Basal cell carcinoma (BCC) is the most common malignant skin tumor. While rarely fatal, it can cause local tissue damage. Part I of the review summarizes the dermoscopic features of BCC and the diagnostic accuracy of dermoscopy in the diagnosis of BCC. [...] Read more.
Introduction: Basal cell carcinoma (BCC) is the most common malignant skin tumor. While rarely fatal, it can cause local tissue damage. Part I of the review summarizes the dermoscopic features of BCC and the diagnostic accuracy of dermoscopy in the diagnosis of BCC. Methods: A search of the PubMed database was performed for studies reporting on the diagnostic accuracy of dermoscopy or dermoscopic findings in BCC, either pigmented or non-pigmented, located anywhere on the body, of any histopathologic subtype, size and at any age of onset. Results: BCC was found to present with a wide range of dermoscopic features, including white structures (shiny white lines, shiny white areas, rosettes), yellow structures (milia-like cysts, yellow lobular-like structures), multiple aggregated yellow-white globules (MAY globules), blue structures (blue ovoid nests), vascular structures (arborizing vessels, short fine telangiectasias), multiple small erosions/ulcerations, features of regression (pepper-like structures, white scar-like areas) and pigmented structures (spoke-wheel areas, maple leaf-like areas (MLLAs), blue/gray dots). Dermoscopy showed a sensitivity of 67.6–98.6% and a positive predictive value (PPV) of 85.9–97% in identifying BCC. The physician’s experience and training improve the accuracy, however, BCCs on the trunk and extremities, particularly of superficial subtypes, may still constitute a challenge. Conclusions: Dermoscopy, especially when performed by a trained physician, increases the accuracy of early BCC detection. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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21 pages, 2972 KiB  
Review
Dermoscopy of Basal Cell Carcinoma Part 2: Dermoscopic Findings by Lesion Subtype, Location, Age of Onset, Size and Patient Phototype
by Irena Wojtowicz and Magdalena Żychowska
Cancers 2025, 17(2), 176; https://doi.org/10.3390/cancers17020176 - 8 Jan 2025
Viewed by 560
Abstract
Introduction: Basal cell carcinoma (BCC) is the most prevalent type of skin cancer worldwide. Despite its low metastatic potential, certain subtypes present an aggressive clinical course. Part II focuses on the different dermoscopic patterns observed in BCC, depending on the lesion subtype, its [...] Read more.
Introduction: Basal cell carcinoma (BCC) is the most prevalent type of skin cancer worldwide. Despite its low metastatic potential, certain subtypes present an aggressive clinical course. Part II focuses on the different dermoscopic patterns observed in BCC, depending on the lesion subtype, its location on the body, the patient’s age, the size of the tumor, and skin phototype. Methods: A search of the PubMed database was conducted for studies reporting dermoscopic findings in BCC across all body locations, histopathologic subtypes, tumor sizes, ages of onset and skin phototypes. Results: There are no dermoscopic features indicative of a particular BCC subtype. However, arborizing, truncated or glomerular vessels, shiny white lines, ulceration, white areas, absence of pink zones and large blue-gray ovoid nests suggest high-risk BCCs (morpheaform, micronodular, infiltrative, basosquamous). Pigmented features can occur in all BCC types, though increased pigmentation indicates less aggressive subtypes (nodular, superficial, fibroepithelioma of Pinkus, adenoid). BCCs most commonly develop on the head, typically presenting as nodular and non-pigmented tumors. Those on the nose, eyes and ears may be more aggressive and prone to recurrence. On the trunk, BCCs are usually superficial and pigmented. Lower limb lesions often show polymorphous vessels rather than arborizing ones, which makes the dermoscopic diagnosis challenging. Dermoscopy aids early detection, with larger tumors exhibiting more established features but no size-specific patterns. Aggressive subtypes display similar dermoscopic findings regardless of size. Conclusions: Dermoscopy is a valuable tool for the early detection of BCC, though no specific dermoscopic features can definitively identify subtypes. High-risk BCCs can be suspected when distinct vascular and structural patterns are present, particularly in lesions located on the face, especially around the nose, eyes and ears, while pigmented features may indicate less aggressive subtypes. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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13 pages, 4566 KiB  
Review
Reflectance Confocal Microscopy and Dermoscopy for the Diagnosis of Solitary Hypopigmented Pink Lesions: A Narrative Review
by Luca Ambrosio, Anna Pogorzelska-Antkowiak, Chiara Retrosi, Giovanni Di Lella, Marco Spadafora, Iris Zalaudek, Caterina Longo, Giovanni Pellacani and Claudio Conforti
Cancers 2024, 16(17), 2972; https://doi.org/10.3390/cancers16172972 - 26 Aug 2024
Viewed by 1007
Abstract
Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic [...] Read more.
Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic features. This similarity extends to some malignant lesions, including basal cell carcinoma, actinic keratosis, and amelanotic melanoma, making differentiation difficult. Recent studies highlight the enhanced diagnostic accuracy of reflectance confocal microscopy (RCM), which offers increased sensitivity and specificity compared to dermoscopy alone for diagnosing skin cancer. This study aims to summarize the application of dermoscopy and RCM in distinguishing between benign and malignant pinkish–reddish skin lesions. The integration of RCM with traditional dermoscopic techniques improves the ability to accurately identify and differentiate these lesions. However, it is crucial to note that for any suspicious lesions, a final diagnosis must be confirmed through surgical excision and histopathological evaluation. This comprehensive approach ensures accurate diagnosis and appropriate treatment, highlighting the importance of combining advanced imaging techniques in clinical practice. Full article
(This article belongs to the Special Issue Dermoscopy in Skin Cancer)
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