Dermatoscopic “Mimickers” of Basal Cell Carcinoma - Adnexal Skin Tumors

Reihane Bislimi Berisha, Djordje Dzokic

International Journal of Biomedicine. 2022;12(4):671-674.
DOI: 10.21103/Article12(4)_ShC
Originally published December 5, 2022


Background: Adnexal skin tumors (AST) are numerous and various, and in their appearance give dermoscopic and clinical features similar to basal cell carcinoma (BCC). Differential diagnosis is difficult, as clinical alteration seems insufficient to distinguish between BCC and many skin lesions that mimic BCC. However, the validity and usefulness of dermatoscopic criteria enable differentiation between BCC and AST.
The purpose of this paper was to present the basic dermatoscopic criteria for diagnosis of BCC as well as minimally invasive methods for treatment and clinical management, with a better aesthetic outcome.
Methods and Results: This study consisted of a retrospective review of 50 skin lesions collected in our institution over a 3-year period. We analyzed the dermoscopic images of 29 skin lesions with a clinical diagnosis of BCC and 21 cases with a clinical diagnosis of AST. All lesions were assessed for the presence of various dermatoscopic criteria using a manual photo dermatoscopy system DermLite (DermLite 3, Gen). Each case was evaluated by the presence of dermatoscopic features. We compared dermatoscopic and clinical features between the BCC and AST groups.
In the AST group, there were 5(23.8%) premalignant and 16(76.2%) benign lesions. Compared to the AST group, the BCC group had a significantly higher frequency of dermatoscopic features (vascular pattern, ulceration, and additional dermatoscopic features). All lesions included in this study showed more than one of the following characteristics of BCC: arborizing vessels, short fine telangiectasia, translucency, ulceration, blue-gray globules, flecked pigmentation, and rolled borders. Cutaneous lesions with 2 or fewer dermatoscopic features of BCC were much more likely to be an adnexal tumor.
Conclusion: The results of this study could be valuable for the differential diagnosis of BCC and BCC-mimicking cutaneous lesions, because dermatoscopy can be especially helpful in better describing, recognizing, and differentiating these lesions.

adnexal skin tumor • basal cell carcinoma • differential diagnosis

1. Del Busto-Wilhelm I, Malvehy J, Puig S. Dermoscopic criteria and basal cell carcinoma. G Ital Dermatol Venereol. 2016 Dec;151(6):642-648.
2. Álvarez-Salafranca M, Ara M, Zaballos P. Dermoscopy in Basal Cell Carcinoma: An Updated Review. Actas Dermosifiliogr (Engl Ed). 2021 Apr;112(4):330-338.. doi: 10.1016/ [Article in English, Spanish]
3. Wozniak-Rito A, Zalaudek I, Rudnicka L. Dermoscopy of basal cell carcinoma. Clin Exp Dermatol. 2018 Apr;43(3):241-247. doi: 10.1111/ced.13387.
4. Enache AO, Pătrașcu V, Simionescu CE, Ciurea RN, Văduva A, Stoica LE. Dermoscopy Patterns and Histopathological Findings in Nodular Basal Cell Carcinoma-Study on 68 Cases. Curr Health Sci J. 2019 Jan-Mar;45(1):116-122. doi: 10.12865/CHSJ.45.01.16.
5. Lallas A, Apalla Z, Argenziano G, Longo C, Moscarella E, Specchio F, Raucci M, Zalaudek I. The dermatoscopic universe of basal cell carcinoma. Dermatol Pract Concept. 2014 Jul 31;4(3):11-24. doi: 10.5826/dpc.0403a02.
6. Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricalà C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part II. Nonmelanocytic skin tumors. J Am Acad Dermatol. 2010 Sep;63(3):377-86; quiz 387-8. doi: 10.1016/j.jaad.2009.11.697.
7. Kittler H, Pehamberger H, Wolff K, Binder M. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002 Mar;3(3):159-65. doi: 10.1016/s1470-2045(02)00679-4.
8. Lupu M, Caruntu C, Popa MI, Voiculescu VM, Zurac S, Boda D. Vascular patterns in basal cell carcinoma: Dermoscopic, confocal and histopathological perspectives. Oncol Lett. 2019 May;17(5):4112-4125. doi: 10.3892/ol.2019.10070.
9. Sgambato A, Zalaudek I, Ferrara G, Giorgio CM, Moscarella E, Nicolino R, Argenziano G. Adnexal tumors: clinical and dermoscopic mimickers of basal cell carcinoma. Arch Dermatol. 2008 Mar;144(3):426. doi: 10.1001/archderm.144.3.426.
10. Al Mushcab N, Husain R, Al Subaiei M, Al Qarni A, Abbas A, Al Duhileb M. Trichoblastoma mimicking basal cell carcinoma and the approach to its management: Case report. Int J Surg Case Rep. 2021 Sep;86:106318. doi: 10.1016/j.ijscr.2021.106318.
11. Zaballos P, Serrano P, Flores G, Bañuls J, Thomas L, Llambrich A, Castro E, Lallas A, Argenziano G, Zalaudek I, del Pozo LJ, Landi C, Malvehy J. Dermoscopy of tumours arising in naevus sebaceous: a morphological study of 58 cases. J Eur Acad Dermatol Venereol. 2015 Nov;29(11):2231-7. doi: 10.1111/jdv.13226.
12. Zaballos P, Gómez-Martín I, Martin JM, Bañuls J. Dermoscopy of Adnexal Tumors. Dermatol Clin. 2018 Oct;36(4):397-412. doi: 10.1016/j.det.2018.05.007.
13. Lai M, Muscianese M, Piana S, Chester J, Borsari S, Paolino G, Pellacani G, Longo C, Pampena R. Dermoscopy of cutaneous adnexal tumours: a systematic review of the literature. J Eur Acad Dermatol Venereol. 2022 Sep;36(9):1524-1540. doi: 10.1111/jdv.18210.
14. Carbotti M, Coppola R, Graziano A, Verona Rinati M, Paolilli FL, Zanframundo S, Panasiti V. Dermoscopy of verrucous epidermal nevus: large brown circles as a novel feature for diagnosis. Int J Dermatol. 2016 Jun;55(6):653-6. doi: 10.1111/ijd.12948.
15. Oyasiji T, Tan W, Kane J 3rd, Skitzki J, Francescutti V, Salerno K, Khushalani NI. Malignant adnexal tumors of the skin: a single institution experience. World J Surg Oncol. 2018 May 30;16(1):99. doi: 10.1186/s12957-018-1401-y.
16. Sharma A, Paricharak DG, Nigam JS, Rewri S, Soni PB, Omhare A, Sekar P. Histopathological study of skin adnexal tumours-institutional study in South India. J Skin Cancer. 2014;2014:543756. doi: 10.1155/2014/543756.
17. Radhika K, Phaneendra BV, Rukmangadha N, Reddy MK. A study of biopsy confirmed skin adnexal tumors: experience at a tertiary care teaching hospital. Journal of Clinical and Scientific Research. 2013;2:132–138.
18. Samaila MO. Adnexal skin tumors in Zaria, Nigeria. Ann Afr Med. 2008 Mar;7(1):6-10. doi: 10.4103/1596-3519.55691.

Download Article
Received November 1, 2022.
Accepted November 30, 2022.
©2022 International Medical Research and Development Corporation.