Dermoscopic features of basal cell carcinoma and its subtypes: A systematic review

Ofer Reiter*, Ilit Mimouni, Stephen Dusza, Allan C. Halpern, Yael Anne Leshem, Ashfaq A. Marghoob

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Multiple studies have reported on dermoscopic structures in basal cell carcinoma (BCC) and its subtypes, with varying results. Objective: To systematically review the prevalence of dermoscopic structures in BCC and its subtypes. Methods: Databases and reference lists were searched for relevant trials according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for the relative proportion of BCC dermoscopic features. Random-effects models were used to estimate summary effect sizes. Results: Included were 31 studies consisting of 5950 BCCs. The most common dermoscopic features seen in BCC were arborizing vessels (59%), shiny white structures (49%), and large blue-grey ovoid nests (34%). Arborizing vessels, ulceration, and blue-grey ovoid nests and globules were most common in nodular BCC; short-fine telangiectasia, multiple small erosions, and leaf-like, spoke wheel and concentric structures in superficial BCC; porcelain white areas and arborizing vessels in morpheaform BCC; and arborizing vessels and ulceration in infiltrative BCC. Limitations: Studies had significant heterogeneity. Studies reporting BCC histopathologic subtypes did not provide clinical data on pigmentation of lesions. Conclusion: In addition to arborizing vessels, shiny white structures are a common feature of BCC. A constellation of dermoscopic features may aid in differentiating between BCC histopathologic subtypes.

Original languageEnglish
Pages (from-to)653-664
Number of pages12
JournalJournal of the American Academy of Dermatology
Issue number3
StatePublished - Sep 2021


  • BCC
  • arborizing vessels
  • basal cell carcinoma
  • blue-white veil
  • concentric structures
  • corkscrew vessels
  • dermatoscopy
  • dermoscopy
  • dotted vessels
  • glomerular vessels
  • hairpin vessels
  • infiltrative basal cell carcinoma
  • large blue-grey ovoid nests
  • leaf-like areas
  • morpheaform basal cell carcinoma
  • multiple blue-grey dots and globules
  • multiple in-focus dots
  • multiple small erosions
  • nodular basal cell carcinoma
  • nonpigmented basal cell carcinoma
  • pigmented basal cell carcinoma
  • polymorphous vessels
  • rosettes
  • shiny white structures
  • shiny white-red structureless background
  • short-fine telangiectasia
  • spoke wheel areas
  • superficial basal cell carcinoma
  • ulceration


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