TY - JOUR
T1 - Association of Multiple Aggregated Yellow-White Globules with Nonpigmented Basal Cell Carcinoma
AU - Navarrete-Dechent, Cristian
AU - Liopyris, Konstantinos
AU - Rishpon, Ayelet
AU - Marghoob, Nadeem G.
AU - Cordova, Miguel
AU - Dusza, Stephen W.
AU - Sahu, Aditi
AU - Kose, Kivanc
AU - Oliviero, Margaret
AU - Rabinovitz, Harold
AU - Busam, Klaus J.
AU - Marchetti, Michael A.
AU - Chen, Chih Chan J.
AU - Marghoob, Ashfaq A.
N1 - Funding Information:
Navarrete-Dechent, Liopyris, Rishpon, Cordova, Rabinoviz, Busam, Chen, A.A. Marghoob. Supervision: Liopyris, Busam, Marchetti, A.A. Marghoob. Conflict of Interest Disclosures: Dr Rabinoviz reported receiving equipment from 3 GEN during the conduct of the study. No other disclosures were reported. Funding/Support: This research is funded in part by grant P30-CA008748 from the National Cancer Institute of the National Institutes of Health to the Memorial Sloan Kettering Cancer Center.
Publisher Copyright:
© 2020 American Medical Association. All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - Importance: Basal cell carcinoma (BCC) is the most common skin cancer. Dermoscopic imaging has improved diagnostic accuracy; however, diagnosis of nonpigmented BCC remains limited to arborizing vessels, ulceration, and shiny white structures. Objective: To assess multiple aggregated yellow-white (MAY) globules as a diagnostic feature for BCC. Design, Setting, and Participants: In this retrospective, single-center, case-control study, nonpigmented skin tumors, determined clinically, were identified from a database of lesions consecutively biopsied during a 7-year period (January 1, 2009, to December 31, 2015). A subset of tumors was prospectively diagnosed, and reflectance confocal microscopy, optical coherence tomography, and histopathologic correlation were performed. Data analysis was conducted from July 1 to September 31, 2019. Exposures: Investigators evaluated for the presence or absence of known dermoscopic criteria. MAY globules were defined as aggregated, white-yellow structures visualized in polarized and nonpolarized light. Main Outcomes and Measures: The primary outcome was the diagnostic accuracy of MAY globules for the diagnosis of BCC. Secondary objectives included the association with BCC location and subtype. Interrater agreement was estimated. Results: A total of 656 nonpigmented lesions from 643 patients (mean [SD] age, 63.1 [14.9] years; 381 [58.1%] male) were included. In all, 194 lesions (29.6%) were located on the head and neck. A total of 291 (44.4%) were BCCs. MAY globules were seen in 61 of 291 BCC cases (21.0%) and in 3 of 365 other diagnoses (0.8%) (P <.001). The odds ratio for diagnosis of BCC was 32.0 (96% CI, 9.9-103.2). The presence of MAY globules was associated with a diagnosis of histologic high-risk BCC (odds ratio, 6.5; 95% CI, 3.1-14.3). The structure was never seen in cases of superficial BCCs. Conclusions and Relevance: The findings suggest that MAY globules may have utility as a new BCC dermoscopic criterion with a high specificity. MAY globules were negatively associated with superficial BCC and positively associated with deeper-seated, histologic, higher-grade tumor subtypes..
AB - Importance: Basal cell carcinoma (BCC) is the most common skin cancer. Dermoscopic imaging has improved diagnostic accuracy; however, diagnosis of nonpigmented BCC remains limited to arborizing vessels, ulceration, and shiny white structures. Objective: To assess multiple aggregated yellow-white (MAY) globules as a diagnostic feature for BCC. Design, Setting, and Participants: In this retrospective, single-center, case-control study, nonpigmented skin tumors, determined clinically, were identified from a database of lesions consecutively biopsied during a 7-year period (January 1, 2009, to December 31, 2015). A subset of tumors was prospectively diagnosed, and reflectance confocal microscopy, optical coherence tomography, and histopathologic correlation were performed. Data analysis was conducted from July 1 to September 31, 2019. Exposures: Investigators evaluated for the presence or absence of known dermoscopic criteria. MAY globules were defined as aggregated, white-yellow structures visualized in polarized and nonpolarized light. Main Outcomes and Measures: The primary outcome was the diagnostic accuracy of MAY globules for the diagnosis of BCC. Secondary objectives included the association with BCC location and subtype. Interrater agreement was estimated. Results: A total of 656 nonpigmented lesions from 643 patients (mean [SD] age, 63.1 [14.9] years; 381 [58.1%] male) were included. In all, 194 lesions (29.6%) were located on the head and neck. A total of 291 (44.4%) were BCCs. MAY globules were seen in 61 of 291 BCC cases (21.0%) and in 3 of 365 other diagnoses (0.8%) (P <.001). The odds ratio for diagnosis of BCC was 32.0 (96% CI, 9.9-103.2). The presence of MAY globules was associated with a diagnosis of histologic high-risk BCC (odds ratio, 6.5; 95% CI, 3.1-14.3). The structure was never seen in cases of superficial BCCs. Conclusions and Relevance: The findings suggest that MAY globules may have utility as a new BCC dermoscopic criterion with a high specificity. MAY globules were negatively associated with superficial BCC and positively associated with deeper-seated, histologic, higher-grade tumor subtypes..
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U2 - 10.1001/jamadermatol.2020.1450
DO - 10.1001/jamadermatol.2020.1450
M3 - Article
C2 - 32459294
AN - SCOPUS:85085882295
SN - 2168-6068
VL - 156
SP - 882
EP - 890
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 8
ER -