The Use of Dermoscopy in the Delineation of Basal Cell Carcinoma for Mohs Micrographic Surgery
A Systematic Review with Meta-Analysis
Keywords:
Mohs micrographic surgery, basal cell carcinoma,, dermatoscopy,, dermoscopy, Slow Mohs, 3D histologyAbstract
Introduction: Several studies investigated the use of dermoscopy in the delineation of Basal cell carcinoma (BCC) for Mohs micrographic surgery (MMS) with conflicting results
Objective: The purpose of this systematic review with meta-analysis was to evaluate the effectiveness of the use of dermoscopy-guided MMS in the treatment of BCC.
Methods: We included all comparative studies including more than twenty-five cases. Cases of BCC treated using dermoscopy-guided MMS (or slow MMS) were compared to those treated with curettage-guided MMS or “standard” MMS.
Results: A total of 6 studies including 508 BCCs were reviewed. There was no statistically significant difference in the proportion of total margin clearance on the first MMS stage between BCCs removed using dermoscopy-guided MMS and those that had curettage or visual inspection. However, lateral margin involvement was significantly lower in BCCs that had dermoscopy-guided MMS.
Limitations: Scarcity of research on this subject
Conclusions: Dermoscopy allows visualization of structures up to 1mm into the dermis, and therefore it is rational to use it for lateral margin evaluation. Currently, there are two comparative studies showing the efficacy of dermoscopy for lateral margin evaluation during MMS. Future studies are required to develop an evidence-based recommendation regarding the utility of dermoscopy in MMS.
References
Cameron MC, Lee E, Hibler BP, et al. Basal cell carcinoma: Contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol. 2019;80(2):321-339. doi:10.1016/j.jaad.2018.02.083
Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the us population, 2012. JAMA Dermatology. 2015;151(10):1081-1086. doi:10.1001/jamadermatol.2015.1187
Danesh MJ, Menge TD, Helliwell L, Mahalingam M, Waldman A. Adherence to the National Comprehensive Cancer Network Criteria of Complete Circumferential Peripheral and Deep Margin Assessment in Treatment of High-Risk Basal and Squamous Cell Carcinoma. Dermatol Surg. 2020;46(12):1473-1480. doi:10.1097/DSS.0000000000002354
Litaiem N, Karray M, Jones M, Rammeh S, Zeglaoui F. Effectiveness of dermoscopy in the demarcation of surgical margins in slow Mohs surgery. Dermatol Ther. 2020;33(6):e14196. doi:10.1111/dth.14196
Rosendahl C, Marozava A, eds. Dermatoscopy and Skin Cancer: A Handbook for Hunters of Skin Cancer and Melanoma. 1st edition. Scion Publishing; 2019.
Asilian A, Momeni I. Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery. Adv Biomed Res. 2013;2:2. Published 2013 Mar 6. doi:10.4103/2277-9175.107961.
Gurgen J, Gatti M. Epiluminescence microscopy (Dermoscopy) versus visual inspection during mohs microscopic surgery of infiltrative basal cell carcinoma. Dermatologic Surg. 2012;38(7 PART 1):1066-1069. doi:10.1111/j.1524-4725.2012.02424.x
Suzuki HS, Serafini SZ, Sato MS. Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery. An Bras Dermatol. 2014;89(1):38-43. doi:10.1590/abd1806-4841.20142400
Dika E, Fanti PA, Christman H, Ravaioli GM, Patrizi A. Videodermoscopy and curettage: The value of simple procedures during Mohs surgery. Dermatologic Surg. 2017;43(12):1411-1417. doi:10.1097/DSS.0000000000001247
Shin K, Kim H-SH-JH, Ko H, Kim B, Kim M-B, Kim H-SH-JH. Dermoscopy-guided Mohs micrographic surgery in post-laser basal cell carcinomas: Is dermoscopy helpful for demarcation of the surgical margin? J Dermatolog Treat. 2020;0(0):1-12. doi:10.1080/09546634.2020.1762839
Yeom SD, Lee SH, Ko HS, et al. Effectiveness of dermoscopy in Mohs micrographic surgery (MMS) for nonmelanoma skin cancer (NMSC). Int J Dermatol. 2017;56(6):e136-e139. doi:10.1111/ijd.13501
Guardiano RA, Grande DJ. A direct comparison of visual inspection, curettage, and epiluminescence microscopy in determining tumor extent before the initial margins are determined for mohs micrographic surgery. Dermatologic Surg. 2010;36(8):1240-1244. doi:10.1111/j.1524-4725.2010.01616.x
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339. doi:10.1136/bmj.b2700
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (Minors): Development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-716. doi:10.1046/j.1445-2197.2003.02748.x
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 1996;17(1):1-12. doi:10.1016/0197-2456(95)00134-4
Jayasekera PSA, Dodd J, Oliphant T, Langtry JAA, Lawrence CM. Dermoscopy prior to Mohs micrographic surgery does not improve tumour margin assessment and leads to fewer Mohs stages. Br J Dermatol. 2018;178(2):565-566. doi:10.1111/bjd.15903
Que SKT. Research Techniques Made Simple: Noninvasive Imaging Technologies for the Delineation of Basal Cell Carcinomas. J Invest Dermatol. 2016;136(4):e33-e38. doi:10.1016/j.jid.2016.02.012
Lupu M, Voiculescu VM, Caruntu A, Tebeica T, Caruntu C. Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma. Diagnostics. 2021;11(1):120. doi:10.3390/diagnostics11010120
Published
Issue
Section
License
Copyright (c) 2022 Noureddine Litaiem, Faten Hayder, Imene Benlagha, Manel Karray, Chedli Dziri, Faten Zeglaoui
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.
How to Cite
Share
