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Clinical and dermoscopic variation of basal cell carcinoma according to age of onset and anatomic location: a multicenter, retrospective study

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Abstract

Basal cell carcinoma (BCC) is rare in young individuals and reported to possess different pathogenetic, clinical and histological features from late-onset BCC. However, the dermoscopic variability of BCC according to age of onset has not been investigated. Anatomic location was revealed to be associated with dermoscopic variation of BCC in Western population, but whether it applies to Asian population remains unknown. We evaluated the clinical and dermoscopic features of 448 BCCs and compared each feature by age of onset (age < 50/ > 50 years) and anatomic location. Early-onset BCCs occurred more frequently on non-sun-exposed sites (OR 3.28, P = 0.001) and were less pigmented than late-onset BCCs (P = 0.003). Blue–gray globules (OR 1.74, P = 0.037) and no vessels (OR 2.04, P = 0.021) were independently associated with early-onset BCCs, whereas arborizing telangiectasia (OR 0.30, P < 0.001), large blue–gray ovoid nests (OR 0.38, P < 0.001) and ulceration (OR 0.33, P < 0.001) were less common in early-onset BCCs. Scalp BCCs were significantly more pigmented than BCCs located elsewhere (P = 0.022). Superficial subtype (OR 5.90, P < 0.001), spoke-wheel areas (OR 4.78, P = 0.034), superficial erosions (OR 4.69, P = 0.003) and polymorph vessels (OR 6.86, P = 0.001) were independently associated with trunk BCCs, whereas nodular subtype (OR 5.48, P < 0.001) and arborizing telangiectasias (OR 3.64, P < 0.001) with BCCs on face and neck. Our findings suggest that age of onset and anatomic location are independent factors affecting the dermoscopic appearance of BCC.

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Data availability

The images and data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants but are available from the corresponding author.

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Funding

This work was supported by the National Natural Science Foundation of China (Grant Nos. 82130089, 81974245).

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Author notes

  1. Zexing Song, Yifei Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China

    Zexing Song, Yifei Wang, Yaoying Gao, Xiangjie An, Jing Yang, Yue Yin, Juan Tao & Liu Yang

  2. Hubei Engineering Research Center of Skin Disease Theranostics and Health, Wuhan, 430022, Hubei, China

    Zexing Song, Yifei Wang, Yaoying Gao, Xiangjie An, Jing Yang, Yue Yin, Juan Tao & Liu Yang

  3. Department of Dermatology, Specialty Medical Center of the Air Force, Chinese People’s Liberation Army, Beijing, 100142, China

    Rusong Meng

  4. Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China

    Zhenyuan Chen

  5. Department of Dermatology, Wuhan No. 1 Hospital, Wuhan, 430030, Hubei, China

    Liuqing Chen

  6. Department of Dermatology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong, China

    Linlin Xin

  7. Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China

    Ying Xia

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  1. Zexing Song
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by ZS, RM and YW. The first draft of the manuscript was written by ZS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liu Yang.

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The authors declare that they have no conflict of interest.

Ethnic statement

The study protocol was accepted by the Independence Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (Approval number: UHCT21208). Written informed consent was exempted because this research involved the use of existing data and because the information presented in this paper does not allow any subject to be identified.

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Song, Z., Wang, Y., Meng, R. et al. Clinical and dermoscopic variation of basal cell carcinoma according to age of onset and anatomic location: a multicenter, retrospective study. Arch Dermatol Res 315, 1655–1664 (2023). https://doi.org/10.1007/s00403-023-02556-y

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