2Department of Radiation Oncology, Gulhane Training and Research Hospital, Ankara-Türkiye DOI : 10.5505/tjo.2026.4805 OBJECTIVE
Basal cell carcinoma (BCC) is the most common skin cancer, and dermoscopy significantly enhances its diagnostic accuracy by enabling early, noninvasive recognition. However, dermoscopic patterns may differ according to histologic subtype, tumor size, and anatomical location. This study aimed to compare the dermoscopic features of BCC according to tumor size and anatomical location (H-zone vs. non-Hzone), and to evaluate the association of histologic subtype on these variations.
METHODS
Dermoscopic images of histopathologically confirmed BCCs from 70 patients were retrospectively analyzed.
Dermoscopic features of BCC were evaluated according to tumor size (≤5 mm vs. >5 mm),
anatomical location (H-zone vs. non-H-zone), and histopathologic subtype, and comparisons were performed
between these predefined groups.
RESULTS
Blue-gray ovoid nests were significantly more frequent in smaller tumors (≤5 mm) (p<0.05). Within
the H-zone, blue-gray ovoid nests were observed more frequently in small tumors (≤5 mm) (p=0.017).
Similarly, in nodular BCCs, blue-gray ovoid nests were significantly more common in smaller lesions
(p=0.048). In contrast, ulceration was significantly more frequent in larger tumors (>5 mm) (p<0.05).
No significant dermoscopic differences were identified between H-zone and non-H-zone lesions, and
no correlations were found when tumor size was analyzed as a continuous variable.
CONCLUSION
Our results show that ulceration was more frequent in larger tumors, whereas blue-gray ovoid nests
predominated in smaller lesions, particularly in the nodular subtype. Recognition of these size- and
subtype-related variations may aid earlier diagnosis and assist clinical evaluation of BCC.