Dermatoscopic Vascular Patterns and Invasive Tumor Depth as Predictors of Aggressive Behavior in Basal Cell Carcinoma
DOI:
https://doi.org/10.52340/GBMN.2026.01.01.168Keywords:
Basal cell carcinoma, Dermatoscopy, Prognostic markers, Recurrence, Skin cancer, Tumor depth, Tumor invasion, Vascular patternsAbstract
BACKGROUND. Basal cell carcinoma (BCC) is generally characterized by indolent behavior; however, a subset of tumors demonstrates aggressive growth and recurrence. While dermatoscopy is widely used for diagnosis, its prognostic value remains insufficiently defined. This study aimed to evaluate the relationship between dermatoscopic vascular patterns and invasive tumor characteristics in BCC. OBJECTIVES. To determine the prognostic value of dermatoscopic vascular patterns in predicting invasive growth and recurrence in basal cell carcinoma. METHODS. A retrospective cohort of 205 patients with surgically excised BCC was analyzed. Dermatoscopic features were assessed using a standardized digital imaging system, with particular emphasis on vascular morphology. Tumor size, invasive depth, histopathologic subtype, and recurrence were evaluated. Statistical analysis included non-parametric tests, correlation analysis, and Kaplan–Meier survival estimation. RESULTS. Polymorphous vascular patterns were strongly associated with recurrence (77% vs 8.4%, p<0.0001). Tumors with polymorphous vessels demonstrated significantly greater invasive depth (median 3.90 mm vs 1.88 mm, p<0.0001), despite smaller dermatoscopic and histologic size. These tumors were also more frequently associated with infiltrative growth, margin involvement, and perineural invasion (all p<0.01). Kaplan–Meier analysis confirmed significantly reduced disease-free survival in tumors exhibiting vascular polymorphism (p<0.0001). CONCLUSIONS. Dermatoscopic vascular complexity, particularly polymorphous patterns, reflects invasive tumor growth and is strongly associated with recurrence in BCC. These findings suggest that dermatoscopy may serve as a clinically applicable, non- invasive tool for predicting tumor aggressiveness and guiding management.References
Pathology Department, Tbilisi State Medical University, Tbilisi, Georgia
Department of Dermatology, Tbilisi State Medical University, Tbilisi, Georgia
Molecular Pathology Department, Tbilisi State Medical University, Tbilisi, Georgia
Department of Molecular and Medical Genetics, Tbilisi, Georgia
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