Introduction:Basal cell carcinoma (BCC) is the most prevalent type of skin cancer worldwide. Despite its low metastatic potential, certain subtypes present an aggressive clinical course. Part II focuses on the different dermoscopic patterns observed in BCC, depending on the lesion subtype, its location on the body, the patient’s age, the size of the tumor, and skin phototype.Methods: A search of the PubMed database was conducted for studies reporting dermoscopic findings in BCC across all body locations, histopathologic subtypes, tumor sizes, ages of onset and skin phototypes.Results:There are no dermoscopic features indicative of a particular BCC subtype. However, arborizing, truncated or glomerular vessels, shiny white lines, ulceration, white areas, absence of pink zones and large blue-gray ovoid nests suggest high-risk BCCs (morpheaform, micronodular, infiltrative, basosquamous). Pigmented features can occur in all BCC types, though increased pigmentation indicates less aggressive subtypes (nodular, superficial, fibroepithelioma of Pinkus, adenoid). BCCs most commonly develop on the head, typically presenting as nodular and non-pigmented tumors. Those on the nose, eyes and ears may be more aggressive and prone to recurrence. On the trunk, BCCs are usually superficial and pigmented. Lower limb lesions often show polymorphous vessels rather than arborizing ones, which makes the dermoscopic diagnosis challenging. Dermoscopy aids early detection, with larger tumors exhibiting more established features but no size-specific patterns. Aggressive subtypes display similar dermoscopic findings regardless of size.Conclusions:Dermoscopy is a valuable tool for the early detection of BCC, though no specific dermoscopic features can definitively identify subtypes. High-risk BCCs can be suspected when distinct vascular and structural patterns are present, particularly in lesions located on the face, especially around the nose, eyes and ears, while pigmented features may indicate less aggressive subtypes.
引言：基底细胞癌是全球范围内最常见的皮肤癌类型。尽管其转移潜能较低，但某些亚型呈现出侵袭性临床病程。第二部分重点探讨基底细胞癌中观察到的不同皮肤镜模式，这些模式取决于病变亚型、身体部位、患者年龄、肿瘤大小及皮肤光型。 方法：在PubMed数据库中检索了报告所有身体部位、组织病理学亚型、肿瘤大小、发病年龄和皮肤光型的基底细胞癌皮肤镜表现的研究。 结果：目前尚无特定的皮肤镜特征能明确指示基底细胞癌的具体亚型。然而，树枝状、截短状或肾小球样血管、亮白色条纹、溃疡、白色区域、粉色区域缺失以及大型蓝灰色卵圆形巢提示高风险基底细胞癌（硬斑病样型、微结节型、浸润型、基底鳞状细胞型）。色素性特征可见于所有基底细胞癌类型，但色素增加往往提示侵袭性较低的亚型（结节型、浅表型、Pinkus纤维上皮瘤、腺样型）。基底细胞癌最常见于头部，通常表现为结节性非色素性肿瘤。位于鼻部、眼部和耳部的病变可能更具侵袭性且易复发。躯干部位的基底细胞癌通常为浅表型且伴有色素沉着。下肢病变常表现为多形性血管而非树枝状血管，这使得皮肤镜诊断更具挑战性。皮肤镜检查有助于早期检测，较大肿瘤表现出更典型的特征但无特定大小相关模式。侵袭性亚型无论大小均呈现相似的皮肤镜表现。 结论：皮肤镜检查是早期检测基底细胞癌的重要工具，但尚无特异性皮肤镜特征能明确区分亚型。当出现特征性血管和结构模式时，特别是在面部（尤其是鼻、眼、耳周围）的病变中，可怀疑高风险基底细胞癌，而色素性特征可能提示侵袭性较低的亚型。
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