Introduction:Basal cell carcinoma (BCC) is the most frequently diagnosed skin cancer globally. Despite the well-established dermoscopic features of BCC, overlapping characteristics with other benign and malignant skin conditions cause challenges in differential diagnosis. Part III of this review highlights the role of dermoscopy in differential diagnosis, treatment planning, therapy monitoring and the integration of novel technologies including ultraviolet-induced fluorescence dermoscopy (UVFD) and optical super-high magnification dermoscopy (OSHMD).Methods:A search of the PubMed database was conducted for studies reporting on advances in the dermoscopic assessment of BCC, including differential diagnosis, treatment, monitoring and novel diagnostic technologies.Results:Even entities with well-defined dermoscopic features distinguishing them from BCC can sometimes mimic BCC. Additionally, rare lesions such as neurothekeoma, reticulohistiocytoma, solitary circumscribed neuroma, dermal leiomyosarcoma and various adnexal tumors often remain dermoscopically indistinguishable from BCC, which underscores the importance of histopathology as the diagnostic gold standard. Dermoscopy aids in delineating the tumor margins, optimizing Mohs micrographic surgery (MMS) and traditional excision. It may also help to monitor therapeutic effects by detecting the disappearance of BCC patterns, the presence of residual tumor or recurrences. Dermoscopy may aid in the prediction of therapeutic responses to imiquimod, photodynamic therapy or vismodegib. UVFD and OSHMD appear to be valuable complementary diagnostic techniques for detecting BCC. UVFD seems to be particularly valuable for the detection of small tumors (<5 mm), facial lesions and nodular or non-pigmented BCC subtypes, while OSHMD is useful for the assessment of superficial and non-pigmented BCCs. Three-dimensional total-body photography enhances diagnostic precision but, so far, only when used in combination with traditional dermoscopy.Conclusions:Dermoscopy is valuable for margin delineation, therapy monitoring and differential diagnosis but can be inconclusive, which highlights the role of histopathology as the gold standard. Modifications in dermoscopy technique may further enhance its accuracy.
引言：基底细胞癌是全球范围内最常被诊断的皮肤癌。尽管基底细胞癌的皮肤镜特征已得到充分确认，但其与其他良恶性皮肤病变的重叠特征给鉴别诊断带来挑战。本综述第三部分重点探讨皮肤镜在鉴别诊断、治疗规划、疗效监测以及整合新型技术（包括紫外线诱导荧光皮肤镜和光学超高倍皮肤镜）中的作用。 方法：在PubMed数据库中检索关于基底细胞癌皮肤镜评估进展的研究，涵盖鉴别诊断、治疗、监测及新型诊断技术。 结果：即使具有明确区别于基底细胞癌的皮肤镜特征的病变，有时也可能与基底细胞癌相似。此外，神经鞘黏液瘤、网状组织细胞瘤、局限性孤立性神经瘤、真皮平滑肌肉瘤及各种附属器肿瘤等罕见病变在皮肤镜下常难以与基底细胞癌区分，这凸显了组织病理学作为诊断金标准的重要性。皮肤镜有助于界定肿瘤边界、优化莫氏显微手术和传统切除术。通过检测基底细胞癌模式的消失、残留肿瘤或复发迹象，皮肤镜还可用于监测治疗效果，并可能预测对咪喹莫特、光动力疗法或维莫德吉的治疗反应。紫外线诱导荧光皮肤镜和光学超高倍皮肤镜似乎是检测基底细胞癌有价值的补充诊断技术。紫外线诱导荧光皮肤镜对检测小肿瘤（<5毫米）、面部病变以及结节性或非色素性基底细胞癌亚型尤其有价值，而光学超高倍皮肤镜则适用于评估表浅性和非色素性基底细胞癌。三维全身摄影技术能提高诊断精确度，但迄今为止仅在与传统皮肤镜联合使用时才显现优势。 结论：皮肤镜在边界界定、疗效监测和鉴别诊断方面具有重要价值，但其结论可能具有不确定性，这进一步凸显了组织病理学作为金标准的地位。皮肤镜技术的改进可能会进一步提升其诊断准确性。
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