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Publicación de la Sociedad Argentina de Derm atolog í a

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Volumen VIII - Nº 5 - 2002<br />

D e rm<strong>atolog</strong>ía<br />

A rg e n t i n a<br />

Utilidad <strong>de</strong> <strong>la</strong><br />

d e rmatoscopía en el<br />

diagnóstico <strong>de</strong>l<br />

c a rcinoma basocelu<strong>la</strong>r<br />

D e rmatoscopy: a useful tool for the<br />

diagnosis of basal cell carc i n o m a<br />

Horacio Cabo*<br />

* Servicio <strong>de</strong> <strong>Derm</strong><strong>atolog</strong>ía - Hospital<br />

<strong>de</strong> Clínicas "José <strong>de</strong> San Martín"<br />

Fecha <strong>de</strong> recepción: 3/9/01<br />

Fecha <strong>de</strong> aprobación: 6/12/01<br />

Resumen<br />

La <strong>de</strong>rmatoscopía es una técnica no invasiva que<br />

mejora el diagnóstico clínico <strong>de</strong> <strong>la</strong>s lesiones pigmentadas.<br />

El diagnóstico <strong>de</strong>rmatoscópico se realiza en dos<br />

pasos o etapas. El primero consiste en diferenciar si<br />

una lesión es me<strong>la</strong>nocítica o no me<strong>la</strong>nocítica, y el<br />

segundo es diferenciar una lesión me<strong>la</strong>nocítica<br />

benigna <strong>de</strong>l me<strong>la</strong>noma.<br />

El carcinoma basocelu<strong>la</strong>r pigmentado es una <strong>de</strong> <strong>la</strong>s<br />

lesiones no me<strong>la</strong>nocíticas que se pue<strong>de</strong> confundir con<br />

un me<strong>la</strong>noma, <strong>de</strong>l que se consi<strong>de</strong>ra un simu<strong>la</strong>dor.<br />

Los criterios <strong>de</strong>rmatoscópicos <strong>de</strong>l carcinoma basocelu<strong>la</strong>r<br />

son:<br />

- Patrón vascu<strong>la</strong>r típico<br />

- Estructuras en forma <strong>de</strong> hoja o digitiformes<br />

- Nidos ovoi<strong>de</strong>s gran<strong>de</strong>s <strong>de</strong> color azul-gris<br />

- Múltiples glóbulos <strong>de</strong> color azul-gris<br />

- Áreas radiadas<br />

- Ulceraciones<br />

Con estos criterios diagnósticos, <strong>la</strong> sensibilidad <strong>de</strong>l<br />

método es <strong>de</strong>l 93% y <strong>la</strong> especificidad, <strong>de</strong>l 89%, por lo<br />

que su conocimiento nos permitirá mejorar el diagnóstico<br />

clínico <strong>de</strong> carcinoma basocelu<strong>la</strong>r (<strong>Derm</strong>atol<br />

Argent 2002; Nº 5: 256-259).<br />

Summary<br />

D e rmatoscopy is a non-invasive technique that<br />

improves the clinical diagnosis of skin pigmented<br />

lesions.<br />

The diagnosis can be ma<strong>de</strong> with the pro c e d u re<br />

known as two-step, where the first step is the differentiation<br />

between me<strong>la</strong>nocitic or non-me<strong>la</strong>nocitic<br />

lesions and the second step is the differentiation<br />

between benign me<strong>la</strong>nocitic lesions and me<strong>la</strong>noma.<br />

Basal Cell Carcinoma (BCC) es one of the nonme<strong>la</strong>nocitic<br />

lesions that can be misdiagonses as<br />

me<strong>la</strong>noma, and is consi<strong>de</strong>red one of the me<strong>la</strong>noma<br />

mimickers. This lesion meets typical <strong>de</strong>rmatoscopy criteria<br />

such as:<br />

- Typical vascu<strong>la</strong>r pattern<br />

- Leaf-like structures<br />

- Large blue-gray ovoid nest<br />

- Multiple blue-gray globulos<br />

- Spoke-wheel areas<br />

- Ulcerations<br />

With this methods the sensivility is 93% and the<br />

specificity is 89%.<br />

Knowledge of these criteria allows us to improve our<br />

clinical diagnosis of BCC.<br />

256

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