The Use of Dermoscopy in the Delineation of Basal Cell Carcinoma for Mohs Micrographic Surgery

Abstract

Introduction: Several studies investigated the use of dermoscopy in the delineation of Basal cell carcinoma (BCC) for Mohs micrographic surgery (MMS) with conflicting results Objective: The purpose of this systematic review with meta-analysis was to evaluate the effectiveness of the use of dermoscopy-guided MMS in the treatment of BCC. Methods: We included all comparative studies including more than twenty-five cases. Cases of BCC treated using dermoscopy-guided MMS (or slow MMS) were compared to those treated with curettage-guided MMS or “standard” MMS.  Results: A total of 6 studies including 508 BCCs were reviewed. There was no statistically significant difference in the proportion of total margin clearance on the first MMS stage between BCCs removed using dermoscopy-guided MMS and those that had curettage or visual inspection. However, lateral margin involvement was significantly lower in BCCs that had dermoscopy-guided MMS. Limitations: Scarcity of research on this subject Conclusions: Dermoscopy allows visualization of structures up to 1mm into the dermis, and therefore it is rational to use it for lateral margin evaluation. Currently, there are two comparative studies showing the efficacy of dermoscopy for lateral margin evaluation during MMS. Future studies are required to develop an evidence-based recommendation regarding the utility of dermoscopy in MMS.