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Letter to Editor Plastic and Aesthetic Research

Two-millimeter dermoscopically detected

excision margins in the treatment of

basal cell carcinoma: an assessment of

radicality and recurrence

Pierfranco Simone, Carlo Carusi, Riccardo Iannuzzi, Paolo Persichetti

Division of Plastic and Reconstructive Surgery, Campus Bio-Medico University, 00128 Rome, Italy.
Corresponding Author: Dr. Pierfranco Simone, Division of Plastic and Reconstructive Surgery, Campus Bio-Medico University, Via
Alvaro del Portillo 200, 00128 Rome, Italy. E-mail: p.simone@unicampus.it

Sir, plate was applied to the skin with little pressure, to avoid
blanching of vessels. The study protocol and procedures
Eighty-five percent of all basal cell carcinomas (BCCs) met the ethical standards of the committee on human
are located in the head and neck, with a markedly experimentation and with the Helsinki Declaration of
increased incidence after the age of 40 years. Complete 1975, as revised in 1983.
extirpation in the early phase allows to limit skin excision
and facilitates reconstruction, reducing consequent Excised skin lesions varied from 4 to 15 mm in maximum
scarring. In the medical literature, it is reported that diameter. The histology report showed: nodular 25 cases
appropriate excision margins should be included (43.9%), infiltrating 2 cases (3.5%), superficial 30 cases (52.6%).
between 3 and 10 mm, based on location, dimensions, In all patients, tumours resulted as being totally excised
margins and histology. BCC margins are defined by the after histological evaluation. Moreover, at follow-up visits,
[1]
discontinuation of well-known dermoscopic features between 12 and 36 months postoperatively, no recurrence
along the skin lesion borders, so separating cancer from was detected. In terms of lesion dimensions, clinical and
healthy skin. The authors conducted a study to assess dermoscopic assessment corresponded. In 12 cases (21%),
[2]
the effectiveness of preoperative dermoscopic evaluation borders were apparently well-defined, but dermoscopy
of BCC peripheral margins, in order to achieve complete showed larger extension, with histologically confirmed
excision. excision margins.

Fifty-seven patients presenting BCC in the head and neck Reduced excision margins allowed preservation of
areas were operated on, from February 2012 to June 2012, at healthy tissue, which consented ellipse excision and
the Department of Plastic and Reconstructive Surgery of the direct wound closure in most cases. This reflects in better
Campus Bio-Medico University, Rome, Italy. Morphea-type, aesthetic results, particularly noteworthy in the facial
recurrent and superficial multifocal BCC were not included area. [3]
in the study. In all cases, margins were identified with a
polarized-light dermoscope, at 30-fold magnification Less invasive reconstructive procedures, fewer secondary
(Videocap , Video Loupe VL-7EXII). A 0.5-mm tip skin surgeries for reoperation imply reduced costs. Preoperative
®
marker was used to draw incision lines, 2 mm off the This is an open access article distributed under the terms of the Creative
dermoscopically detected borders [Figure 1]. The contact Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak and build upon the work non-commercially, as long as the
Access this article online author is credited and the new creations are licensed under the identical terms.
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How to cite this article: Simone P, Carusi C, Iannuzzi R,
Persichetti P. Two-millimeter dermoscopically detected excision
margins in the treatment of basal cell carcinoma: an assessment of
DOI: radicality and recurrence. Plast Aesthet Res 2016;3:269-70.
10.20517/2347-9264.2016.49
Received: 01-07-2016; Accepted: 08-07-2016
© 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc. 269