Diagnostic Accuracy of Dermoscopic Characteristics in Cutaneous Squamous Cell Carcinoma: A Retrospective Analysis.

Abstract

Objective: This study aims to evaluate the diagnostic efficacy of dermoscopy for cutaneous squamous cell carcinoma (cSCC).

Methods: A retrospective analysis was conducted on skin lesions diagnosed as cSCC via histopathology at the Department of Dermatology, Pingdu District, The Affiliated Hospital of Qingdao University, between January 2021 and August 2024 (case group). Lesions suspected of cSCC but ultimately diagnosed as other conditions served as the control group. The study compared disease progression and dermoscopic features between the two groups through chi-square test and logistic regression analysis, using histopathological results as the diagnostic reference standard.

Results: The case group consisted of 41 lesions, while the control group comprised 18 lesions diagnosed with conditions including actinic keratosis, basal cell carcinoma, and keratoacanthoma. The clinical misdiagnosis rate was approximately 30.5%. Notably, a disease duration of less than 2 years (28/41, 68.29%), the presence of white circles (21/41, 51.22%) and blood spots (35/41, 85.37%), and a total of ≥ 5 dermoscopic features (19/41, 46.34%) were significantly more prevalent in the case group compared to the control group (both p < 0.05). Among these, a disease duration of less than 2 years, along with the presence of white circles and blood spots, demonstrated statistical significance in differentiating cSCC from other conditions (both p < 0.05).

Conclusions: For patients with clinically suspected cSCC, a disease duration of less than 2 years and dermoscopic observation of white circles and blood spots provide substantial diagnostic value.