The presence of shiny white blotches and strands is linked with high diagnostic specificity for nonpigmented basal cell carcinoma (BCC) according to an analysis of nonpigmented skin tumors from 2,375 individuals.

Blinded investigators evaluated the polarized dermoscopic images for the presence of shiny white structures, estimating measures of diagnostic accuracy for BCC. They identified 2,891 biopsied skin lesions, 457 of which were nonpigmented neoplasms.

287 (62.8%) of the nonpigmented neoplasms were BCCs, 106 (23.2%) were squamous cell carcinoma, 39 (8.5%) were lichen planus–like keratosis, 21 (4.6%) were melanomas, and 4 (0.9%) were nevi. The prevalence of shiny white structures was nearly 50%.

In multivariate analysis:

• The presence of any shiny white structures was linked with a diagnosis of BCC.

• Blotches, strands, and blotches and strands together were positively associated with BCC.

• Shiny white blotches and strands together had a diagnostic sensitivity of 30% and specificity of 91%.

Citation: Navarrete-Dechent C, Bajaj S, Marchitti, Rabinovitz H, Dusza S, Marghoob A. Association of shiny white blotches and strands with nonpigmented basal cell carcinoma: Evaluation of an additional dermoscopic diagnostic criterion. [Published online ahead of print January 20, 2016]. JAMA Dermatol. doi:10.1001/jamadermatol.2015.5731.