Diagnose van basaalcelcarcinoom in het hoofd-hals gebied door dermatoscopie en reflectie confocale microscopie.

Lesions with a negative BCC punch biopsy outcome will be re-evaluated at 6 months. All other research related data will be collected on the day of initial consultation or during standard of care.

Consecutive patients with suspected BCC in the head and neck on naked-eye examination will be prospectively enrolled during regular consultation.

Study group procedures :
I. Standardized skin overview and macroscopic lesion photography by coordinating investigator.
II. Dermoscopic imaging by coordinating investigator.
III. HH-RCM assessment by coordinating investigator.
IV. 3mm punch biopsy by coordinating investigator
V. Punch biopsy specimen evaluation by a board-certified pathologist blinded to clinical/dermoscopic/HH-RCM outcomes.
a. BCC positive: to VI
b. BCC negative: 6 month follow-up to minimize chance of false negatives.
VI. Therapeutic excision with margin based on current Dutch BCC guidelines by a board-certified dermatologist or oncologic head and neck surgeon, followed by evaluation by a board-certified pathologist blinded to clinical/ dermoscopic/ HH-RCM/ punch biopsy outcomes. 
In case Mohs surgery is indicated, tumor debulking will be performed during surgery for conventional histopathological analysis in addition to evaluation of the Mohs slides.
VII. Additional evaluation:
a. Expert evaluation of outcomes II and III blinded to the outcome of the diagnostic reference standard and excisional outcomes.
b. Blinded evaluation of the histopathologic outcomes by a second pathologist. In case of discordance this will be solved by discussion/third pathologist.