- Clinical science
Basal cell carcinoma (BCC), a malignant neoplasm, is the most common type of skin cancer and primarily affects individuals with light skin. Although excessive exposure to sun is the main risk factor, chemicals and genetic factors also increase the risk of developing the disease. BCC is characterized by slowly growing nodules with a classic "pearly" appearance, which tend to ulcerate during the course of disease. Surgical excision is the treatment of choice. As BCC does not metastasize, the prognosis is excellent.
Areas of skin exposed to sun
- The palms, soles of the feet, and mucous membranes are rarely affected.
- Areas of skin exposed to sun
- Pearly, indurated and nodular lesion with rolled border that is usually nontender
- Central depression (crater) with ulceration
- Slowly growing over months to years
- Very rarely metastasizes
Most basal cell carcinomas occur on areas of skin exposed to sun!
There are several types of basal cell carcinoma:
Nodular basal cell carcinoma
- Most common type of BCC
- Lesions: pearly nodules with a rolled border and central depression
- Most common site: face (esp. the nose)
Superficial basal cell carcinoma
- Lesions: flat, eczematous (scaly) plaque with a pearly border
- Most common site: trunk
Basal cell carcinoma lesions are usually readily identifiable, but the diagnosis should always be histologically confirmed (via full-thickness biopsy done at the edge of the lesion).
- : initial clinical evaluation of suspected BCC lesions (dermoscopy cannot confirm BCC)
Excisional biopsy: ( or ) first choice
- Most accurate assessment of the histologic subtype of the tumor
- : used to evaluate large lesions
- Definition: rare, benign tumor of the hair follicle that usually occurs in younger individuals
- Skin-colored, firm papules
- May occur as single or multiple lesions
- Localization: mainly nose and cheeks
- Treatment: excision or laser ablation
Other differential diagnoses
The differential diagnoses listed here are not exhaustive.
- Standard treatment
Other options: cryosurgery, laser ablation, and topical chemotherapy with imiquimod or 5-Fluorouracil
- Indications: small, superficial tumors
- Excellent prognosis with surgical excision because of the low rate of metastasis