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Basal cell carcinoma

Last updated: February 16, 2021

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Basal cell carcinoma (BCC) is a malignant neoplasm and the most common type of skin cancer. BCC primarily affects individuals with light skin. Although excessive sun exposure is the primary risk factor, chemicals (e.g., arsenic) and genetic factors also increase the risk of developing BCC. Slow-growing nodules (classic "pearly" appearance) that tend to ulcerate during the course of disease are the characteristic lesions associated with BCC. Surgical excision is the treatment of choice. Because BCC does not metastasize, the prognosis is usually excellent.

References:[1][2]

Epidemiological data refers to the US, unless otherwise specified.

References:[1][5]

Most basal cell carcinomas occur on areas of sun-exposed skin.

To remember the usual site of occurrence of basal cell carcinoma, think of: “Basal cell carcinoma is more common aBove the upper lip.”

References:[1][8]

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

References:[5][9][10]

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).

References:[5][11]

References:[5]

Trichoepithelioma

Other differential diagnoses

References:[5]

The differential diagnoses listed here are not exhaustive.

References:[5]

  • Excellent prognosis with surgical excision because of the low rate of metastasis
  1. Pestana C. Dr. Pestana's Surgery Notes: Top 180 Vignettes for the Surgical Wards. Kaplan ; 2015
  2. Marks JG Jr, Miller JJ . Lookingbill and Marks' Principles of Dermatology. Saunders Elsevier ; 2013
  3. Wu PA. Epidemiology, pathogenesis, and clinical features of basal cell carcinoma. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. http://www.uptodate.com/contents/epidemiology-pathogenesis-and-clinical-features-of-basal-cell-carcinoma.Last updated: February 17, 2017. Accessed: March 14, 2017.
  4. Skin Cancer Facts and Statistics. http://www.skincancer.org/skin-cancer-information/skin-cancer-facts. . Accessed: March 14, 2017.
  5. Marçon CR, Maia M. Albinism: epidemiology, genetics, cutaneous characterization, psychosocial factors. An Bras Dermatol. 2019; 94 (5): p.503-520. doi: 10.1016/j.abd.2019.09.023 . | Open in Read by QxMD
  6. Daya-Grosjean L. Xeroderma Pigmentosum and Skin Cancer. Springer New York ; 2020 : p. 19-27
  7. Choi JH, Kim YJ, Kim H, Nam SH, Choi YW. Distribution of Basal Cell Carcinoma and Squamous Cell Carcinoma by Facial Esthetic Unit. Archives of Plastic Surgery. 2013; 40 (4): p.387. doi: 10.5999/aps.2013.40.4.387 . | Open in Read by QxMD
  8. Janjua OS, Qureshi SM. Basal Cell Carcinoma of the Head and Neck Region: An Analysis of 171 Cases. Journal of Skin Cancer. 2012; 2012 : p.1-4. doi: 10.1155/2012/943472 . | Open in Read by QxMD
  9. Şahan B, Çiftçi F, Özkan F, Öztürk V. The importance of frozen section-controlled excision in recurrent basal cell carcinoma of the eyelids. Turk J Ophthalmol. 2016; 46 (6): p.277-281. doi: 10.4274/tjo.48640 . | Open in Read by QxMD
  10. James WD, Berger T, Elston D. Andrews' Diseases of the Skin: Clinical Dermatology. Elsevier Health Sciences ; 2015
  11. Basal cell carcinoma. http://www.dermnetnz.org/topics/basal-cell-carcinoma/. Updated: December 1, 2015. Accessed: March 14, 2017.
  12. Bader RS. Basal Cell Carcinoma. Basal Cell Carcinoma. New York, NY: WebMD. http://emedicine.medscape.com/article/276624-overview. Updated: September 21, 2016. Accessed: February 17, 2017.