8/04/2020
Basal Cell Carcinoma
Basal Cell Carcinoma (BCC) is a slow-growing locally invasive malignant tumour (malignant skin ulcer) arising from basal epidermis and hair follicles – hence affecting the pilosebaceous skin!
90% of the lesions are found on the face above a line from the lobe of the ear to the corner of the mouth.
It rarely metastasize.
EPIDEMIOLOGY
- White people are almost exclusively affected
- Middle-aged and elderly people (40-80 years)
- More in men
RISK FACTORS FOR
- UV light (But 33% arises in parts of the body not exposed to sun)
- Arsenic
- Coal tar
- Aromatic hydrocarbons
- Ionising radiation
- Genetic skin cancer syndromes (Gorlin’s syndrome, Xeroderma pigmentosum)
- Immunosuppression (AIDS)
- Premalignant lesions (Naevus of Jadassohn)
CLASSIFICATION OF BASAL CELL CARCINOMA
BY APPEARANCE
- LOCALIZED
- Nodular
- Nodulocystic
- Cystic
- Pigmented
- Naevoid
- GENERALIZED
- Superficial
- Infiltrative (morphoeic)

Micrograph of a BCC, showing the characteristic histomorphologic features
By Nephron – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=22082605
BY PROGNOSIS
- HIGH RISK (The risk of recurrence is high)
- Located at specific sites – periorbital, nose, perioral, nasolabial folds, pre/post auricular
- Ill defined margins
- Histology – morphoeic or infiltrative
- Those occurring in immunosuppressed
- LOW RISK
- The types other than the above-mentioned ones
MANAGEMENT OF BASAL CELL CARCINOMA
SURGICAL MANAGEMENT
NON-SURGICAL MANAGEMENT
- Radiotherapy (for elderly patients)
- Topical chemotherapy (with 5-FU)
- Cryotherapy
- Photodynamic therapy (application of photosensitising agents to the skin that are preferably absorbed by tumour cells