Basal Cell Carcinoma

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)
Basal_cell_carcinoma_histology

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

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