A Simple Guide to Basal cell carcinoma

A Simple Guide to Basal cell carcinoma
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What is Basal cell carcinoma?
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Basal cell carcinoma is a localized malignant tumor of the basal cells of the skin which seldom spread beyond its location.

It is the most common skin cancer.

It usually occurs in fair skinned people above the age of 50.

It is never life threatening.

Who is affected by Basal cell carcinoma?
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Basal cell carcinoma is more common in :

1.People with fair skin than in those with darker skin.

2.People who spend time outdoors under the sun than those staying indoors.

3.People with a family history of Basal cell carcinoma.

What is the Cause of Basal cell carcinoma?
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A. Familial:

Familial cases of Basal cell carcinoma with

1.autosomal dominant genes(basal cell nevus) and

2.xeroderma pigmentosum(autosomal recessive)

are more common especially in fair skin people.

B.Sun exposure:

Exposure to the sun is one of the most common causes of Basal cell carcinoma.

The majority of basal cell carcinomas occur on sun-exposed areas of the body.

Risk factors are:

1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

C:Environmental causes:

1.Arsenic exposure in certain occupations(preparation of arsenic products)

2.Exposure to X-ray radiation especially radiotherapy

What are the types of Basal cell carcinoma?
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1.Nodular: flesh-colored papule with capillaries which can become ulcerated ( called rodent ulcer )

2.Cystic: less common with a central cystic cavity.

3.Pigmented: pigmented nodular form

4.Sclerosing: looks like a keloid

5.Superficial: a red scaly flat lesion.

What are the Symptoms and signs of Basal cell carcinoma?
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Basal cell carcinoma can present as:

1.firm nodule which grows within the skin and below it

2.Color may be like normal skin, dark brown or black.

3.Border is characteristic rolled up edge

4. red, flat, scaling areas similar to a patch of eczema.

How do you make the Diagnosis of Basal cell carcinoma?
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1.Skin biopsy under local anesthesia

2.small lesions can be totally removed

3.larger ones are biopsied first and surgically removed if there is confirmed malignancy.


What are the complications of Basal cell carcinoma?
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1.local growth and destruction of neighboring tissues (e.g. nose).

2.Growth into vital structures resulting in the loss of extension or function

3.rarely metastases or cause death.

What is the treatment of Basal cell carcinoma?
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Surgery:

Most basal cell carcinomas are removed by surgical excision with margins of 4-6mm.


Chemotherapy:

local therapy with 5-fluorouracil(a chemotherapy agent) with 70-90% success rate

Radiation:

Radiation therapy may be used in older patients not suitable for surgery.

Cryosurgery:

Cryosurgery can be done for basal cell cancer that invades cartilage.

Mohs surgery:

Mohs micrographic surgery is an outpatient procedure in which the cancer nodule is surgically excised and then immediately examined under a microscope. The base and edges are microscopically examined to confirm no evidence of malignancy before repair is done.

Immunotherapy:

Immunotherapy research indicates that treatment with Euphorbia peplus, a common garden weed, may be effective against Basal cell carcinoma.

What is the prognosis of Basal cell carcinoma?
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Prognosis of majority of cases is good if there is complete removal.

Sclerosing lesions are harder to treat because they invade deeper into the tissues.

What are the preventive measures for Basal cell carcinoma?
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1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats). Use sunscreens.

2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.

3.Patients with family history of skin cancer should be reviewed yearly