​Dermatology - Basal Cell Carcinoma (BCC)

​Dermatology - Basal Cell Carcinoma (BCC)
BCC, or basal cell carcinoma, arises from exposure to ultraviolet light and is the most prevalent form of cancer in the human population. BCC exhibits characteristics of local invasiveness, aggressiveness, and destructiveness, while also displaying a moderate growth rate. Metastasis is unlikely to occur unless there is a process of dedifferentiation, such as after receiving insufficient radiation.
However, the tumor has the potential to infiltrate the dura mater, causing destruction of muscle and bone in the brain. BCC typically manifests beyond the age of 40, exhibits a higher prevalence in males, and is infrequent among individuals with dark or black skin.


BCC is a gradually progressing, frequently symptomless abnormality that erodes or bleeds when mildly irritated. Typically, it manifests in the facial region, particularly in the vicinity of the ears and nasolabial folds. The sclerosing kind frequently occurs on the trunk.

The nodular lesion is characterized by its translucent or pearly appearance, firm texture, and smooth surface. It may also exhibit telangiectasia, and in certain cases, there may be erosions or melanin stippling present. Ulcerating The ulcer is characterized by its translucent appearance, pearly texture, and smooth surface. It often exhibits telangiectasia, and may have a crust and a rolling border. Sclerosing refers to a small area of morphea or superficial scar on the skin. It is typically poorly defined, and can appear flesh-colored, white, or have a speckled pigmentation.
Sclerosing basal cell carcinoma has the potential to develop into either nodular or ulcerating forms. The superficial multicentric form is characterized by thin, pink or red plaques with threadlike edges and telangiectasia. It may also exhibit significant scaling. Superficial multicentric basal cell carcinoma (BCC) can lead to the development of nodular and ulcerating BCC.
Pigmented basal cell carcinoma The lesion can have a smooth, shining surface that ranges in color from brown to blue or black. It is hard, rigid, and typically round or oval in shape. It may also have a cystic or umbilicated appearance.

The diagnosis is made through a clinical assessment that involves a thorough examination with a hand lens, palpation, and dermoscopy. It is then confirmed through histological analysis. The term "differential" encompasses all smooth raised skin lesions. If these lesions are pigmented, they may indicate superficial spreading or nodular melanoma. If the lesions are ulcerated, they may indicate nonpainful hard ulcers such as squamous cell carcinoma or extragenital primary chancre of syphilis. Solar keratoses can be distinguished from BCC by the absence of blood when scraped or irritated.Excisions and repair are considered the standard of care. Cryosurgery and electrosurgery are viable alternatives exclusively for diminutive lesions situated below the neck. Utilize radiation therapy exclusively in cases when surgery may result in notable deformity or in advanced stages of old age. Superficial basal cell carcinomas (BCCs) located below the neck can be effectively treated with cryosurgery or electrocautery with curettage. However, it is important to note that both of these treatment methods can result in scarring. The cream consists of 5-fluorouracil and imiquimod, which are applied directly to the skin. Performing the activity 5 times per week over a period of 6 weeks is both efficient and does not result in scarring. However, it may not completely eliminate all tumor tissue.