​Dermatology - Basal Cell Carcinoma (BCC)

​Dermatology - Basal Cell Carcinoma (BCC)
Basal cell carcinoma (BCC) arises due to exposure to ultraviolet (UV) radiation and is the prevailing form of cancer among individuals. BCC exhibits characteristics of local invasiveness, aggressiveness, and destructiveness, while also demonstrating a moderate growth rate. Metastasis is highly unlikely unless there is a process of dedifferentiation, such as after receiving insufficient radiation.
However, the tumor has the potential to infiltrate the dura mater, leading to the destruction of muscle and bone in the brain. BCC typically manifests beyond the age of 40 and is more prevalent among males. It is infrequent in individuals with brown or black skin.


BCC is a gradually progressing, frequently symptomless abnormality that erodes or bleeds when subjected to mild abrasion. Typically, it manifests on the face, particularly in the areas behind the ears and nasolabial folds. The scleroxing type is frequently seen on the trunk.
Abnormalities
Characterized by the presence of small, rounded growths or nodules. The 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 small dots of melanin present. Ulcerating The ulcers are translucent, pearly, and smooth, and they often include telangiectasia. Additionally, these ulcers typically have a crust and a rolling edge. Sclerosing refers to a small area of morphea or superficial scar that is typically poorly defined, skin-colored, white, and may also have 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 that have threadlike edges and telangiectasia. These plaques 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 has a smooth, glistening surface that can range in color from brown to blue or black. It is rigid, firm, and has a round or oval shape. It may also have a cystic or umbilicated appearance.


The diagnosis is made through a clinical assessment involving meticulous examination with a hand lens, palpation, and dermoscopy. This diagnosis 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 and nodular melanoma. If the lesions are ulcerated, they may include nonpainful hard ulcers such as squamous cell carcinoma (SCC) and extragenital primary chancre of syphilis. Solar keratoses can be distinguished from basal cell carcinoma (BCC) based on the absence of blood when scratched or scraped.


Surgical removal and subsequent restoration is the established medical practice. Cryosurgery and electrosurgery are viable alternatives exclusively for diminutive lesions situated below the neck. Utilize radiation therapy solely in cases when surgery may result in notable deformity or in individuals of advanced 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 application of topical 5-fluorouracil and imiquimod cream five times a week for a duration of 6 weeks has been proven to be helpful in treating the condition. However, it is important to note that while this treatment is non-scarring, it may not completely eliminate all tumor tissue.