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{{Basal cell carcinoma}}
{{Basal cell carcinoma}}
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==Overview==
==Overview==
'''Basal cell carcinoma''' ('''BCC''') is the most common form of [[skin cancer]]. It can be destructive and disfiguring. The risk of developing BCC is increased for individuals with a family history of the disease and with a high cumulative exposure to[[Ultraviolet]] light via sunlight or, in the past, were exposed to carcinogenic  chemicals especially [[arsenic]]. Treatment is with [[surgery]], topical [[chemotherapy]], x-ray, [[cryosurgery]], [[photodynamic therapy]]. It is rarely life-threatening but if left untreated can be disfiguring, cause bleeding and produce local destruction (eg., eye, ear, nose, lip).
In 1827, Jacob Arthur, reported the "rodent ulcer". In 1900, Edmund Krompecher, identified the histological features as an epithelial carcinoma. The classification of basal cell carcinoma (BCC) is divided into many clinical variants. After sunlight exposure, cumulative DNA damage leads to mutations. There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum. There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma. In 2014, the average annual incidence of basal cell carcinoma in the United States was 878 cases per 100,000 individuals. The incidence increases with age and is higher in men. BCC is the most common in the Caucasian race. There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum. The U.S. Preventive Services Task Force has found no evidence to recommend for or against screening. The American Cancer Society recommends that a health care provider examine the skin every year if the patient is older than 40 years, and every 3 years if the patient is between 20-40 years. Basal cell carcinoma is slow-growing and locally invasive. Common complications of BCC include reoccurrence and development of other types of skin cancer. The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system. T, M, and N are combined into stages, called stage grouping. The history and symptoms of basal cell carcinoma include skin growths on sun-exposed skin. They are fragile and may bleed easily. The physical examination of basal cell carcinoma is based on a clinical exam. The laboratory tests of basal cell carcinoma consist of a biopsy and visualization of its histological findings. CT scans and radiography may be performed if there is involvement of deeper structures, such as the bone. After the suspicious lesion is evaluated, the medical therapy is divided into low-risk and high-risk basal cell carcinoma patients. Medical therapy consists of surgery, radiation therapy, and follow-up for recurrence. Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery. The primary prevention of basal cell carcinoma involves avoidance and protection from the sun. A skin biopsy and chemotherapeutic agents such as 5-Fluorouracil or Imiquimod may prevent the further development of basal cell carcinoma.
 
 
 
==Historical Perspective==
In 1827, Jacob Arthur, reported the "rodent ulcer". In 1900, Edmund Krompecher, identified the histological features as an epithelial carcinoma.
 
==Classification==
The classification of basal cell carcinoma (BCC) is divided into many clinical variants.
 
==Pathophysiology==
Basal cell carcinomas develop in the basal cell layer of the skin. Cumulative DNA damage leads to mutations, after sunlight exposure.
 
==Causes==
There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum.
 
==Differential Diagnosis==
There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma.
 
==Epidemiology and Demographics==
In 2014, the average annual incidence of basal cell carcinoma in the United States was 878 cases per 100,000 individuals. The incidence increases with age and is higher in men. BCC is the most common in the Caucasian race.
 
==Risk Factors==
There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum.
 
==Screening==
The U.S. Preventive Services Task Force has found no evidence to recommend for or against screening. The American Cancer Society recommends that a health care provider examine the skin every year if the patient is older than 40 years, and every 3 years if the patient is between 20-40 years.
 
==Natural History, Complications, and Prognosis==
Basal cell carcinoma is slow-growing and locally invasive. Common complications of BCC include reoccurrence and development of other types of skin cancer.
 
==Staging==
The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system. T, M, and N are combined into stages, called stage grouping.
 
==History and Symptoms==
The history and symptoms of basal cell carcinoma include skin growths on sun-exposed skin. They are fragile and may bleed easily.
 
==Physical Examination==
The physical examination of basal cell carcinoma is based on a clinical exam.


It is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts and bleeds. Metastasis is rare, but local invasion destroys underlying and adjacent tissue. In 90 percent of all cases, the lesion is seen between the hairline and the upper lip. It can be destructive and disfiguring.
==Diagnostic Studies==


The risk of skin cancer is related to the amount of sun exposure and pigmentation in the skin. The longer the exposure to the sun and the lighter the skin, the greater the risk of skin cancer.  
===Laboratory Findings===
The laboratory tests of basal cell carcinoma consist of a biopsy and visualization of its histological findings.


'''There are three types of BCC:'''
===Other Diagnostic Studies===
CT scans and radiography may be performed if there is involvement of deeper structures, such as the bone.


The most common type of basal cell carcinoma is nodular basal cell carcinoma, a flesh-colored (cream to pink), round or oval translucent nodule with overlying small blood vessels and a pearly-appearing rolled border.  
==Medical Therapy==
After the suspicious lesion is evaluated, the medical therapy is divided into low-risk and high-risk basal cell carcinoma patients. Medical therapy consists of surgery, radiation therapy, and follow-up for recurrence.


The second type of BCC is the pigmented lesion. This is darker than the nodular type, appearing blue, brown or black. It may be similar in appearance to the very aggressive malignant melanoma tumor. It is very important to distinguish between malignant melanomas and pigmented BCC.  
==Surgery==
Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery.


A third type of BCC is the superficial type, which appears as red, and often scaly, localized plaque. It is frequently confused with psoriasis or eczema.
==Primary Prevention==
The primary prevention of basal cell carcinoma involves avoidance and protection from the sun.


Basal cell skin cancer almost never spreads; however, large and longstanding tumours may metastasize into regional lymph nodes and surrounding areas such as nearby tissues and bone.<ref>{{MedlinePlus|000824|Basal cell carcinoma}}</ref><ref>{{cite web|url=http://www.healthscout.com/ency/1/199/main.html |title=Basal Cell Carcinoma - Symptoms, Treatment and Prevention |format=|work= |accessdate=}}</ref>
==Secondary Prevention==
A skin biopsy and chemotherapeutic agents such as 5-Fluorouracil or Imiquimod may prevent the further development of basal cell carcinoma.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{Epithelial neoplasms}}
{{Diseases of the skin and appendages by morphology}}
{{Tumors of bone, cartilage, skin, connective, and soft tissue}}
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Revision as of 19:54, 28 July 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In 1827, Jacob Arthur, reported the "rodent ulcer". In 1900, Edmund Krompecher, identified the histological features as an epithelial carcinoma. The classification of basal cell carcinoma (BCC) is divided into many clinical variants. After sunlight exposure, cumulative DNA damage leads to mutations. There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum. There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma. In 2014, the average annual incidence of basal cell carcinoma in the United States was 878 cases per 100,000 individuals. The incidence increases with age and is higher in men. BCC is the most common in the Caucasian race. There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum. The U.S. Preventive Services Task Force has found no evidence to recommend for or against screening. The American Cancer Society recommends that a health care provider examine the skin every year if the patient is older than 40 years, and every 3 years if the patient is between 20-40 years. Basal cell carcinoma is slow-growing and locally invasive. Common complications of BCC include reoccurrence and development of other types of skin cancer. The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system. T, M, and N are combined into stages, called stage grouping. The history and symptoms of basal cell carcinoma include skin growths on sun-exposed skin. They are fragile and may bleed easily. The physical examination of basal cell carcinoma is based on a clinical exam. The laboratory tests of basal cell carcinoma consist of a biopsy and visualization of its histological findings. CT scans and radiography may be performed if there is involvement of deeper structures, such as the bone. After the suspicious lesion is evaluated, the medical therapy is divided into low-risk and high-risk basal cell carcinoma patients. Medical therapy consists of surgery, radiation therapy, and follow-up for recurrence. Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery. The primary prevention of basal cell carcinoma involves avoidance and protection from the sun. A skin biopsy and chemotherapeutic agents such as 5-Fluorouracil or Imiquimod may prevent the further development of basal cell carcinoma.


Historical Perspective

In 1827, Jacob Arthur, reported the "rodent ulcer". In 1900, Edmund Krompecher, identified the histological features as an epithelial carcinoma.

Classification

The classification of basal cell carcinoma (BCC) is divided into many clinical variants.

Pathophysiology

Basal cell carcinomas develop in the basal cell layer of the skin. Cumulative DNA damage leads to mutations, after sunlight exposure.

Causes

There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum.

Differential Diagnosis

There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma.

Epidemiology and Demographics

In 2014, the average annual incidence of basal cell carcinoma in the United States was 878 cases per 100,000 individuals. The incidence increases with age and is higher in men. BCC is the most common in the Caucasian race.

Risk Factors

There are many causes associated with basal cell carcinoma such as sunlight, gene mutations, and other conditions, for example, xeroderma pigmentosum.

Screening

The U.S. Preventive Services Task Force has found no evidence to recommend for or against screening. The American Cancer Society recommends that a health care provider examine the skin every year if the patient is older than 40 years, and every 3 years if the patient is between 20-40 years.

Natural History, Complications, and Prognosis

Basal cell carcinoma is slow-growing and locally invasive. Common complications of BCC include reoccurrence and development of other types of skin cancer.

Staging

The American Joint Committee on Cancer (AJCC) stages basal cell carcinoma based on the TNM system. T, M, and N are combined into stages, called stage grouping.

History and Symptoms

The history and symptoms of basal cell carcinoma include skin growths on sun-exposed skin. They are fragile and may bleed easily.

Physical Examination

The physical examination of basal cell carcinoma is based on a clinical exam.

Diagnostic Studies

Laboratory Findings

The laboratory tests of basal cell carcinoma consist of a biopsy and visualization of its histological findings.

Other Diagnostic Studies

CT scans and radiography may be performed if there is involvement of deeper structures, such as the bone.

Medical Therapy

After the suspicious lesion is evaluated, the medical therapy is divided into low-risk and high-risk basal cell carcinoma patients. Medical therapy consists of surgery, radiation therapy, and follow-up for recurrence.

Surgery

Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery.

Primary Prevention

The primary prevention of basal cell carcinoma involves avoidance and protection from the sun.

Secondary Prevention

A skin biopsy and chemotherapeutic agents such as 5-Fluorouracil or Imiquimod may prevent the further development of basal cell carcinoma.

References


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