Introduction:-

Basal cell carcinoma is one of the many forms of skin cancer which starts in the basal cells—those cells that create new skin cells to replace the old ones. This skin cancer most of the time manifests as a waxy bump, though it can also take other forms. Basal cell carcinoma is believed to have been brought about by too much exposure to the radiation from the sun.

Alternative Nomenclature:-

  • Rodent ulcer
  • Non-melanoma skin cancer
  • Basal cell NMSC
  • Basal cell skin cancer

Epidemiology:-

  • Basal cell carcinoma is very common in individuals who are fair-skinned with a history of having one of the family members diagnosed with the same illness.
  • Approximately, there are 800,000 new cases that are recorded annually in the U.S. only.
  • Up to 30% of the Caucasians have to suffer from this disease in their whole lifetime.

Classification:- :-

  • Superficial. These are those that appear as pinkish and scaly lesions, like psoriasis or eczema. This develops most of the time on the arms, legs and trunk.
  • Pigmented. These may be brown, blue or black in color.
  • Infiltrating. More challenging to treat than superficial type, infiltrative type is pearly, smooth and firm.
  • Nodular. This accounts for up to 80% of all the basal cell skin cancers. This is dome-shaped showing tiny blood vessels in the center of the lesion.
  • Morphea form. These are skin colored, whitish and ill-defined.

Causes and Risk Factors:-

Causes

  • Too much UV radiation from the sun
  • Commercial tanning beds and lamps
  • Conditions that makes the immune system weak
  • Exposure to the toxic substances in the environment

Risk Factors

  • Too much exposure to the sun’s UV radiation will pose a threat most especially to those who are under the age of 18 years old.
  • The risk is higher if a person has blistering sunburn.
  • Having fair or very light skin: it can easily be sunburned which increases the risk of having basal cell carcinoma.
  • Men are more likely to have this skin cancer compared to women.

Symptoms and Signs:-

  • Waxy or bleeding bump
  • Brown, scaly patch on the chest or back that grows bigger every time
  • White scar
  • Bump that creates crust in the center

Diagnosis:-

In order for the doctor to diagnose that you are indeed suffering from basal cell carcinoma, he still has to perform the following tasks:

  • Perform skin examination by taking a close look over the patient’s body for areas that are having unusual bumps or marks.
  • Get skin sample which can mean a skin biopsy for laboratory testing.

Complications of Disease:-

  • Possibility of recurrence
  • Increases the chances of other skin cancer types to develop
  • Some aggressive forms of this skin cancer can destroy or invade other muscles, bones and nerves.

Treatment Options:-

Medical

  • Radiation
  • Cryosurgery
  • Photodynamic Therapy

Surgical

  • Mohs Micrographic Surgery
  • Excisional Surgery
  • Curettage
  • Electrodesiccation

Complications of Treatment:-

Complications of Medical Management

While it can be said that medical treatment has 90% cure rate, long term treatment has to be done, meaning multiple visits to the doctor’s clinic.

Complications of Surgical Care

Aside from the fact that a surgery can be significantly expensive, they can also be very painful which is why anesthesia is required. It may take some time for the discomfort to go away and the scars might stay forever after some parts of the skin are scraped off.

Prognosis:-

The timeframe as to how well the patient is cured is not something that can be predicted because it may depend on a lot of factors. An example of this is how early the cancer has been diagnosed and acted upon. There are those basal cell carcinoma cases that return especially the small ones.

Prevention:-

In order to keep yourself from having to suffer from basal cell carcinomas make sure that you remember the following:

  • Avoid going out during midday when the sun is hottest.
  • Make use of sunscreen every single day to block UV radiation.
  • Wear clothing that would help protect the skin from UV rays.
  • Be very cautious about the changes in the condition of your skin.
  • Get a screening from your doctor.

References:-

http://en.wikipedia.org/wiki/basal-cellcarcinoma

http://www.mayoclinic.com/health/basal-cell

http://www.skincancer.org/skin-cancer-information/basal-cell-carcinoma


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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