Basal cell carcinoma

Question 1

Definition

Answer 1

locally invasive tumour of epidermal keratinocytes

MOST COMMON TYPE OF SKIN CANCER

Question 2

features

Answer 2

small, skin-coloured or pink nodule with a central depression.
They often have a pearly rolled edge and surface telangiectasia.
CAN BE ULCERATED

Question 3

Distribution

Answer 3

On sun-exposed sites (DNA mutation following UV radiation exposure)

Question 4

Subtypes

Answer 4

Nodular (which is the most common),
Superficial,
Pigmented,
Cystic,
Keratotic and
Morphoeic BCCs.

Question 5

RFs

Answer 5

Type I or II skin (fair skin which always burns and never or rarely tans)
History of frequent or severe previous sun burn
Outdoor occupation or hobbies
Personal or family history of skin cancer
Immunosuppression
Increasing age
Male sex

Question 6

Mx

Answer 6

Routine referral
Surgical excision with a 4mm margin
curettage
cryotherapy
topical cream: imiquimod, fluorouracil
radiotherapy

Question 7

Why routine referral and not 2ww?

Answer 7

Extremely unlikely to metastasise