Basal Cell Carcinoma

Question 1

What is it?

Whys this type of cancer good to get?

Answer 1

Slow growing, locally invasive malignant tumour of the epidermal keratinocytes normally in older individuals

Least dangerous as hardly metastasises and its the most common

Question 2

Risk factors

Answer 2

UV exposure 
Hx of freq sunburn in childhood 
Type 1 skin 
Male 
Increasing age 
Immunosuppression 
Previous Hx of skin cancer

Question 3

Presentation

Answer 3

It has various morphological types:

• nodular
• superficial
• cystic
• morphoeic
• keratotic and pigmented

Question 4

Nodular BCC:

Describe

SCAM

How is the edge described?

Answer 4

S - small
C - skin coloured
A - surface telangiectasia, pearly rolled edge
M - papule

pearly rolled edge

Question 5

If it has a necrotic or ulcerated centre, what is it referred to as?

Answer 5

Rodent ulcer

Question 6

Where is it most commonly found?

Answer 6

Head and neck

Question 7

Management

Gold standard

What is Mohs micrographic surgery and why you’d do it?

What is curettage and when its used?

Answer 7

Surgical excision with a 4 mm margin is gold standard

Segments are excised in stages and examined histologically - used for difficult sites and where tissue preservation is important e.g. eyelid

Removal of tumour soft tissue and cautery of the base - small BCC’s

Question 8

Management

Other options

What topical treatment can be given for low risk lesions?

Answer 8

Topical cyrotherapy
Topical photodynamic therapy
Radiotherapy

Imiquimod cream

Question 9

Complications

Answer 9

Local tissue invasion and destruction