Basal cell carcinoma (BCC) is the most common form of skin cancer. Sunburn is the main culprit. They usually develop as small, round, raised, red or pearly coloured spots. They may become ulcerated and look like a sore that will not heal.
BCC is a locally invasive skin tumour and very rarely spread to other organs. Most BCC’s are treated surgically. Patients often develop multiple BCC’s over time.
Risk factors
- Sun induced skin damage
- Multiple episodes of sunburn
- Fair skin, blue eyes and blond or red hair
- Previous BCC or other form of skin cancer
Clinical feautures
- Slowly growing lesion
- Skin coloured, pink or pigmented
- Friable and spontaneously bleed or ulcerate
Types of BCC
- Nodular BCC: Shiny pink bump that may bleed and ulcerate
- Superficial BCC: Red patch mainly on the trunk
- Pigmented BCC: Has darker areas and can look like melanoma
- Morphoeic BCC: Often mistaken for a white scar
Complications
Recurrence are possible in high risk areas and in certain types.
Diagnosis
Some typical superficial BCCs are clinically diagnosed (supported with dermatoscopy) and may be treated without histology. The diagnosis is confirmed with a biopsy or following excision.
Treatment
It depends on its type, size and location, the number to be treated and patient factors. Long-term follow-up is recommended to check for new lesions.
- Surgical Excision
- Mohs micrographically controlled excision
- Shave, curettage, and electrocautery.
- Cryotherapy
- Photodynamic therapy
- Imiquimod cream
- Fluorouracil cream
- Radiotherapy
Prevention
- Avoid sunburn - especially in early life
- Sun protection daily and year-round
Follow-up
- Regular self-skin examinations and annual skin checks
- 50% of people with BCC develop a second one within 3 years of the first
- Check for other skin cancers, especially melanoma.
