Basalioma

Basal Cell Carcinoma
Basal_cell_carcinoma.jpg
Synonyms	Basalioma, Rodent ulcer
Pronounce	N/A
Specialty	N/A
Symptoms	Skin lesion, bleeding, ulceration
Complications	Local tissue destruction
Onset	Typically after age 50
Duration	Chronic
Types	N/A
Causes	Ultraviolet radiation, genetic predisposition
Risks	Sun exposure, fair skin, immunosuppression
Diagnosis	Skin biopsy
Differential diagnosis	N/A
Prevention	N/A
Treatment	Surgical excision, Mohs surgery, cryotherapy, topical chemotherapy
Medication	N/A
Prognosis	Excellent with treatment
Frequency	Most common skin cancer
Deaths	N/A

Overview

Basal Cell Carcinoma (BCC), also known as Basalioma, is the most common form of skin cancer and one of the most frequently occurring forms of all cancers. It arises from the basal cells, which are small, round cells found in the lower part of the epidermis. BCC is a slow-growing cancer that rarely metastasizes or spreads to other parts of the body.

Epidemiology

Basal cell carcinoma is the most common cancer in humans, with millions of cases diagnosed annually worldwide. It predominantly affects individuals with fair skin and is more common in older adults, typically appearing after the age of 50. The incidence of BCC is higher in regions with intense sun exposure, such as Australia and the southern United States.

Etiology

The primary cause of basal cell carcinoma is prolonged exposure to ultraviolet (UV) radiation from the sun or from tanning beds. UV radiation causes DNA damage in skin cells, leading to mutations that can result in cancer. Other risk factors include:

• Genetic predisposition: Conditions such as Gorlin syndrome (nevoid basal cell carcinoma syndrome) increase the risk.
• Immunosuppression: Individuals with weakened immune systems, such as organ transplant recipients, are at higher risk.
• Radiation therapy: Previous radiation treatment can increase the risk of developing BCC in the treated area.

Pathophysiology

Basal cell carcinoma originates in the basal cells of the epidermis. These cells undergo malignant transformation due to genetic mutations, often involving the PTCH1 gene, which is part of the Hedgehog signaling pathway. The uncontrolled proliferation of these cells leads to the formation of a tumor.

Clinical Presentation

BCC typically presents as a persistent, non-healing sore or a pearly, flesh-colored papule. Common features include:

• A shiny, translucent nodule with telangiectasia (small visible blood vessels)
• A flat, scaly, reddish patch
• A white, waxy scar-like lesion
• Ulceration and bleeding in advanced cases

Diagnosis

Diagnosis of basal cell carcinoma is primarily clinical, supported by a skin biopsy. The biopsy involves taking a small sample of the lesion for histopathological examination. Dermoscopy can also aid in the diagnosis by revealing characteristic features such as arborizing vessels and blue-gray ovoid nests.

Treatment

The treatment of basal cell carcinoma depends on the size, location, and subtype of the tumor. Common treatment options include:

• Surgical excision: The tumor is cut out along with a margin of healthy tissue.
• Mohs micrographic surgery: A precise surgical technique that removes the cancer layer by layer, examining each layer microscopically until no abnormal cells remain.
• Cryotherapy: Freezing the cancer cells with liquid nitrogen.
• Topical chemotherapy: Application of creams such as 5-fluorouracil or imiquimod.
• Radiation therapy: Used for patients who cannot undergo surgery.

Prognosis

The prognosis for basal cell carcinoma is excellent, especially when detected early and treated appropriately. Recurrence is possible, particularly in cases of incomplete excision. Regular follow-up and skin examinations are recommended to monitor for new lesions.

Prevention

Preventive measures include:

• Limiting sun exposure, especially during peak hours
• Using broad-spectrum sunscreen with a high SPF
• Wearing protective clothing, hats, and sunglasses
• Avoiding tanning beds

See Also

• Squamous cell carcinoma
• Melanoma
• Skin cancer

External Links

• [American Academy of Dermatology](https://www.aad.org)
• [Skin Cancer Foundation](https://www.skincancer.org)

Classification
External resources