Basal Cell Carcinoma

  • Malignant neoplasm of germinative basal layer of epidermis and hair follicles
  • Rarely metastasize (<0.025%) but can cause extensive tissue damage
  • BCC/SCC ratio is 4:1

Types

  1. Nodular
  2. Superficial
  3. Morpheaform; solid - hard
  4. Pigmented

Nodular Basal Cell Carcinoma

  • Most common variant
  • Pearly, waxy papule, nodule, or plaque
  • Superficial telangiectasia - small dilated blood vessels
  • Frequent superficial ulceration

Morpheaform Basal Cell Carcinoma

  • Scar-like plaque
  • whitish dermal plaque with atrophy
  • More extensive subclinical spread

Superficial Basal Cell Carcinoma

  • Red scaly plaque, mimics superficial dermatitis
  • Most common on the trunk and extremities
  • Seen with chronic arsenic and areas of radiation damage

Pigmented Basal Cell Carcinoma

  • Dark brown or blue pearly papule
  • Mimics dysplastic nevus or nodular melanoma
  • Seen with darker skin types

Pigmented BCC

Epidemiology

  • 95% Caucasians
  • 95% between ages 40-79 years old
  • 85% head and neck
  • Nose most common site, approximately 30% of all tumors