Basal cell carcinoma is a form of skin cancer characterized by the development of a bump, lump, or lesion on the epidermis, the skin’s outermost layer. These growths typically appear on skin areas frequently exposed to sunlight. Successful treatment generally results in a favorable prognosis.
An Overview of Basal Cell Carcinoma
Basal cell carcinoma (BCC) originates in the basal cells found at the bottom of the epidermis. It manifests as a small, sometimes glossy bump or a scaly, flat patch that slowly enlarges over time.
What are basal cells?
Basal cells are tiny cells located in the epidermis, the visible layer of the skin. Their primary function is to generate new skin cells by dividing. As new cells emerge, the older cells are pushed to the skin’s surface, where they are shed.
What are the types of basal cell carcinoma?
There are four primary forms of BCC:
1. Nodular: The most prevalent type, presenting as a round, pimple-like bump with visible blood vessels (telangiectasias).
2. Superficial Spreading: Results in small, shallow lesions that appear lighter than the surrounding skin, often found on the torso, arms, and legs.
3. Sclerosing (Morpheaform): Appears as scar-like lesions that gradually expand, typically on the face, sometimes appearing as a small red dot.
4. Pigmented: A rare type causing darkening of the affected skin area compared to the surrounding skin.
Who is Affected by Basal Cell Carcinoma?
BCC can develop in anyone but is slightly more frequent in men. It commonly affects individuals over 50, particularly those with fair skin and light-colored eyes. A history of BCC increases the risk of developing other nonmelanoma skin cancers.
How common is basal cell carcinoma?
This is the most prevalent cancer type overall, as well as the most common skin cancer, with over 4 million cases diagnosed annually in the United States.
Symptoms and Causes
Identifying Basal Cell Carcinoma
Signs include:
– Bumps, lumps, pimples, scabs, or scaly patches on the skin
– Lumps may be translucent and can range from white to pink, or from brown to blue-black
– May shine more than surrounding skin and show tiny blood vessels
– Lumps could grow slowly, be itchy or painful, and sometimes ulcerate or ooze fluid
Locations Prone to Basal Cell Carcinoma
BCC chiefly appears on parts of the body exposed to the sun, such as the face, scalp, nose, eyelids, legs, ears, and arms.
Causes of Basal Cell Carcinoma
The primary cause is a DNA alteration frequently resulting from excessive exposure to ultraviolet (UV) rays from the sun or tanning beds. Genetic mutations may disrupt DNA, impairing cell replication controls, leading to excessive basal cell growth.
Diagnosis and Tests
Diagnosing Basal Cell Carcinoma
Healthcare providers might suspect BCC based on a lesion’s appearance, confirmed by a physical examination and symptom inquiry. Questions may include the appearance timeframe, changes in size, and previous skin cancer history.
Diagnostic Tests for Basal Cell Carcinoma
– Skin Biopsy: Removing and examining a skin sample.
– Imaging Tests: Rarely, MRIs or CT scans might be performed if cancer spread is suspected.
The diagnosis stage is determined based on the lesion size, growth, and any spread to lymph nodes or other body parts.
Management and Treatment
Treatment for Basal Cell Carcinoma
Cancer removal might involve:
– Electrodessication and Curettage: Scraping and burning cancer with an electric needle.
– Surgery: Excision or Mohs surgery to remove the lesion.
– Cryotherapy: Freezing the lump.
– Chemotherapy: Using drugs to destroy cancer cells.
– Photodynamic Therapy (PDT): Applying light-sensitive agents with blue light.
– Laser Therapy: High-energy lasers replace surgical methods.
Treatment choice considers health, age, lesion size, and location.
Consequences of Untreated Basal Cell Carcinoma
Untreated BCC may grow and affect deeper tissues, causing pain, bleeding, and potentially life-threatening complications if it rarely spreads.
Medication for Basal Cell Carcinoma
For advanced cases, the FDA has approved medications like Vismodegib and Sonidegib for patients ineligible for surgery or radiation, bearing potential side effects like muscle cramps and taste changes.
Surgical Treatment Side Effects
Surgery may cause scarring, with minimal risk of bleeding or infection.
Prevention
Reducing Basal Cell Carcinoma Risk
While prevention isn’t always possible, risk can be minimized by:
– Avoiding sun exposure, especially from 10 a.m. to 4 p.m.
– Steering clear of tanning beds.
– Using sunscreen with an SPF of 30 or higher, applied every two hours when outdoors.
– Wearing protective clothing, hats, and sunglasses.
– Conducting monthly skin self-examinations.
– Having an annual dermatologist skin check.
– Taking vitamin B3 (nicotinamide) twice daily to decrease new BCC occurrences.
