Basal cell carcinoma

Question 1

Define

Answer 1

DEFINITION: COMMONEST form of skin malignancy, also known as a rodent ulcer

Question 2

Causes/risk factors

Answer 2

MAIN RISK FACTOR: prolonged sun exposure or UV radiation

Seen in Gorlin’s syndrome

Other risk factors:

• Photosensitising pitch
• Tar
• Arsenic

Question 3

Epidemiology

Answer 3

COMMON in those with FAIR SKIN

Common in areas of high sunlight exposure

Common in the elderly

Rare before the age of 40 yrs

Lifetime risk in Caucasians = 1 in 3

Question 4

Symptoms

Answer 4

A chronic slowly progressive skin lesion

Usually found on the:

• FACE
• Scalp
• Ears
• Trunk

Question 5

Signs

Answer 5

Nodulo-ulcerative (MOST COMMON)

• Small glistening translucent skin over a coloured papule
• Slowly enlarges
• Central ulcer with raised pearly edges
• Fine telangiectasia over the tumour surface
• Cystic change in larger lesions

Morphoeic

• Expanding
• Yellow/white waxy plaque with an ill-defined edge
• More aggressive than nodulo-ulcerative

Superficial

• Most often on trunk
• Multiple pink/brown scaly plaques with a fine edge expanding slowly

Pigmented

• Specks of brown or black pigment may be present in any BCC

Question 6

Investigations

Answer 6

Biopsy is RARELY necessary

Diagnosis is mainly on clinical suspicion