BCC Flashcards
What is basal cell carcinoma (BCC)?
BCC is a neoplasm of the basal layer of the epidermis that is locally destructive but has a low metastatic potential.
What are the histologic features of BCC?
Nests of basaloid cells, palisading nuclei, and mucinous stroma.
What are the major risk factors for BCC?
- Ultraviolet (UV) light exposure 2. Fair skin 3. History of sunburns 4. Ionizing radiation exposure 5. Chronic arsenic exposure.
What are the two major clinical subtypes of BCC?
- Nodular BCC: Pearly, waxy nodule with peripheral telangiectasias, commonly found on the head and neck, prone to ulceration and bleeding.
- Superficial BCC: Scaly, erythematous, well-demarcated patch or plaque, often seen on the trunk.
What is the typical appearance of nodular BCC?
Pearly, waxy lesion with rolled borders, peripheral telangiectasias, central ulceration, and frequent bleeding.
What is the typical appearance of superficial BCC?
Scaly, pink, or erythematous well-demarcated plaque, often misdiagnosed as eczema or psoriasis.
What fungal lesion resembles BCC, how can this be distinguished from BCC?
Cryptococcal skin infections occasionally resemble basal cell carcinoma (pink, skin-colored papule). However, cryptococcal skin infections have multiple lesions (not a single lesion) that arise over days (not months).
How is BCC diagnosed?
Biopsy (shave, punch, or excisional) revealing nests of atypical basal epithelium in the dermis.
What is the first-line treatment for BCC?
Surgical excision with 5 mm margins to ensure complete removal.
What are alternative treatments for BCC?
Electrodesiccation and curettage, Mohs micrographic surgery (for lesions <6 mm in high-risk areas like the face), and topical therapies for non-surgical candidates.
What is Mohs surgery, and when is it used?
Mohs micrographic surgery is a tissue-sparing technique used for high-risk locations (face, ears, genitals) and recurrent or aggressive BCC.
When is topical therapy used for BCC?
For non-surgical candidates, options include Imiquimod (immune response modifier) and 5-fluorouracil (5-FU) (antimetabolite therapy).
What is the prognosis of BCC?
Excellent prognosis with early treatment; however, patients are at increased risk of developing additional BCCs or other skin cancers.
