BCC

Question 1

What are BCC’s?

Answer 1

Malignant epidermal skin tumours arising from hair follicles in the basal layer of the epidermis

Question 2

Give 2 epidemiological facts about BCC’s

Answer 2

Most common skin cancer in UK

Caucasians have higher risk

Question 3

List 3 characteristics of BCCs

Answer 3

Slow growing
Locally invasive
AKA “rodent ulcers”

Question 4

What are the most significant risk factors for BCC?

Answer 4

genetics

UV radiation.

Question 5

Which areas are most commonly effected in BCC?

Answer 5

Sun exposed head + neck

Question 6

List 6 factors which may increase risk of BCC

Answer 6

Age
Skin types 1 + 2
Male
Immunosuppression
Arsenic exposure
High dietary fat intake

Question 7

In which condition are multiple BCCs a feature of?

Answer 7

Gorlin’s syndrome

Question 8

Give 5 features of a Nodular BCC

Answer 8

Solitary, shiny, red nodule
Common on face.
Cystic, pearly, large telangiectasia.
May be ulcerated.
Micronodular + microcystic types may infiltrate deeply.

Question 9

Give 5 features of the appearance of a superficial BCC

Answer 9

Often multiple, usually on upper trunk + shoulders.
Erythematous well-demarcated scaly plaques
Often > 20mm at presentation.
Central clearing
Thread-like border.
Rolled edge seen if stretched.
May bleed or weep.

Question 10

What may a superficial BCC be confused with?

Answer 10

Bowen’s disease or inflammatory dermatoses.

Question 11

What treatment route are superficial BCCs particularly responsive to?

Answer 11

Medical

rather than surgical

Question 12

Describe the nature of a superficial BCC

Answer 12

Slow growth over months/ years; usually not aggressive
Rarely become invasive
Extremely rarely metastasise.
Less likely to erode + ulcerate than nodular BCCs.

Question 13

Give 2 features of the appearance of a Morphoeic BCC

Answer 13

Poorly defined borders.

Thickened yellowish plaques

Question 14

Describe the nature of a Morphoeic BCC

Answer 14

AKA. sclerosing or infiltrative BCC.
Mid-facial sites.
Aggressive
May infiltrate cutaneous nerves (perineural spread).

Question 15

Describe presentation and treatment of morphemic BCCs

Answer 15

Present late; may become very large + then require extensive plastic surgical reconstruction.
Prone to recurrence after treatment.

Question 16

List 4 features of a pigmented BCC

Answer 16

Brown, blue or greyish lesion.
Nodular or superficial histology.
More common in those with dark skin
May resemble malignant melanoma.

Question 17

What investigations are performed in suspected BCC?

Answer 17

Biopsy RARELY necessary

Diagnosis is mainly on clinical suspicion