Curriculum · ENT, Ophthalmology, and Dermatology
Basal cell carcinoma
What it is
Basal cell carcinoma (BCC) is one of the three main types of skin cancer. Its lesions are also known as rodent ulcers and are characterised by slow-growth and local invasion. Metastases are extremely rare. BCC is the most common type of cancer in the Western world, and it is listed as the most common skin cancer in the USA.
Causes and risk
Sun exposure is the background, and significant sun exposure runs with the lesion. Skin cancer is also one of the malignancies of immunosuppression, where squamous cell carcinoma, BCC and malignant melanoma are named together. Fair skin and chronic sun damage are listed beside sun exposure as the setting in which the lesion arises. Multiple basal cell carcinomas are one feature of Basal Cell Nevus Syndrome (Gorlin), which also gives palmar pits, jaw cysts and a calcified falx cerebri, and carries a risk of medulloblastoma.
How it presents
Many types of BCC are described, and the most common one is nodular BCC. Sun-exposed sites, especially the head and neck, account for the majority of lesions. The lesion is initially a pearly, flesh-coloured papule with telangiectasia, and it may later ulcerate leaving a central crater. What is seen is a pearly nodule with a rolled, raised edge and telangiectatic vessels surrounding that central crater.