basal cell carcinoma The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... Image File history File links Basal_cell_carcinoma. ...

Basal cell carcinoma (BCC) is the most common skin cancer. It can be destructive and disfiguring. Risk is increased for individuals with a family history of the disease and a high cumulative exposure to UV light via sunlight or, in the past, carcinogenic chemicals especially arsenic. Treatment is with surgery, topical chemotherapy, x-ray, cryosurgery, photodynamic therapy. It is rarely life-threatening but if left untreated can be disfiguring, cause bleeding and produce local destruction (eg., eye, ear, nose, lip). Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ... Wikipedia does not have an article with this exact name. ... Skin cancer is a malignant growth on the skin, which can have many causes, including repeated severe sunburn or long-term exposure to the sun. ... Ultraviolet (UV) radiation is electromagnetic radiation of a wavelength shorter than that of the visible region, but longer than that of soft X-rays. ... Prism splitting light High Resolution Solar Spectrum Sunlight in the broad sense is the total spectrum of the electromagnetic radiation given off by the Sun. ... General Name, Symbol, Number arsenic, As, 33 Chemical series metalloids Group, Period, Block 15, 4, p Appearance metallic gray Atomic mass 74. ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Chemotherapy is the use of chemical substances to treat disease. ...

Forms

Various forms are recognised:

• Nodular: flesh-colored papule with telangiectasis. If it ulcerates, it becomes a "rodent ulcer" (ulcus rodens), an ulcerating nodule with (often) a pearly border.
• Cystic: rarer and hard to distinguish from the nodular form. It has a central cavity with fluid.
• Pigmented: a variant of the nodular form that may be confused with melanoma.
• Sclerosing/cicratising: a scar-like lesion.
• Superficial: a red scaling patch

About two thirds of the carcinomas occur in sun-exposed areas and one third occur in non-sun-exposed areas, emphasizing the genetic susceptibility of the basal cell cancer patients. Telangiectasias are small enlarged blood vessels near the surface of the skin, usually they measure only a few millimetres. ... Melanoma is a malignant tumor of melanocytes and, less frequently, of the eye (see uveal melanoma). ...

Diagnosis

To diagnose, a biopsy (where tissue is taken for pathological study) is done using local anesthesia. In small lesions, the tumor is generally removed in its entiriety, while larger ones are biopsied first and surgically removed later if it is confirmed that it is malignant. A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Histopathology: Basal cell carcinoma is a malignant epithelial tumor arising only in skin, from the basal layer of the epidermis or of the pilosebaceous adnexa. Tumor is represented by compact areas, well delineated and invading the dermis, apparent with no connection with the epidermis. Tumor cells resemble normal basal cells (small, monomorphous) are disposed in palisade at the periphery of the tumor nests, but are spindle-shaped and irregular in the middle. Tumor clusters are separated by a reduced stroma with inflammatory infiltrate. 1

Pathophysiology

Basal cell carcinomas develop in the basal cell layer of the skin. Sunlight exposure leads to DNA crosslinking between thymidine residues. While DNA repair removes most UV-induced damage, not all crosslinks are excised. There is, therefore, cumulative DNA damage leading to mutations. Apart from the mutagenesis, sunlight depresses the local immune system, possibly decreasing immune surveillance for new tumor cells. The basal cell layer is also called the Stratum Germinativum or Stratum Basale and is the innermost layer of the epidermis. ... It has been suggested that this article or section be merged with Epidermis (skin). ... The chemical structure of deoxythymidine Thymidine (more precisely called deoxythymidine can also be labelled deoxyribosylthymine, and thymine deoxyriboside) is a chemical compound, more precisely a pyrimidine deoxynucleoside. ... DNA damage resulting in multiple broken chromosomes DNA repair refers to a collection of processes by which a cell identifies and corrects damage to the DNA molecules that encode its genome. ... It has been suggested that mutant be merged into this article or section. ... A scanning electron microscope image of a single lymphocyte, a component of the human immune system A poop system is a collection of mechanisms within an organism that protect against infection by identifying and killing pathogens. ...

Histology of a nodular basal cell carcinoma Image File history File links Basal_cell_carcinoma_pathology. ...

Prevention and early diagnosis

Basal cell carcinoma is the most common skin cancer. It occurs mainly in fair-skinned patients with a family history of this cancer. Sunlight is a factor in about two thirds of these cancers, but one third occur in non sun-exposed areas. Therefore, dermatologists recommend sun screens and annual skin cancer exams to prevent or provide early detection of this common tumor.

Treatment

Most basal cell carcinomas are removed surgically. A common method is "electrodessication and curettage" (ED&C). This is done by scraping the tumor out with a curette and cauterizing the base and margins. The wound is left to heal by itself (secondary intention healing). The cure rate and cosmetic result are excellent, especially in concave areas. It is also the most cost effective treatment. Surgical excision by the dermasurgeon is another option with the margins of excised tissue examined under the microscope. Certain types, like the sclerosing basal cell cancers may need a wider margin, as they develop subtle processes that project outside the visible part of the tumor. Noun A spoon-shaped surgical instrument for cleaning a diseased surface. ...

Some superficial cancers respond to local therapy with 5-fluorouracil, a chemotherapy agent. Topical treatment with 5% IMIQUIMOD cream, with 5 applications per week for six weeks has a reported 70 - 90% success rate at reducing, even removing the BCC [basal cell carcinoma]. Imiquimod may be used prior to surgery to reduce the size of the carcinoma. See www. skincancer.org/chemotherapy.html Fluorouracil (5-FU) is a drug that is used in the treatment of cancer. ... Chemotherapy is the use of chemical substances to treat disease. ...

Mohs micrographic surgery[1] has the highest cure rate and is especially indicated for recurrent tumors or tumors in areas (eg. eyelid or nose) where minimal amounts of tissue removal are important. Mohs surgery involves checking the base and edges under a microscope before the surgical repair of the site. Specially trained dermasurgeons do this procedure, usually in-office.

A new immune enhancement agent (topical imiquimod, "Aldara") is effective for the treatment of superficial skin cancers (basal cell and squamous cell cancer, and even malignant melanoma in-situ). It is also used pre-operatively to shrink nodular basal cell cancers, thus allowing a smaller surgical excision. Imiquimod (INN, marketed by 3M under the trade name Aldaraâ„¢) is a prescription medication used to treat certain diseases of the skin, including skin cancer (basal cell carcinoma, Bowens disease, superficial squamous cell carcinoma, some superfical malignant melanomas and actinic keratosis) as well as genital warts. ...

X-ray is still appropriate in older patients who are not candidates for surgery. Cryosurgery is another option, particularly for basal cell cancer invading cartilage, as the healthy cartilage is cryo-resistant.

Treating surgeons (dermasurgeons, plastic surgeons, or other specialists) will recommend one of these modalities as appropriate treatment depending on the tumor size, location, patient age and other variables.

There is also a new treatment using Euphorbia peplus a common garden weed. [2] Binomial name Euphorbia peplus L. Euphorbia peplis , the Petty spurge is small plant, with very wide distribution commonly found in cultivated land and gardens in the UK, Europe, USA, France, Australia, New Zealand and other countries in temperate and sub-tropical regions. ...

Prognosis

Although basal cell carcinoma rarely metastasizes, it grows locally without stopping. The cancer can impinge on vital structures and result in loss of function or rarely death. The vast majority of cases can be successfully treated before serious complications occur. Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ... This article or section does not cite its references or sources. ...

Epidemiology

Basal cell cancer is the most common skin cancer. It is much more common in fair skinned individuals with a family history of basal cell cancer and increases in incidence closer to the equator or at higher altitude. According to Skin Cancer Foundation[3], there are approximately 800,000[4] new cases yearly in the United States alone.

Most sporadic BCC arise in small numbers on sun-exposed skin of people over age 50, although younger people may also be affected. The development of multiple basal cell cancer at an early age could be indicative of Nevoid basal cell carcinoma syndrome. The Nevoid Basal Cell Carcinoma Syndrome (NBCCS) (also known as Basal Cell Nevus Syndrome, Multiple Basal Cell Carcinoma Syndrome, Gorlin syndrome, or Gorlin-Goltz syndrome) is an inherited group of multiple defects involving the skin, nervous system, eyes, endocrine system, and bones. ...

External links

• The American College of Mohs Micrographic Surgery
• The Skin Cancer Foundation
• Photo at: Atlas of Pathology
• Natural history of Basal cell carcinoma
• Dermatlas: Images of Basal cell carcinoma