Basal Cell Carcinoma: Overview and More


Basal cell carcinoma (BCC) is a skin cancer that begins in the lower part of the epidermis . It can cause shiny skin lesions that may (but not always) disappear. Basal cell carcinoma accounts for approximately 80% of all non-melanoma skin cancers worldwide, and skin damage caused by ultraviolet radiation (sunlight, tanning beds) is a leading cause .

Biopsy is the most accurate way to confirm the diagnosis of basal cell carcinoma, and surgical removal of the cancer is generally recommended. Of course, a commitment to prevention is critical when it comes to BCC and all forms of skin cancer .

Basal cell carcinoma types and symptoms

Basal cell involvement is often described as a pearly papule because it has a slight sheen. These papules rise (sometimes very slightly) above the surface of the skin and are usually the same color or slightly lighter than the surrounding skin.

In some cases, various symptoms and characteristics can develop, including:

  • Telangiectasias – These small, dilated blood vessels can form in areas affected by BCC. These lesions appear pink, red, or purple.
  • Discoloration: Cancerous areas on the skin may appear dark or brown due to the presence of dead cells.
  • Itching around the injury
  • An injury that looks like a persistent wound that does not heal

BCC lesions can appear suddenly. They can start at 1 centimeter (cm) and continue to grow in size after they first appear, becoming more visible over time.

Basal cell carcinoma lesions usually appear on areas of the body that have been exposed to sunlight, especially strong sunlight, including the face, ears, arms, legs, back, and abdomen. t generally exposed to ultraviolet radiation, such as on the scalp, although this is not common .

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Basal cell carcinoma lesions can be divided into several different types, each of which has a different appearance.

  • Knotty: 60% to 80% of CCBs are nodular. They start out as flat, well-defined lesions, then often develop into small bumps that eventually collapse in the middle, leaving a raised ring at the edge. Most ganglionic CBCs are found on the face and can be disfigured if not treated promptly.
  • Pigmented: Pigmented CBCs are similar to nodular ones, but they can contain brown or black spots that can give them an appearance that resembles certain types of melanoma .
  • Fibrosis or hardening – These bcc are usually found on the face and look like scars. They are usually dense, indistinct at the edges, flat or slightly depressed, yellowish in color. The surface is usually smooth and shiny.
  • Superficial: this type represents approximately 15% of the BCC. They extend outward from a red, well-defined, scaly patch and are most commonly found on the trunk and extremities. They can easily be mistaken for psoriasis or eczema .
  • Carnation fibroepithelioma: This is a rare type of BCC. It is usually a small, raised, smooth nodule on the back, extremities, groin, or bottom of the foot. Since these areas are not exposed to the sun, it is likely that this is not related to the sun.


If basal cell carcinoma is not treated, the lesions can grow and eventually ulcerate (break through the skin) or damage the surrounding tissue or bones.

Although this is rare, there are people who have lost an eye, nose, or ear due to lack of treatment for CBC.

Cancer can spread (metastasize) to other parts of the body, which can cause serious health problems, although this does not happen often.


Like other cancers, BCC is caused by mutations, which are changes in the molecular structure of a cell's DNA. Several genetic mutations associated with basal cell carcinoma have been identified, including changes in the PTCH1, PTCH2, SMO, PTPN14, LATS1, TERT, and DPH3-OXNAD1 genes .

However, genetic changes in BCC are not inherited. Cell damage caused by exposure to ultraviolet (UV) light leads to changes in DNA that predispose a person to skin cancer. Of note, it can take 10 to 20 years for basal cell carcinoma to develop after exposure to ultraviolet radiation.

Some of the BCC-related DNA changes that occur can stimulate cancer cell proliferation, and some of these changes interfere with the body's ability to inhibit tumor cell growth. Scientists continue to study exactly how damaged DNA leads to skin cancer .

Other types of skin cancer, such as squamous cell carcinoma , are more closely related to UV exposure than BCC. However, this should not rule out the role of ultraviolet radiation in increasing the risk of basal cell carcinoma.

UVA and UVB light

UVA and UVB rays have different wavelengths, from 280 to 315 nm (nm) and from 315 to 400 nm, respectively. This means that UVA light penetrates deeper into the skin, although both can cause skin damage that manifests itself in the form of sunburn and sunburn. or, ultimately, skin cancer.

Excessive UV exposure can come from the sun or tanning beds . Outdoor exposure to each type of UV light depends on weather conditions and the time of day. For example , if you are exposed to them in sunny weather, UV-A rays penetrate more in cloudy weather.

Sunscreen can help protect your skin, but UVA and UVB rays can also penetrate sunscreen and sunscreen. This means that prolonged exposure, even with sunscreen, will still expose your skin to damaging effects .

Risk factor's

More than 4 million people are diagnosed with BCC each year in the United States. Although this type of cancer usually begins in middle age or older, it can affect younger people as well. In fact, experts warn that BCC affects younger and younger people .

Certain risk factors increase the risk of basal cell cancer:

  • Race: White people, especially those with blue eyes, fair skin, and red, blonde, or light brown hair, are at the highest risk for BCC. (African Americans, Asians, and Hispanics can develop this type of cancer, but not often.)
  • Location: You live in a state closer to the equator, like Florida.
  • History of sunburn in childhood: This not only increases the risk of developing basal cell carcinoma, but also at a younger age.

Compared to whites, blacks have a reduced risk of BCC in areas exposed to UV rays, but the same incidence of BCC on covered skin. Darker skin does not mean that you are protected against basal cell carcinoma or any type of skin cancer, in fact.


Your healthcare professional can recognize (and classify as a specific type) a skin lesion as CBC by its appearance, but a biopsy is needed to confirm the diagnosis.

A skin biopsy is the removal of tissue from the skin for examination under a microscope. There are several types of skin biopsies . The correct procedure depends on several factors, including whether the lesion is elevated above the skin.

  • After shave biopsy: Your healthcare provider takes a sample of your tissue with a fine surgical blade to shave off the top layers of your skin. This is the most common biopsy method for diagnosing BCC.
  • Perforated biopsy – uses a small round device that works like a cookie cutter. It is used to take a deeper sample of the skin.
  • Lymph node biopsy : If you are concerned that your cancer has spread to a nearby lymph node , your doctor may take a tissue sample from the lymph node for examination.

Tumor stage is a classification used to describe the size of the tumor and the degree of spread. Classification of tumors shows how fast cells grow.

The physical examination and biopsy are used to stage and classify the tumor.

Watch out

Your treatment depends on the type, extent, and location of your injury. Although BCC does not usually spread to distant organs, the lesions can ultimately lead to disfigurement and should be removed as soon as possible.

Methods that are commonly used to treat BCC include:

  • Scraping and electrodesification : This procedure involves scraping the tumor and burning it with an electrical current to kill cancer cells.
  • Mohs surgery (micrographic surgery): This is a specialized procedure in which your doctor will remove an area that appears to be cancerous and send it for a microscopic examination to confirm whether the cancer has been completely removed. The deeper area may need to be surgically removed until it is confirmed that the entire malignant area has been removed.
  • Surgical excision (excision): The entire lesion and possibly metastases can be removed surgically.
  • Aldara (imiquimod) is a topical cream approved for the treatment of bcc. Exfoliates cancers.
  • Radiation therapy is an option to treat some tumors, especially if they are located in an area that is not optimal for surgery, such as the ear.

The treatment needed to remove basal cell carcinoma is much easier and it is less likely to cause significant scarring when it is small.

Generalized lesions should be treated with orally targeted agents specifically formulated to treat BCC. Currently, the FDA approves two drugs for the treatment of CBC: Erivedge (Vismodegib) and Odomzo (Sonidegib).


When it comes to skin cancer, it is very important to invest in prevention strategies. It's best to avoid using tanning beds / booths altogether and be aware of the amount of sun that is falling on you (as well as keeping yourself safe when outdoors).

Regular skin self -exams can help you catch any lesions early, before they start to grow or spread.

Safe sun exposure

It must be protected from ultraviolet rays, whether it is bright, sunny or cloudy.

If you have to work outside in the hot sun, wear clothing that covers your skin and, if possible, wear a hat. It's not always easy to find clothes that cover your skin without overheating, so it's worth planning ahead. You can even look for clothes made with SPF rated fabrics.

If you can change your schedule, try to go outside when the sun isn't so bright, and make sure you spend at least some of your time in the shade.

If you're dining at a street cafe, consider using a beach umbrella or sitting under a canopy.


When choosing a sunscreen, you need to pay attention to a number of characteristics. Some points to keep in mind:

  • Most sunscreens protect against UVB light, but only 'broad spectrum' products also protect against UVA light.
  • The higher the sun protection factor (SPF) , the more protection the product offers.
  • Not all sunscreens are waterproof or water resistant. If you tend to sweat a lot or know you are going to swim, be sure to check that you have it.
  • Products that contain zinc are usually thicker and more visible, so they are easier to see when washed. But if this is not desirable from an aesthetic point of view, choose a product that absorbs into the skin. The best product will be the one you use without hesitation .

Note that the SPF does not necessarily depend on whether a product is waterproof, broad spectrum or not. Therefore, you must consider each of these functions individually.

Maintain the health of the skin.

Get a medical evaluation of any dark spots, bright spots, or any areas of color or texture change before they grow larger or worse.

You can see your dermatologist regularly if you are at risk for BCC, and you can also make an appointment when you notice skin lesions.

Get the word of drug information

Basal cell carcinoma is the most common, but also one of the most curable cancers. However, even after effective treatment, a person with a history of CBC is more likely to develop it again than a person without a history of the disease. You should be more vigilant about prevention if you have a history of bcc.

Keep in mind that avoiding the sun altogether is harmful – sunlight is not just a source of vitamin D. Lack of sunlight is linked to seasonal affective disorder.

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