Overview
Definition
The most common type of skin cancer, arising from the basal cells of the lower epidermis.
Epidemiology
Extremely common. Accounts for ~80% of all non-melanoma skin cancers. Very low metastatic potential.
Etiology & Risk Factors
- Cumulative, chronic UV light (sun) exposure.
- Associated with PTCH1 gene mutations.
Clinical Symptoms
- Pearly, translucent papule or nodule with rolled borders
- Telangiectasias (visible blood vessels) on the surface
- Central ulceration ('rodent ulcer')
- Often found on sun-exposed areas (face, nose, neck)
Clinical Approach
Diagnosis
- Shave biopsy or Punch biopsy: Shows basophilic palisading cells dropping into the dermis
Management
- Surgical Excision: Standard treatment for most lesions
- Mohs Micrographic Surgery: Preferred for high-risk areas (face, hands, genitals) to spare healthy tissue while ensuring clear margins
- Topical therapies (Imiquimod, 5-FU) for superficial BCC
Complications
- Local tissue destruction and disfigurement (rarely metastasizes, but can aggressively destroy local cartilage/bone if neglected)