Basal Cell Carcinoma

A 65-year-old woman presents with a 1-cm raised, light brown, circular, nodular lesion on the top of her head, which has progressively enlarged during the last 6 months. The growth was removed by shave excision; electrodesiccation and curettage were performed on the base. Pathologic evaluation determined the lesion was a basal cell carcinoma.

Basal cell carcinoma is the most prevalent skin cancer as well as the most common of all cancers in the United States. These neoplasms are classified by their clinical appearance:

• Nodular (the most common form).

• Infiltrative.

• Pigmented.

• Superficial.

• Morpheaform.

• Fibroepithelioma.

These skin cancers more frequently occur in men, in persons older than 40, and in those with light skin. Risk factors include arsenic intoxication, ionizing radiation, thermal burns, and prolonged exposure to the sun. Basal cell carcinomas rarely metastasize.

The choice of treatment is based on the neoplasm's size, location, and type. Select the modality that best eradicates the entire lesion and offers the most pleasing cosmetic result. Options include surgical excision, Mohs microsurgery, radiation therapy, electrodesiccation and curettage, and cryosurgery.

FOR MORE INFORMATION:

• Barone EJ, Jones JC, Schaefer JE. Skin Disorders. Philadelphia: Lippincott Williams & Wilkins; 2000:114-116.

• Blereau RP, Monroe J. Photo essay: basal cell carcinoma. Consultant. 2000;40:1693-1705.