Basal cell carcinoma

Basal cell carcinoma otherwise known as rodent ulcer is the most common skin cancer. This is a locally invasive carcinoma of basal layer of epidermis with no lymphatic spread and rare hematogenous spread.

Risk factors

  • Ultraviolet light particularly UV-B
  • Mutation in regulatory genes
  • Exposure to ionizing radiation
  • Immunosupression (lymphoma, leukemia, corticosteroids)
  • Elderly white male
  • Prolonged administration of arsenic usually in the form of liruor arsenicalis.

Pathogenesis

BCC is associated with dysregulation of the sonic hedgehog, or PTCH pathway. Inherited defects in the PTCH gene with subsequent loss of heterozygosity in the numerous individual tumor foci lead to familial basal cell carcinoma syndrome called the GORLIN syndrome.

Clinical features

These tumors present as pearly papules, often containing prominent, dilated subepidermal blood vessels (telangectasia). Some tumors contain melanin pigment and thus appear similar to melanoma. Advanced lesions may ulcerate and extensive local invasion of bone or facial sinuses may occur after years of neglect.



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