Basal Cell Carcinoma: A Narrative Review on Contemporary Diagnosis and Management

Abstract

Basal cell carcinoma (BCC) is the most common, accounting for 80-90% of skin cancers. It arises from the basal layer of the epidermis and its appendages. A complex interplay of environmental, phenotypic and genetic variables leads to the development of BCC. Literature has documented several clinical subtypes of BCC, the most common of which are nodular, superficial and morpheaform. Expeditious diagnosis and analysis are essential for improving the outcome of BCC. Preventive measures, particularly when implemented in childhood and adolescence, may play a critical role. Due to its low metastatic potential, treatment for BCC mostly focuses on local management. The standard treatment of basal cell carcinoma involved complete removal of the lesion by excision or Mohs surgery. In special circumstances, basal cell carcinoma can be treated with cryosurgery, electrodesiccation and curettage, topical medications and photodynamic therapy. This review aimed to evaluate the contemporary diagnosis and management of basal cell carcinoma.

Prediction of Diagnostic Gene Biomarkers Associated with Immune Infiltration for Basal Cell Carcinoma

“…The other treatments include cryosurgery, electrodesiccation and curettage, topical medications and photodynamic therapy. 5 BCC is a tumor with the most genetic mutations in the coding DNA. Nearly 75.7% of the “UV labeled mutation”, cyclobutane pyrimidine dimer (CPD), of the coding DNA is attributed to UVB radiation sources.…”

Multimodal Considerations Concerning Basal Cell Carcinoma Clefting – Profile of Structural and Aggressive Traits – Perspectives

“…The patient’s education will play an important role in the future concerning sun exposure and avoidance, with emphasis on (childhood and/or adolescence) protective measures (sun protection creams), the precocious tumor detection and expeditious positive diagnosis, and early treatment measures (invasive or not, with updated management alternatives such as Hedgehog pathway inhibitors or immune checkpoint inhibitors). 2 , 3 …”

“…The characteristic-affected population has been represented up until now by the elderly men (having a steep rise in incidence over 40 years of age), with increasing numbers among female patients in the last years, a change reflected in the living style and/or environmental factors' exposure. [1][2][3] The pathogenesis of BCC is highly complex, with interplay between lifestyle factors, phenotype and genotype, the most important risk factor remaining the ultraviolet (UV) light exposure. The patient's education will play an important role in the future concerning sun exposure and avoidance, with emphasis on (childhood and/or adolescence) protective measures (sun protection creams), the precocious tumor detection and expeditious positive diagnosis, and early treatment measures (invasive or not, with updated management alternatives such as Hedgehog pathway inhibitors or immune checkpoint inhibitors).…”

“…The patient's education will play an important role in the future concerning sun exposure and avoidance, with emphasis on (childhood and/or adolescence) protective measures (sun protection creams), the precocious tumor detection and expeditious positive diagnosis, and early treatment measures (invasive or not, with updated management alternatives such as Hedgehog pathway inhibitors or immune checkpoint inhibitors). 2,3 BCC is a skin tumor clinically possessing certain traits which aid in its positive diagnosis, such as the presence of an ulcerated or eroded nodule or papule or plaque, translucency, telangiectasia (dilated blood vessels), pigmentation (black/ blue hue) and rolled borders. 1 BCC development is frequently associated with sun exposure, appearing on sun-exposed areas of the face and body; some anatomical areas are considered to be of high-risk, such as facial periorificial zones which frequently develop aggressive types of BCCs.…”

“…1,4 Clinically, BCC should not be confused with a large variety of differential diagnoses which include skin tumors or inflammatory disorders, such as: Darier's disease, adult-onset xanthogranuloma, epidermal cysts, lymphoma, rhabdomyomatous mesenchymal hamartoma, adnexal tumors (having either follicular, sebaceous or sweat gland differentiation), squamous cell carcinoma, Ewing's sarcoma, Merkel cell carcinoma, trichoblastoma, allergic contact dermatitis, irritant contact dermatitis, psoriasis, lymphoepithelioma-like carcinoma, pomade crust, and many others, all of these presenting with traits which could determine a physician to give an erroneous positive diagnosis of BCC. 1,3,[5][6][7] The positive BCC diagnosis is made on the basis of the clinical traits, the dermoscopic analysis and histopathologic evaluation (considered to be the gold standard and an invasive procedure); other new, emerging non-invasive procedures have been taken into consideration for BCC diagnosis, as indicated below. 8…”