Guidelines for the management of basal cell carcinoma

Abstract

Summary This article represents a planned regular updating of the previous British Association of Dermatologists guidelines for the management of basal cell carcinoma. These guidelines present evidence‐based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.

Evaluation of The Diagnosis and Treatment of Non-Melanoma Skin Cancer and its Impacts on The Prevention Habits in a Specific Population of Southeastern Brazil

“…The vast majority of patients in this study were farmers and rural residents, similar to what was reported in the literature concerning the environmental risk factors for developing NMSC (15,17). Associated with sun exposure, other risk factors may influence the onset of NMSC (1,2,8,9). In this series, there was a predominance of patients with phototypes I to III Fitzpatrick classes, consistent with the predominance of fair-skinned people in the study area due to the local colonization pattern (13).…”

“…Chronic sun exposure seems to be the main cause of SCC (1-3, 9, 15). In contrast, BCC occurs due to intermittent sunlight exposure (1)(2)(3)15) and history of sunburns (2), especially during childhood and adolescence (1,2,8). Most of the evaluated patients (18/25) reported exposure to UV radiation since childhood in a chronic form.…”

“…However, clinical examination and histopathologic evaluation should not be substituted yet (1,7). Incisional biopsy of the lesion, for suspicion of both BCC and SCC is indicated when there is diagnostic uncertainty (8,9); it can be time consuming, costly and sometimes crippling and painful for the patient, not being justified in most cases (7). The accuracy of the NMSC clinical diagnosis is approximately 60.2% (20); in relation to BCC it ranges from 59% to 88.93% (18,(20)(21)(22)(23) and for SCC it ranges from 25% to 67.4% (18,(20)(21)(22)(23).…”

“…Many of these technologies can assist in the diagnostic accuracy (6), for example, good lightning and visual magnification of the examination field with a dermatoscope (8). However, clinical examination and histopathologic evaluation should not be substituted yet (1,7).…”

“…The surgical excision with predetermined safety margins is the most appropriate treatment (1,8,9). Prevention and early detection in NMSC cases are fundamentally important to hold down the rise in incidence rates (4), reduce financial costs (2,3,5) and morbidity (1,3,5).…”