Update of the European guidelines for basal cell carcinoma management

Abstract

Background European guidelines for the management of basal cell carcinoma (BCC) prepared by the former BCC subcommittee of the Guidelines Committee of the European Dermatology Forum (EDF) were published in 2006. Objectives To present updated guidelines that include consensual expert definitions on various BCC types, prognosis and risk factors for BCC as well as review recommendations for diagnosis and treatment reflecting current published evidence. Methods These guidelines (S1 type) were prepared by the new BCC subgroup of the European Dermatology Forum (EDF)'s Guidelines Committee through extensive literature review (up to 2012) and expert experience; they were extensively discussed within the EDF subcommittee and approved by peer reviewers of the EDF. Results BCC is a common tumour with an incidence rising worldwide. Three major clinical types of BCC are recognized: nodular, superficial and morpheaform. Four histological subtypes are defined: superficial, nodular, infiltrative and morpheaform. On the basis of the risk of relapse, three prognosis groups have been identified: high, intermediate and low risk. According to these classifications and evidence-based evaluation of the therapeutic strategies available, a decision tree is proposed for the management of BCCs. Conclusions. The guidelines offer a useful tool that will help dermatologists to select the most appropriate treatment for individual patients.

Hyperspectral imaging system in the delineation of Ill‐defined basal cell carcinomas: a pilot study

“…A high risk of recurrence is associated most importantly with aggressive growth patterns along with location in high‐risk anatomic areas (nose, ears, eyes and periocular areas), clinically unclear visualization of the border, immunosuppression, recurrence and perineural involvement . Clinically, BCCs are classified by visual assessment as either indolent (nodular, superficial) or ill‐defined (aggressive subtypes) . Roughly one of five BCCs is the histologically verified aggressive subtype .…”

“…Thus, 80% of BCCs – and most of the aggressive types – are located on the head and neck area, where preserving the anatomy and function plays a major role. Surgery and, if available, Mohs micrographic surgery (MMS) with a 100% margin control are the treatment of choice for high‐risk BCCs …”

Simple 3‐criteria‐based ex vivo confocal diagnosis of basal cell carcinoma

“…The gold standard therapy and diagnostic method for selected BCC subtypes (eg, nodular, sclerosing or morpheaform BCC) in special anatomical localizations (eg, face) is Mohs surgery with a histological examination of the excised tissue. The recommendations for other BCC subtypes, for example, superficial BCCs, include less invasive, topical therapeutic approaches .…”

Fresh/frozen Tübingen technique (margin strip method) for head and neck basal cell carcinoma: A retrospective study of 298 cases

“…Microscopically controlled surgery (MCS) is the treatment of choice for high‐risk basal cell carcinoma (BCC), and Mohs micrographic surgery (MMS) is worldwide considered as the gold standard for this approach (Trakatelli et al, ). However, several variants of MMS have been subsequently described (Löser et al, ).…”