Basal Cell Carcinoma

Basal cell carcinoma is a skin cancer that affects basal skin cells. It presents as a partly transparent, shiny skin bump but can appear in other forms. It occurs due to long-term exposure to ultraviolet (UV) rays. It primarily affects areas of the head and neck that are exposed to the sun. However, it can be prevented by avoiding UV light exposure and using sunscreen while out in the sun.

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What causes basal cell carcinoma?

Basal cell carcinoma occurs when the DNA in the basal cells changes or mutates. Basal cells are skin cells that are found at the bottom of the outermost layer of skin or the epidermis. Basal cells produce new skin cells that push older cells to the skin’s surface, where old cells eventually die.

The basal cell’s DNA regulates skin cell production. A mutation in the DNA affects the process, causing basal cells to multiply and grow abnormally. The cells accumulate and lead to changes in the skin, forming a cancerous lesion.

UV radiation is a major risk factor for basal cell carcinoma. Long-term sun exposure and using tanning equipment like sunlamps or tanning beds can expose the skin to UV radiation and damage basal cell DNA.  

How Does Basal Cell Carcinoma Present?

Basal cell carcinoma often develops on sun-exposed body parts like the head and neck. But it can affect other parts like the genitals.

It presents as changes in the skin or lesions. It can be a growth or sore that doesn’t heal. A person with basal cell carcinoma may present with any of the following symptoms: 

  • Shiny, translucent skin bump, which may bleed and form a scab
  • A slightly raised lesion with dark spots or a blue, brown, or black lesion with a clear, translucent border 
  • Flat, scaly skin patch with a slightly raised edge
  • Waxy, scar-like lesion without a clear border

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How Basal cell carcinoma is Treated

Surgery

Excision involves cutting the cancerous lesion with a part of the healthy skin to ensure that no cancer cells remain. Mohs surgery involves removing the cancer layer by layer. Each layer is then checked under the microscope to ensure that the cancer is completely removed.

Curettage and electrodessication

This involves scraping the cancer cells with a curette and destroying the base using an electric needle.

Radiation therapy

It uses laser energy to kill cancer cells. It may be used after surgery to ensure that the cancer cells are destroyed.

Cryosurgery

Cryosurgery involves freezing cancer cells of small, thin, or superficial basal cell carcinomas with liquid nitrogen.

Photodynamic therapy

It uses medication to make superficial skin cancer cells light-sensitive. Light is then applied to destroy the cells.

Targeted drug therapy

Drugs are used to specifically target cancer cells and kill them, especially when they spread or metastasize.

Chemotherapy

Chemotherapy involves the injection or ingestion of strong chemical agents to kill cancer cells. If a person notices changes in their skin, they must visit their doctor for early diagnosis and treatment before the basal cell carcinoma worsens and spreads. Follow-up visits are required to prevent basal cell carcinoma recurrence.

Frequently Asked Questions

Other risk factors of basal cell carcinoma include:

  • Severe sunburns 
  • Radiation therapy to treat acne or other skin conditions 
  • Fair skin, light-colored eyes, and red or blond hair 
  • Older age, but it may affect people in their 20s or 30s
  • Medical or family history of skin cancer
  • Medications that weaken the immune system
  • Exposure to arsenic, which is a toxic, cancer-causing metal
  • Rare genetic diseases like Gorlin-Goltz syndrome or xeroderma pigmentosum.

Basal cell carcinoma very rarely spreads or metastasizes to other body parts such as lymph nodes, skin, lungs, and bones. 

Doctors diagnose basal cell carcinoma by checking your medical history and symptoms. They may check the suspected area and other body parts for lesions.

They may perform a skin biopsy by removing a small skin sample from the affected area and testing it in a laboratory. This is done to study the skin cells and identify the basal cell carcinoma type and stage. Doctors may also perform imaging tests like CT scans or MRIs to check if cancer has spread to other body parts.

Basal cell carcinoma has stages 0 to 4. The stage depends on how big the tumor is, how deep it is in the skin, and whether it has spread to surrounding or distant body parts. 

There are eight types of basal cell carcinoma, depending on its appearance. They include:

  • Nodular, which looks like pearl-shaped nodules
  • Cystic, which has one or more cyst-like formations
  • Sclerodermiform or morpheiform, which appears as a shiny, raised skin patch 
  • Infiltrated, which is a lesion with irregular borders
  • Micronodular, which is a flat, white or yellow lesion with clear borders 
  • Superficial, which looks like broken skin but has clear borders and pearl-shaped edges 
  • Pigment, which appears as a dark brown to black, raised patch on the skin
  • Fibroepithelioma of Pinkus, which is a raised, pink patch or nodule on the skin 

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