Epidemiology

• Most common malignant skin tumor

Etiology

• Intermittent UV exposure is the most significant risk factor
  • As opposed to cumulative UV exposure, which is a recognized risk factor for cSCC.

Pathophysiology

Clinical features

• Nonhealing well-circumscribed pearly papule, nodule, or plaque with rolled borders, telangiectasia, and/or central umbilication
• Typically located in areas with sun exposure; most commonly on the face and neck
• Often painless
• Lesions gradually increase in size (indolent growth)
• Metastasizes rarely (< 1%); if lack of treatment, can spread to lymph nodes, soft tissue, lungs, and bone

Subtypes

Nodular basal cell carcinoma

• Papule or nodule with the following:
  • Pink or skin-colored papule, shiny with a pearl-like appearance
  • Rolled borders
  • Central depression, erosion, or ulceration (rodent ulcer)
  • Superficial telangiectasias with arborizing pattern (tree-like branching)
• Most commonly located on the face, especially the nose

Superficial basal cell carcinoma

• Thin and scaly
• Raised border with a pearl-like appearance
• Most commonly located on the trunk and legs

Diagnostics

• Pathology
  • Palisading nuclei: Nuclei appear aligned.

Treatment