Basal cell carcinoma (BCC) is the most common form of invasive skin cancer in the world and affects more than 3.3 million persons annually in the United States. 85% of BCCs occur on the head and neck region, due to UV light exposure and can be readily treated as outpatient if detected early. While they rarely become metastatic, BCC can be locally destructive and cause significant disfigurement. Recently, an expert work group was convened to determine evidence-based guidelines to provide guidance for biopsy, staging, treatment and follow-up of BCC.
BCC is an extremely common skin cancer | Main risk factor for development of BCC is ultraviolet light exposure | Many BCCs occur in relatively sun-protected sites, such as behind the ears
There are 5 clinical types or presentations of BCC: Nodular | Pigmented | Sclerosing/Morpheaform | Superficial | Nevoid
Sclerosing or Morpheaform BCC
Nevoid BCC Syndrome (Gorlin-Goltz Syndrome)
Extramammary Paget’s or Bowen’s Disease
Squamous Cell Carcinoma
Melanoma (can look similar to pigmented BCC)
A formal staging system for risk stratification for patients with BCC is not available
The available literature does not identify a single optimal biopsy technique, with either saucerization punch or excisional biopsy with margins acceptable
Treatment options include both surgical and non-surgical, with surgery remaining the first-line treatment choice
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