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Nodular basal cell carcinoma - Hair and Scalp
See also in: Overview,External and Internal Eye,Anogenital
Other Resources UpToDate PubMed

Nodular basal cell carcinoma - Hair and Scalp

See also in: Overview,External and Internal Eye,Anogenital
Contributors: Gaurav Singh MD, MPH, William M. Lin MD, Sarah Hocker DO, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Basal cell carcinoma (BCC) is the most common cancer in humans and the most common cancer of the skin. Two million Americans are diagnosed with BCC every year. It is a neoplasm of basal keratinocytes that is found more frequently in men than women. Rates of BCC have been increasing over the last several decades, particularly in young women. BCCs can be seen at almost any age. Nonetheless, the malignancy has greater incidence in older individuals, with a median age at diagnosis of 68 years.

There are many subtypes of BCC, including nodular, superficial, infundibulocystic, fibroepithelial, morpheaform (sclerosing, desmoplastic), infiltrative, micronodular, and basosquamous. Nodular BCC is the most common subtype overall and accounts for half of all lesions. In Black and Hispanic patients, BCCs are more often pigmented BCCs.

Nodular BCC is typically seen on the face, most commonly on the cheeks, nose, melolabial fold, forehead, and eyelids. Although BCCs typically arise in hair-bearing areas, they can rarely be seen in hairless genital mucosa for an unknown reason.


The greatest risk factor contributing to the development of BCCs is sun exposure, and people with light skin phototypes are at higher risk. Intermittent sun exposure is more associated with the development of BCCs than cumulative ultraviolet (UV) exposure. Other risk factors for BCCs include environmental exposure (ie, ionizing radiation, indoor tanning, chemicals such as arsenic, psoralen plus UVA, and coal tar), phenotype (freckling, red hair, light skin that always burns and never tans), immunosuppression such as organ transplantation (which results in a 5-10 times higher risk of BCCs than the general population), and various genetic syndromes including xeroderma pigmentosum, oculocutaneous albinism, Muir-Torre syndrome, basal cell nevus syndrome (Gorlin syndrome), Rombo syndrome, and Bazex-Dupré-Christol syndrome. The gene most frequently altered in BCCs is the PTCH1 gene, followed by the TP53 gene.

Although BCCs are almost never fatal, local tissue destruction and disfiguration occur. The metastasis rate of BCCs is approximately 1 in 35 000. Metastasis is rare and typically occurs through perineural spread, lymph node metastasis, and then lung / bone metastasis.

Codes

ICD10CM:
C44.91 – Basal cell carcinoma of skin, unspecified

SNOMEDCT:
403911008 – Nodulo-ulcerative basal cell carcinoma

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Last Reviewed:11/07/2021
Last Updated:04/30/2024
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Patient Information for Nodular basal cell carcinoma - Hair and Scalp
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Nodular basal cell carcinoma - Hair and Scalp
See also in: Overview,External and Internal Eye,Anogenital
A medical illustration showing key findings of Nodular basal cell carcinoma : Telangiectasia, Sun-exposed distribution
Clinical image of Nodular basal cell carcinoma - imageId=204149. Click to open in gallery.  caption: 'A reddish plaque with telangiectasias and a raised, shiny, rolled border at the anterior hairline.'
A reddish plaque with telangiectasias and a raised, shiny, rolled border at the anterior hairline.
Copyright © 2024 VisualDx®. All rights reserved.