Infiltrating basal cell carcinoma
The most prevalent 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. Notably, BCCs can occur on any hair-bearing site but are most commonly found on the face.
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.
C44.91 – Basal cell carcinoma of skin, unspecified
402527000 – Basal cell carcinoma - infiltrative
Differential Diagnosis & Pitfalls
- Atypical fibroxanthoma
- Adenoid cystic carcinoma (see adenoid cystic carcinoma of ear)
- Merkel cell carcinoma
- Eccrine carcinoma
- Microcystic adnexal carcinoma
- Nevus sebaceus
- Squamous cell carcinoma in situ (Bowen disease)
- Lichen planus-like keratosis
- Dermatofibrosarcoma protuberans
- Basosquamous carcinoma
Drug Reaction Data