SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (7)

Infiltrating basal cell carcinoma - Hair and Scalp
See also in: Overview
Other Resources UpToDate PubMed

Infiltrating basal cell carcinoma - Hair and Scalp

See also in: Overview
Contributors: Yevgeniy Balagula MD, Susan Burgin MD, Gaurav Singh MD, MPH, William M. Lin MD, Sarah Hocker DO, Belinda Tan MD, PhD
Other Resources UpToDate PubMed


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. 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. Infiltrating BCCs are less common but tend to be more aggressive with local tissue invasion.

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

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Atypical fibroxanthoma
  • Adenoid cystic carcinoma (see Adenoid cystic carcinoma of ear)
  • Dermatofibroma
  • Merkel cell carcinoma
  • Eccrine gland carcinoma
  • Microcystic adnexal carcinoma
  • Nevus sebaceus
  • Trichoblastoma
  • Trichoepithelioma
  • Squamous cell carcinoma in situ (Bowen disease)
  • Lichenoid keratosis
  • Scar
  • Morphea
  • Dermatofibrosarcoma protuberans
  • Basosquamous carcinoma of skin

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required


Subscription Required

Last Reviewed:12/19/2018
Last Updated:01/29/2023
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Infiltrating basal cell carcinoma - Hair and Scalp
Print E-Mail Images (7)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Infiltrating basal cell carcinoma - Hair and Scalp
See also in: Overview
A medical illustration showing key findings of Infiltrating basal cell carcinoma : Face, Pink color, Skin ulcer, Atrophic scar, Sun-exposed distribution
Clinical image of Infiltrating basal cell carcinoma - imageId=88519. Click to open in gallery.  caption: 'A close-up of a shiny, whitish-pink plaque with a central depressed erosion and scale.'
A close-up of a shiny, whitish-pink plaque with a central depressed erosion and scale.
Copyright © 2024 VisualDx®. All rights reserved.