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

See also in: Overview,External and Internal Eye,Anogenital
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Contributors: William M. Lin MD, Susan Burgin MD, Belinda Tan MD, PhD, Mary Gail Mercurio MD, Jeffrey D. Bernhard MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Basal cell carcinoma (BCC) is the most common skin cancer, a neoplasm of basal keratinocytes. This is largely a non-metastasizing form of cancer, although lesions become locally destructive without treatment. It is typically limited to sun-exposed areas such as the head, neck, face and nose, upper chest, and back. There are 4 types of BCC: nodular, infiltrating, pigmented, and superficial. The nodular variant is the most common subtype overall; however, pigmented BCC remains the most common variant among individuals of African, Hispanic, and Asian descent. Nodular BCC often presents as a pearly papule with a rolled border that may ulcerate and have superficial telangiectasias.

Risk factors for BCCs include: light skin phototype, sun exposure, radiation, advanced age, immunosuppression, and a personal history of non-melanoma skin cancer. Hereditary conditions associated with BCCs in general include albinism, xeroderma pigmentosum, nevoid basal cell carcinoma syndrome, Rasmussen syndrome, Rombo syndrome, Bazex-Dupré-Christol syndrome, and Darier disease.

The molecular pathogenesis of BCC formation is just beginning to be understood. The primary pathway that appears to be dysregulated is the sonic-hedgehog pathway that normally regulates early embryonic development. Mutations in this pathway, particularly inactivation of PTCH1 as seen in nevoid basal cell carcinoma syndrome or sporadic activating mutations in SMO, lead to BCC formation.

Prognosis is excellent with prompt identification and treatment. Patients should be followed regularly, as there is a significant chance of a second BCC.

Codes

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

SNOMEDCT:
403911008 – Nodulo-ulcerative basal cell carcinoma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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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.

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References

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Last Updated: 10/10/2018
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Nodular basal cell carcinoma - Hair and Scalp
See also in: Overview,External and Internal Eye,Anogenital
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Nodular basal cell carcinoma : Smooth papule, Telangiectasia, Sun-exposed distribution
Clinical image of Nodular basal cell carcinoma
A reddish plaque with telangiectasias and a raised, shiny, rolled border at the anterior hairline.
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