Basal Cell Carcinoma (BCC)
The most common malignant skin cancer in humans, BCC arises from basal cells in the epidermis. It is primarily driven by chronic UV exposure and is characterized by slow growth and rare metastasis.
Key Clinical Features
- Appearance: A pearly, flesh-colored or erythematous papule or nodule.
- Hallmarks: “Rolled borders” and telangiectasias (visible superficial blood vessels) on the surface.
- Behavior: Often presents as a non-healing ulcer that bleeds easily with minor trauma.
Diagnostic & Management Pearls
| Aspect | Details |
|---|---|
| Diagnosis | Shave or punch biopsy confirms the diagnosis (histology: nests of basaloid cells with peripheral palisading). |
| Treatment | Excisional surgery or Mohs micrographic surgery (preferred for high-risk or cosmetically sensitive areas). |
High-Yield Exam Pearl:
- Buzzwords: Always look for “pearly papule” and “telangiectasias” in exam descriptions.
- Morpheaform BCC: This is a high-risk, aggressive variant that presents as a scar-like, indurated plaque. It is often poorly demarcated and requires Mohs surgery.