Laboratory of Dermatology and Venerology Referat

Medical Faculty October 2018

Pattimura University

BASAL CELL CARCINOMA

Present by:
Sally Neilvinda Poermara

Consultant:
dr. Novriyani Masuku, Sp.KK-M.Kes
Definition
Basal cell carcinoma (BCC) is a non-melanocytic
skin cancer originating from basal cells of the
epidermal basal stratum.

Tumor size varies from a few millimeters to several

centimeters. Tumors can invade the dermis but rarely
invade other parts of the body.
Epidemiology

BCC is the most common

skin cancer, 75-80% of
non-melanoma cancers.

The ratio of men and

women is 3: 2.

BCC often occurs in the

elderly, between 50 - 80
years, on average around
65 years.
Etiology

BCC Mutations Abnormal

(basal cell UV of p53 and cell
PTCH formation
carcinoma)
Molecular pathogenesis of BCC
The Classification of BCC

• Basal cell carcinoma (BCC) is classified into

several subtypes including nodular subtype
BCC, pigmentation subtype BCC, superficial
subtype BCC, morpheafom subtype BCC, and
fibroepitelioma subtype BCC.
Nodular subtype of basal cell
carcinoma
Clinical feature

it’s often occurs on the head, neck and upper back.

Typical nodular type is a broad lesion with a central

part of necrosis (rodent ulcer).

The lesion are papules with a central depression,

pearl-like color, there is erosion or ulceration,
spontaneous bleeding, hardening of the skin,
indistinct, translucent, telangiectasis and bleeding
history with minor trauma.
Pigmented basal cell carcinoma
 Pigmented basal cell carcinoma is a subtype of nodular BCC
that shows increased melanization. Pigmented basal cell
carcinomas appear as hyperpigmented, brown or
homogeneous (evenly black) papules.
Superficial subtypes

Superficial types appear usually on the torso and shoulders.

Lesions are patches of eczema-like erythema, often multiple, pink
or red, grow slowly in a few months or years, bleed easily and
can form ulcers.
Morpheaform subtype
 Morpheaform subtype is a subtype of basal cell carcinoma
with progressive growth and clear clinical and histological
features. Lesions in this subtype are white and there are scars.
Usually found in the middle of the face and can infiltrate the
facial nerve.
Fibroepithelioma subtype

 The fibroepitelioma or fibroepithelioma subtype of

pinkus has a picture of one or several hard nodules,
the surface is smooth and slightly reddish (pink),
commonly found on the lower shoulders.
Diagnosis

History

Physical
examination

Laboratory
examination
ANAMNESIS

Anamnesis : Ask about the patient's perceived complaints,

the course of the disease and the factors that might be a
risk for basal cell carcinoma.

Patients usually complain of itching or pain. Lesions

experience significant changes in color, size and
consistency. Color changes can be darker, pale or
bright. The size is enlarged in a short amount of time.

Asked if there was a history of previous trauma to the

lesion, history of ulcers and history of infections that were
difficult to heal.
Physical examination
• Lesions seen in basal cell carcinoma include hairless, color ranging from
hypopigmentation to hyperpigmentation, in certain types of typical
colors such as pearls (translucent).

• he surface of basal cell carcinoma lesions is usually uneven, concave in

the middle with slightly protruding margins (linear or papular), sometimes
with subtle squamous or crusting attached, if bleeding is easily raised.

• Tiles vary according to circumstances, can be hard, supple, painful, and

in the initial stages are easily moved from the bottom.
A B

C
D

(A) cross section of skin: epidermal, dermal and subcutaneous tissue layer and
upper tumor invasion area; (B) there is a hyperchromatic nucleus and palisade
cell in KSB; (C) histopathological features of CBB fibroepitelioma subtypes; (D)
thin and irregular basal cells in KSB subtype morphea
General Management
General management that can be recommended for patients with
basal cell carcinoma include:
 (a) protecting the skin from sunlight by using a hat, long-

sleeved shirt, long pants or long skirt;

 (b) you should avoid the sun at midday because the strongest

sunshine is at midday
Con’t
 (c) use a high-quality sunscreen half an hour before traveling
at a minimum with SPF (Sun Protection Factor) 15, which inhibits
ultraviolet A and ultraviolet B light;
 (d) check the skin regularly to find out the various changes that
lead to malignancy (new growth in the skin that forms ulcers,
bleed easily, difficult to heal, change color, size, structure, feel
pain, inflamed or itchy).
Therapy
 Non-surgical  Surgical
 a. 5-fluorourasil 5%
(Efudex) topical
 Interferon alfa-2b
 Imiquimod 5 % cream
 GDC-0449
 Radiotherapy
 The management of basal
cell carcinoma (BCC)
through surgical
procedures are electrical
surgery and scalpel
surgery.
 Electrical surgery consists
of electrodesiccation and
curettage (without
electrodesiccation). While
scalpel surgery consists of
excision surgery, plastic
surgery, Mohs micrography,
cryosurgery and laser
surgery.
Thank youuu