the most common type of skin cancer. It arises from the basal cells of the outermost layer of skin (epidermis), external root sheath of hair follicles or from a precursor lesion (sebaceous nevus of Jadassohn-usually seen on the scalp). They occur most frequently in areas with the largest concentration of pilosebaceous follicles i.e. the face. They are locally invasive & only 1 in 1,000 to 1 in 35,000 metastasize to distant areas of the body. The cancers are more friable than normal skin & so bleed easily when rubbed.
Factors that increase one’s risk for basal cell cancer include sun exposure (it is frequently seen in surfers, outdoor construction workers…), light complexion, radiation therapy to the skin, immunosuppresive therapy after organ transplantation, exposure to arsenic insecticides & a congenital disease called xeroderma pigmentosum. Cells damaged by sun exposure may take 20 or more years to visibly manifest themselves as basal cell cancers. Thus, it can be hard to distinguish between a new & a recurrent basal cell cancer.
There are 4 clinical types (nodulo-ulcerative, superficial, sclerosing/morpheaform & cicatricial) based on their appearance. However, the treatment is the same for all- currettage(scraping), topical 5-FU cream, surgical excision or radiation therapy(for older patients with cancers in areas that cannot be excised). Proper care results in greater than 95% cure rates. Recurrent cancers are more aggressive & harder to cure. The recurrence rate is dependent on the entire removal of the cancer (proven by microscopic examination of the excised specimen) rather than the clinical type. However, once you have had one you are obviously at greater risk of getting another anywhere you have skin than someone who has never had basal cell carcinoma. They are only predictive of future basal cell carcinomas or squamous cell carcinomas of the skin. They are not predictors of any other type of cancer. It is important that you wear strong sun screen anywhere you have had these skin cancers & all areas exposed to the sun.