From the Guidelines
Basal cell carcinoma starts from the basal cell layer of the epidermis, which is the deepest layer of the outer skin. This cancer develops when DNA damage from ultraviolet radiation or other factors causes basal cells to multiply uncontrollably instead of maturing and moving toward the skin surface as they normally would. The basal cell layer contains stem cells and progenitor cells responsible for continuously renewing the epidermis, making it particularly susceptible to malignant transformation when damaged 1. Some key points to consider when managing basal cell carcinoma include:
- Early detection and complete removal are crucial to prevent local tissue destruction and potential invasion of surrounding tissues, including cartilage and bone in advanced cases 1.
- The management of basal cell carcinoma primarily consists of surgical approaches, with radiation therapy as an alternate or adjuvant option, and the use of hedgehog pathway inhibitors for advanced and metastatic cases 1.
- Basal cell carcinomas typically grow slowly and rarely metastasize, but they can cause significant morbidity and impact quality of life if left untreated or not managed properly 1. The current guidelines recommend a multidisciplinary approach to managing basal cell carcinoma, including consultation with specialists such as surgical, medical, or radiation oncologists, head and neck surgeons, plastic surgeons, or dermatologists specializing in basal cell carcinoma 1.
From the Research
Basal Cell Carcinoma Origin
- Basal cell carcinoma (BCC) originates from the basal cells in the skin's outer layer 2
- The exact layer from which BCC starts is not explicitly mentioned in the provided studies, but it is known to arise from the basal cells, which are part of the epidermis, the outermost layer of the skin
Risk Factors and Detection
- Prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds is a common risk factor for BCC 2
- Early detection is essential to prevent extensive damage and potential disfigurement 2
- Medical history can be used to predict the risk of BCC, with diagnoses related to the Integument system showing a higher likelihood of being associated with BCC 2
Treatment Options
- Various treatment options are available for BCC, including surgical excision, Mohs micrographic surgery, curettage and electrodessication, radiotherapy, and topical field therapies 3, 4, 5, 6
- Topical treatments such as photodynamic therapy, imiquimod, and fluorouracil are effective for superficial BCC, but may not be suitable for other subtypes or squamous cell carcinoma 4, 5, 6