From the Research
Basal cell carcinoma originates from the interfollicular layer of the epidermis, specifically from the basal cells, which are the deepest layer of cells in the outermost part of the skin. These cells normally divide to form new cells that eventually move up to replace old cells on the skin's surface. When DNA damage occurs in these basal cells, often from ultraviolet radiation exposure from the sun or tanning beds, it can trigger abnormal, uncontrolled growth leading to cancer formation 1. The basal cells contain keratin and are responsible for producing new skin cells, and when they become cancerous, they typically form slow-growing tumors that rarely metastasize but can be locally destructive if left untreated.
Some key points to consider about basal cell carcinoma include:
- The most common locations for basal cell carcinoma are sun-exposed areas like the face, ears, neck, scalp, shoulders, and back 2.
- Prevention focuses on sun protection, including sunscreen use, protective clothing, and avoiding peak sun hours 3.
- Treatment typically involves surgical removal, with specific approaches depending on the tumor's size, location, and characteristics 4, 3.
- The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity, and recent guidelines have updated the management of basal cell carcinoma 2.
- Characteristic molecular events in these tumours are: (i) activation of the hedgehog pathway, which has allowed the development of hedgehog inhibitors for difficult-to-treat lesions that are not accessible to surgery or radiotherapy; (ii) high mutational burden, which suggests that hedgehog inhibitor refractory tumours could be offered immunotherapy 2.
Overall, understanding the cellular origin of basal cell carcinoma is crucial for developing effective treatment strategies and improving patient outcomes. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence 2.