Basal cell carcinoma is a superficial, slowly growing papule or nodule that derives from certain epidermal cells. They arise from keratinocytes near the basal layer and can be referred to as basaloid keratinocytes. Metastasis is rare, but local growth can be highly destructive. It is more common in fair-skinned people with a history of sun exposure and is very rare in blacks.

Symptoms and Signs

Basal cell carcinomas usually develop on sun-exposed parts of your body, especially your head and neck

A pearly white or waxy bump, often with visible blood vessels on your face, ears or neck. The bump may bleed, develop a crust or form a depression in the center

A flat, scaly, brown or flesh-colored patch on your back or chest. Over time, these patches can grow quite large — up to about 4 to 6 inches (about 10 to 15 centimeters)

More rarely, a white, waxy scar. This type of basal cell carcinoma is easy to overlook, but it may be a sign of a particularly invasive and disfiguring cancer called morphea form basal cell carcinoma

Causes

• Environmental factors- exposure to UV radiation from sunlight
• Therapeutic radiation. Psoralen plus ultraviolet A (PUVA) treatments for psoriasis and X-rays to the head or neck increase your risk of basal cell carcinoma
• Chemical toxins- arsenic
• Immunosuppressant drugs-have greatly increased risk of basal cell carcinoma
• Genetic factors- Several inherited disorders cause basal cell carcinoma or greatly increase your risk, including Nevoid basal cell carcinoma syndrome (Gorlin's syndrome) and Xeroderma pigmentosum

When to see a doctor

• A skin sore that bleeds easily or doesn't heal in about two weeks
• A sore that repeatedly crusts or oozes
• Visible blood vessels in or around a sore
• A scar in an area where you haven't injured yourself

Diagnosis

Skin biopsy and histological examination

Treatment

Electrodessication and curettage (ED and C). This treatment can successfully remove new basal cell carcinomas, but is less effective for recurring tumors

Surgical excision- which is used for both new and recurring tumors

Laser and cryosurgery is also helpful in some cases

Topical treatment includes Tazarotene (Tazorac), a prescription cream normally used for acne, appears to be effective in preventing basal cell tumors. Other, approved topical treatments include imiquimod (Aldara) and 5-fluorouracil.