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What Causes Basal Cell Carcinoma?

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Posted on Fri, 4 Jul 2014
Question: my father, 67 yrs old has been diagonized for Basal Cell carcinoma, He has undergone wide excision surgery, now second biopsy says the section shows ulcerated base of the excised lesion with inflammatory grannulation tissue in the ulcer floor, marked suppuration of the abutting stratum corniuem and panniculutis in the deeper and lateral margins. There is no residual malignancy. Kindly advice
doctor
Answered by Dr. Ashish Verma (35 minutes later)
Brief Answer:
there is no residual malignancy

Detailed Answer:
Hi XXXXXXX

Welcome to HealthcareMagic.

The report is very good, as it says that the surgery was a success and there is no redidual tumour.

Basal cell carcinoma spreads locally and rarely metastasize, so in this case i don't think that anything else is needed.

Chance of recurrence is very very less, almost nil. But it can occur at a new site, as whole of the skin must have been exposed to the same factors. So just keep a watch.

Hope i have been helpful.

Regards
Dr. Ashish Verma
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashish Verma (23 hours later)
My father has a history of psoriasis also from 2007. He had a small scar on his right leg below knee which he got during his childhood days. He applies steroid skin ointment for his psoriasis. He just casually applied the same skin ointment to this scar also so that the marks will go. Over the years, he never realized, but one fine day after 7 years that scar started to bleed.

When he showed it to doctor, they did excision biopsy. The biopsy result came as Basal Cell carcinoma.

The report which i sent you before was the second biopsy report.

My question is whether basal cell carcinoma is due to steroid application or sun exposure??

2) What are the causes of basal cell carcinoma?


doctor
Answered by Dr. Ashish Verma (59 minutes later)
Brief Answer:
its due to both

Detailed Answer:
Hi XXXXXXX

Yes basal cell carcinoma is caused by sun and exposure where UV rays of the sun causes mutation of the rapidly dividing cells of the skin, leading to cancer development. These mutations also occur is unexposed skin also, but body has the ability to repair these errors.

Now regarding the steroids, they cause immunosuppression, meaning they prevent the body from fighting infection and prevent repair of damaged cells.

So when a cell gets damaged by sun rays, body tries to repair it, this was hampered by steroid application leading to cancer. And scar tissue are more prone for this kind of damage as scar has lesser blood and lymphatic supply compared to normal tissue. Hence it has weaker defence.

Apart from the UV rays of the sun, other risk factors for basal cell cancer are male gender and age more than 50 years.

Regards,
Dr. Ashish Verma
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashish Verma (13 hours later)
Thank you doctor for the reply

"the section shows ulcerated base of the excised lesion with inflammatory grannulation tissue in the ulcer floor, marked suppuration of the abutting stratum corniuem and panniculutis in the deeper and lateral margins." WHAT IS THE MEANING OF THIS? CAN YOU ELABORATE ON IT.

2)Why it occurs in males and age more than 50?

3)Whether he has to consult the dermatologist for further application of steroid ointments for his psoriasis treatment?

4)How to find out Basal cell carcinoma signs and symtoms , if it reoccurs?
doctor
Answered by Dr. Ashish Verma (5 hours later)
Brief Answer:
see below

Detailed Answer:
Hi XXXXXXX

1) This is a normal histopathological description of an healing ulcer/wound in medical terms. The inflammatory granulation tissue are signs of normal healthy healing. There is little dead tissue (slough/suppuration) present at the base and lateral margins, which is very much acceptable at this stage of healing. Nothing to worry about it. With regular dressing it should heal well.

2) It occurs in males more because it is they who work outside in the sun more, as compared to females. So more the sun exposure, more chances of the cancer. And as it takes years of sun exposure so this is rarely seen at a younger age. Also at older age the body's repair mechanism slows down, so most of the cancers are seen in older age only.

3) The steroid ointment has to be applied only to the active lesions or as directed by your dermatologist. Do not apply on any other areas. You can talk about it with your dermatologist at the next appointment, nothing urgent about it.

4) Basal cell carcinoma usually presents as a non healing ulcer with raised margins with bloody or serous discharge. In any clean wound is not healing for more than one week, show it to a surgeon for a clinical evaluation and a biopsy.

Regards,
Dr. Ashish Verma
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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ashish Verma

General Surgeon

Practicing since :2008

Answered : 1290 Questions

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What Causes Basal Cell Carcinoma?

Brief Answer: there is no residual malignancy Detailed Answer: Hi XXXXXXX Welcome to HealthcareMagic. The report is very good, as it says that the surgery was a success and there is no redidual tumour. Basal cell carcinoma spreads locally and rarely metastasize, so in this case i don't think that anything else is needed. Chance of recurrence is very very less, almost nil. But it can occur at a new site, as whole of the skin must have been exposed to the same factors. So just keep a watch. Hope i have been helpful. Regards Dr. Ashish Verma