Dermatology
Basal Cell Carcinoma
기저세포암
Slow-growing, rarely metastasizing non-melanoma skin cancer
- How common
- Most common skin cancer
- Typical age
- Ages 50+
What is it?
UV damage activates PTCH1/Hedgehog pathway driving basal cell proliferation.
Commonly affected: Face (nose, forehead, cheeks)
How it develops
- Cumulative UVLifetime cumulative UV exposure
- PTCH1 mutationAberrant Hedgehog activation
- BC proliferationPearly nodule forms
- Local invasionLocally destructive (metastasis rare)
Symptoms
- Pearly papuleTranslucent pearl-like nodule
- Central ulcerRodent ulcer; bleeds occasionally
- Non-healing sorePersistent non-healing lesion
- TelangiectasiasSurface fine vessels
- Rolled borderRaised rolled edge
How it is examined
- Visual examPearly papule with telangiectasias
- DermoscopyArborizing vessels, blue-gray nests
- BiopsyPunch biopsy for diagnosis
Imaging
Imaging unnecessary for localized BCC.
- Clinical diagnosis
MRI/CT if large or deeply invasive.
- Deep invasion
- Bony invasion
Non-surgical care
- CryotherapySmall superficial BCC
- Topical 5-FU/imiquimodSuperficial BCC
- Photodynamic therapyEffective for shallow lesions
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Locally invasive or recurrent
Procedures that may be discussed
- Mohs surgery (gold standard for face)
- Excision with 4 mm margins
- Vismodegib (Hedgehog inhibitor) - advanced
Outlook
>95% 5-yr cure with treatment. Sun protection essential.