Basal cell carcinoma

Diagnosis: Basal cell carcinoma

Case submitted by Shahbaz A. Janjua to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Shahbaz A. Janjua. Originally posted March 10, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Squamous cell carcinoma • Amelanotic melanoma • Intradermal nevus • Sebaceous hyperplasia • Trichoepithelioma • Merkel cell carcinoma • Dermatofibroma

Key Learnings

• Most common human cancer — accounts for ~80% of non-melanoma skin cancers • Locally destructive but rarely metastasizes (<0.1%) • Classic dermoscopy: arborizing vessels, blue-gray ovoid nests, leaf-like structures, spoke-wheel structures • Subtypes: nodular (most common), superficial, morpheaform/infiltrative (highest recurrence), pigmented • Gorlin syndrome (PTCH1 mutation): multiple BCCs, odontogenic keratocysts, skeletal anomalies • Hedgehog pathway inhibitors (vismodegib, sonidegib) for advanced/inoperable BCC

Tags: basal, cell, carcinoma, shahbaz a. janjua