Basal Cell Carcinoma: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate basal cell carcinoma (BCC; basal cell carcinoma):

  • Inconspicuous, usually flat raised yellowish-reddish papules (Latin: papula “vesicle” or nodule) bordered by a bead-like rim, with telangiectasias (small blood vessels) shining through on their surface
  • Other forms of growth are: red spots (often on the trunk) or whitish and atrophic (scarring) changes, often not even recognized as a tumor.
  • In advanced basal cell carcinoma, erosions (superficial substance defects confined to the epidermis, without scarring)/ulcerations (ulcerations) may occur on these changes

Predilection sites (body regions where the disease occurs preferentially) of BZK are the head and neck, followed by the trunk and extremities:

Localization

  • Occurrence exclusively on hairy skin, i.e., no basal cell carcinomas occur on mucous membranes, palms, and soles.
  • The 5 most common locations of basal cell carcinoma.
    • Forehead 9%
    • Nose 20 %
    • Preauricular (“in front of the ear”) 12 %.
    • Cheeks 9 %
    • Back 9 %
  • Sex-specific localizations of basal cell carcinoma (listed the sex more affected in each case).
    • Men
      • Ear 7.42
      • Back 9.65 %
      • Upper arm 6.39 %
      • Preauricular 12.93 %
      • Retroauricular (“behind the ear”) 3.1 %
    • Women
      • Nose 22.93 %
      • Eye 8.13 %
      • Lips 3.8 %
      • Cheek 9.7 %
      • Forehead 9.91 %
  • Without early in situ precursors v. a. on light-exposed skin areas (80% of cases: facial skin, head and neck; décolleté). Furthermore, basal cell carcinoma can occur clustered in a nevus sebaceus (sebaceous nevus).
  • Very rare localizations are: Lip area; at the transition to the columella (nasal bridge).

These changes develop over months to years.

Other forms of basal cell carcinoma:

  • Nodular basal cell carcinoma (>50%); clinical picture: shiny nodus (nodule; skin-colored to erythematous/”associated with skin redness”) with central depression and atrophy, up to ulceration (ulceration), surrounded with a raised pearly cord-like marginal mound with telangiectasia (dilation of small, superficial skin vessels).
  • Sclerodermiform basal cell carcinoma; localization: chronically light-exposed areas such as the face, scalp and décolleté; scarred-flat basal cell carcinoma; clinical picture: whitish and atrophic; sclerodermiform basal cell carcinoma belongs to the infiltrative growing variants of basal cell carcinoma
  • Superficial basal cell carcinoma (sBZK; synonyms: trunk skin basal cell carcinoma; trunk skin BCCs); multicentric superficial basal cell carcinoma (approx. 15-25 %); localization: preferentially on trunk and extremities; shows a rather eczema-like clinical picture: solid (nodular) can be distinguished from superficial (flat raised) plaques (areal or plate-like substance proliferation of the skin); characteristic are erythematous, often multiple macules (patchy color change of the skin) or plaques, usually with erosions (superficial substance defects confined to the epidermis, without scarring), which bleed in the center and easily.
  • Ulcero-nodular forms of basal cell carcinoma: characteristic are pearly nodes with telangiectasia (dilation of small, superficial skin vessels) and raised margins, often with central ulceration (ulceration), sometimes cystic; nodular basal cell carcinoma (synonym: solid (nodular) basal cell carcinoma) is the most common form with about 50% of all BZK.