Medical history (history of illness) represents an important component in the diagnosis of basal cell carcinoma (BCC; basal cell carcinoma). Family history Are there any skin diseases in your family that are common? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical history (somatic … Basal Cell Carcinoma: Medical History
Skin and subcutaneous (L00-L99). Actinic keratosis – cornification disorder of the skin caused by radiation – especially UV radiation (precancerous; risk factor for squamous cell carcinoma). Nummular eczema (synonyms: bacterial eczematoid, dermatitis nummularis, dysregulatory-microbial eczema, microbial eczema) – unclear disease resulting in eczema characterized by sharply demarcated, coin-shaped, itchy foci of disease, some of which … Basal Cell Carcinoma: Or something else? Differential Diagnosis
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 … Basal Cell Carcinoma: Symptoms, Complaints, Signs
Pathogenesis (disease development) Basal cell carcinoma (BCC; basal cell carcinoma, BCC) is not only the most common cancer in humans, but also has the highest mutation rate of all cancers. This is due to DNA damage caused by UV radiation. In about 90% of all BCCs, the so-called Sonic Hedgehog (SHh) signal cascade is affected … Basal Cell Carcinoma: Causes
General measures Strive to maintain normal weight! Determine BMI (body mass index) or body composition using electrical impedance analysis. Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight. Nicotine restriction … Basal Cell Carcinoma: Therapy
Basal cell carcinoma (BCC; basal cell carcinoma) can be divided into the following histologic forms: Basal cell carcinoma syndrome (synonyms: Basal cell nevus syndrome; Fifth phacomatosis; Gorlin syndrome, Gorlin-Goltz syndrome; Nevoid basal cell carcinoma syndrome (NBCCS); nevus epitheliomatodes multiplex) – genetic disease with autosomal dominant inheritance, associated with the occurrence of numerous basal cell carcinomas … Basal Cell Carcinoma: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin and mucous membranes [due tosymptoms: Ulcero-nodular forms Inconspicuous, usually flat raised yellowish-reddish papules (Latin: papula “vesicle” or nodule) bordered by a bead-like rim with telangiectasia (small blood vessels) … Basal Cell Carcinoma: Examination
Laboratory parameters 1st order Histology (fine tissue examination) from sample excision (tissue removal) or total excision (surgical removal of the tumor as a whole) [examination on HE(hematoxylin-eosin)-stained specimen]. Note: Trial biopsy required only if: Suspected tumor type with high risk of recurrence (risk of disease recurrence; infiltrative, sclerodermal, micronodular, metatypical). Superficial (“superficial”) basal cell carcinoma … Basal Cell Carcinoma: Test and Diagnosis
Therapeutic targets Healing Improvement of prognosis Palliative Therapy recommendations First-line therapy is complete surgical removal of the tumor Local therapy (topical therapy) for superficial basal cell carcinoma or basal cell nevus syndrome using immunomodulators (5% imiquimod cream) or cytostatics (5% 5-FU [5-fluorouracil] cream). Systemic therapy: hedgehog signal transduction pathway inhibitors: vismodegib, sonidegib; indications: Patients with … Basal Cell Carcinoma: Drug Therapy
Optional medical device diagnostics – depending on the results of history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic workup Dermoscopy (reflected-light microscopy; increases diagnostic certainty; differential diagnostic differentiation from amelanotic melanoma, Bowen’s disease, and squamous cell carcinoma) [Basal cell carcinoma: Presence of multiple vascular patterns (tree-like vessels). Shiny white … Basal Cell Carcinoma: Diagnostic Tests
Therapy goals Histologically (fine tissue) complete excision (surgical removal). Functional and aesthetically adequate reconstruction. Avoidance of recurrence (recurrence of the disease). Surgical therapy Surgical therapy of basal cell carcinoma (BCC). Superficial BCC Solid BZK BCC with high risk of recurrence (sclerodermiform, micronodular, metatypical, infiltrative; recurrent tumor, tumor > 1 (-15 mm) cm)BCC with problem localization … Basal Cell Carcinoma: Surgical Therapy
To prevent basal cell carcinoma (BCC; basal cell carcinoma), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. UV radiation (sun; solarium) Environmental pollution – intoxications (poisonings). Occupational contact with carcinogens such as arsenic. UV radiation (chronic and intermittent UV exposure): recreational … Basal Cell Carcinoma: Prevention
