小结
定义
BCC of the skin is a common neoplasm, related to exposure to sunlight.[1][2][Figure caption and citation for the preceding image starts]: Nodular basal cell carcinoma on the cheek, on background of diffuse solar damage with marked solar elastosisFrom the collection of Prof. Robert A. Schwartz [Citation ends].
BCC can be locally aggressive, but rarely metastasizes. While certain factors can result in higher-grade behavior, in most cases early detection and treatment have made extensive local invasion and destruction from this neoplasm a thing of the past.[3]
病史和体格检查
关键诊断因素
- papules with associated telangiectasias
- plaques, nodules, and tumors with rolled borders
- small crusts and nonhealing wounds
- nonhealing scabs
- pearly papules and/or plaques
其他诊断因素
- metastases associated with large or neglected BCC
- local destruction with advanced lesion
危险因素
- Ultraviolet (UV) radiation
- sun exposure
- x-ray exposure
- arsenic exposure
- aberrant hedgehog signaling pathway
- xeroderma pigmentosum
- nevoid basal cell carcinoma (Gorlin-Goltz) syndrome
- history of nonmelanona skin cancer
- childhood cancer survivors
- transplant recipient
诊断性检查
首要检查
- biopsy for dermatohistopathology
新兴检查
- in vivo multiphoton microscopy
治疗流程
nevoid basal cell carcinoma (Gorlin-Goltz) syndrome
low-risk subtype in noncosmetically challenging location
low-risk subtype in cosmetically challenging location
high-risk subtype
positive margins on initial procedure
complicated BCC recurrences and/or site not accessible to surgical and topical therapies
advanced disease
撰稿人
作者
Robert A. Schwartz, MD, MPH, DSc (Hon), MAE, FAAD, FRCP (Edin)
Professor & Head
Dermatology
Rutgers University New Jersey Medical School
Newark
NJ
利益声明
RAS declares that he has no competing interests. RAS is an author of a number of references cited in this topic.
鸣谢
Professor Robert A. Schwartz would like to gratefully acknowledge Dr James R. DeBloom and Dr Drazen Jukic, the previous contributors to this topic.
利益声明
JRD and DJ declare that they have no competing interests.
同行评议者
Richard Bull, BMBCh
Consultant Dermatologist
Homerton University Hospital NHS Foundation Trust
London
UK
利益声明
RB declares that he has no competing interests.
David Cassarino, MD, PhD
Assistant Professor
Department of Pathology and Laboratory Medicine
University of California
Los Angeles
CA
利益声明
DC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Nasr I, McGrath EJ, Harwood CA, et al; British Association of Dermatologists' Clinical Standards Unit. British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021. Br J Dermatol. 2021 Nov;185(5):899-920.全文 摘要
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: basal cell skin cancer [internet publication].全文
Kim JYS, Kozlow JH, Mittal B, et al; Work Group, Invited Reviewers. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018 Mar;78(3):540-59.全文 摘要
Thomson J, Hogan S, Leonardi-Bee J, et al. Interventions for basal cell carcinoma of the skin. Cochrane Database Syst Rev. 2020 Nov 17;(11):CD003412.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Microcystic adnexal carcinoma
- Trichoepithelioma/trichoblastoma
- Merkel cell carcinoma
更多 鉴别诊断指南
- NCCN clinical practice guidelines in oncology: basal cell skin cancer
- Guidelines for the management of basal cell carcinoma
更多 指南患者教育信息
Staying safe in the sun
Basal cell carcinoma
更多 患者教育信息
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