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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- biopsy for dermatohistopathology
Novos exames
- in vivo multiphoton microscopy
Algoritmo de tratamento
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
Colaboradores
Autores
Robert A. Schwartz, MD, MPH, DSc (Hon), MAE, FAAD, FRCP (Edin)
Professor & Head
Dermatology
Rutgers University New Jersey Medical School
Newark
NJ
Declarações
RAS declares that he has no competing interests. RAS is an author of a number of references cited in this topic.
Agradecimentos
Professor Robert A. Schwartz would like to gratefully acknowledge Dr James R. DeBloom and Dr Drazen Jukic, the previous contributors to this topic.
Declarações
JRD and DJ declare that they have no competing interests.
Revisores
Richard Bull, BMBCh
Consultant Dermatologist
Homerton University Hospital NHS Foundation Trust
London
UK
Declarações
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
Declarações
DC declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
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.Texto completo Resumo
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: basal cell skin cancer [internet publication].Texto completo
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.Texto completo Resumo
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.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Microcystic adnexal carcinoma
- Trichoepithelioma/trichoblastoma
- Merkel cell carcinoma
Mais Diagnósticos diferenciais指南
- NCCN clinical practice guidelines in oncology: basal cell skin cancer
- Guidelines for the management of basal cell carcinoma
Mais 指南患者教育信息
Staying safe in the sun
Basal cell carcinoma
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明