Last reviewed: 27 Aug 2021
Last updated: 13 May 2021

Summary

Definition

History and exam

Key diagnostic factors

  • papules with associated telangiectasias
  • plaques, nodules, and tumors with rolled borders
  • small crusts and nonhealing wounds
  • nonhealing scabs
  • pearly papules and/or plaques

Other diagnostic factors

  • metastases associated with large or neglected BCC
  • local destruction with advanced lesion

Risk factors

  • 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 non-melanona skin cancer
  • childhood cancer survivors
  • transplant patients

Diagnostic investigations

Emerging tests

  • in vivo multiphoton microscopy

Treatment algorithm

Contributors

Authors

Robert A. Schwartz, MD, MPH, FAAD, FRCP (Edin)
Robert A. Schwartz

Professor & Head

Dermatology

Rutgers University New Jersey Medical School

Newark

NJ

Honorary Professor

China Medical University

Shenyang

China

Honorary Professor

Sree Balaji Medical College

Bharath University

Chennai

India

Disclosures

RAS declares that he has no competing interests. RAS is an author of a number of references cited in this topic.

Acknowledgements

Professor Robert A. Schwartz would like to gratefully acknowledge Dr James R. DeBloom and Dr Drazen Jukic, the previous contributors to this topic. JRD and DJ declare that they have no competing interests.

Peer reviewers

Richard Bull, BMBCh

Consultant Dermatologist

Homerton University Hospital NHS Foundation Trust

London

UK

Disclosures

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

Disclosures

DC declares that he has no competing interests.

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