Resumo
Definition
O CBC de pele é uma neoplasia comum, relacionada à exposição solar.[1][2][Figure caption and citation for the preceding image starts]: Carcinoma basocelular nodular na região malar, secundário a danos solares difusos com elastose solar importanteDo acervo do Prof. Robert A. Schwartz [Citation ends].
O CBC pode ser localmente agressivo, mas raramente produz metástases. Embora alguns fatores possam resultar em um comportamento mais agressivo, na maioria dos casos, a detecção precoce e o tratamento transformaram as extensas neoplasias destrutivas locais invasivas em algo do passado.[3]
History and exam
Key diagnostic factors
- presença de fatores de risco
- pápulas com telangiectasias associadas
- placas, nódulos e tumores com bordas arredondadas
- pequenas crostas e feridas que não cicatrizam
- crostas que não cicatrizam
- pápulas e/ou placas peroladas
Other diagnostic factors
- metástases associadas a carcinoma basocelular (CBC) grande ou negligenciado
- destruição local com lesão avançada
Risk factors
- Radiação ultravioleta (UV)
- exposição ao sol
- exposição a raios-X
- exposição a arsênico
- vias aberrantes de sinalização hedgehog
- xeroderma pigmentoso
- síndrome do carcinoma basocelular nevóide (Gorlin-Goltz)
- história de câncer de pele não melanoma
- sobreviventes de câncer na infância
- receptor de transplante
Diagnostic investigations
1st investigations to order
- biópsia para dermato-histopatologia
Emerging tests
- microscopia multifóton in vivo
Treatment algorithm
síndrome do carcinoma basocelular nevóide (Gorlin-Goltz)
subtipo de baixo risco em localização esteticamente favorável
subtipo de baixo risco em localizações esteticamente desfavoráveis
subtipo de alto risco
margens positivas no procedimento inicial
carcinomas basocelulares (CBCs) recorrentes complicados e/ou local não acessível a terapias cirúrgicas e tópicas
doença avançada
Contributors
Authors
Robert A. Schwartz, MD, MPH, DSc (Hon), MAE, FAAD, FRCP (Edin)
Professor & Head
Dermatology
Rutgers University New Jersey Medical School
Newark
NJ
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.
Disclosures
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.
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.
References
Key articles
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.Full text Abstract
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: basal cell skin cancer [internet publication].Full text
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.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Carcinoma anexial microcístico
- Tricoepitelioma/tricoblastoma
- Carcinoma de células de Merkel
More DifferentialsGuidelines
- Suspected cancer: recognition and referral
- NCCN clinical practice guidelines in oncology: basal cell skin cancer
More GuidelinesPatient information
Como tomar sol de forma segura
Carcinoma basocelular
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