Basal cell carcinoma

Background

  • 80% of skin cancers are basal cell, 16% are squamous cell, and 4% are melanomas
  • 5% to 10% of basal cell carcinomas are aggressive, invade and destroy skin and surrounding tissues, sometimes reaching bone
  • Rarely a metastatic process

Risk Factors

  • UV radiation
  • Chronic arsenic exposure
  • Ionizing radiation
  • Immunosuppression
  • Age and skin colour (light tone)
  • Also known of a certain genetic predisposition (higher in people from the northern hemisphere)

Clinical Features

Ulcerated basal-cell carcinoma affecting the skin of the nose in an elderly patient.
Basal cell carcinoma.JPG
  • Slow growing
  • Usually head and neck
  • About 20% appear on areas less exposed to the sun, such as chest, back, extremities and scalp.
  • Only where hair follicles exist
  • Pearly nodule with telangiectatic vessels, rolled border and central ulceration

Differential Diagnosis

Other Rash

Evaluation

  • Clinical examination by trained clinician (dermatology referral)
  • Skin biopsy

Management

  • Not typically managed within ED

Disposition

  • Discharge with derm follow up

See Also

External Links

References