Basal cell carcinoma of the skin

Basal Cell Carcinoma (BCC) is the most common malignant skin tumor. It arises from the basal cells of the epidermis and usually grows slowly, with minimal risk of metastasis. However, it can cause significant local destruction, especially if not treated promptly. It occurs most often on photoexposed areas of the body.

Risk factors
- Chronic sun exposure (UV radiation)
- Light skin phototype (type I–II)
- Advanced age
- Chronic skin inflammation and injuries
- Radiation exposure
- Immunosuppression
- Genetic syndromes (e.g. basal cell nevus syndrome)

Clinical forms
- **Nodular BCC** – the most common type; pearly raised nodule with telangiectasias, often with central ulceration
- **Superficial BCC** – reddish, scaly plaque, often on the trunk
- **Infiltrative (sclerosing) BCC** – whitish, dense infiltrate with unclear boundaries, often on the face
- **Pigmented BCC** – dark colored, resembling melanoma
- **Ulcerative BCC** – „– ulcerated, destructive lesion

Diagnosis
- Clinical examination
- Dermatoscopy – visualization of specific structures (pearl edges, telangiectasias, gray nests, „branch lines“)
- Biopsy for histological confirmation
- In aggressive or recurrent forms – imaging diagnostics (ultrasound, CT, MRI)

Treatment
**Surgical methods:**
- Standard excision with healthy margin (gold standard)
- Mohs micrographic surgery – for BCC of the face or recurrent lesions

**Non-surgical methods:**
- Curettage and electrocoagulation – for small, nodular forms
- Cryotherapy – for superficial lesions
- Photodynamic therapy – for superficial BCC
- Topical creams (imiquimod, 5-fluorouracil) – for non-invasive lesions
Forecast
BCC usually has an excellent prognosis with early diagnosis and treatment. Metastasis is extremely rare (<0.1%), but local destruction can be serious with late diagnosis.

Basal cell carcinoma is the most common, but also the most treatable, skin cancer. Its early detection and the right therapeutic approach ensure an excellent prognosis and avoidance of complications.