Basal Cell CarcinomaBasal Cell CarcinomaDan Ladd, D.O, Rick Lin, D.O., MPH Dan Ladd, D.O, Rick Lin, D.O., MPH
Bill V. Way, D.O.Bill V. Way, D.O.
BCC: What are they?BCC: What are they?
PEARLY PAPULES OR NODULES
ROLLED BORDER TELANGIECTASES CENTRAL ULCER CRUSTING BLEED EASILY
BCC: Where are they?BCC: Where are they?
HEAD, NECK 85% MC NOSE, 30% FOREHEAD EARS CHEEKS UPPER TRUNK
BCC: When?BCC: When?
OFTEN – 1/3 OF ALL CA IN USA.
Chronic UVB, Xray Immunosuppression Renal Transplant Genetics, ie. XP, NBCCS
BCC: Who?BCC: Who?
ELDERLY & MIDDLE AGED
Ages 40-79 ANGLO-SAXON
Blue Eyes, Fair Skin X-Ray Exposure, ie
Physicians, Dentists, Technicians, Workers
BCC: How?BCC: How?
Arise from immature pluripotential cells.Mutations in the HEDGEHOG pathway
(genes which controls cell growth)PATCHED (tumor suppressor) inactivated. HEDGEHOG and SMOOTHENED (cell
growth inhibitors) activated.P53 and RAS mutations also play a role.
BCC look-alikes: SGHBCC look-alikes: SGH
BCC look-alikes: KABCC look-alikes: KA
BCC Look alikes: SCCBCC Look alikes: SCC
BCC: VariantsBCC: Variants
SUPERFICIAL BCCMORPHEAFORM BCCPIGMENTED BCC CYSTIC BCCBASAL CELL NEVUS SYNDROME(GORLIN’S SYNDROME)
SUPERFICIAL BCCSUPERFICIAL BCC
PSORIASIFORM TRUNK LIMBS FLAT GROWTHS YOUNGER
PATIENTS ONGOING
STUDIES WITH ALDARA
MORPHEAFORM BCCMORPHEAFORM BCC
RESEMBLES LOCALIZED SCLERODERMA
ALMOST ALWAYS ON THE CHEEKS OR FOREHEAD
MOH’S SURGERY AGGRESSIVE
PIGMENTED BCCPIGMENTED BCC
DARK SKINNED PATIENTS
LATIN AMERICANS
JAPANESE NOT BLACKS ARSENIC
INGESTION 6% OF ALL BCC
BCC – CYSTIC/SOLIDBCC – CYSTIC/SOLID
DOME SHAPED BLUE GRAY CYSTIC NODULES 4-8% OF ALL BCCS
NEVOID BCC NEVOID BCC SYNDROMESYNDROME
JAW CYSTS PALMAR PITS SKELETAL
DEFECTS CALCIFICATION
OF FALX CEREBRI MOHS SURGERY
BCC TREATMENTBCC TREATMENT
EXCISIONFULGURATION AND CURETTAGEIONIZING RADIATIONCRYOSURGERYTOPICAL 5-FULASERMOHS’ MICROGRAPHIC 99% CURE
THE END
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