Posts Tagged ‘Basal cell carcinoma’
Treatments Of Basal Cell Carcinoma
How is it treated?
* Surgical excision, if possible, is the preferred technique because it allows to remove the tumor in its entirety and make a subsequent histological study to determine if the edges of the surgical specimen are free. A variant of this technique is Mohs microsurgery, which is performed histological study of the piece on the operative act itself so as to determine whether or not it is necessary to continue to expand the margins of excision, is a technique used primarily when affect areas involved such as the eyelids. It is probably the treatment of choice in the forms sclerodermiform.
* Curettage and electrocoagulation: This technique is removal by curette, based on the greater friability of the tumor relative to healthy skin. Subsequently, the treated area is electrocoagulation to remove debris. The drawback of this technique is unable to confirm the total removal.
* Cryosurgery (liquid nitrogen) can be used in small lesions, but does not allow histological confirmation or determine if excision has been complete.
* Radiation therapy: Their primary indications are elderly, large lesions, when surgical treatment fails or if it’s difficult.
* Topical cytotoxic agents: 5-fluorouracil can be used only in the treatment of superficial basal cell carcinoma.
* Laser: This is a difficult treatment availability and does not allow histological control. So although it should not be a treatment of choice may be used in selected cases, as the Gorlin syndrome. CO2 can be used or photodynamic therapy.
* Imiquimod: This emerging drug was initially approved for the treatment of genital warts. It has an immunomodulatory effect by stimulating the immune response of the individual in charge of eliminating viral injury. There are also several studies that prove antitumor action. It has been recently approved in Europe for use in the treatment of superficial and nodular basal cell carcinomas of small size. The disadvantages are that we have focused on histological control of the removal of the tumor and its high irritant.
Clinical forms of basal cell carcinoma
Basal cell carcinoma is characterized by very heterogeneous from a clinical standpoint, which can sometimes make diagnosis difficult. Its most common location is on the face. It has a slow growing and painless, although as noted earlier, the evolution can produce invasion and destruction of adjacent structures.
The most common presentation is as pearly papule with teleangiectasia on its surface, which tends to be localized in the medial canthus, nose, or forehead. Corresponds to 95% of basal cell carcinomas. In the evolution may ulcerate in the center of the lesion, although the edges remain pearly papules features. In some cases the ulceration occurs early and massive way, then called ulcus Rodens, a less frequent but more aggressive.
Other clinical forms are:
* Basal Cell Carcinoma sclerodermatous: Board shiny smooth, flat and sometimes depressed slightly ill-defined borders resembling morphea. Sometimes we can see the look on their margins teleangiectasia pearl and typical of this tumor. Characteristically, the growth in depth of these lesions over the limits that we see clinically.
* Superficial Basal Cell Carcinoma: a raised red plaque with scaly surface, which is typically located in the trunk. Sometimes it can appear as multiple lesions in this case being generally related to previous exposure to arsenic.
* All clinical forms of basal cell carcinoma can appear as pigmented lesions, making it difficult differential diagnosis with melanoma.
Basal Cell Carcinoma
The known risk factors are:
* Chronic sun exposure
* Phototype skin I / II
* Treatment with radiation therapy
* Ingestion of arsenic chronically
* Immunosuppression
* Genetic predisposition:
– Gorlin syndrome or multiple basal cell nevus
– Bazex syndrome
– Xeroderma pigmentosum
Diagnosis and differential diagnosis
Preliminary diagnosis is clinical basal cell carcinoma. It is essential to know the existence of other types of presentation in addition to the characteristic pearly papule. Definitive diagnosis is by histological confirmation by biopsy.
The differential diagnosis of basal cell carcinoma is wide due to the diverse clinical manifestations. Arises mainly with the following entities:
* Actinic Keratosis
* Seborrheic Keratosis
* Tumors of skin appendages
* Giant Melanocytic
* Melanoma
* Bowen’s Disease
* Squamous cell carcinoma
Description of Skin Cancer Types (Part 1)
Squamous cell carcinoma (or squamous cell carcinoma) develops in the middle layers of the epidermis and accounts for 20% of all cases of skin cancer.
Usually occurs in areas that have been exposed to the sun, like the top of the nose, ears, forehead, upper lip and backs of hands.
You can also occur in areas of skin that have been in contact with chemicals that have undergone radiotherapy, or have been burned. In the genital area, appears less frequently.
Usually occurs usually a red bump and drive. Sometimes it may look, scaly, or bleed and develop a scab that never heals. As you have enlarged nodular and sometimes presents a warty surface. In the end, it becomes an open sore and growing into the underlying tissue.
Through the lymph system can extend to any body part, but this happens rarely. It is a tumor with a tendency to grow and be on the same site, once removed. But it tends to spread.
Basal cell carcinoma is the most common type of nonmelanoma skin cancer. About 75% of all skin cancers are basal cell carcinomas.