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Posts Tagged ‘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.

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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