Basal Cell Carcinoma Differential Diagnoses

  • Author: Robert S Bader, MD; Chief Editor: Jules E Harris, MD   more...
 
Updated: Feb 13, 2012
 
 

Diagnostic Considerations

Although basal cell carcinoma rarely metastasizes, a tumor can extend beneath the skin to the bone, causing considerable local damage due to tissue destruction. This process leads to an ulcer that is sometimes known as ulcus rodens, or a rodent ulcer.

Other medical problems/issues to consider include the following:

  • Dermatitis
  • Desmoplastic trichoepithelioma
  • Eczema
  • Intradermal nevus
  • Lichenoid benign keratosis
  • Ringworm
  • Fibroepithelioma of Pinkus
  • Adnexal carcinoma (very rare)
  • Actinic keratosis
  • Sebaceous hyperplasia
  • Nevi malignant melanoma
  • Keratoacanthoma
  • Seborrheic keratosis
  • Bowen disease
  • Darier disease (keratosis follicularis)[5]
  • Cutaneous T-cell lymphoma (mycosis fungoides)
  • Metastatic malignancies

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Robert S Bader, MD  Assistant Clinical Professor, Department of Dermatology, Drexel University College of Medicine; Dermatologist, Section of Dermatology, Department of Medicine, North Broward Medical Center

Robert S Bader, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and Florida Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Michael Giono Barakat  California Surgical Institute

Disclosure: Nothing to disclose.

Daniel Berg, MD, FRCP(C)  Professor of Dermatology, Director of Dermatologic Surgery, University of Washington School of Medicine

Daniel Berg, MD, FRCP(C) is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, and American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Robert A Copeland Jr, MD  Chair, Professor, Department of Ophthalmology, Howard University College of Medicine

Robert A Copeland Jr, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Laura Diomede  University of Bari School of Medicine, Italy

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Hon-Vu Q Duong, MD  Clinical Instructor of Ophthalmology and Ophthalmic Pathology, Westfield Eye Center

Hon-Vu Q Duong, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Jaime R Garza, MD, DDS, FACS  Consulting Staff, Private Practice

Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Shahin Javaheri, MD  Chief, Department of Plastic Surgery, Martinez Veterans Affairs Outpatient Clinic; Consulting Staff, Advanced Aesthetic Plastic & Reconstructive Surgery

Shahin Javaheri, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Shang I Brian Jiang, MD  Associate Clinical Professor of Medicine and Dermatology, Director, Dermatologic and Mohs Micrographic Surgery, Program Director, UCSD Dermatologic and Mohs Surgery Fellowship, University of California School of Medicine, San Diego

Shang I Brian Jiang, MD, is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, and Association of Professors of Dermatology

Disclosure: DUSA Corporation Grant/research funds PI for Industry Sponsored Clincal Trial

Andrew Scott Kennedy, MD  Co-Medical Director, Wake Radiology Oncology

Andrew Scott Kennedy, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Hepato-Pancreato-Biliary Association, American Society for Therapeutic Radiology and Oncology, American Society of Clinical Oncology, and Radiological Society of North America

Disclosure: Nothing to disclose.

Klaus-Dieter Lessnau, MD, FCCP  Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Maurice Y Nahabedian, MD, FACS  Associate Professor, Department of Plastic Surgery, Georgetown University Hospital

Maurice Y Nahabedian, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Society for Reconstructive Microsurgery, American Society of Plastic Surgeons, Johns Hopkins Medical and Surgical Association, and Northeastern Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Samia Nawaz, MBBS, MD  Associate Professor, Department of Pathology, University of Colorado Health Science Center

Samia Nawaz, MBBS, MD is a member of the following medical societies: American Society for Clinical Pathology, American Society of Cytopathology, and International Academy of Pathology

Disclosure: Nothing to disclose.

Ron W Pelton, MD, PhD  Private Practice, Colorado Springs, Colorado

Ron W Pelton, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Society of Ophthalmic Plastic and Reconstructive Surgery, AO Foundation, and Colorado Medical Society

Disclosure: Nothing to disclose.

Michael L Ramsey, MD  Director, Mohs Surgery Fellowship, Co-Director, Procedural Dermatology Fellowship, Department of Dermatology, Geisinger Medical Center

Michael L Ramsey, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, and Pennsylvania Academy of Dermatology

Disclosure: Nothing to disclose.

Rana Rofagha Sajjadian, MD  Clinical Instructor, Department of Dermatology, University of Irvine, California; Division of Mohs Surgery, Department of Dermatology, Southern California Permanente Medical Group

Rana Rofagha Sajjadian, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, and American Society for MOHS Surgery

Disclosure: Nothing to disclose.

Thomas M Roy, MD  Chief, Division of Pulmonary Diseases and Critical Care Medicine, Quillen Mountain Home Veterans Affairs Medical Center; Professor, Department of Internal Medicine, Division of Pulmonary Medicine, East Tennessee State University, James H Quillen College of Medicine

Thomas M Roy, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, Southern Medical Association, and Wilderness Medical Society

Disclosure: Nothing to disclose.

M Sherif Said, MD, PhD  Associate Professor of Pathology, Director of Head and Neck Pathology, Department of Pathology, University of Colorado School of Medicine

M Sherif Said, MD, PhD is a member of the following medical societies: American Society for Clinical Pathology and College of American Pathologists

Disclosure: Nothing to disclose.

Ali Sajjadian, MD, FACS  Private Practice, Newport Beach, California; Former Assistant Professor of Plastic Surgery, Former Director of Aesthetic Plastic Surgery Satellite Centers, University of Pittsburgh Medical Center

Ali Sajjadian, MD, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, American Society of Plastic Surgeons, American Society of Plastic Surgeons, California Medical Association, Northeastern Society of Plastic Surgeons, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Negar Sajjadian, MD  Assistant Professor of Pediatrics, Tehran University of Medical Sciences, Shariati Hospital

Disclosure: Nothing to disclose.

Luigi Santacroce, MD  Assistant Professor, Medical School, State University at Bari, Italy

Disclosure: Nothing to disclose.

Wayne Karl Stadelmann, MD  Stadelmann Plastic Surgery, PC

Wayne Karl Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Katherine Szyfelbein, MD  Staff Physician, Department of Dermatology, Boston University, Boston Medical Center

Disclosure: Nothing to disclose.

R Stan Taylor, MD  The JB Howell Professor in Melanoma Education and Detection, Departments of Dermatology and Plastic Surgery, Director, Skin Surgery and Oncology Clinic, University of Texas Southwestern Medical Center

R Stan Taylor, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, Christian Medical & Dental Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Sanjiv S Agarwala, MD  Chief of Oncology and Hematology, St Luke's Cancer Center, St Luke's Hospital and Health Network; Professor, Temple University Shool of Medicine

Sanjiv S Agarwala, MD is a member of the following medical societies: American Association for Cancer Research, American Society for Head and Neck Surgery, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, and European Society for Medical Oncology

Disclosure: BMS Honoraria Speaking and teaching; Novartis Consulting fee Consulting; Merck Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gregory Caputy, MD, PhD, FICS  Chief Surgeon, Aesthetica Plastic and Laser Surgery Center, Inc

Gregory Caputy, MD, PhD, FICS is a member of the following medical societies: American Society for Laser Medicine and Surgery, Canadian Medical Association, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association, and Wound Healing Society

Disclosure: Syneron Corporation Salary Speaking and teaching

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

Chief Editor

Jules E Harris, MD  Clinical Professor of Medicine, Section of Hematology/Oncology, University of Arizona College of Medicine, Arizona Cancer Center

Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research

Disclosure: GlobeImmune Salary Consulting

References

  1. Erba P, Farhadi J, Wettstein R, Arnold A, Harr T, Pierer G. Morphoeic basal cell carcinoma of the face. Scand J Plast Reconstr Surg Hand Surg. 2007;41(4):184-8. [Medline].

  2. Fresini A, Rossiello L, Severino BU, Del Prete M, Satriano RA. Giant basal cell carcinoma. Skinmed. Jul-Aug 2007;6(4):204-5. [Medline].

  3. Shindel AW, Mann MW, Lev RY, Sengelmann R, Petersen J, Hruza GJ, et al. Mohs micrographic surgery for penile cancer: management and long-term followup. J Urol. Nov 2007;178(5):1980-5. [Medline].

  4. Mulvany NJ, Allen DG. Differentiated intraepithelial neoplasia of the vulva. Int J Gynecol Pathol. Jan 2008;27(1):125-35. [Medline].

  5. Cabrera HN, Cuda G, López M, Costa JA. [Basal cell epithelioma of the vulva in chronic endemic regional arsenic poisoning]. Med Cutan Ibero Lat Am. 1984;12(2):81-5. [Medline].

  6. Newman JC, Leffell DJ. Correlation of embryonic fusion planes with the anatomical distribution of basal cell carcinoma. Dermatol Surg. Aug 2007;33(8):957-64; discussion 965. [Medline].

  7. Cabrera HN, Gómez ML. Skin cancer induced by arsenic in the water. J Cutan Med Surg. Mar-Apr 2003;7(2):106-11. [Medline].

  8. Romão-Corrêa RF, Maria DA, Soma M, Sotto MN, Sanches JA Jr, Neto CF, et al. Nucleolar organizer region staining patterns in paraffin-embedded tissue cells from human skin cancers. J Cutan Pathol. May 2005;32(5):323-8. [Medline].

  9. Ozyazgan I, Kontas O. Previous injuries or scars as risk factors for the development of basal cell carcinoma. Scand J Plast Reconstr Surg Hand Surg. 2004;38(1):11-5. [Medline].

  10. Mohanty P, Mohanty L, Devi BP. Multiple cutaneous malignancies in xeroderma pigmentosum. Indian J Dermatol Venereol Leprol. Mar-Apr 2001;67(2):96-7. [Medline].

  11. Keyhani K, Ashenhurst M, Oryschak A. Periocular basal cell carcinoma arising in a site of previous trauma. Can J Ophthalmol. Jun 2007;42(3):467-8. [Medline].

  12. Barry J, Oon SF, Watson R, Barnes L. The management of basal cell carcinomas. Ir Med J. Jun 2006;99(6):179-81. [Medline].

  13. Dandurand M, Petit T, Martel P, Guillot B. Management of basal cell carcinoma in adults Clinical practice guidelines. Eur J Dermatol. Jul-Aug 2006;16(4):394-401. [Medline].

  14. Aldara cream 5% (imiquimod) [package insert]. Graceway Pharmaceuticals; 2007.

  15. Geisse J, Caro I, Lindholm J, Golitz L, Stampone P, Owens M. Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: results from two phase III, randomized, vehicle-controlled studies. J Am Acad Dermatol. May 2004;50(5):722-33. [Medline].

  16. Sapijaszko MJ. Imiquimod 5% cream (Aldara) in the treatment of basal cell carcinoma. Skin Therapy Lett. Jul-Aug 2005;10(6):2-5. [Medline].

  17. Micali M, Nasca MR, Musumeci ML. Treatment of an extensive superficial basal cell carcinoma of the face with imiquimod 5% cream. Int J Tissue React. 2005;27(3):111-4. [Medline].

  18. Bilu D, Sauder DN. Imiquimod: modes of action. Br J Dermatol. Nov 2003;149 Suppl 66:5-8. [Medline].

  19. Wuest M, Dummer R, Urosevic M. Induction of the members of Notch pathway in superficial basal cell carcinomas treated with imiquimod. Arch Dermatol Res. Dec 2007;299(10):493-8. [Medline].

  20. Efudex (fluorouracil) [package insert]. Valeant Pharmaceuticals; 2005.

  21. Bale AE, Yu KP. The hedgehog pathway and basal cell carcinomas. Hum Mol Genet. Apr 2001;10(7):757-62. [Medline].

  22. Wicking C, McGlinn E. The role of hedgehog signalling in tumorigenesis. Cancer Lett. Nov 8 2001;173(1):1-7. [Medline].

  23. Zhang H, Ping XL, Lee PK, Wu XL, Yao YJ, Zhang MJ, et al. Role of PTCH and p53 genes in early-onset basal cell carcinoma. Am J Pathol. Feb 2001;158(2):381-5. [Medline]. [Full Text].

  24. National Center for Biotechnical Information. Tumor Protein p53; TP53. Available at http://www.ncbi.nlm.nih.gov/omim/191170. Accessed November 7, 2007.

  25. Young LC, Listgarten J, Trotter MJ, Andrew SE, Tron VA. Evidence that dysregulated DNA mismatch repair characterizes human nonmelanoma skin cancer. Br J Dermatol. Jan 2008;158(1):59-69. [Medline].

  26. Lim JL, Stern RS. High levels of ultraviolet B exposure increase the risk of non-melanoma skin cancer in psoralen and ultraviolet A-treated patients. J Invest Dermatol. Mar 2005;124(3):505-13. [Medline].

  27. Walling HW, Fosko SW, Geraminejad PA, Whitaker DC, Arpey CJ. Aggressive basal cell carcinoma: presentation, pathogenesis, and management. Cancer Metastasis Rev. Aug-Dec 2004;23(3-4):389-402. [Medline].

  28. Centers for Disease Control and Prevention (CDC). Sunburn prevalence among adults--United States, 1999, 2003, and 2004. MMWR Morb Mortal Wkly Rep. Jun 1 2007;56(21):524-8. [Medline].

  29. Cohen MM Jr. Nevoid basal cell carcinoma syndrome: molecular biology and new hypotheses. Int J Oral Maxillofac Surg. Jun 1999;28(3):216-23. [Medline].

  30. Klein RD, Dykas DJ, Bale AE. Clinical testing for the nevoid basal cell carcinoma syndrome in a DNA diagnostic laboratory. Genet Med. Nov-Dec 2005;7(9):611-9. [Medline].

  31. Karagas MR. Occurrence of cutaneous basal cell and squamous cell malignancies among those with a prior history of skin cancer. The Skin Cancer Prevention Study Group. J Invest Dermatol. Jun 1994;102(6):10S-13S. [Medline].

  32. Michaëlsson G, Olsson E, Westermark P. The Rombo syndrome: a familial disorder with vermiculate atrophoderma, milia, hypotrichosis, trichoepitheliomas, basal cell carcinomas and peripheral vasodilation with cyanosis. Acta Derm Venereol. 1981;61(6):497-503. [Medline].

  33. Heal C, Buettner P, Browning S. Risk factors for wound infection after minor surgery in general practice. Med J Aust. Sep 4 2006;185(5):255-8. [Medline].

  34. Marks R, Jolley D, Dorevitch AP, Selwood TS. The incidence of non-melanocytic skin cancers in an Australian population: results of a five-year prospective study. Med J Aust. May 1 1989;150(9):475-8. [Medline].

  35. Brasseur R, Lagesse Ch. [Contribution of psychometry of clinical evaluation of the therapeutic effect of "Solcoseryl" in states of intellectual weakness connected with chronic cerebral circulatory insufficiency (author's transl)]. Schweiz Rundsch Med Prax. Mar 8 1977;66(10):312-7. [Medline].

  36. Cook BE Jr, Bartley GB. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota. Ophthalmology. Apr 1999;106(4):746-50. [Medline].

  37. Leffell DJ, Headington JT, Wong DS, Swanson NA. Aggressive-growth basal cell carcinoma in young adults. Arch Dermatol. Nov 1991;127(11):1663-7. [Medline].

  38. Patel MS, Thigpen JT, Vance RB, Elkins SL, Guo M. Basal cell carcinoma with lung metastasis diagnosed by fine-needle aspiration biopsy. South Med J. Mar 1999;92(3):321-4. [Medline].

  39. Akinci M, Aslan S, Markoç F, Cetin B, Cetin A. Metastatic basal cell carcinoma. Acta Chir Belg. Mar-Apr 2008;108(2):269-72. [Medline].

  40. Mc Loone NM, Tolland J, Walsh M, et al. Follow-up of basal cell carcinomas: an audit of current practice. J Eur Acad Dermatol Venereol. Jul 2006;20(6):698-701.

  41. Pieh S, Kuchar A, Novak P, Kunstfeld R, Nagel G, Steinkogler FJ. Long-term results after surgical basal cell carcinoma excision in the eyelid region. Br J Ophthalmol. Jan 1999;83(1):85-8. [Medline]. [Full Text].

  42. Marcil I, Stern RS. Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. Arch Dermatol. Dec 2000;136(12):1524-30. [Medline].

  43. Levi F, Randimbison L, Maspoli M, Te VC, La Vecchia C. High incidence of second basal cell skin cancers. Int J Cancer. Sep 15 2006;119(6):1505-7. [Medline].

  44. Bruce AJ, Brodland DG. Overview of skin cancer detection and prevention for the primary care physician. Mayo Clin Proc. May 2000;75(5):491-500. [Medline].

  45. Kumar N, Saxena YK. Two cases of rare presentation of basal cell and squamous cell carcinoma on the hand. Indian J Dermatol Venereol Leprol. Nov-Dec 2002;68(6):349-51. [Medline].

  46. Betti R, Radaelli G, Mussino F, Menni S, Crosti C. Anatomic location and histopathologic subtype of basal cell carcinomas in adults younger than 40 or 90 and older: any difference?. Dermatol Surg. Feb 2009;35(2):201-6. [Medline].

  47. Griffin JR, Cohen PR, Tschen JA, Mullans EA, Schulze KE, Martinelli PT, et al. Basal cell carcinoma in childhood: case report and literature review. J Am Acad Dermatol. Nov 2007;57(5 Suppl):S97-102. [Medline].

  48. Gorlin RJ. Nevoid basal cell carcinoma (Gorlin) syndrome: unanswered issues. J Lab Clin Med. Dec 1999;134(6):551-2. [Medline].

  49. Bernardini FP. Management of malignant and benign eyelid lesions. Curr Opin Ophthalmol. Oct 2006;17(5):480-4. [Medline].

  50. Ly JQ. Scintigraphic findings in Gorlin's syndrome. Clin Nucl Med. Dec 2002;27(12):913-4. [Medline].

  51. Barton K, Curling OM, Paridaens AD, Hungerford JL. The role of cytology in the diagnosis of periocular basal cell carcinomas. Ophthal Plast Reconstr Surg. Sep 1996;12(3):190-4; discussion 195. [Medline].

  52. Orengo IF, Salasche SJ, Fewkes J, Khan J, Thornby J, Rubin F. Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane. J Am Acad Dermatol. Sep 1997;37(3 Pt 1):395-7. [Medline].

  53. Cherpelis BS, Turner L, Ladd S, Glass LF, Fenske NA. Innovative 19-minute rapid cytokeratin immunostaining of nonmelanoma skin cancer in Mohs micrographic surgery. Dermatol Surg. Jul 2009;35(7):1050-6. [Medline].

  54. Ackerman AB, Gottlieb GJ. Fibroepithelial tumor of pinkus is trichoblastic (Basal-cell) carcinoma. Am J Dermatopathol. Apr 2005;27(2):155-9. [Medline].

  55. Bowen AR, LeBoit PE. Fibroepithelioma of pinkus is a fenestrated trichoblastoma. Am J Dermatopathol. Apr 2005;27(2):149-54. [Medline].

  56. Strauss RM, Edwards S, Stables GI. Pigmented fibroepithelioma of Pinkus. Br J Dermatol. Jun 2004;150(6):1208-9. [Medline].

  57. Mannor GE, Wardell K, Wolfley DE, Nilsson GE. Laser Doppler perfusion imaging of eyelid skin. Ophthal Plast Reconstr Surg. Sep 1996;12(3):178-85. [Medline].

  58. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Basal Cell and Squamous Cell Skin Cancers. 2011;v.1:Accessed June 3 2011. Available at http://www.nccn.org/professionals/physician_gls/pdf/nmsc.pdf.

  59. Babilas P, Landthaler M, Szeimies RM. Photodynamic therapy in dermatology. Eur J Dermatol. Jul-Aug 2006;16(4):340-8. [Medline].

  60. Foley P. Clinical efficacy of methyl aminolaevulinate photodynamic therapy in basal cell carcinoma and solar keratosis. Australas J Dermatol. Feb 2005;46 Suppl 3:S8-10; discussion S23-5. [Medline].

  61. Zimmermann A, Walt H, Haller U, Baas P, Klein SD. Effects of chlorin-mediated photodynamic therapy combined with fluoropyrimidines in vitro and in a patient. Cancer Chemother Pharmacol. Feb 2003;51(2):147-54. [Medline].

  62. Love WE, Bernhard JD, Bordeaux JS. Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: a systematic review. Arch Dermatol. Dec 2009;145(12):1431-8. [Medline].

  63. Berman B. Scientific rationale: combining imiquimod and surgical treatments for basal cell carcinomas. J Drugs Dermatol. Jan 2008;7(1 Suppl 1):s3-6. [Medline].

  64. Brownell I. Nodular basal cell carcinoma: when in doubt, cut it out. J Drugs Dermatol. Dec 2007;6(12):1245-6. [Medline].

  65. Farhi D, Dupin N, Palangié A, Carlotti A, Avril MF. Incomplete excision of basal cell carcinoma: rate and associated factors among 362 consecutive cases. Dermatol Surg. Oct 2007;33(10):1207-14. [Medline].

  66. Miller BH, Shavin JS, Cognetta A, Taylor RJ, Salasche S, Korey A, et al. Nonsurgical treatment of basal cell carcinomas with intralesional 5-fluorouracil/epinephrine injectable gel. J Am Acad Dermatol. Jan 1997;36(1):72-7. [Medline].

  67. Greenway HT, Cornell RC, Tanner DJ, Peets E, Bordin GM, Nagi C. Treatment of basal cell carcinoma with intralesional interferon. J Am Acad Dermatol. Sep 1986;15(3):437-43. [Medline].

  68. Geisse JK, Rich P, Pandya A, Gross K, Andres K, Ginkel A, et al. Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: a double-blind, randomized, vehicle-controlled study. J Am Acad Dermatol. Sep 2002;47(3):390-8. [Medline].

  69. Garcia-Martin E, Gil-Arribas LM, Idoipe M, et al. Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma. Br J Ophthalmol. Oct 2011;95(10):1393-6. [Medline].

  70. [Best Evidence] Eigentler TK, Kamin A, Weide BM, Breuninger H, Caroli UM, Möhrle M, et al. A phase III, randomized, open label study to evaluate the safety and efficacy of imiquimod 5% cream applied thrice weekly for 8 and 12 weeks in the treatment of low-risk nodular basal cell carcinoma. J Am Acad Dermatol. Oct 2007;57(4):616-21. [Medline].

  71. Stockfleth E, Ulrich C, Hauschild A, Lischner S, Meyer T, Christophers E. Successful treatment of basal cell carcinomas in a nevoid basal cell carcinoma syndrome with topical 5% imiquimod. Eur J Dermatol. Nov-Dec 2002;12(6):569-72. [Medline].

  72. Bianchi L, Orlandi A, Campione E, Angeloni C, Costanzo A, Spagnoli LG, et al. Topical treatment of basal cell carcinoma with tazarotene: a clinicopathological study on a large series of cases. Br J Dermatol. Jul 2004;151(1):148-56. [Medline].

  73. Wilson F. Psoriasis medication does battle with basal cell carcinoma. Dermatology Times 2000.

  74. Von Hoff DD, et al. "Efficacy data of GDC-0449, a systemic Hedgehog pathway antagonist, in a first-in-human, first-in-class phase I study with locally advanced, multifocal, or metastatic basal cell carcinoma patients". AACR Meeting. 2008;Abstract LB-138.

  75. Garber K. Hedgehog drugs begin to show results. J Natl Cancer Inst. May 21 2008;100(10):692-7. [Medline].

  76. Lewis JE. Keloidal basal cell carcinoma. Am J Dermatopathol. Oct 2007;29(5):485. [Medline].

  77. Mendenhall WM, Amdur RJ, Hinerman RW, Cognetta AB, Mendenhall NP. Radiotherapy for cutaneous squamous and basal cell carcinomas of the head and neck. Laryngoscope. Oct 2009;119(10):1994-9. [Medline].

  78. Braathen LR, Szeimies RM, Basset-Seguin N, Bissonnette R, Foley P, Pariser D, et al. Guidelines on the use of photodynamic therapy for nonmelanoma skin cancer: an international consensus. International Society for Photodynamic Therapy in Dermatology, 2005. J Am Acad Dermatol. Jan 2007;56(1):125-43. [Medline].

  79. [Guideline] Morton CA, McKenna KE, Rhodes LE. Guidelines for topical photodynamic therapy: update. Br J Dermatol. Dec 2008;159(6):1245-66. [Medline].

  80. Calzavara-Pinton PG, Szeimies RM, Ortel B, Zane C. Photodynamic therapy with systemic administration of photosensitizers in dermatology. J Photochem Photobiol B. Nov 1996;36(2):225-31. [Medline].

  81. Puccioni M, Santoro N, Giansanti F, Ucci F, Rossi R, Lotti T, et al. Photodynamic therapy using methyl aminolevulinate acid in eyelid basal cell carcinoma: a 5-year follow-up study. Ophthal Plast Reconstr Surg. Mar-Apr 2009;25(2):115-8. [Medline].

  82. Mosterd K, Thissen MR, Nelemans P, Kelleners-Smeets NW, Janssen RL, Broekhof KG, et al. Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial. Br J Dermatol. Sep 2008;159(4):864-70. [Medline].

  83. Rhodes LE, de Rie MA, Leifsdottir R, Yu RC, Bachmann I, Goulden V, et al. Five-year follow-up of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma. Arch Dermatol. Sep 2007;143(9):1131-6. [Medline].

  84. Christensen E, Mørk C, Skogvoll E. High and sustained efficacy after two sessions of topical 5-aminolaevulinic acid photodynamic therapy for basal cell carcinoma: a prospective, clinical and histological 10-year follow-up study. Br J Dermatol. Feb 6 2012;[Medline].

  85. Kempf RA. Systemic therapy of skin carcinoma. Cancer Treat Res. 1995;78:137-62. [Medline].

  86. Von Hoff DD, LoRusso PM, Rudin CM, Reddy JC, Yauch RL, Tibes R, et al. Inhibition of the hedgehog pathway in advanced basal-cell carcinoma. N Engl J Med. Sep 17 2009;361(12):1164-72. [Medline].

  87. Erevedge (vismodegib) Prescribing Information. Available at http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/203388lbl.pdf. Accessed January 30, 2012.

  88. National Center for Biotechnical Information. Bazex Syndrome; BZX. Online Mendelian Inheritance in Man. Available at http://http://www.ncbi.nlm.nih.gov/omim/301845 \t _blank. Accessed November 7, 2007.

 
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A superficial basal cell carcinoma (BCC). Clinically, an erythematous, well-circumscribed macule with minimal scale is present. This tumor is often misdiagnosed as eczematous dermatitis or guttate psoriasis and is often difficult to distinguish clinically from Bowen disease (squamous cell carcinoma in situ). Features that suggest the diagnosis of superficial BCC are the absence of significant white, adherent scale, and a history of the lesion remaining unchanged for several months or years. Treatment options for this tumor include electrodesiccation and curettage, surgical excision, cryosurgery, 5-fluorouracil, 5% imiquimod cream, and superficial radiographic therapy. Electrodesiccation and curettage is the modality most commonly used, with a cure rate of approximately 95%.
Basal cell carcinoma.
A 68-year-old patient presenting with an advanced basal cell carcinoma (BCC) of the right periorbital region, frontal view (Images courtesy of M Abraham Kuriakose, DDS, MD)
Lateral view of face showing extent of tumor (Images courtesy of M Abraham Kuriakose, DDS, MD)
Basal cell carcinoma of the right lower lid.
Biopsy-proven basal cell carcinoma of the upper lid margin. Note the loss of cilia (madarosis) in the area of the tumor.
Medial canthal/lower lid basal cell. Note the pearly nodular surface with characteristic telangiectatic vessels. Proximity to the lacrimal system will impact its treatment and reconstruction.
Nodular basal cell carcinoma.
Nodular basal cell carcinoma appearing as a waxy, translucent papule with central depression and a few small erosions.
Scale, erythema, and a threadlike raised border are present in this superficial basal cell carcinoma on the trunk.
Large, superficial basal cell carcinoma.
Basal cell carcinoma (Image courtesy of Hon Pak, MD)
Pigmented basal cell carcinoma.
Pigmented basal cell carcinoma.
Pigmented basal cell carcinoma has features of nodular basal cell carcinoma with the addition of dark pigmentation from melanin deposition. The pigmentation often has the appearance of dark droplets in the lesion, as shown here.
This infiltrating basal cell cancer has ill-defined borders and telangiectases.
This translucent pink papule has telangiectases and a crusted erosion, characteristic of nodular basal cell carcinoma.
Large, scarlike morpheaform basal cell cancer.
Nodular basal cell carcinoma. Nodular aggregates of basalioma cells are present in the dermis and exhibit peripheral palisading and retraction artifact. Melanin is also present within the tumor and in the surrounding stroma, as seen in pigmented basal cell carcinoma.
Histology of superficial basal cell carcinoma. Nests of basaloid cells are seen budding from the undersurface of the epidermis.
Histologic pattern of a well-differentiated basal cell carcinoma (original magnification X140). (Image courtesy of Prof Pantaleo Bufo, University of Foggia, Italy)
Histologic pattern of a well-differentiated basal cell carcinoma (original magnification X250). (Image courtesy of Prof Pantaleo Bufo, University of Foggia, Italy)
Micronodular basal cell carcinoma often has an absence of retraction artifact. The characteristic histology is small size and uniformity of the tumor nodules. (Image courtesy of Shang I Brian Jiang, MD)
Infiltrative basal cell carcinoma. Tumor cells are arranged in narrow strands, and mucin-rich stroma is often present. (Image courtesy of Shang I Brian Jiang, MD)
Keratotic basal cell carcinoma. Rare type characterized by keratocysts. (Image courtesy of Shang I Brian Jiang, MD)
Basosquamous basal cell carcinoma. Foci of neoplastic cells with squamous differentiation are present. (Image courtesy of Shang I Brian Jiang, MD)
Histology of superficial basal cell carcinoma. Nests of basaloid cells are seen budding from the undersurface of the epidermis. (Image courtesy of Michael L Ramsey, MD)
 
 
 
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