Medical Care

Treatment is primarily surgical. In rare instances, intralesional or topical chemotherapy may be useful.

Vismodegib, a selective Hedgehog pathway inhibitor that binds to and inhibits smoothened (SMO), is the first US Food and Drug Administration (FDA)–approved treatment for patients with locally advanced, unresectable, or metastatic basal cell carcinomas.^[18]

Surgical Care

Options for treatment are similar to those for other forms of basal cell carcinoma, and the clinician's choice will likely be case dependent. Recommended treatment options include complete surgical excision or electrodesiccation followed by curettage. Cryosurgery, Mohs micrographic surgery, or radiation therapy may also be used.

Prevention

Encourage all patients to use sunscreens with a sun protective factor of at least 15. Avoidance of sun exposure during the peak intensity hours of the day, from 10 am to 3 pm, is also recommended.

Long-Term Monitoring

The development of one nonmelanoma skin cancer predisposes the patient to a higher risk for developing a second cancer. Therefore, close follow-up care is recommended to monitor for the development of similar tumors at the site of treatment and at alternate locations. Current recommendations suggest yearly skin examinations by a dermatologist.

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Media Gallery

Basal cell fibroepithelioma (Pinkus tumor). Courtesy of L Wozniak & KW Zielinski (own work), via Wikimedia Commons.

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Author

Darius Mehregan, MD Associate Professor, Hermann Pinkus Chairman of Dermatology, Department of Dermatology, Wayne State University School of Medicine; Clinical Associate Professor of Pathology, University of Toledo College of Medicine; Dermatopathologist, Pinkus Dermatopathology Laboratory; Consulting Staff, Department of Dermatology, J Dingell Veterans Affairs Medical Center

Darius Mehregan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, International Society of Dermatology, International Society of Dermatopathology, Phi Beta Kappa, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Rahil M Dharia Wayne State University School of Medicine

Rahil M Dharia is a member of the following medical societies: American Association of Physicians of Indian Origin, American Medical Association, American Medical Student Association/Foundation, Association of Students for Hinduism Awareness, Michigan Association of Physicians of Indian Heritage

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

Maureen B Poh-Fitzpatrick, MD Professor Emerita of Dermatology and Special Lecturer, Columbia University College of Physicians and Surgeons

Maureen B Poh-Fitzpatrick, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, New York Dermatological Society

Disclosure: Nothing to disclose.

Jennifer Michelle Heyl, MD Resident Physician, Department of Dermatology, Wayne State University School of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, David Pegouske MD, to the development and writing of this article.