Abstract
Basal cell carcinoma (BCC) is the most common cancer in the United States. BCC is categorized by its clinical appearance and histology. The tumor subtype, anatomical location and patient’s health are factored into the treatment choice. Multiple treatment options exist with varying efficacy. Post-treatment, patient monitoring is important for possible recurrence and for the development of new skin cancers.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Verkouteren JA, et al. Epidemiology of basal cell carcinoma: scholarly review. Br J Dermatol. 2017;177:359.
Wysong A, Aasi SZ, Tang JY. Update on metastatic basal cell carcinoma: a summary of published cases from 1981 through 2011. JAMA Dermatol. 2013;149(5):615–6.
Zhang Y, et al. Body mass index, height and early-onset basal cell carcinoma in a case-control study. Cancer Epidemiol. 2017;46:66–72.
Wu S, et al. Cumulative ultraviolet radiation flux in adulthood and risk of incident skin cancers in women. Br J Cancer. 2014;110(7):1855–61.
Cockerell CJ, Tan KT, Carucci J, Tierney E, Lang P, Maize JC Sr, Rigel D. Basal cell carcinoma. In: Cancer of the skin. Edinburgh: Elsevier Inc; 2011. p. 99–123.
Wang GY, et al. Differing tumor-suppressor functions of Arf and p53 in murine basal cell carcinoma initiation and progression. Oncogene. 2017;36(26):3772–80.
Chaudhary SC, et al. Naproxen inhibits UVB-induced basal cell and squamous cell carcinoma development in Ptch1+/− /SKH-1 hairless mice. Photochem Photobiol. 2017;93:1016.
Fan Z, et al. A missense mutation in PTCH2 underlies dominantly inherited NBCCS in a Chinese family. J Med Genet. 2008;45(5):303–8.
Kijima C, et al. Two cases of nevoid basal cell carcinoma syndrome associated with meningioma caused by a PTCH1 or SUFU germline mutation. Familial Cancer. 2012;11(4):565–70.
Scheinfeld N, et al. Identification of a recurrent mutation in the CYLD gene in Brooke-Spiegler syndrome. Clin Exp Dermatol. 2003;28(5):539–41.
Berlin NL, et al. Family history of skin cancer is associated with early-onset basal cell carcinoma independent of MC1R genotype. Cancer Epidemiol. 2015;39(6):1078–83.
Levine JA, et al. The indoor UV tanning industry: a review of skin cancer risk, health benefit claims, and regulation. J Am Acad Dermatol. 2005;53(6):1038–44.
Narala S, Cohen PR. Basal cell carcinoma of the umbilicus: a comprehensive literature review. Cureus. 2016;8(9):e770.
Loh TY, Rubin AG, Jiang SI. Basal cell carcinoma of the dorsal foot: an update and comprehensive review of the literature. Dermatol Surg. 2017;43(1):32–9.
Alsaedi M, Shoimer I, Kurwa HA. Basal cell carcinoma of the nipple-areola complex. Dermatol Surg. 2017;43(1):142–6.
Watson GA, et al. An unusual case of basal cell carcinoma of the vulva with lung metastases. Gynecol Oncol Rep. 2016;18:32–5.
Loh T, Rubin AG, Brian Jiang SI. Management of mucosal basal cell carcinoma of the lip: an update and comprehensive review of the literature. Dermatol Surg. 2016;42(12):1313–9.
Hone NL, Grandhi R, Ingraffea AA. Basal cell carcinoma on the sole: an easily missed cancer. Case Rep Dermatol. 2016;8(3):283–6.
Hoashi T, et al. A case of penile basal cell carcinoma reconstructed by scrotal myofasciocutaneous flap. Dermatol Ther. 2016;29(5):349–52.
Hernandez-Aragues I, Baniandres-Rodriguez O. Basal cell carcinoma of the scrotum. Actas Urol Esp. 2016;40(9):592–3.
Buljan M, et al. Variations in clinical presentation of basal cell carcinoma. Acta Clin Croat. 2008;47(1):25–30.
Sarkar S, et al. Neglected basal cell carcinoma on scalp. Indian J Dermatol. 2016;61(1):85–7.
Mehta KS, et al. Metastatic Basal cell carcinoma: a biological continuum of Basal cell carcinoma? Case Rep Dermatol Med. 2012;2012:157187.
Brodell RT, Wagamon K. The persistent nonhealing ulcer. Could it be basal cell carcinoma? Postgrad Med. 2001;109(1):29–32.
Lim KR, et al. Basal cell carcinoma presenting as a hypertrophic scar. Arch Plast Surg. 2013;40(3):289–91.
Nadiminti U, Rakkhit T, Washington C. Morpheaform basal cell carcinoma in African Americans. Dermatol Surg. 2004;30(12 Pt 2):1550–2.
Park JY, et al. A rare dermoscopic pattern of nodular basal cell carcinoma with amyloid deposition. J Am Acad Dermatol. 2017;76(2s1):S55–6.
Diluvio L, Bavetta M, Di Prete M, Orlandi A, Bianchi L, and Campione E. Dermoscopic monitoring of efficacy of ingenol mebutate in the treatment of pigmented and non-pigmented basal cell carcinomas. Dermatologic Therapy 2017;30:e12438. doi:10.1111/dth.12438. (electronic publication)
Arpaia N, et al. Vascular patterns in cutaneous ulcerated basal cell carcinoma: a retrospective blinded study including dermoscopy. Acta Derm Venereol. 2017;97:612.
Hirofuji A, et al. Superficial type of multiple basal cell carcinomas: detailed comparative study of its dermoscopic and histopathological findings. J Skin Cancer. 2011;2011:385465.
Mary Nolen VB, King J, Bryn N, Morin LK. Nonmelanoma skin cancer: part 1. J Dermatol Nurses Assoc. 2011;3(5):260–81.
Yoneta A, et al. A case of cystic basal cell carcinoma which shows a homogenous blue/black area under Dermatoscopy. J Skin Cancer. 2011;2011:450472.
Lima NL, et al. Basosquamous carcinoma: histopathological features. Indian J Dermatol. 2012;57(5):382–3.
Akay BN, et al. Basosquamous carcinoma: dermoscopic clues to diagnosis. J Dermatol. 2016;44:127–134
Tan CZ, Rieger KE, Sarin KY. Basosquamous carcinoma: controversy, advances, and future directions. Dermatol Surg. 2017;43(1):23–31.
Tchernev G, et al. Multiple nonsyndromic acquired basal cell carcinomas : Uncommon clinical presentation in a Bulgarian patient. Wien Med Wochenschr. 2017;167:134.
Hendrix JD Jr, Parlette HL. Duplicitous growth of infiltrative basal cell carcinoma: analysis of clinically undetected tumor extent in a paired case-control study. Dermatol Surg. 1996;22(6):535–9.
Coleman CI, Wine-Lee L, James WD. Pigmented basal cell carcinoma: uncommon presentation in blue-eyed patients. JAMA Dermatol. 2013;149(8):995–6.
Alcantara-Reifs CM, et al. Linear basal cell carcinoma: report of three cases with dermoscopic findings. Indian J Dermatol Venereol Leprol. 2016;82(6):708–11.
Yamaguchi Y, et al. A case of linear basal cell carcinoma: evaluation of proliferative activity by immunohistochemical staining of PCTAIRE1 and p27. J Eur Acad Dermatol Venereol. 2017;31:e359.
Yazdani Abyaneh MA, et al. Giant basal cell carcinomas express neuroactive mediators and show a high growth rate: a case-control study and meta-analysis of etiopathogenic and prognostic factors. Am J Dermatopathol. 2017;39(3):189–94.
Bellahammou K, et al. Metastatic giant basal cell carcinoma: a case report. Pan Afr Med J. 2016;24:157.
Kornreich DA, Lee JB. White network in fibroepithelioma of Pinkus. JAAD Case Rep. 2016;2(5):400–2.
Gomez-Martin I, et al. Pigmented fibroepithelioma of Pinkus: a potential dermoscopic simulator of malignant melanoma. J Dermatol. 2017;44(5):542–3.
Dongre AM, et al. Fibroepithelioma of Pinkus in continuity with nodular basal cell carcinoma: a rare presentation. Indian Dermatol Online J. 2016;7(4):285–7.
Crowson AN. Basal cell carcinoma: biology, morphology and clinical implications. Mod Pathol. 2006;19(Suppl 2):S127–47.
Saxena K, et al. Adenoid basal cell carcinoma: a rare facet of basal cell carcinoma. BMJ Case Rep. 2016;2016. https://doi.org/10.1136/bcr-2015-214166.
Murkey N, et al. Adenoid variant of basal cell carcinoma: a case report with a glance at biological behavior of the tumor. Indian J Dermatol. 2017;62(1):103–5.
Anjum N, et al. Follicular proliferation or basal cell carcinoma? The first prospective UK study of this histological challenge during Mohs Surgery. Br J Dermatol. 2017;177(2):549–50.
Viera M, et al. A new look at fibroepithelioma of pinkus: features on confocal microscopy. J Clin Aesthet Dermatol. 2008;1(2):42–4.
Hasbun Acuna P, et al. Pigmented basal cell carcinoma mimicking a superficial spreading melanoma. Medwave. 2016;16(11):e6805.
Nagi R, Sahu S, Agarwal N. Unusual presentation of pigmented basal cell carcinoma of face: surgical challenge. J Clin Diagn Res. 2016;10(7):Zj06–7.
Christian MM, et al. A correlation of alpha-smooth muscle actin and invasion in micronodular basal cell carcinoma. Dermatol Surg. 2001;27(5):441–5.
Bard RL. High-frequency ultrasound examination in the diagnosis of skin cancer. Dermatol Clin. 2017;35(4):505–11.
Hong H, Sun J, Cai W. Anatomical and molecular imaging of skin cancer. Clin Cosmet Investig Dermatol. 2008;1:1–17.
Zeitouni NC, et al. Preoperative ultrasound and photoacoustic imaging of nonmelanoma skin cancers. Dermatol Surg. 2015;41(4):525–8.
MacFarlane D, et al. The role of imaging in the management of patients with nonmelanoma skin cancer: diagnostic modalities and applications. J Am Acad Dermatol. 2017;76(4):579–88.
Belkin DA, Wysong A. Radiographic imaging for skin cancer. Semin Cutan Med Surg. 2016;35(1):42–8.
Humphreys TR, et al. The role of imaging in the management of patients with nonmelanoma skin cancer: when is imaging necessary? J Am Acad Dermatol. 2017;76(4):591–607.
Duncan JR, Carr D, Kaffenberger BH. The utility of positron emission tomography with and without computed tomography in patients with nonmelanoma skin cancer. J Am Acad Dermatol. 2016;75(1):186–96.
Lubeek SF, Arnold WP. A retrospective study on the effectiveness of curettage and electrodesiccation for clinically suspected primary nodular basal cell carcinoma. Br J Dermatol. 2016;175(5):1097–8.
Woldow AB, Melvin ME. Early detection of desiccation and curettage failure in the treatment of basal cell carcinoma. Dermatology. 2016;232:696.
Lara F, Santamaria JR, Garbers LE. Recurrence rate of basal cell carcinoma with positive histopathological margins and related risk factors. An Bras Dermatol. 2017;92(1):58–62.
Sexton M, Jones DB, Maloney ME. Histologic pattern analysis of basal cell carcinoma. Study of a series of 1039 consecutive neoplasms. J Am Acad Dermatol. 1990;23(6 Pt 1):1118–26.
Gulleth Y, et al. What is the best surgical margin for a basal cell carcinoma: a meta-analysis of the literature. Plast Reconstr Surg. 2010;126(4):1222–31.
Thomas DJ, King AR, Peat BG. Excision margins for nonmelanotic skin cancer. Plast Reconstr Surg. 2003;112(1):57–63.
Sin CW, Barua A, Cook A. Recurrence rates of periocular basal cell carcinoma following Mohs micrographic surgery: a retrospective study. Int J Dermatol. 2016;55(9):1044–7.
Wolfe CM, Cognetta AB Jr. Radiation therapy (RT) for nonmelanoma skin cancer (NMSC), a cost comparison: clarifying misconceptions. J Am Acad Dermatol. 2016;75(3):654–5.
McGregor S, Minni J, Herold D. Superficial radiation therapy for the treatment of nonmelanoma skin cancers. J Clin Aesthet Dermatol. 2015;8(12):12–4.
Duinkerken CW, et al. Orthovoltage X-rays for postoperative treatment of resected basal cell carcinoma in the head and neck area. J Cutan Med Surg. 2017;21(3):243–9. https://doi.org/10.1177/1203475416687268.
Vuong W, Lin J, Wei RL. Palliative radiotherapy for skin malignancies. Ann Palliat Med. 2017;6(2):165–72.
Piccinno R, et al. Dermatologic radiotherapy in the treatment of extensive basal cell carcinomas: a retrospective study. J Dermatolog Treat. 2017;28(5):1–5.
Avril MF, et al. Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study. Br J Cancer. 1997;76(1):100–6.
Zouboulis CC. Cryosurgery in dermatology. Hautarzt. 2015;66(11):834–48.
Erratum. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?: Erratum. Indian Dermatol Online J. 2015;6(4):314.
Har-Shai Y, et al. Intralesional cryosurgery for the treatment of basal cell carcinoma of the lower extremities in elderly subjects: a feasibility study. Int J Dermatol. 2016;55(3):342–50.
Weshahy AH, et al. The efficacy of intralesional cryosurgery in the treatment of small- and medium-sized basal cell carcinoma: a pilot study. J Dermatolog Treat. 2015;26(2):147–50.
Gaitanis G, Kalogeropoulos CD, Bassukas ID. Cryosurgery during Imiquimod (Immunocryosurgery) for periocular basal cell carcinomas: an efficacious minimally invasive treatment alternative. Dermatology. 2016;232(1):17–21.
Lanoue J, Goldenberg G. Basal cell carcinoma: a comprehensive review of existing and emerging nonsurgical therapies. J Clin Aesthet Dermatol. 2016;9(5):26–36.
Soleymani T, Abrouk M, Kelly KM. An analysis of laser therapy for the treatment of nonmelanoma skin cancer. Dermatol Surg. 2017;43(5):615–24.
Ortiz AE, Anderson RR, Avram MM. 1064 nm long-pulsed Nd:YAG laser treatment of basal cell carcinoma. Lasers Surg Med. 2015;47(2):106–10.
Konnikov N, et al. Pulsed dye laser as a novel non-surgical treatment for basal cell carcinomas: response and follow up 12-21 months after treatment. Lasers Surg Med. 2011;43(2):72–8.
Carija A, et al. Single treatment of low-risk basal cell carcinomas with pulsed dye laser-mediated photodynamic therapy (PDL-PDT) compared with photodynamic therapy (PDT): a controlled, investigator-blinded, intra-individual prospective study. Photodiagn Photodyn Ther. 2016;16:60–5.
Kessels JP, et al. Ambulatory photodynamic therapy for superficial basal cell carcinoma: an effective light source? Acta Derm Venereol. 2017;97:649.
Karabulut GO, et al. Imiquimod 5% cream for the treatment of large nodular basal cell carcinoma at the medial canthal area. Indian J Ophthalmol. 2017;65(1):48–51.
Yang X, Dinehart MS. Triple hedgehog pathway inhibition for basal cell carcinoma. J Clin Aesthet Dermatol. 2017;10(4):47–9.
Williams HC, et al. Surgery versus 5% Imiquimod for nodular and superficial basal cell carcinoma: 5-year results of the SINS randomized controlled trial. J Invest Dermatol. 2017;137(3):614–9.
Singal A, et al. Facial basal cell carcinoma treated with topical 5% Imiquimod cream with Dermoscopic evaluation. J Cutan Aesthet Surg. 2016;9(2):122–5.
Urech M, et al. Dermoscopic ulceration is a predictor of basal cell carcinoma response to Imiquimod: a retrospective study. Acta Derm Venereol. 2017;97(1):117–9.
Jung YS, et al. Superficial basal cell carcinoma treated with two cycles of ingenol mebutate gel 0.015. Ann Dermatol. 2016;28(6):796–7.
Izzi S, et al. Successfully treated superficial basal cell carcinomas with ingenol mebutate 0.05% gel: report of twenty cases. Dermatol Ther. 2016;29(6):470–2.
Bettencourt MS. Treatment of superficial basal cell carcinoma with ingenol mebutate gel, 0.05%. Clin Cosmet Investig Dermatol. 2016;9:205–9.
Wong Y, Low JA, Chio MT. Role of topical tranexamic acid in hemostasis of locally advanced basal cell carcinoma. JAAD Case Rep. 2016;2(2):162–3.
Ker K, Beecher D, Roberts I. Topical application of tranexamic acid for the reduction of bleeding. Cochrane Database Syst Rev. 2013;(7):CD010562.
Micali G, et al. Topical pharmacotherapy for skin cancer: part I. Pharmacology. J Am Acad Dermatol. 2014;70(6):965.e1–12; quiz 977–8.
Chang J, et al. Association between programmed death ligand 1 expression in patients with basal cell carcinomas and the number of treatment modalities. JAMA Dermatol. 2017;153:285.
Chen L, Silapunt S, Migden MR. Sonidegib for the treatment of advanced basal cell carcinoma: a comprehensive review of sonidegib and the BOLT trial with 12-month update. Future Oncol. 2016;12(18):2095–105.
Cox KF, Margo CE. Role of vismodegib in the management of advanced periocular basal cell carcinoma. Cancer Control. 2016;23(2):133–9.
Falchook GS, et al. Responses of metastatic basal cell and cutaneous squamous cell carcinomas to anti-PD1 monoclonal antibody REGN2810. J Immunother Cancer. 2016;4:70.
Lacouture ME, et al. Characterization and management of hedgehog pathway inhibitor-related adverse events in patients with advanced basal cell carcinoma. Oncologist. 2016;21(10):1218–29.
McGrane J, Carswell S, Talbot T. Metastatic spinal cord compression from basal cell carcinoma of the skin treated with surgical decompression and vismodegib: case report and review of hedgehog signalling pathway inhibition in advanced basal cell carcinoma. Clin Exp Dermatol. 2017;42(1):80–3.
Fife D, et al. Vismodegib therapy for basal cell carcinoma in an 8-year-old Chinese boy with xeroderma pigmentosum. Pediatr Dermatol. 2017;34(2):163–5.
Fife K, et al. Managing adverse events associated with vismodegib in the treatment of basal cell carcinoma. Future Oncol. 2017;13(2):175–84.
Guo D, Kossintseva I, Leitenberger J. Neoadjuvant vismodegib before Mohs: lack of tissue sparing and squamous differentiation of basal cell carcinoma in a patient with chronic lymphocytic leukemia. Dermatol Surg. 2016;42(6):780–3.
Kwon GP, et al. Update to an open-label clinical trial of vismodegib as neoadjuvant before surgery for high-risk basal cell carcinoma (BCC). J Am Acad Dermatol. 2016;75(1):213–5.
Lima JP. Statistical concerns on vismodegib for basal cell carcinoma meta-analysis. JAMA Dermatol. 2017;153:337.
Paulsen JF, et al. Vismodegib and surgery combined – effective treatment of locally advanced basal cell carcinoma. Acta Oncol. 2016;55(12):1492–4.
Casey D, et al. FDA approval summary: sonidegib for locally advanced basal cell carcinoma. Clin Cancer Res. 2017;23:2377.
Tibes R. Sonidegib phosphate: new approval for basal cell carcinoma. Drugs Today (Barc). 2016;52(5):295–303.
Yin VT, Esmaeli B. Targeting the hedgehog pathway for locally advanced and metastatic basal cell carcinoma. Curr Pharm Des. 2017;23(4):655–9.
Silapunt S, Chen L, Migden MR. Hedgehog pathway inhibition in advanced basal cell carcinoma: latest evidence and clinical usefulness. Ther Adv Med Oncol. 2016;8(5):375–82.
Ramelyte E, Amann VC, Dummer R. Sonidegib for the treatment of advanced basal cell carcinoma. Expert Opin Pharmacother. 2016;17(14):1963–8.
Collier NJ, Ali FR, Lear JT. The safety and efficacy of sonidegib for the treatment of locally advanced basal cell carcinoma. Expert Rev Anticancer Ther. 2016;16(10):1011–8.
Dreno B, et al. Two intermittent vismodegib dosing regimens in patients with multiple basal-cell carcinomas (MIKIE): a randomised, regimen-controlled, double-blind, phase 2 trial. Lancet Oncol. 2017;18(3):404–12.
Yonjan Lama I, Wharton S. Comment Re: ‘Treatment of basal cell carcinoma with surgical excision and perilesional interferon-alpha’. J Plast Reconstr Aesthet Surg. 2015;68(6):877–8.
Wettstein R, et al. Treatment of basal cell carcinoma with surgical excision and perilesional interferon-alpha. J Plast Reconstr Aesthet Surg. 2013;66(7):912–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Higgins, S., Chow, M., Wysong, A. (2018). Basal Cell Carcinoma. In: Hanlon, A. (eds) A Practical Guide to Skin Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-74903-7_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-74903-7_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74901-3
Online ISBN: 978-3-319-74903-7
eBook Packages: MedicineMedicine (R0)