Basal Cell Carcinoma

  • Dimitrios PapakostasEmail author
  • Eggert Stockfleth


Basal cell carcinoma (BCC), 80 % of all nonmelanoma skin cancers (NMSCs), is the most common malignancy in humans, with an increasing incidence. Sun exposure, genetic predisposition, and immunosuppression are the main risk factors. Metastases are extremely rare and morbidity rather than mortality is the main issue regarding the socioeconomic impact of BCC. Surgical excision remains the treatment of choice in most cases, with radiotherapy still being a reliable alternative in selected cases. A variety of nonsurgical destructive methods such as cryotherapy, photodynamic treatment, and electrodessication after curettage, along with topical treatments such as imiquimod, are reserved for the treatment of superficial BCCs or basal cell nevus syndrome (BCNS). Recently, novel targeted systemic therapies inhibiting the sonic hedgehog pathway promise to revolutionize the treatment of advanced BCCs, metastasized or locally destructive and inoperable.


Basal cell carcinoma Nonmelanoma skin cancer Mohs surgery Hedgehog inhibitors Cryotherapy Photodynamic therapy Imiquimod Radiotherapy Vismodegib 

Further Reading

  1. Abramson AK, Krasny MJ, Goldman GD. Tangential shave removal of basal cell carcinoma. Dermatol Surg. 2013;39(3 Pt 1):387–92.PubMedGoogle Scholar
  2. Arits AH, Mosterd K, Essers BA, Spoorenberg E, Sommer A, De Rooij MJ, et al. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma: a single blind, non-inferiority, randomised controlled trial. Lancet Oncol. 2013;14(7):647–54.PubMedGoogle Scholar
  3. Atwood SX, Chang AL, Oro AE. Hedgehog pathway inhibition and the race against tumor evolution. J Cell Biol. 2012;199(2):193–7.PubMedPubMedCentralGoogle Scholar
  4. Axelson M, Liu K, Jiang X, He K, Wang J, Zhao H, et al. U.S. Food and drug administration approval: vismodegib for recurrent, locally advanced, or metastatic basal cell carcinoma. Clin Cancer Res. 2013;​19(9):2289–93.PubMedGoogle Scholar
  5. Basset-Seguin N, Bissonnette R, Girard C, Haedersdal M, Lear JT, Paul C, et al. Consensus recommendations for the treatment of basal cell carcinomas in Gorlin syndrome with topical methylaminolaevulinate-photodynamic therapy. J Eur Acad Dermatol Venereol. 2014;28:626–32.PubMedGoogle Scholar
  6. Blixt E, Nelsen D, Stratman E. Recurrence rates of aggressive histologic types of basal cell carcinoma after treatment with electrodesiccation and curettage alone. Dermatol Surg. 2013;39(5):719–25.PubMedGoogle Scholar
  7. Fecher LA. Systemic therapy for inoperable and metastatic basal cell cancer. Curr Treat Options Oncol. 2013;14(2):237–48.PubMedGoogle Scholar
  8. Hauschild A, Breuninger H, Kaufmann R, Kortmann RD, Schwipper V, Werner J, et al. Short German guidelines: basal cell carcinoma. J Dtsch Dermatol Ges. 2008;6 Suppl 1:S2–4.PubMedGoogle Scholar
  9. Kasper M, Jaks V, Hohl D, Toftgård R. Basal cell carcinoma – molecular biology and potential new therapies. J Clin Invest. 2012;122(2):455–63.PubMedPubMedCentralGoogle Scholar
  10. Liu LS, Colegio OR. Molecularly targeted therapies for nonmelanoma skin cancers. Int J Dermatol. 2013;​52(6):654–65.PubMedGoogle Scholar
  11. Macbeth AE, Grindlay DJ, Williams HC. What’s new in skin cancer? An analysis of guidelines and systematic reviews published in 2008–2009. Clin Exp Dermatol. 2011;36(5):453–8.PubMedGoogle Scholar
  12. Messeguer F, Serra-Guillen C, Echeverria B, Requena C, Sanmartin O, Llombart B, et al. A pilot study of clinical efficacy of imiquimod and cryotherapy for the treatment of basal cell carcinoma with incomplete response to imiquimod. J Eur Acad Dermatol Venereol. 2012;26(7):879–81.PubMedGoogle Scholar
  13. Miller SJ. The National Comprehensive Cancer Network (NCCN) guidelines of care for nonmelanoma skin cancers. Dermatol Surg. 2000;26(3):289–92.PubMedGoogle Scholar
  14. Moutran R, Maatouk I, Stephan F, Tomb R. Treatment of nodular basal cell carcinoma with cryotherapy and reduced protocol of imiquimod. Cutis. 2012;​90(5):256–7.PubMedGoogle Scholar
  15. Rogers CR, Bentz ML. An evidence-based approach to the treatment of nonmelanoma facial skin malignancies. Plast Reconstr Surg. 2011;127(2):940–8.PubMedGoogle Scholar
  16. Roozeboom MH, Arits AH, Nelemans PJ, Kelleners-Smeets NW. Overall treatment success after treatment of primary superficial basal cell carcinoma: a systematic review and meta-analysis of randomized and nonrandomized trials. Br J Dermatol. 2012;​167(4):733–56.PubMedGoogle Scholar
  17. Roozeboom MH, Aardoom MA, Nelemans PJ, Thissen MR, Kelleners-Smeets NW, Kuijpers DI, et al. Fractionated 5-aminolevulinic acid photodynamic therapy after partial debulking versus surgical excision for nodular basal cell carcinoma: a randomized controlled trial with at least 5-year follow-up. J Am Acad Dermatol. 2013;69(2):280–7.PubMedGoogle Scholar
  18. Sekulic A, Mangold AR, Northfelt DW, LoRusso PM. Advanced basal cell carcinoma of the skin: targeting the hedgehog pathway. Curr Opin Oncol. 2013;25(3): 218–23.PubMedGoogle Scholar
  19. Shokrollahi K, Javed M, Aeuyung K, Ghattaura A, Whitaker IS, O’Leary B, et al. Combined carbon dioxide laser with photodynamic therapy for nodular and superficial basal cell carcinoma: almost scarless cure with minimal recurrence. Ann Plast Surg. 2014;​73:552–8.PubMedGoogle Scholar
  20. Sterry W, European Dermatology Forum Guideline Committee. Guidelines: the management of basal cell carcinoma. Eur J Dermatol. 2006;16(5):467–75.PubMedGoogle Scholar
  21. Stockfleth E, Trefzer U, Garcia-Bartels C, Wegner T, Schmook T, Sterry W. The use of toll-like receptor-7 agonist in the treatment of basal cell carcinoma: an overview. Br J Dermatol. 2003;149 Suppl 66:53–6.PubMedGoogle Scholar
  22. Telfer NR, Colver GB, Morton CA. British Association of Dermatologists Guidelines for the management of basal cell carcinoma. Br J Dermatol. 2008;​159(1):​35–48.PubMedGoogle Scholar
  23. Ulrich M, Stockfleth E, Roewert-Huber J, Astner S. Noninvasive diagnostic tools for nonmelanoma skin cancer. Br J Dermatol. 2007;157 Suppl 2:56–8.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of DermatologyUniversity of Athens Medical School, Andreas Sygros HospitalAthensGreece
  2. 2.Department of Dermatology, Venerology and AlergologySt. Josef-Hospital RUHR-University BochumBochumGermany

Personalised recommendations