Basal cell epithelioma at a glance

EpidemiologyPrevalence100 000 cases in the UK, 2001; 90% of non-melanoma skincancers

AgeMore common in the elderly

RaceRaces with fair complexion

OtherAssociated with chronic exposure to UVB and, more rarely,exposure to non-ionizing radiation and inorganic arsenic

Clinical featuresLesions commonly at sides of the nose and around the orbitSlow-growing, pearly, flesh-coloured translucent smoothpapules or nodules with rolled edges or plaquesSurface telangiectasiaFrequent central necrosis with crusting or ulcerationMore rarely, cystic or pigmented lesions

ManagementCryosurgeryCurettage/cauteryExcisional surgery (± grafting)Mohs’ micrographic surgery (± grafting)Chemosurgery (intralesional 5-fluorouracil)Radiotherapy

Fig. C Superficial basal cell carcinoma on back of shin. Redscaly patch.

Fig. D Morphoeic basal cell carcinoma on the face. Irregularplaque.

1144 Chapter 18 Skin disease

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Fig. A Basal cell carcinoma below the right eye. Nodule.

Fig. E Pigmented basal cell carcinoma. Courtesy of Dr R.C.D.Staughton.

Fig. B Classical crateriform basal cell carcinoma. Ulceratingnodule.

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