written by: Finn Orfano
• edited by: Diana Cooper
• updated: 10/13/2010
Basal cell cancer most often develops on areas of the skin that have been exposed to sunlight over a prolonged period of time. This form of skin cancer can usually be treated successfully with medications or surgery. Three main types of basal cell cancer are nodular, superficial, and infiltrative.
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Basal cell carcinoma is a common variety of skin cancer that most frequently develops on the head, neck, torso, and other areas of the body that are at risk for excessive sun exposure. Not all types of basal cell cancer are the same. The physical characteristics of these skin carcinomas can be grouped into three main categories, which are described in further detail below.
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Nodular Basal Cell Carcinoma
Nodular basal cell carcinoma is the type that affects most individuals who are diagnosed with skin cancer. Nodular lesions are often located on the upper back, neck, and head.
Causes: Possible causes of nodular basal cell cancer include genetic predisposition, a condition known as Basal Cell Nevus Syndrome, and DNA damage from ultraviolet light. Risk factors increase for fair-skinned, elderly adults who have a family history of the disease and were exposed to sunlight often as children.
Symptoms: Nodular basal cell cancer lesions are often pearl-like and waxy in appearance. The centers of these lesions are depressed and the borders are raised. The lesions have a translucent quality and can be prone to bleed. Pigment may be present in some cases.
Diagnosis and Treatment: This type of carcinoma is diagnosed through a skin biopsy. Treatment options include radiation therapy, surgical excision, Mohs micrographic surgery, and curettage with electrodesiccation.
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Superficial Basal Cell Carcinoma
Superficial basal cell carcinoma is a non-aggressive form of skin cancer that responds well to topical treatments. This type of basal cell cancer commonly occurs on the torso area of the body.
Causes: The possible causes and risk factors of superficial basal cell carcinoma are similar to those of nodular basal cell carcinoma. Individuals who have a large number of superficial lesions may have been exposed to arsenic.
Symptoms: Superficial basal cell cancer often resembles eczema and develops in the form of pink or red patches. These lesions are scaly and commonly present with clear centers and uneven raised borders. This type of carcinoma is slow to progress and rarely invasive.
Diagnosis and Treatment: Also diagnosed through skin biopsies, superficial basal cell cancer can often be treated with topical chemotherapy medications. These medications, which include Aldara (imiquimod) and fluorouracil, are particularly effective for treating small lesions. Surgical methods are also an option.
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Infiltrative Basal Cell Carcinoma
Infiltrative basal cell carcinoma is an aggressive type of skin cancer that requires surgical treatment. Subtypes of infiltrative basal cell lesions include micronodular carcinoma and morpheaform carcinoma.
Causes: Infiltrative forms of basal cell cancer, like those of the nodular and superficial types, are linked to both genetic factors and environmental factors such as prolonged sun exposure in youth.
Symptoms: The symptoms of infiltrative basal cell lesions vary according to subtype. Micronodular lesions are typically firm, yellowish-white in color, and have a distinct border. Morpheaform lesions resemble plaque or scar tissue, have vague and far-reaching borders, and are prone to crusting and bleeding.
Diagnosis and Treatment: A thorough skin biopsy is necessary for this type of basal cell cancer, as infiltrative lesions are visually easy to mistake for other non-cancerous forms of scar tissue. Surgical excision with margin examination, radiation therapy, and Mohs micrographic surgery are the most effective treatment options.
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Once a patient has been diagnosed with one of the types of basal cell cancer, he or she can discuss treatment options with medical professionals and can proceed with having the cancer removed. Because several effective basal cell surgical procedures and medication options are available, patients who are diagnosed while the disease is in early stages often have a very good prognosis.