An introduction to the issue of basal cell carcinoma

Patient Portal Skin Cancer Skin cancer is the most common of all cancers, afflicting more than two million Americans each year, a number that is rising rapidly.

An introduction to the issue of basal cell carcinoma

References Discussion The most important risk factor of the incidence of BCC is directly related to intense exposure to ultraviolet radiation [10].

It has not been elucidated the reasons for the appearance of BCC in the vulva. Syphilis, chronic irritation, chronic infection, trauma, arsenic, age, immune deficiency, certain genetic diseases such as Gorlin syndrome, xeroderma pigmentosum, human papilloma virus the most relevant in the squamous cells of the genital etiologymutations in the p53 gene and ionizing radiation have been implicated as potential causes [1,6,15,16].

Usually, vulvar BCC affects Caucasian and postmenopausal women [15], being relatively rare in childrens and black women [3]. It is found mainly between the ages of 34 to 96, with an average age of 70 [1,15], and there is one report of a patient with 20 years of age [8].

The vulvar BCC is a disease with late diagnosis, characterized for being often asymptomatic, with non-specific physical signs and slow gradual growth [4,6].

An introduction to the issue of basal cell carcinoma

When expressed, the symptoms are often present for a long period of time, the most common are itching, irritation and presence of palpable mass in the vulvar region [15].

The vulvar BCC is characterized by a lack of pigmentation and by showing similar clinical signs of other dermatological diseases such as infectious or inflammatory dermatoses, eczema or psoriasis.

Therefore, the correct diagnosis is generally delayed by inadequate therapeutic measures, allowing tumor growth and increasing their invasiveness and discomfort to the patient.

Vulvar BCCs, as well as in other body sites, can be presented as a rounded ulcer with jagged edges or as nodules or blotches.

In the vulva most of the lesions are smaller than 2 cm in diameter and typically located in the labia [1,7].

An introduction to the issue of basal cell carcinoma

Although they are usually slow growing tumors, they are locally invasive and destructive, with the risk of recurrence and metastasis. They have a tendency to grow over the anatomical path of least resistance, most commonly on the labia majora; this explains the delayed bone invasion, cartilage and muscle [7].

Owing to the innocuous appearance BCC in these places, it is recommended the biopsy of all suspicious lesions [9] and the standard treatment consists of wide local excision with clear margins of approximately 1 cm histologically proven [8,15,17].

In cases where due to aesthetic or functional factors can not be obtained free margins, Benedet concluded that these patients can perform clinical follow-up safely due to the low propensity of tumor spread [15]. Surgical resection of these lesions of the vulva should be larger than in other regions of the body due to the high number of recurrences.

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In bulky or histologically aggressive types of BCC as morphea-like, or basosquamous metatypical carcinoma and perineural invasion of tissue involvement may be greater than clinically suggested.

In the cases where the wide resection of the lesion is inadequate, with local recurrence risk and insufficient treatment, it is indicated the Mohs micrographic surgery [6,9,18]. Mohs surgery involves excision of the tumor under controlled and careful microscopic monitoring, with the advantage of the study of deep and lateral margins at the time of resection, providing a relative certainty of complete tumor resection with minimum removal of healthy tissue [6].

It should also be considered in cases where it is necessary to preserve tissue in critical anatomical regions, such as the vulva and the clitoris [6,8]. At first it was thought that the vulvar BCC did not generate metastasis, until in Jimenez reported the first known case of metastasis to the inguinal lymph nodes [19].

Despite cases of vulvar BCC metastasis are rare, with an incidence lower than 0. BCCs are moderately sensitive to radiation therapy. Although there are few cases reported for a long period of time, cure rates are similar with other approaches such as chemotherapy [6,7,20] associated with unpleasant clinical and aesthetic effects [6,8,17].

The systematic chemotherapy is not useful for treatment of localized BCC. Some studies suggest that Cisplatin can present results alone or in combination with doxorubicin in patients with metastatic disease, however, with no definitive conclusions [6,8].

Adjuvant treatment of metastatic vulvar BCCs should be individualized to the type and degree of dissemination of the disease as well as the needs of the patient [6].An Introduction to the Issue of Basal Cell Carcinoma PAGES 3.

WORDS 1, View Full Essay. More essays like this: basal cell carcinoma treatment, cancerous cells, basal cell carcinoma. Not sure what I'd do without @Kibin - Alfredo Alvarez, student @ Miami University. Exactly what I needed.

Understanding Skin Cancer is reviewed approximately every two years. Check the publication you may wish to discuss issues raised in this book with them. cancer – basal cell carcinoma and squamous cell carcinoma. For information about melanoma, call Cancer Council 13 11 20 and. Basal cell carcinoma, also known as basal cell cancer, is the most common type of skin cancer.

Metastatic basal cell carcinoma - ScienceDirect

It begins in basal cells in the deepest part of the epidermis. It often starts in areas of skin exposed to the sun, such as the face, head, neck, arms, and hands. expand/collapse Basal Cell Carcinoma Treatment Options expand/collapse Five Warning Signs of Basal Cell Carcinoma expand/collapse Early Detection and Self Exams.

Nov 14,  · The differential diagnosis included basal cell carcinoma, melanoma, squamous cell carcinoma, keratoacanthoma, and atypical fibroxanthoma. A biopsy specimen showed nests of epithelioid cells in the dermis, many with punctate nuclear chromatin, along with scattered mitotic figures.

Cutaneous human papillomavirus infection and basal cell carcinoma of the skin

Basal cell carcinoma (BCC) is the most frequently occurring skin tumor. It mostly occurs on actinic damaged skin of older people. BCC is slow growing, locally invasive, and destructive and develops from the basal layers of the epidermis and hair follicles.

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