Nodular Basal Cell Carcinoma
Definition: Nodular Basal Cell carcinoma is a subtype of BCC that is marked by raised, pearly flesh coloured nodules with melanogenesis typically localized to the face (2,3).
Etiology: Similar to other BCCs, Nodular BCC is caused primarily by exposure to ultraviolet light as well as genetic factors (3). In the skin of color, pigmented Nodular BCCs are more common (1).
Epidemiology: Nodular Basal Cell carcinoma is the most common subtype of BCC and has a high incidence in individuals with fair skin with a significant history of sun exposure (1). Approximately 60% to 80% of BCC are of the Nodular subtype (4).
Signs: Nodular BCC manifests as skin-coloured papules or nodules with pearly or translucent telangiectatic border (3,4). It may be described as having a rolled border in which the edges of the lesion are higher than the center (4). Large lesions may include ulceration (4).
Symptoms: Typically asymptomatic but with time the lesions may crust or bleed (2,3).
Differentials: Trichoblastoma and trichoepithelioma (1).
Diagnosis: Diagnosis is confirmed through a shave or punch biopsy but clinical exam and dermoscopy can supplement the assessment (2).
Treatment: Treatment is usually surgical involving either surgical excision or Mohs micrographic surgery (1,3). Non-surgical options include cryotherapy, topical therapies or radiation in some cases (1,3).
References: (AMA)
1. 1. McDaniel B. Basal cell carcinoma. StatPearls [Internet]. March 13, 2024. Accessed August 18, 2024. https://www.ncbi.nlm.nih.gov/books/NBK482439/#:~:text=BCC%20typically%20presents%20as%20a,rolled%20or%20rodent%20ulcer%20appearance.
2. Oakley A. Basal cell carcinoma: Symptoms, causes, and treatment – dermnet. DermNet®. July 3, 2024. Accessed August 18, 2024. https://dermnetnz.org/topics/basal-cell-carcinoma.
3. 1. Robert S Bader M. Basal cell carcinoma. Practice Essentials, Background, Pathophysiology. April 3, 2024. Accessed August 18, 2024. https://emedicine.medscape.com/article/276624-overview?gad_source=1&gbraid=0AAAAADoSQiUCwFng3uMBdxWlXHVuNMVrw&gclid=Cj0KCQjwt4a2BhD6ARIsALgH7Dqhf-P79uzm848PdW5k8auVX_QjoRGo38V0m2dFrNN42l3MpFCbyS0aAm4_EALw_wcB&form=fpf#a2.
4. Tanese K. Diagnosis and management of basal cell carcinoma. Current Treatment Options in Oncology. 2019;20(2). doi:10.1007/s11864-019-0610-0