What Is the Treatment for Basal Cell Carcinoma?

Basal cell carcinoma has a low rate of metastasis and is more benign, so it is also called basal cell epithelioma. Because it is more destructive, it is also called invasive ulcer. Basal cell carcinoma is more common in the elderly, and it occurs in the head, face, neck, and back of the hand, especially in the prominent parts of the face. The beginning is a small nodule infiltrated with skin color to dark brown, more typically a waxy, translucent nodule, with curled edges. The center began to rupture, with black necrotic crests, and the central necrosis extended to deep tissues. It was a large piece of invasive necrosis, which could reach soft tissues and bone tissues.

Basic Information

Also known as: Basal cell epithelioma, invasive ulcer
English name: basalcellcarcinoma
Visiting department: Oncology
Multiple groups: Seniors
Common locations: Head, face, neck, back of hand, etc.

Common causes: Sunlight
Common symptoms: Rupture, black necrotic crest, central necrosis spreads to deep tissues, and large pieces of invasive necrosis can reach deep into soft tissue and bone tissue
Contagious: no

Causes of Basal Cell Carcinoma

This disease is a malignant tumor derived from basal cells. It is closely related to sunlight, so it occurs on the head, face, neck, or back of the hand. It is now generally considered to be a tumor derived from epidermal pluripotent cells, and monoclonal antibodies have been used to confirm that basal cell carcinoma is derived from epidermal cells.

Clinical manifestations of basal cell carcinoma

Basal cell carcinoma is more common in the elderly, and it occurs in the head, face, neck, and back of the hand, especially in the prominent parts of the face. The beginning is a small nodule infiltrated with skin color to dark brown, more typically a waxy, translucent nodule, with curled edges. The center began to rupture, with black necrotic crests, and the central necrosis spread to deep tissues. It was a large piece of invasive necrosis, which could reach soft tissues and bone tissues. This is an aggressive ulcer. Basal cell carcinoma often has black pigmentation at the base and edges, and the disease develops chronically progressively. According to histopathology and clinical symptoms, it can be divided into nodular type, superficial type, cystic type, adenoid type, pigmented type, hard spot type, irregular type, fibrous epithelioma and nevus basal cell epithelioma type.

Basal cell carcinoma diagnosis

The disease is an invasive ulcer with a curly pearl-like edge, a black base, and a chronic course. The diagnosis depends on pathological examination. Histopathology showed that the basal cells in the epidermis were melt-like masses, and the edges were arranged in a fence-like manner. Keratinous cysts were possible, and the diagnosis was not difficult.

Differential diagnosis of basal cell carcinoma

The disease should be distinguished from pigmented nevus, seborrheic keratosis, keratoacanthoma, squamous cell carcinoma and melanoma.

Basal cell carcinoma treatment

There are many treatment methods for basal cell carcinoma, and the most important thing is to choose the best treatment plan based on the patient's condition.

Surgical removal

When the damage is deep in the uneven special area or the invasive ulcer is deep, and other treatments are not suitable, surgical removal and skin grafting can be performed.

2.X-ray irradiation

Basal cell carcinoma is more sensitive to radiation and has no pain. The patient is willing to accept it, and it is most suitable for the elderly.

3. Electric Burn

For early small basal cell carcinoma, electrocautery can be used to completely remove it, but scars will remain after healing.

4. Sharp spoon curettage

It has been reported to cure basal cell carcinoma with a sharp spatula, which has not recurred for more than 5 years, and has an excellent cosmetic effect.

5. Liquid nitrogen freezing

Liquid nitrogen up to 195 ° C has excellent destruction effect, and can be used for cryotherapy with liquid nitrogen for small area basal cell carcinoma. Cryotherapy can also be done for large areas of basal cell carcinoma, but the healing time is longer.

6. Laser treatment

Some people have adopted carbon dioxide laser to treat basal cell carcinoma with excellent results. It heals quickly and is less painful after surgery, but leaves scars.

7. Topical cytotoxic drugs

The cytotoxic drug commonly used in the treatment of basal cell carcinoma is 5% fluorouracil, which can completely destroy the basal cell carcinoma, but the medication is very painful, and irritation such as redness and swelling must occur.

8. New methods

(1) Retinoids Although there are adverse reactions and require long-term treatment, it is promising for patients with multiple basal cell carcinoma to treat with retinoids.

(2) Immunotherapy Recently, there have been many reports on the use of interferon alpha-2a as a local injection immunotherapy to treat basal cell carcinoma.

(3) Photodynamic therapy Photodynamic therapy is to irradiate the whole body with a hematoporphyrin derivative or dihemoporphyrin with a tunable dye laser (wavelength 630nm). It is very effective in treating basal cell carcinoma. The partial and complete cure rates of the tumor are 44% and 82%, respectively. The main adverse reaction is photosensitivity.

(4) Chemotherapy Topical topical fluorouracil can successfully treat multiple superficial basal cell carcinomas and prevent them from continuing. Systemic chemotherapy drugs are used to treat large and aggressive non-metastatic basal cell carcinomas. Treatment with cisplatin and doxorubicin with or without radiation is mostly effective. Treatment with bleomycin also has different effects.

Basal cell cancer prevention

In adolescents, care should be taken to prevent excessive sunlight exposure, and the elderly should also protect their skin and prevent excessive sunlight exposure. Various chronic skin diseases should be actively treated to prevent canceration.