Basal cell carcinoma of the skin (Carcinoma basocellulare, Basalioma) is the most common form of cutaneous tumor and affects more than 90% of all skin tumors at all. It is a cancer cell located on the lower part of the skin’s highest layer, the epidermis. These keratinocyte-like cells are characterized by infiltrative growth into the skin’s deeper layers and surrounding tissues.
What are the predispositions for the development of basal cell carcinoma?
● Light complexion – people with light skin and blue eyes are more prone to the appearance of basal cell carcinoma.
● Sun exposure: there is evidence that, unlike basal cell carcinoma, the squamous cell tumor is not associated with accumulated sun exposure but is associated with occasional exposure to strong sunlight. During the holidays, especially in childhood or adolescence.
● age – the frequency increases with age, so the tumor more often affects the elderly population
Are there any other risk factors for basal cell carcinoma of the skin?
The following factors can influence the development of basal cell carcinoma:
● The weakening of the immune system,
● Long-term illness or treatment
● Race. Basal cell carcinoma of the skin mainly affects whites worldwide, while it is rarely found in dark-skinned people and is especially rare in blacks.
● Profession. Basal cell carcinoma is more common in people who are professionally exposed to the sun, such as farmers or fishers.
● Place of residence: People who live in the part of the globe where there is a lot of UV radiation from the Sun are more prone to developing tumors. Thus, e.g., the highest growth rate of skin tumors is found in South Africa and Australia, which are areas that receive high levels of UV radiation.
● Age. Most often, skin tumors appear after 50 that year, but the sun’s harmful effect begins in the early years. Therefore, protection should begin in early childhood.
● Therapeutic radiation is radiation given to treat other forms of tumors.
Which parts of the body are most commonly affected by basal cell carcinoma?
The face is the most common location for basal cell carcinoma lesions. However, about 20% of these tumors occur in areas not exposed to the sun, such as the chest, back, arms, legs, and scalp.
What does basal cell carcinoma of the skin look like?
The skin’s basal cell carcinoma usually begins as a small dome-shaped growth a few millimeters in diameter that is usually covered with small superficial blood vessels called telangiectasias. The growth is usually bright and airy, sometimes described as pearly. Some basal cell carcinomas primarily appear as an ulcer defect on the skin that does not heal for a long time, and some basal cell carcinomas in turn. They contain melanin pigment making it look more like a youth.
What are the forms of basal cell carcinoma?
Forms of the disease:
basalioma solidum (nodulare): the most common form of the disease, a nodular formation occurs s telangiectasias on the surface
basalioma ulcerosum: a change characterized by the appearance of skin defects and erosions that heal with difficulty and slowly and bleed occasionally
basal cell carcinoma: a change that has the properties of a malignant tumor; it grows invasively into the surrounding tissue with frequent bone destruction
Basalioma pigmentosum: change characterized by increased pigmentation
Superior basal cell carcinoma usually appears on the chest or back and looks more like a patch of sensitive, dry skin.
The diagnosis is based on the clinical picture and confirmed by histological findings.
It is said that basal cell carcinoma of the skin is not a very dangerous tumor, why?
Basal cell carcinoma grows slowly, over months or years. Although it spreads to other parts of the body, metastases are rare. The main damage caused by basal cell carcinoma is its local growth, which can damage and distort the organs close to it (eyes, ears, or nose).
How is basal cell carcinoma of the skin treated?
There are many ways to succeed in skin cancer treatment, with a chance of success of up to 90% or more. They mostly try to remove or destroy the tumor.
When developing a treatment plan, you should take the tumor’s location and size, the risk of scarring and age, general health, and medical history into account.
What methods are used in the treatment of tumors?
Methods used for treatment include:
● Surgical removal – the tumor is removed, and the damaged skin is sutured.
● Curettage and dissection. Dermatologists sometimes use this method, which involves removing the basal cell carcinoma using a spoon-like instrument called a curette. Dissection is an additional electric current application to control bleeding and kill the remaining tumor cells. Leather whole without suturing. This technique is best suited for small tumors in non-critical areas such as the trunk and limbs.
● Radiotherapy: Radiation therapy is used for skin tumors that appear in parts of the body that are difficult to treat surgically (face).
● Cryosurgery: Some doctors achieve good results with freezing basal cell carcinoma. Liquid nitrogen is applied to freeze and kill abnormal cells.
● Mohs micrographic surgery: The name is pioneering. Dr. Frederic Mohs better called this skin cancer removal technique “microscopically controlled excision.” Surgery very carefully and precisely removes small parts of the tumor and examines them under a microscope during surgery. The incision and microscopic examination outcome are in a flawless appearance so that the basal cell carcinoma can be marked and removed without worrying about the appropriate width and thickness of the lesion. This method removes a small portion of healthy normal tissue. The healing rate is very high, exceeding 98%. Mohs micrographic surgery is used for large basal cell carcinomas and recurrent basal cell carcinomas.
● Creams that attack tumor cells
– cytostatic creams 5-fluorouracil, Efudex, Fluoroplexy or
– Creams stimulate the immune system, such as Imiquimod (Aldara).
These creams are applied several times a week for several weeks. They produce a rapid, sharply limited inflammatory reaction. The advantage of this method is that it avoids surgery, the treatment can be carried out at home, and can give a better cosmetic result (without scars). The disadvantage of this method is the low cure rate.
How is basal cell carcinoma of the skin prevented?
● Sensitive people need to avoid sun exposure.
● Self-examinations and regular check-ups with general practitioners and dermatologists
● People who already have skin tumors should be checked more often.
What should be adhered to in the prevention of skin tumors?
For good protection from the Sun and its radiation, it is necessary:
● reduce sun exposure during sports and recreation
● avoid sun exposure during peak radiation (around noon)
● Wear a wide-brimmed hat and tightly woven protective clothing while in the sun
● Use waterproof or water-resistant sunscreen with UVA protection SPF 30 or higher.
● Regularly monitor and remove suspicious or changeable-looking lesions
● Protective creams must be applied every two to three hours, especially after swimming or physical activity when the body is sweating and when even sunscreen marked as waterproof can rinse.
Interesting facts
Scientists at the U.S. National Institutes of Health near Washington have announced that they have successfully cured skin cancer using gene therapy for the first time. Experts have modified the immune system’s cells to fight melanoma, the most deadly form of cancer.
Lymphocytes, white blood cells, usually successfully fight bacteria and viruses, but not cancer. But now, after years of research on 17 patients with advanced cancer, experts have announced that they have made progress. This method completely cured two patients, and the others were not completely cured, but they have an increased number of white blood cells in their bodies to fight cancer than before.
Summary
Basal cell carcinoma of the skin is the most common skin tumor, it very rarely metastasizes, but locally it can destroy the surrounding structures and disfigure a person. The most important thing is to stay away from the risk factors that lead to its occurrence, the most important of which is protection from the sun and its radiation and the treatment of the tumor while it is still in its initial phase.
