Basal Cell Carcinoma

Basal cell carcinoma is the most common non-melanoma skin cancer and accounts for about 90% of skin cancer cases in the United States. It is characterized by the location it arises from in the basal cells of the lower layer of the epidermis. It develops on the body as a bump that is usually pink and waxy in appearance with a central depression. The affected area occasionally oozes or crusts as the cancer spreads. The cancer itself is very slow growing compared to most. It typically takes 1 to 2 years to grow 0.5 cm.
There are several different types of basal cell carcinoma that are classified by location and appearance. Nodular is the most common type and presents as a round, cystic, pearly and flesh colored papule with telagiectases. Infiltrative is less apparent and found within the dermis in thin strands between collagen fibers. Micronodular has a well-defined border, appears yellow when stretched and is firm to the touch. Morpheaform is slightly depressed, fibrotic, and firm with yellow or white, waxy, sclerotic plaque. Superficial has a whitish scale erythematous, well circumcised plaque in appearance and is mostly found on the upper trunk and shoulders.
The primary cause for basal cell carcinoma is exposure to ultraviolet light most specifically within the ranges of 290 to 320 nm. These rays are produced from the sun and tanning beds. When they hit the skin the rays damage the DNA in the cells of the skin and keep the cells from repairing properly. Usually the skin cancer occurs in people over the age of 50 after sun exposure has repeatedly damaged the DNA of the cells.
Other risk factors for basal cell carcinoma can be physical traits, behaviors, or medical history. Some of the physical traits that can be risk factors include fair, light-colored or freckled skin, blue, green or gray eyes, blond or red hair, and an inability to tan. Some behaviors that can be risk factors are spending a lot of time outside in the sun peak hours without sunscreen or other cover and using a tanning be regularly. The medical history risk factors can include previous basal cell carcinoma, close relative with basal cell carcinoma, taking of drugs that suppress the immune system and overexposure to X-rays. There is also rare chances of the cancer developing at the age of 20 years but it must be caused by another underlying condition.
There are four main ways to treat basal cell carcinoma of which could either be topical or surgical. Topical chemotherapy can be used to treat superficial basal cell carcinoma by using anticancer agents such as 5-flourouracil, also known as Efudex or Carac, to treat the effected cells. Topical immunomodulators can also be used on the outside of the skin with a cream that contains imiquimod or Aldara but it focuses on stimulating the immune response against tumor cells. The surgical methods include curettage and electrodesiccation in which the tumor cells are scraped away and the area is cauterized with an electric needle to control the bleeding. This treatment is only appropriate for