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Basal Cell Epithelioma

Basal cell epithelioma is also called basal cell carcinoma and basal cell cancer. This type of cancer can have many different appearances: a red patch or irritated area; a smooth, shiny and waxy looking bump; a white or yellow scar-like area; a smooth reddish growth; or an open sore that won't heal, bleeds or oozes. Not all growths on your skin are cancer.

Basal cell epithelioma, a slow-growing, destructive skin tumor, usually occurs in people over age 40. Basal cell epithelioma is most prevalent in blond, fair-skinned men, and it's the most common malignant tumor that affects whites. The two major types of basal cell epithelioma are noduloulcerative and superficial.

Causes

Prolonged sun exposure is the most common cause of basal cell epithelioma - 90% of tumors occur on sun-exposed areas of the body. Arsenic ingestion, radiation exposure, burns, immunosuppression and, rarely, vaccinations are other possible causes.

Although the pathogenesis is uncertain, some experts hypothesize that basal cell epithelioma originates when undifferentiated basal cells become carcinomatous instead of differentiating into sweat glands, sebum, and hair.

Diagnostic tests 

All types of basal cell epitheliomas are diagnosed by clinical appearance. Incisional or excisional biopsy and histologic study may help to determine the tumor type and histologic subtype.

Treatment

Depending on the size, location, and depth of the lesion, treatment may include curettage and electrodesiccation, chemotherapy, surgical excision, irradiation, or chemosurgery:

  • Curettage and electrodesiccation offer good cosmetic results for small lesions.
  • Topical fluorouracil is often used for superficial lesions. This medication produces marked local irritation or inflammation in the involved tissue but no systemic effects.
  • Microscopically controlled surgical excision carefully removes recurrent lesions until a tumor-free plane is achieved. After removal of large lesions, skin grafting may be required.
  • Irradiation is used if the tumor location requires it. It's also preferred for elderly or debilitated patients who might not tolerate surgery.
  • Chemosurgery may be necessary for persistent or recurrent lesions. It consists of periodic applications of a fixative paste (such as zinc chloride) and subsequent removal of fixed pathologic tissue. Treatment continues until tumor removal is complete.
  • Cryotherapy, using liquid nitrogen, freezes the cells and kills them.
Prevention

Regular exams by a dermatologist, and a monthly scan of ones own skin for new and changing growths should be done. Of course, all skin cancer patients should limit or avoid sun exposure, wear hats and other protective clothing, and use sunscreens with a sun protection factor of at least 15.



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