Basal Cell Carcinoma - Symptoms, Diagnosis

Signs and Symptoms

Basal cell carcinoma occurs most often on the head and neck, but it can affect any area. The most common sign is a pink, translucent, and/or pearly looking papule that frequently has small blood vessels running through it. These lesions bleed and scab easily, and as they grow larger, they do not "heal."

BCC can be pigmented (dark), particularly in darker-skinned individuals. In these cases, the tumors resemble non-pigmented lesions, except they are brown instead of pink.

A fairly common BCC variant is superficial BCC. As its name suggests, it rarely invades and is typically confined to the epidermis. It usually develops on the trunk and extremities and appears as a red, scaly plaque, with crusting. Its appearance and slow growth are similar to that of eczema or psoriasis, so careful diagnosis is extremely important to exclude these conditions and determine proper treatment.

A form of BCC known as morpheaform or sclerosing BCC causes a more aggressive lesion. It appears whitish, without a defined edge, and is firm to the touch. It may look like a scar and can blend in fairly well with the surrounding skin, thus escaping detection for years, while continuing to spread. When these tumors are excised (cut out), they are surprisingly larger than expected.

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Diagnosis

A physician can often diagnose basal cell carcinoma on sight; however, definitive diagnosis is essential, especially given the possibility of morpheaform BCC. A skin biopsy is performed to confirm the diagnosis and to guide treatment options. A biopsy also may be used to rule out a more aggressive form of skin cancer (e.g., malignant melanoma).

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