Basal Cell Carcinoma

Basal cell carcinoma most commonly develops on sun-exposed skin anywhere on the body. It is especially common on the face, ears, neck and scalp. Most of the time, these cancers do not cause pain.  Basal cell carcinoma can present with various signs and symptoms, including:

• A pearly or waxy bump: Basal cell carcinoma often appears as a translucent, pearly or waxy bump on the skin, which may be shiny or have a slightly raised border. Basal cell carcinoma may contain visible blood vessels, giving them a spider-like or spider web-like appearance.
• A nonhealing sore: Basal cell carcinoma can develop into a sore that continuously scabs, crusts, or bleeds, but never completely heals.
• A flesh-colored or pink patch: Basal cell carcinoma can also manifest as a flesh-colored or pink patch on the skin, which may resemble a scar or a dry, scaly spot like eczema or psoriasis.
• A flat white scar-like area or a brown growth: In some cases, basal cell carcinoma can resemble a flat, white scar-like area on the skin or a dark brown or black growth. Pigmented Basal cell carcinoma is especially common in darker skinned individuals or those of Mediterranean descent.

Basal cell carcinoma primarily develops due to prolonged exposure to ultraviolet (UV) radiation. Overexposure to UV radiation damages the DNA of skin cells, leading to mutations that can trigger the growth of basal cell carcinoma. Sunburns, frequent tanning, and outdoor activities without proper sun protection increase the risk. Other factors that contribute to the development of basal cell carcinoma include:

• Fair Skin: Individuals with fair skin, light-colored eyes, and blond or red hair are at a higher risk of developing basal cell carcinoma because they have less natural protection against UV radiation.
• Age: Basal cell carcinoma is more common in older adults, particularly those over the age of 50, although it can occur at any age.
• Personal or Family History: A history of prior basal cell carcinoma or other types of skin cancer increases the risk of developing future basal cell carcinoma. Additionally, a family history of skin cancer can predispose individuals to the condition.
• Genetic Syndromes: Rare genetic syndromes, such as basal cell nevus syndrome (Gorlin syndrome), predispose individuals to the development of multiple basal cell carcinoma at a young age.

The diagnosis of basal cell carcinoma is typically made through a combination of medical history, physical examination, and often a skin biopsy. Unlike other types of cancer, you can see skin cancers. This makes it easier to detect them early. Skin cancer screening exams and self-exams at home help detect skin cancer earlier. If you notice a new or suspicious spot on your skin, or develop a nonhealing sore or growth, it is best to check in with a board-certified dermatologist and skin cancer expert like Dr. Thomas Knackstedt.

Here’s how the process generally unfolds (ideally the following paragraphs are separated by arrows):

Medical History

The team at Apex Skin Center will inquire about your medical history, including any previous skin conditions, sun exposure habits, family history of skin cancer, and any symptoms or changes in the skin.

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Physical Examination

Board-certified dermatologist Dr. Knackstedt will conduct a thorough examination of the skin, focusing on any suspicious lesions or growths. Dermoscopy, a tool that allows for the magnification of structures within a skin growth is used to aid in the diagnosis of basal cell carcinoma.

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Skin Biopsy

If Dr. Knackstedt suspects basal cell carcinoma based on the physical examination and dermoscopy findings, a skin biopsy may be performed. During a skin biopsy, a small sample of tissue is removed from the suspicious lesion under local anesthesia (numbing) and sent to a laboratory for analysis. The tissue is examined under a microscope to confirm the presence of basal cell carcinoma and to assess the cancer’s characteristics.

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Once the diagnosis of basal cell carcinoma is confirmed, further evaluation may be necessary to determine the extent of the cancer and plan appropriate treatment. As a fellowship trained, board-certified Mohs surgeon and dermatology oncologist (cancer specialist), Dr. Thomas Knackstedt and the team at Apex Skin Center have significant expertise in the management of all types of skin cancer. Dr. Knackstedt has authored numerous studies on basal cell carcinoma.