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Basal Cell Carcinoma - The Facts

What Is A Basal Cell Carcinoma?

Otherwise known as a rodent ulcer or Jakobi Ulcer, they are the most common types of skin cancer in the UK and are reported to affect over a million Americans. BCC's rarely spread to other parts of the body (metastasise), however, when it does, it can invade the surrounding area causing vast skin cell damage, often requiring skin grafts or cosmetic surgery. Because of its potential severity, the urgency of its treatment is on par with a malignant melanoma.

Typically, basal cell cancer is found on the head and neck areas. Very commonly on the nose, ear and other areas that have had extreme sun exposure.

Basal Cell Carcinoma On Ear

Basal Cell Carcinoma On Nose

What Causes It?

According to The Skin Cancer Foundation, this type of skin lesion occurs mainly on areas that are exposed to sunlight, therefore causing the widest occurrance on the face, particularly the nose and ear. They state that recently far more incidences of basal cell carcinoma occuring on the trunk of the body and on other areas that have not had UV exposure. This may suggest additional causes such as the frequent use of tanning beds, arsenic and radiation exposure, chronic ulcers, burns, tatoos and scar sites.

Signs of It

There are approximately ten differing types of BCC which can be split into five main categories-

  1. NODULAR - The most commonly seen BCC mostly affecting the face, especally the nose, scalp and cheek. It has a waxy, wart-like, pearly papule appearance that can occasionally ulcerate in the centre. These are usually removed with a tool called a curette and then an electric current is passed through an electrode destroying any remaining cancer cells (electrodesiccation and curettage).

  2. IN-SITU or SUPERFICIAL - This means that the damaged cells are limited to the very top layer of the skin (epidermis), presenting as a well defined area of whitish scaly skin. This skin lesion will not have spread or invaded surrounding skin tissue causing further damage and therefore is an excellent candidate for topical chemotherapy (applied as a cream to the skin) for its complete removal.

  3. INFILTRIVE - Otherwise referred to as Morpheaform Basal Cell Carcinoma, this skin tumor invades deeply into the skin and is aggressive. It presents as whitish, scar-like tissue that does not ulcerate like the nodular type above. The method of removal is commonly Mohs Surgery.

  4. PIGMENTED - This BCC is a variation of the Nodular type. It commonly presents as a deeply pigmented area that may be confused with a mole.

  5. CYSTIC - Again, this is a variation of Nodular BCC but presents as a fluid filled, blue/grey nodular cyst.


Basal Cell Carcinoma is mainly seen in fair skinned people with a history of chronic sun exposure. These types of skin cancer are 50% more common in men than women and rarely affects people under forty years of age. The risk of developing it increases significantly with age and it is vital that you seek en expert opinion if you suspect you have a skin lesion on any of the areas listed.

Pictures courtesey of - jmh649 & Klaus D. Peter, Wiehl, Germany

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