Basal cell carcinomahttps://en.wikipedia.org/wiki/Basal-cell_carcinoma
Basal cell carcinoma is the most common type of skin cancer. It often appears as a painless, raised, hard area of skin. The lesion may be shiny and may have small blood vessels running over it, or it may present as a raised area with ulceration. Basal cell carcinoma grows slowly and can damage the surrounding tissue, but it is unlikely to metastasize or cause death.

Risk factors include exposure to ultraviolet light, radiation therapy, long‑term exposure to arsenic, and poor immune‑system function (e.g., organ transplantation). Exposure to UV light during childhood is particularly harmful.

After diagnosis by biopsy, treatment is typically surgical removal. This can be simple excision if the cancer is small; if the cancer is larger, Mohs surgery is generally recommended.

Basal cell carcinoma accounts for at least 32% of all cancers globally. Of skin cancers other than melanoma, about 80% are basal‑cell cancers. In the United States, about 35% of white males and 25% of white females are affected by basal cell carcinoma at some point in their lives.

○ Diagnosis and Treatment
#Dermoscopy
#Skin biopsy
#Mohs surgery
☆ In the 2022 Stiftung Warentest results from Germany, consumer satisfaction with ModelDerm was only slightly lower than with paid telemedicine consultations.
  • Ulcerated lesions affecting the skin of the nose in an elderly individual are often diagnosed as Basal cell carcinoma. The nose is a common site of occurrence for this type of skin cancer.
  • Basal cell carcinoma may present with irregular borders and ulcers.
  • Basal cell carcinoma is often misdiagnosed as a nevus in Asian patients. Pigmented basal cell carcinoma frequently occurs on the nose.
  • Basal cell carcinoma should be suspected when a hard nodule is observed protruding at the border.
  • Basal cell carcinoma often presents with an irregular, asymmetric shape. Such lesions are frequently misdiagnosed as an intradermal nevus.
  • It may be misdiagnosed as an intradermal nevus.
  • Basal cell carcinoma can be mistaken for wart.
  • Basal cell carcinoma can also appear in the form of an ulcer. In this case, It should be differentiated from squamous cell carcinoma.
  • In Westerners, Basal cell carcinoma appears as a hard nodule with telangiectasia.
  • Basal cell carcinoma has a similar shape to a birthmark, but the fact that the lesion is a hard nodule is important to distinguish it from a nevus.
  • While it may resemble an intradermal nevus (benign), it is important to note that a basal cell carcinoma lesion feels hard.
  • Among Asian individuals, basal cell carcinoma typically presents as a solid black nodule with a raised border.
  • Basal cell carcinoma must be distinguished from melanoma because it has a much better prognosis.
  • If these widespread patches feel firm to the touch, it strongly suggests a diagnosis of superficial basal cell carcinoma.
  • It can be misdiagnosed as an intradermal nevus.
References Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management 26029015 
NIH
Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease.
 Update in the Management of Basal Cell Carcinoma 32346750 
NIH
Basal cell carcinomas are the most frequent skin cancers in the fair-skinned adult population over 50 years of age. Their incidence is increasing throughout the world. Ultraviolet (UV) exposure is the major carcinogenic factor. Some genodermatosis can predispose to formation of basal cell carcinomas at an earlier age. Basal cell carcinomas are heterogeneous, from superficial or nodular lesions of good prognosis to very extensive difficult-to-treat lesions that must be discussed in multidisciplinary committees. The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence. Superficial lesions can be treated by non-surgical methods with significant efficacy.
 European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023 37604067
The primary treatment for BCC is surgery. For high-risk or recurring BCC, especially in critical areas, micrographically controlled surgery is recommended. Patients with low-risk superficial BCC might consider topical treatments or destructive methods. Photodynamic therapy works well for superficial and low-risk nodular BCCs. For locally advanced or metastatic BCC, Hedgehog inhibitors (vismodegib, sonidegib) are recommended. If there's disease progression or intolerance to Hedgehog inhibitors, immunotherapy with anti-PD1 antibody (cemiplimab) can be considered. Radiotherapy is a good option for patients who can't have surgery, especially older patients. Electrochemotherapy could be considered if surgery or radiotherapy isn't an option.