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These studies suggest that basal cell carcinoma (BCC) is a common, often localized skin cancer with various growth patterns and a low mortality rate, where early diagnosis and treatment are important for better outcomes, and advancements in artificial intelligence may improve diagnosis, while management depends on the lesion's type and location.
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Basal cell carcinoma (BCC) is the most common type of skin cancer, originating from the basal cells in the epidermis. It is a subtype of non-melanoma skin cancer and is primarily caused by prolonged exposure to ultraviolet (UV) radiation from the sun or indoor tanning . BCC typically develops on sun-exposed areas of the skin, particularly the head and neck, but it can occur anywhere on the body.
BCC can present in various forms, each with distinct visual characteristics. The most common subtypes include:
Traditional diagnosis of BCC involves a visual examination followed by a biopsy for histopathological confirmation. However, advanced diagnostic tools like dermoscopy and reflectance confocal microscopy (RCM) have significantly improved the accuracy of non-invasive BCC diagnosis . RCM, in particular, allows for cellular-level imaging of skin lesions, reducing the need for biopsies and improving diagnostic specificity.
The pathogenesis of BCC involves a combination of genetic predispositions and environmental factors. The aberrant activation of the Hedgehog signaling pathway is a key driver in BCC development . UV radiation is the primary environmental risk factor, with additional risks including exposure to radiation therapy and indoor tanning .
BCC is the most common cancer among white-skinned individuals, with incidence rates rising globally due to increased sun exposure and an aging population . It accounts for approximately 80% of all non-melanoma skin cancers.
Surgery remains the first-line treatment for localized BCC, offering the advantage of complete excision and low recurrence rates . For superficial lesions, non-surgical treatments such as topical therapies, cryotherapy, and photodynamic therapy are effective alternatives.
For advanced or metastatic BCC, targeted therapies like Hedgehog pathway inhibitors (e.g., vismodegib and sonidegib) have shown promising results . These inhibitors are particularly useful for patients with tumors that are not amenable to surgery or radiotherapy. Additionally, ongoing research into immunotherapy offers potential new avenues for treatment, especially for tumors resistant to Hedgehog inhibitors.
Basal cell carcinoma is a prevalent and increasingly common form of skin cancer, primarily driven by UV exposure and genetic factors. Early diagnosis through advanced imaging techniques and a variety of treatment options, including surgical and non-surgical methods, are crucial for effective management. Understanding the visual characteristics and subtypes of BCC can aid in timely recognition and treatment, ultimately improving patient outcomes.
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