Tuesday, 7 June 2011

Superficial Basal Cell Carcinoma – A closer look

Superficial basal cell carcinoma (SBCC) is a growth pattern of basal cell carcinoma (BCC) which accounts for approximately 10-30% of all BCCs.


SBCC presents typically as a reddish (erythematous) patch ranging in size from approximately 3 to >10 mm. They often have a fine pearly border with central superficial erosions. Pale areas within the lesion can be a clue to regression and the lesion may have a history of bleeding. SBCCs are most commonly found on the trunk.


SBCC is seen as superficial collections of atypical basaloid cells originating from the bottom layer (basal layer, stratum basale) of the epidermis and projecting down into the papillary dermis. These collections are typically surrounded by a loose myxoid (mucin-like) stroma. Although histologically they have an apparent multifocal appearance recent 3D imaging techniques have found that a huge majority of these foci are truly interconnected and therefore not multifocal. Remember SBCC is also usually seen in conjunction with other BCC growth patterns such as nodular and infiltrative.


Due to its superficial nature, SBCC has a very good prognosis and there is a wide range of treatments available. SBCC does have a high recurrence rate due to its margins being difficult to assess (this is attributed to its apparent multifocal appearance histologically). Treatments include topical chemotherapy (eg. aldara), photodynamic therapy (PDT) and curettage.

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