BCCs are the most common form of skin cancer. They are usually caused by long or intense exposure to UV light or to chemicals. People at risk usually have a fair complexion and people who work outside. BCCs rarely occur on non sun exposed areas. They arise from the bottom of the top layer of skin (epidermis).
BCCs may begin as sores or an irritated area that does not heal. They can be pearly nodules, scaly, scar-like, or red patches. Almost all BCCs occur on parts of the body excessively exposed to the sun — especially the face, ears, neck, scalp, shoulders, and back.
The best way to diagnose a skin cancer is through a skin biopsy. Biopsies are performed by either the shave method or punch excision. If the area is raised, the shave method is recommended. If the lesion is flat, or has a questionable history, then the punch biopsy excision is performed. The punch method lets the pathologist examine all levels of the skin.
Treatment is based on the location and the type of BCC. The most aggressive form of BCC is morpheaform type. It is recommend to have the lesion completely excised if it lies on the head or neck. A Mohs surgeon is a dermatologist specially trained in the surgical excisions of skin cancers. Surgical excision has the highest cure rate. Some BCCs can be treated with topical therapies ( imiquimod or 5-FU), however, chance of recurrence or incomplete treatment are high. PDT has also been approved for superficial and nodular BCCs. ErivedgeTM (vismodegib), the first medicine ever for advanced BCC, is an oral drug approved by the FDA in early 2012 only for very limited circumstances where the nature of the cancer precludes other treatment options (such as surgery or radiation).