Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O. - PowerPoint PPT Presentation

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Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O. PowerPoint Presentation
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Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O.

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  1. Basal Cell CarcinomaDan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O.

  2. BCC: What are they? • PEARLYPAPULES OR NODULES • ROLLED BORDER • TELANGIECTASES • CENTRAL ULCER • CRUSTING • BLEED EASILY

  3. BCC: Where are they? HEAD, NECK 85% • MC NOSE, 30% • FOREHEAD • EARS • CHEEKS • UPPER TRUNK

  4. BCC: When? • OFTEN – 1/3 OF ALL CA IN USA. • Chronic UVB, Xray • Immunosuppression • Renal Transplant • Genetics, ie. • XP, NBCCS

  5. BCC: Who? • ELDERLY & MIDDLE AGED • Ages 40-79 • ANGLO-SAXON Blue Eyes, Fair Skin • X-Ray Exposure, ie Physicians, Dentists, Technicians, Workers

  6. BCC: How? • Arise from immature pluripotential cells. • Mutations in the HEDGEHOG pathway (genes which controls cell growth) • PATCHED (tumor suppressor) inactivated. • HEDGEHOG and SMOOTHENED (cell growth inhibitors) activated. • P53 and RAS mutations also play a role.

  7. BCC look-alikes: SGH

  8. BCC look-alikes: KA

  9. BCC Look alikes: SCC

  10. BCC: Variants • SUPERFICIAL BCC • MORPHEAFORM BCC • PIGMENTED BCC • CYSTIC BCC • BASAL CELL NEVUS SYNDROME • (GORLIN’S SYNDROME)

  11. SUPERFICIAL BCC • PSORIASIFORM • TRUNK • LIMBS • FLAT GROWTHS • YOUNGER PATIENTS • ONGOING STUDIES WITH ALDARA

  12. MORPHEAFORM BCC • RESEMBLES LOCALIZED SCLERODERMA • ALMOST ALWAYS ON THE CHEEKS OR FOREHEAD • MOH’S SURGERY • AGGRESSIVE

  13. PIGMENTED BCC • DARK SKINNED PATIENTS • LATIN AMERICANS • JAPANESE • NOT BLACKS • ARSENIC INGESTION • 6% OF ALL BCC

  14. BCC – CYSTIC/SOLID • DOME SHAPED • BLUE GRAY • CYSTIC NODULES • 4-8% OF ALL BCCS

  15. NEVOID BCC SYNDROME • JAW CYSTS • PALMAR PITS • SKELETAL DEFECTS • CALCIFICATION OF FALX CEREBRI • MOHS SURGERY

  16. BCC TREATMENT • EXCISION • FULGURATION AND CURETTAGE • IONIZING RADIATION • CRYOSURGERY • TOPICAL 5-FU • LASER • MOHS’ MICROGRAPHIC 99% CURE

  17. THE END