Basal cell carcinoma ( BCC )

Definition -BCC is a slow growing , locally invasive malignant epidermal skin tumour predominantly affecting Caucasians

Epidemiology

Most common cancer in Europe , Australia and US Incidence increasing worldwide & shows marked geographical variationAccurate incidence figures difficult to obtain ( under-reported )Reflects effects of UVB radiation and ethnicity ( on BCC pathogenesis ) Non-melanoma skin cancer NMSCTogether with cutaneous squamous cell carcinoma form the bulk of NMSCs Rarely metastisizes Men generally have higher rates Uncommon in dark-skinned people and rare before age 20 Typically a neoplasm of the elderly ( median age 68 yrs )

Risk factors

Tends to arise in sun exposed areas of the head and neckCommonest peri-ocular malignancy Sun exposure in childhood may be important Positive family history Increasing age Male sex Fair skin types I and II ( Fitzpatrick skin type ) Immunosuppression History of previous BCC Arsenic exposure Individual suffering from haematological diseases Hereditary conditions as ○ nevoid basal cell nevus ( Gorlin-Goltz syndrome )○ Bazex- Spiegler syndrome○ abinism High dietary fat intake Smoking also appears to be a risk factor

Aetiology

Multifactorial UV radiation- direct DNA damage , indirect DNA damage through reactive oxygen species and immune suppression DNA mutations in the patched (...