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.

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Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O. BCC: What are they? PEARLY PAPULES OR NODULES ROLLED BORDER TELANGIECTASES CENTRAL ULCER ... – PowerPoint PPT presentation

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Title: Basal Cell Carcinoma Dan Ladd, D.O, Rick Lin, D.O., MPH Bill V. Way, D.O.


1
Basal Cell CarcinomaDan Ladd, D.O, Rick Lin,
D.O., MPH Bill V. Way, D.O.
2
BCC What are they?
  • PEARLY PAPULES 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
  • (GORLINS 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
  • MOHS 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
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