Basal Cell Carcinoma: A Comprehensive Overview

Jean Djorkaef

doi:10 .4172/2327-4581.1000411

Editorial, Int J Ophthalmic Pathol Vol: 13 Issue: 2

Basal Cell Carcinoma: A Comprehensive Overview

Jean Djorkaeff^*

Department of Optometry, Ecole SupÃ©rieure de Gestion et dâ??Administration des Entreprises, Congo

*Corresponding Author:: Jean Djorkaeff
Department of Optometry, Ecole SupÃ©rieure de Gestion et dâ??Administration des Entreprises, Congo
E-mail: jean084@gmail.com

Received: 01-Apr-2025, Manuscript No. iopj-25-169461; Editor assigned: 4-Apr-2025, Pre-QC No. iopj-25-169461 (PQ); Reviewed: 19-Apr-2025, iopj-25-169461; Revised: 26-Apr-2025, Manuscript No. iopj-25-169461 (R); Published: 30-Apr-2025, DOI: 10.4172/2324-8599.1000055

Citation: Jean D (2025) Basal Cell Carcinoma: A Comprehensive Overview. Int J Ophthalmic Pathol 13: 055

Supplementary File

Introduction

Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide, accounting for approximately 80% of all non-melanoma skin cancers. Though rarely life-threatening, BCC can cause significant local destruction and disfigurement if not treated early. Arising from the basal cells in the epidermis, this cancer typically develops in areas exposed to ultraviolet (UV) radiation, such as the face, ears, neck, and arms. Fortunately, BCC tends to grow slowly and seldom metastasizes, making early detection and treatment highly effective.

Basal cell carcinoma (BCC) is the most common form of skin cancer and the most frequently diagnosed cancer overall in humans. It arises from the basal cells of the epidermis, which are located at the bottom layer of the skin's outermost layer. Although BCC is typically slow-growing and rarely metastasizes, it can cause extensive local tissue destruction if left untreated. Its high prevalence and generally favorable prognosis make it a significant focus of dermatologic and oncologic care [1].

The primary cause of BCC is chronic exposure to ultraviolet (UV) radiation, either from natural sunlight or artificial sources like tanning beds. As such, BCC commonly occurs in sun-exposed areas of the body—especially the face, neck, and arms—and is most frequently seen in individuals with fair skin, light-colored eyes, and a history of sunburns. Other risk factors include advanced age, male gender, immunosuppression (such as in organ transplant recipients), and genetic disorders like basal cell nevus syndrome (Gorlin syndrome).

Clinically, BCC can present in various forms, including pearly nodules, ulcerated lesions, or scar-like plaques, depending on the subtype. While it rarely spreads to distant organs, BCC can invade nearby structures like cartilage and bone, especially when located near the eyes, nose, or ears. Therefore, early detection is crucial to prevent functional or cosmetic damage [2].

Diagnosis is typically confirmed by skin biopsy, and treatment is tailored to the size, location, and subtype of the tumor. Options include surgical excision, Mohs micrographic surgery, topical therapies, cryotherapy, and, in advanced cases, targeted molecular therapy [3].

Despite its relatively low mortality, BCC represents a significant public health concern due to its high recurrence rate and the sheer number of cases diagnosed annually. Effective prevention through sun protection, patient education, and regular skin examinations remains essential in reducing both incidence and recurrence. With early intervention and appropriate management, the prognosis for basal cell carcinoma is overwhelmingly positive.

Discussion

Basal cell carcinoma (BCC) is not only the most common type of skin cancer but also the most common human malignancy overall. Although BCC is rarely life-threatening due to its low metastatic potential, it presents a significant burden on healthcare systems due to its high incidence, recurrence rate, and potential for disfigurement, especially in cosmetically sensitive areas [4].

One of the primary challenges with BCC lies in early detection and diagnosis, particularly because it can mimic benign skin conditions such as eczema, psoriasis, or seborrheic keratosis. Lesions can appear as pearly papules, ulcerated nodules, or flat, scar-like plaques, depending on the subtype (nodular, superficial, morpheaform, etc.). Dermoscopy can aid in clinical recognition, but histopathological confirmation via biopsy remains the gold standard for diagnosis [5].

BCCs are most commonly found on sun-exposed areas such as the face, neck, and arms. The strong link between ultraviolet (UV) radiation and BCC underscores the importance of cumulative sun exposure in pathogenesis. Genetic mutations, particularly involving the PTCH1 gene in the Hedgehog signaling pathway, are frequently implicated, opening the door for targeted therapies in advanced cases [6].

From a treatment standpoint, surgical excision remains the most widely used and effective method, offering high cure rates when margins are clear. Mohs micrographic surgery is considered the treatment of choice for high-risk or recurrent BCCs, especially in areas requiring tissue conservation, such as the nose, eyelids, or ears. It provides maximal tissue preservation with minimal recurrence risk.

In cases where surgery is not feasible—such as in elderly or immunocompromised patients—non-surgical treatments like topical therapies (e.g., imiquimod, 5-FU), cryotherapy, or radiation therapy can be used, albeit with lower efficacy. For locally advanced or metastatic BCC, which is extremely rare, Hedgehog pathway inhibitors like vismodegib or sonidegib offer a systemic option [7].

From a public health perspective, the increasing incidence of BCC highlights the need for effective prevention strategies, including sun protection education, routine dermatologic screening, and early intervention. Despite its low mortality, BCC contributes significantly to healthcare costs due to frequent treatments, follow-ups, and potential reconstructive procedures.

In conclusion, while basal cell carcinoma is rarely fatal, its potential for significant morbidity, especially in cosmetically and functionally important regions, makes it a clinically relevant condition. Early recognition, proper treatment selection, and lifelong skin surveillance are key to reducing the burden of this highly prevalent skin cancer [8].

Pathophysiology

Basal cell carcinoma originates in the basal layer of the epidermis and is often caused by DNA mutations induced by ultraviolet (UV) radiation. These mutations activate oncogenes or inactivate tumor suppressor genes, leading to uncontrolled cell growth. The most common mutation involves the PTCH1 gene in the Hedgehog signaling pathway, which plays a critical role in cell proliferation and development [9].

Although BCC grows slowly and rarely spreads to distant organs, it can invade deeper tissues, including cartilage and bone, particularly if left untreated [10].

Conclusion

Basal cell carcinoma is the most common and one of the most treatable forms of skin cancer. Although it rarely spreads beyond the skin, it can cause significant local damage if left untreated. Early recognition, accurate diagnosis, and appropriate management are essential for excellent outcomes. With growing awareness and proper sun protection, the incidence of BCC and its complications can be significantly reduced.