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Basal Cell Carcinoma


A basal cell carcinoma (BCC) is a type of skin cancer.

Diagnostic features

Clinical Description

    Nodular or ulcerative  – glistening skin coloured papule; central necrosis may leave crusted ulcer  with rolled telangiectatic pearly edge.

  • Cystic – tense translucent telangiectatic papule/nodule.
  • Morphoeic – slowly expanding yellow or white waxy plaque with ill defined edge; may ulcerate; may resemble scar
  • Superficial – usually trunk; often multiple; slowly expanding pink/brown scaly plaque with fine ‘whip-cord’ edge
  • Pigmented – pigment may be present in any type of BCC.

Differential Diagnosis

  • Squamous cell carcinoma
  • Solar keratosis
  • Intradermal naevus
  • Small lesions: sebaceous gland hyperplasia, molluscum contagiosum
Indications for referral
  • Any lesion suspicious of BCC
  • High risk BCC will be accepted via the 2WW system as they may be difficult to differentiate from SCC
  • Suspected ‘high risk’ BCC should be all referred to Dermatology (i.e.face or scalp lesion; >2cm diameter; previous BCC; immunosuppressed) 
  • Known ‘high risk’ BCC
  • Biopsy-proven: morphoeic or infiltrating pattern, basosquamous morphology, perineural invasion or deep extension below dermis.

Cambridge University Hospitals NHS Foundation Trust Acne Referral Guidelines (June 2010)

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