Reviewed on : 23 May 2019

Reviewed by : Dr Joanna Gach, Consultant Dermatologist, UHCW

Expires : 23 May 2021

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.

References/Sources

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