What is Basal Cell Carcinoma?

Signs of Basal Cell Carcinoma & Why It’s Called a Rodent Ulcer

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer, impacting millions of individuals around the globe each year. While it is a locally invasive and destructive cancer, if left untreated, it can cause considerable damage to the nearby tissues. Knowing its characteristics, typical locations, and related terms is essential for early detection and effective treatment.

What are basal cell skin cancers?

Basal cell carcinoma, a form of skin cancer, arises in the basal cells, which are found in the deepest layer of the epidermis. These basal cells play a crucial role in generating new skin cells as the old ones naturally die off.

Typically, BCC appears as a slow-growing lump, bump, or lesion on the skin, often giving off a shiny or pearly look.

Some key features of basal cell carcinoma are as follows:

• Slow Growth: BCCs usually grow slowly, sometimes going unnoticed for months or even years.
• Rare Metastasis: Unlike many other types of cancer, BCC rarely spreads to distant organs. However, if not treated correctly or on time, it may invade and destroy nearby tissues.
• Local Tissue Damage: If ignored, BCC can lead to significant local destruction, especially when it is situated close to vital parts like the eyes, nose, or ears.

Several common symptoms of BCC include:

• A shiny bump looking like skin, or it may have a pearly appearance, sometimes featuring visible blood vessels
• A flat, scaly area with a raised edge that may gradually increase in size
• A waxy, white-coloured lesion that appears like a scar but does not always have a clearly defined border
• A sore that keeps bleeding, forming scabs, and just won’t seem to heal

Many elements or situations are considered to be major risk factors for BCC, such as:

• Long-term exposure to UV rays on tanning beds or from direct sunlight
• Age going beyond 50 years
• Fair skin, light eyes and a history of sunburns
• A few genetic conditions, like Gorlin syndrome or xeroderma pigmentosum

Where is Basal Cell Carcinoma Most Commonly Found?

Basal cell carcinoma mainly involves areas of the skin that receive significant amounts of sun exposure. A person’s head and neck are the most prominent spots, making up the majority of cases.

Doctors have found the distribution of BCC in the following regions:

• Nose: The nose is among the most frequent locations for BCC. It accounts for almost half of all facial BCCs reported, as per research.
• Other Facial Areas: You may also find cases of BCC frequently around the eyes (classified as periorbital), on the cheeks, and in the nasolabial folds.
• Ears and Lips: These sun-exposed areas see higher rates of both basal cell carcinoma occurrence and recurrence.
• Trunk and Extremities: While less common, BCC can show up on the torso, arms, or legs, particularly in people who have had a lot of sun exposure.
• Rare sites: Occasionally, BCC can appear in places that are usually shielded from the sun, like the genitals, but that is very rare.

Why is Basal Cell Carcinoma Called a Rodent Ulcer?

The term ‘rodent ulcer’ that refers to a specific type of basal cell carcinoma that has progressed to an ulcerative stage, often leading to significant tissue damage. While this term is largely outdated, you may still come across it in clinical settings or older medical texts.

The following pointers provide a brief explanation supporting the origin of the name ‘rodent ulcer’:

• The name ‘rodent ulcer’ comes from the way the lesion looks in its later stages. It appears as if the affected region has been ‘gnawed’ or eaten away, much like the destruction caused by a rodent.
• These ulcers usually have uneven edges and a central area where tissue has been lost, often with a rolled, pearly border and visible blood vessels.

While examining the clinical features of rodent ulcer, medical teams have found that it typically starts as a small, pearly nodule that eventually breaks down into an ulcer. As time goes on, the ulcer can deepen and spread, damaging nearby skin, cartilage, or even bone if not treated in time.

Modern Terminology of Basal-cell Carcinoma

While not frequently used, 'rodent ulcer' remains a fitting description for severe, ulcerated basal cell carcinoma. However, the widely preferred term is 'basal cell carcinoma' itself, with various subtypes identified based on their clinical and histological characteristics (like nodular, superficial, or morpheaform).

Consult a healthcare professional for evaluation and biopsy if you notice any persistent, unusual skin growths or sores, especially those on sun-exposed areas. Early intervention offers the best outcomes for conditions like basal cell carcinoma.