Basal cell carcinoma is the most common skin cancer in New Zealanders

It arises from the bottom layer of the skin’s surface and generally grows very slowly over a number of months. It virtually never spreads to other parts of the body. It can present in a number of ways ranging from a red scaly patch of skin, to a pearly basal cell carcinoma is almost always caused by excessive exposure to ultraviolet light. Basal cell carcinoma, if neglected or inappropriately managed can give rise to significant morbidity and even death. There are a number of useful and proven treatment modalities. It is estimated that approximately 40% of New Zealanders will develop a basal cell carcinoma in the course of their life time. Basal cell carcinoma is also the most common cancer occurring in men. Basal cell cancers rarely spread to other parts of the body and thus rarely cause death although they can and do result in considerable inconvenience and discomfort, disfigurement and scarring.

Types of basal cell carcinoma

Nodular and superficial basal cell carcinoma
These are the of basal cell carcinoma. They are the most common variety to occur on the trunk and limbs. When principally nodular, they usually present as an early pink nodule on the skin which ultimately form a scab or bleed easily. If more superficial in variety they tend to appear as a glistening pinkish patch on the skin, the edges of which may be hard to define. Sometimes these types of basal cell carcinoma can contain pigment in which case they can be easily mistaken for melanoma.

Aggressive subtypes of basal cell carcinoma

Micronodular basal cell carcinoma
This type of basal cell carcinoma occurs most commonly on the head a  Often appears as a faint whitish or pearly area. There is often more cancer present than appears on the skin surface.

Infiltrative basal cell carcinoma
This is also a It typically appears as a whitish or pearly patch of skin. Once again there may be more tumour present than is indicated by the appearance. The tumour grows with widespread fine rootlets which are invisible from the skin surface. Other variants of this subtype include morphoea form or sclerosing basal cell carcinoma where the appearance may be somewhat scar-like due to the presence of increased collagen within the tumour and metaplastic or basosquamous cell carcinoma which has an appearance intermediate between that of basal cell carcinoma and squamous cell carcinoma.

Peri-neural invasion
Sometimes infiltrative types of basal cell carcinoma show a tendency to spread down nerves. This can make their removal by standard treatment methods very difficult. In reality basal cell carcinomas often show a mixed pattern. Unsuccessful previous treatment of basal cell carcinoma tends to select a more aggressive element of the basal cell carcinoma and a tumour which first appeared nodular may after several inadequate treatments develop a substantially infiltrative growth pattern.