Basal cell carcinoma, or basalioma for short, is a semi-malignant skin cancer that is almost always locally restricted and prone to metastasis. However, if left untreated, the basalioma may damage surrounding tissue, bone, or cartilage by further growth.

What is a basalioma (basal cell carcinoma)?

Malignant melanoma or black skin cancer is a highly malignant tumor of the pigment cells (melanocytes).

The basalioma develops from the basal cells of the epidermis and can assume various manifestations. Typical of the basalioma is the skin-colored change.

In contrast, the pigmented basalioma is less common. The skin tumor usually appears as a node, but can also take the form of a hemisphere, crater-shaped with a raised edge or grow like a scar.

Basaliomas usually develop on sun-exposed areas such as head, face, neck and décolleté. On the trunk and limbs, basaliomas are extremely rare.

Fair-skinned people are at an increased risk of developing basal cell carcinoma. While in the past decades the basal cell carcinoma often occurred in people over the age of 60 years, more and more younger people are suffering from this form of skin cancer.

causes

The cause of a basalioma is above all in the changed leisure behavior. These include regular visits to the sunbeds and holiday trips to countries with intense solar radiation. Excessive sunbathing promotes the formation of sunburns and, subsequently, skin tumors.

In Germany, about 0.1 percent of the population gets a basal cell carcinoma during their lifetime.

In intense sunlight, the UV rays damage the DNA of the skin cells and can lead to the formation of a basalioma. The indirect effect of excessive sun exposure is the weakening of the immune system, which in turn can promote the development of skin tumors.

As a possible cause for the formation of a basalioma but also a certain genetic predisposition and certain skin diseases such as psoriasis, photophobia, tendency to sun allergy, etc. into consideration.

Symptoms, complaints & signs

Schematic representation of the anatomy and structure of the skin with black skin cancer. Click to enlarge.

The basal cell carcinoma usually develops at a site that already has skin damage. Particularly typical here are the so-called sun damage. The affected area of ​​the skin, which has been exposed to the sun for many years and has also suffered sunburn, assumes a pink to light red color.

This is the preliminary stage of a basalioma, which can still be treated well under dermatological supervision. Regeneration is possible in the least cases, but the formation of a basalioma can be delayed or prevented. If the basal cell carcinoma develops from the present skin damage, this is usually not noticeable to the person concerned, but can only be determined by the doctor using a special lamp.

The final diagnosis requires the removal of a tissue sample. The basal cell itself does not cause any direct symptoms such as pain or inflammation. A scaly crust on its surface can be observed in some cases. If the existing basalioma continues to be exposed to the sun, it may become redder and develop a slightly bloody surface, as can be seen, for example, in a healing mosquito bite.

Signs of the formation of a basalioma may, in principle, be any conspicuous change in the skin at one or more sites. In order to prevent major damage, regular check-ups with the dermatologist are advisable.

Diagnosis & History

Basaliomas grow very slowly, usually over years. They form superficial lesions such as small nodules, which are barely noticed at first. If the basalioma is not treated, it will continue to grow. The nodule can grow in the middle inwards, with only a raised edge remains visible, which itself consists of nothing but small nodules that look like strung on a string of pearls.

The ulcer-like basalioma, on the other hand, looks like a small non-healing skin injury that may be covered with scabs. A closer look reveals the blood vessels that feed the skin tumor in all forms of basal cell carcinoma.

The less common pigmented basalioma has a reddish-brown color, which can sometimes appear very dark. In this case, a differentiation from the dangerous black skin cancer is necessary, which often looks like a dark liver spot. Basaliomas are usually not sensitive to pain.

The clear diagnosis of a basalioma is made after microscopic-histological examination. In order to determine the spread of the skin tumor, the diseased skin site and its surroundings are treated with a special cream. The tumor cells can then be visualized using a special lamp.

complications

Since basal cell carcinoma is a cancer, the various complications of a tumor occur. In most cases, the diagnosis is made relatively late, as the basal cell carcinoma forms over a few years and is barely visible from the outside.

In case of a strong spread, however, it can lead to knots on the skin, which are often covered with scabs. In most cases, the carcinoma can be distinguished relatively well from a liver spot. If the black spots appear in an unfavorable place, there may also be psychological problems due to optical limitations.

Basal cell carcinoma is usually treated by removal. The removal of the tissue is usually without complications, but also healthy tissue around the tumor are also removed. In hard-to-reach areas, other methods of tumor removal can be used.

In most cases, a new formation of the basal cell carcinoma can not be prevented, so that the patient may have to perform another surgical procedure for removal if necessary. Since the tumor only occurs locally, no other tissue is damaged, so there are no further complications. Life expectancy is not reduced by basal cell carcinoma.

When should you go to the doctor?

If a basal cell carcinoma is left untreated, the worst case scenario may be the death of the patient. For this reason, any discrepancy on the skin or any conspicuous parts of the skin should always be examined by a dermatologist. Thus, complications can be avoided at a later age. As a rule, the patient should then consult a doctor if certain abnormalities occur on the skin. Pigment spots can change in color, shape or size.

If at least one of these changes is present, a doctor must be consulted in any case. If the basal cell is detected, it usually leads to a positive course of the disease and the life expectancy of the person affected is not reduced. The person concerned is dependent on the use of sunscreen to avoid further discomfort. In the case of a basal cell carcinoma or other changes on the skin, a dermatologist should always be consulted. In acute emergencies, the hospital can also be visited directly. As a rule, various preventive examinations can be carried out to avoid skin cancer.

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Treatment & Therapy

For the treatment of basal cell carcinoma there are various options available, which depend on the size and spread of the carcinoma. In most cases, the basal cell carcinoma is surgically removed under local anesthesia. It also removes a few millimeters of healthy tissue around the tumor to make sure all the spurs of the basalioma have been removed.

If the basal cell carcinoma is in an unfavorable position, it can also be treated by radiation. Cryotherapy (icing with liquid nitrogen) or phototherapy (treatment of the tumor with light-sensitive substances) also promise good therapeutic results.

The chances of recovery of the basalioma are very good, with the fewest recurrences (neoplasms) are to be expected at the surgical removal.

Outlook & Forecast

Early diagnosis and treatment of the basal cell can be good for the patient. The doctor removes the skin lesions in surgery or radiation therapy. The treatment takes place routinely and is completed within a few hours. After the subsequent wound healing, the patient is usually considered cured. Without removal of the basal cell carcinoma it can spread unhindered in the organism. It damages the surrounding healthy tissue and in the worst case can form metastases.

People in old age are more likely to suffer from lower basal cell tumors than younger ones. Nevertheless, the number of sufferers in young or middle adulthood is increasing significantly. The prognosis improves if the person concerned takes sufficient measures to protect the direct sunlight. The older the patient and the longer he exposes his skin to UV radiation, the worse the chances of recovery.

Even if a basal cell carcinoma is completely removed in a single procedure, new carcinomas can form on the skin at any time. To improve the chances of recovery should take place as soon as possible in a new formation of basaliomas medical treatment. This also reduces the risk of complications and wound infections. In addition, regular participation in skin cancer screening can detect the appearance of skin lesions very early.

prevention

Especially fair-skinned people should avoid excessive exposure to the sun and solarium visits as a precaution against basal cell growth. Sunscreens with a high sun protection factor provide some protection against harmful UV rays when staying outdoors.

Families in which basaliomas are more prevalent should have their family members regularly check themselves for suspiciously altered areas of their skin, or consult a dermatologist, whose costs are fully covered by the health insurer every two years for patients over the age of 35 years.

aftercare

After surgical removal of a basal cell, the operated area of ​​the skin must be kept dry and clean for a few days. In general, the affected area is protected by a dressing that should only be changed by the doctor. The removal of the threads takes place with satisfactory wound healing one to two weeks after the operation.

If severe pain occurs during the healing phase, the attending physician may prescribe a pain reliever. Smoking delays wound healing and should be avoided in the first time after surgery. Slight exercise is possible as soon as the wound has healed well; Competitive sports and other strenuous physical exercises can often only be resumed after approximately three months in the case of larger surgical wounds.

In the first three to six months after surgery, the operated area should not be exposed to direct sunlight, otherwise it may cause abnormal pigmentation. Even after that, it is important to ensure adequate sun protection.

If the patient tends to form basal cell carcinomas, all sun-exposed areas of the body must be well protected from the UV rays by sunscreens with a high sun protection factor. It is very important to have regular self-monitoring of the skin in order to detect a recurrence or recurrence of the skin tumors at an early stage. In addition, one-to-two-year follow-up examinations should take place at the treating dermatologist.

You can do that yourself

The basal cell carcinoma is a disease in which there are some opportunities for self-help for the person affected. This applies first of all for the time after the operation. Since basaliomas are to be removed as extensively as possible, ie in the healthy, the regeneration of the affected area after surgery comes into focus.

Here, the patient can actively contribute by following the doctor's rules of conduct very carefully so that the desire can heal quickly and no complications such as inflammation occur. If you have mental health problems related to white-skinned skin disease, it may be a good idea to seek a support group or consult a psychologist.

Self-help in everyday life also means avoiding the appearance of a new basal cell carcinoma. Consistent sunscreen (for example, scalp and face protection through a hat), about which the treating dermatologist advises comprehensively, is important. It also means that the patient is well informed about the appearance of the basalioma (and also of the malignant melanoma), regularly examines his or her body for changes in the immune system and observes the regular pre- and post-operative visits to his doctor.

In addition to preventive measures, the patient can also do some things to come to rest after the operation and possibly further treatments. If you want to do good for yourself, pay attention to a healthy diet, sufficient drinking volume, adequate sleep and relaxation through methods such as yoga.

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