The most common type of oncological skin pathology is basal cell carcinoma, which is a basal cell carcinoma, basal cell carcinoma. This tumor neoplasm begins in the germinal epithelial layer. The most characteristic signs for basal cell carcinoma are slow growth and very rare metastasis. Most oncologists prefer to attribute a similar tumor process to semi-malignant neoplasms.
Pathology Description
Basal cell carcinoma is distinguished by its persistent recurrent course. Quite often, an invasion occurs in almost all skin layers, including the deepest. This process can cause cosmetic functional defects on the surface of the skin. Diseases are affected by people of various ages, however, according to statistics, every fourth person before and after 50 years of age is sensitive to the sun and has fair skin.
Provocative factors
Factors that can provoke the development of basal cell carcinoma on the face include:
- sun exposure;
- ionizing factor;
- exposure to substances of a chemical nature, for example, arsenic, hydrocarbon derivatives;
- frequent injury to the skin.
Basal cell carcinoma in the deep layer of the skin is born. After this, its gradual germination to the surface areas of the skin begins.
Signs
Basal cell carcinoma (photo below) can manifest itself in several clinical forms:
- Nodular-ulcerative. This form is most often localized on the inner surface in the corners of the eyes, on the surface of the eyelids, in the nasolabial folds. Over the skin, such a basal cell protrudes in the form of a red or pink dense formation of a nodular shape. The surface of the formation is brilliant. Increasing gradually, the node begins to ulcerate, and a greasy deposit forms at the bottom of the ulcer. On the surface of the node, characteristic vascular expansion (telangiectasia) is formed. It is also possible the appearance of a crust, which is surrounded by a dense roller of pearl color.
- Perforating basalioma on the face. This form of basal cell carcinoma is quite rare, it is characterized by a very rapid infiltration. Its appearance practically does not differ from the nodular-ulcerative form of basal cell carcinoma.
- Exophytic, warty, papillary. These basal cell carcinomas on the skin surface appear in the form of dense rounded nodules that resemble cauliflower in appearance. For this form, infiltration is not peculiar.
- Coarse nodular. This tumor is characterized by a single localization of a nodular neoplasm. Signs of telangiectasia are clearly visible on the surface.
- Pigmented basal cell carcinoma (photo is in the article). The appearance of such a neoplasm is very similar to melanoma. The main difference is that the knot has dark internal pigmentation, surrounded by its pearl-colored roller.
- Atrophic cicatricial. The shape of such a basal cell is flat, ulcerated, surrounded by a dense roller having a pearl color. A characteristic difference of this form of basal cell carcinoma is that the erosive spot grows at the moment when scarring occurs in the center.
- Scleroderma basal cell carcinoma. Prone to scarring and ulceration. The initial stages of development are characterized by the appearance of small dense nodes, which quickly transform into flat dense spots with vascular translucency.
- Pagetoid superficial tumor. This form of basal cell carcinoma on the face is characterized by the appearance of many neoplasms that have a flat shape. Tumors reach quite large sizes. In this case, the plaques have raised edges that do not rise above the skin. Color can be represented by any shade of scarlet. Quite often, it is accompanied by the appearance of various diffuse processes, for example, in the form of a cyst in the area of the lower jaw.
- Turban basal cell carcinoma. It affects only the scalp. Its color is purple-pink, the base is wide, about 10 centimeters. The development process takes a long time. The clinical picture is benign.
Stages of basal cell carcinoma
The classification of pathology by stages is based on the characteristics that appear in the clinical picture, such as the area of the lesion, the depth of germination, signs of destruction, and others. In accordance with these characteristics, it is customary to distinguish four stages of basal cell carcinoma:
- The initial stage of basal cell carcinoma is characterized by the appearance of neoplasms, the size of which is no more than two centimeters. They are locally limited and did not have time to grow into neighboring tissues.
- Nodular tumors, the size of which is more than two centimeters, belong to the second stage of the disease. There are signs that the basalioma has grown into all layers of the skin, but the fatty tissue has remained unaffected.
- Neoplasms measuring three or more centimeters belong to the third stage. At this stage of development, the tumor grows to the bone.
- The fourth stage basal cell tumors are lesions that affect bone and cartilage.
Signs of the initial stage of basal cell carcinoma
A characteristic feature of the tumor is its location in different areas of the neck and face. It is localized on the skin of the nose, which is also not uncommon. At the very beginning, the tumor appears in the form of small and painless nodules that match the skin in color. Most often, they appear on the forehead or in the nasolabial folds and resemble ordinary acne.
At the initial stage, the basalioma looks like a small pearl nodular formation. After a while, it begins to get wet, and a crust begins to form on the surface, through which you can distinguish an ulcerated surface.
There is no pain or discomfort. Such nodules can appear in whole groups and then merge into one. As a result, an angiitis plaque having a lobed surface is formed. This is what basal cell carcinoma is.
Characteristic feature
A characteristic feature is the appearance of telangiectasis signs on the surface of the plaque, that is, stains formed by small capillaries. After some time, a bubble edging is formed around the perimeter of the formation, which then turns into a canton of dense structure. It is this cushion that is a characteristic difference between basal cell carcinoma. If you try to stretch the skin at the site of the neoplasm, you will clearly see the ring of inflammation, which has a red color.
The breakdown of tissues on the surface of the tumor provokes an erosive or ulcerative process. If you remove the crust covering the ulcer, a crater indentation or an uneven bottom is exposed under it. Such tumors can partially scar, crust, but, despite this, they continue to grow slowly, without causing any discomfort.
Slow growth can detect the disease in 80% of patients. Moreover, if the disease is detected in a timely manner, then the prognosis is very favorable: in 98% of cases, the disease can be completely cured.
Treatment of basal cell carcinoma on the face with folk remedies is used, but only at the initial stage and in combination with other methods.
Late period of the disease
The late period of development of carcinoma is characterized by its germination into the deep layers of the skin, as a result of which a depression forms in the form of a crater. The structure of ulceration becomes dense and ceases to shift to the side upon examination. The bottom of the wound becomes oily and shiny, the ulcer itself is surrounded by clearly visible capillaries.
As we have already mentioned, basal cell carcinoma develops over a long period and is characterized by proliferation in depth rather than in area. In this regard, after the treatment of basal cell carcinoma in the later stages, a very noticeable cosmetic defect remains in patients, which is subsequently difficult to correct.
In many patients, carcinoma has a recurrent nature.
The danger of basal cell carcinoma and the need for its removal
A long process of tumor development provokes its penetration deep into the body, as a result of which soft tissues, bones and cartilage are damaged and destroyed. Cell growth of the neoplasm occurs along the nerve fibers, inside the tissue layers and along the surface of the periosteum.
If basal cell carcinoma is not removed in a timely manner, destruction is not limited to tissue structures.
Complications
Bazalioma is able to disfigure and deform the nose and ears as a result of the destruction of bone and cartilage. The course of the disease can be aggravated by a purulent process, to which a variety of infections can join. In addition, it is possible:
- damage to the mucous membranes in the nose;
- the transition of the tumor process into the oral cavity;
- damage and destruction of the bone tissue of the skull;
- damage to the orbits;
- the occurrence of blindness and deafness.
The introduction of a tumor into the skull, occurring along natural cavities and holes, is especially dangerous.
In such cases, brain damage and subsequent death of the patient become inevitable. Despite the fact that basal cell carcinoma is considered a non-metastatic tumor, there are about two hundred described cases of the fact that she nevertheless gave metastases.
Consider how to treat basal cell carcinoma on the face.
Treatment of Basal Cell Carcinoma
Therapeutic techniques include:
- Drug therapy with local chemotherapy using cytostatic drugs, for example, Cyclophosphamide. It is also possible to use applications with fluorouracil and methotrexate.
- Surgery. Facial basal cell carcinoma is completely removed. At the same time, adjacent tissues are captured by about 1-2 centimeters. In the event that the cartilage tissue was damaged, then it must also be resected.
What ointment to apply for facial skin basal cell carcinoma?
At the initial stage or with a relapse of the pathology, the following ointments can be used:
- Omain Ointment.
- Solcoseryl.
- "Kuderm cream."
- Iruxol.
- Metvix
Other treatments
Contraindications to the operation - a complex background pathology, advanced age, the inability to use anesthesia:
- Cryodestruction. Allows you to remove basal cell carcinoma with liquid nitrogen. Destruction of tumor tissue occurs as a result of exposure to too low a temperature. Such a technique is suitable exclusively for the destruction of small tumors that are located on the legs or arms. If the tumor is large, deep infiltration or located on the face, this method is contraindicated.
- Radiation therapy of basal cell skin. It can be used as an independent method of treatment, or in combination with others. It is possible to use to remove formations having a size of not more than 5 centimeters and located on the surface. At the same time, the development period should be early, but localization does not matter. A similar technique is acceptable in the treatment of elderly patients and in the case of advanced form of the disease. Therapy can be complex, mixed with the drug form of treatment.
- Removal by carbon dioxide or neodymium laser. The use of this technique is possible if the neoplasms are small in size. The method is highly effective, the efficiency reaches 85%.
- Photodynamic therapy. It is carried out by exposure to basal cell laser radiation. The introduction of a photosensitizer to the patient is required.
What is photodynamic therapy?
The mechanism of action of the latter method is as follows: tumor cells accumulate a photosensitizer, as a result of exposure to it with a laser, it provokes the development of tissue necrosis of basal cell carcinoma. Cancer cells die without causing damage to the connective tissues. This method in modern medicine is the most popular and common. It is often used to remove both primary tumors and recurrent, especially those located on the skin of the face.
Forecast
Despite the recurrent nature of this type of tumor, the prognosis is most often favorable. Achieve a positive result is possible in 80% of cases. If the neoplasm has a local and not neglected form, then timely diagnosis and the beginning of therapy can completely cure it.
We examined in this article what basal cell carcinoma is.