Flat basal cell carcinoma. Treatment of skin basal cell carcinoma at home

Basal cell carcinoma is considered an oncological process that develops from epidermal cells. Basal cell carcinoma of the face– a common disease, most often it is registered after the age of 40 years. A high likelihood of this cancer is observed in men. You can recognize this cancer yourself.

What is the danger of the disease?

This type of cancer is not dangerous. In most cases, the disease can be overcome. But, unfortunately, people suffering from basal cell carcinoma remain at high risk of developing it again. In the first stages, the disease is mild and responds well to treatment. Its repeated development may be more aggressive. If treatment is started late, the tumor may spread to the brain.

The first signs of basal cell carcinoma of the face

This cancerous skin lesion is characterized by the appearance of a small nodule. It may be red or flesh-colored. The formation slowly increases in size, but it does not bother the person at all. There is no pain or discomfort. As the tumor progresses, a gray crust forms on the surface of the tumor. After its removal, a slight depression is observed on the skin, which disappears over time.

A characteristic feature developing disease is the appearance of a thin roll of dense consistency. Upon careful examination, you can notice small grains on its surface, similar to pearls.

Mature symptoms

Progression of the disease leads to the growth of cancer. New nodules appear on the skin, which eventually merge with each other. Oncology provokes vasodilation, which is why blood vessels appear between tumors. spider veins. Gradually the formation turns into a large ulcer. If left untreated, it grows into surrounding tissues. At this stage, severe pain syndrome appears.

How to independently recognize basal cell carcinoma of the face?

There are several main types of the disease, which differ in their clinical manifestations. you can do it yourself; to do this, you just need to carefully examine the skin of your face. If suspicious formations are detected, it is recommended to consult a doctor.

The superficial type of oncology is distinguished by round or oval spots of a characteristic pink hue.

The tumor form has the appearance of a nodule that rises above the upper layer of the epidermis.

The ulcerative type of cancer is presented in the form of an ulcer or erosion. Upon careful examination, you will notice raised edges in the form of a roller.

Pigmented basal cell carcinoma is pronounced and has a rich hue in the affected area.

The scleroderma-like form looks like a white plaque with growths.

What is needed to make an accurate diagnosis?

Only an oncologist can make an accurate diagnosis after a thorough examination of the patient. Additionally conducted laboratory research, in particular, cytological analysis. Due to the similarity of the clinical picture with other diseases, differential diagnosis is carried out. This will eliminate the development of herpes zoster, melanoma, scleroderma and senile keratosis.

Are you unsure of the correctness of the diagnosis and treatment prescribed for you? A video consultation with a world-class specialist will help dispel your doubts. This is a real opportunity to benefit from qualified assistance from the best of the best and not overpay for anything.

Based on the data obtained, the specialist makes a diagnosis and prescribes comprehensive treatment.

Is it possible to completely cure basal cell carcinoma on the face?

The disease in its early stages is easily treatable. Modern medicine has sufficient knowledge and techniques to eliminate skin cancer. The choice of treatment method is influenced by the prevalence of the disease, its location and the depth of the lesion.

The most popular treatment methods for facial skin basal cell carcinoma today are:

1. Curettage and fulguration.
2. Cryosurgery.
3. Mohs surgery.

Curettage and fulguration- these are two common techniques used to eliminate cancer on the surface of the body. The surgical intervention is based on desquamation with further burning of the tissue. During the procedure, not only the tumor is removed, but also the bleeding is stopped.

Cryosurgery is appropriate if there is surface formations. It is based on the use of liquid nitrogen. The procedure involves freezing and then removing the tumor. As an alternative technique, your doctor may recommend laser removal. It is possible to use surgical excision; this method is appropriate for aggressive disease.

Mohs surgery is a micrographic technique. It was developed specifically to eliminate cancerous lesions on the skin. Used on sensitive areas, particularly the face. The technique is based on layer-by-layer freezing of the formation. This allows you to completely remove the defect with minimal risk of scar development. This technique is the most effective; it significantly reduces the risk of relapse.

Each of the presented methods allows you to cure basal cell carcinoma. The main thing is to start the fight at an early stage. The aggressive course is a more complex process, but timely medicine gives good results.

Forecast and what to expect?

The prognosis of the disease is favorable in almost all cases. This type of cancer rarely metastasizes. Basal cell carcinoma of the face treatable. If the aggressive stage develops, it may be necessary complex therapy. In general, the prognosis is favorable. An unfavorable course is observed when the tumor grows into the brain.

The most common type of oncological skin pathology is basal cell carcinoma on the face, which is a basal cell carcinoma, basal cell carcinoma. This tumor neoplasm originates in the germinal epithelial layer. Most characteristic features for basal cell carcinoma are slow growth and very rare metastasis. Most oncologists prefer to classify this as a semi-malignant neoplasm.

Description of the pathology

Basal cell carcinoma is distinguished by its persistent relapsing course. Quite often, invasion occurs in almost all skin layers, including the deepest ones. This process can cause cosmetic functional defects on the skin surface. People of all ages are affected by the disease, however, as statistics show, every fourth person before and after 50 years of age who is sensitive to sun exposure and has fair skin is at risk.

Provoking factors

Factors that can trigger the development of basal cell carcinoma on the face include:

• solar exposure;
• ionizing factor;
• exposure to substances of a chemical nature, for example, arsenic, hydrocarbon derivatives;
• frequent injury to the skin.

Basal cell carcinoma originates in the deep layer of the skin. After this, its gradual germination begins to the superficial areas of the skin.

Signs

Basalioma (photo below) can manifest itself in several clinical forms:

Stages of basal cell carcinoma

The classification of pathology by stages is based on the characteristics manifested in clinical picture, such as the area affected, 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 tumors, the size of which is no more than two centimeters. They are locally limited and have not had 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 basal cell carcinoma has grown into all layers of the skin, but the fatty tissue remains unaffected.
• New growths measuring three centimeters or more are classified as stage three. At this stage of development, the tumor grows to the bone.
• Stage four basaliomas are neoplasms that affect bone and cartilage tissue.

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. 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, matching the color of the skin. Most often they appear on the forehead or in the nasolabial folds and resemble ordinary pimples.

On initial stage basal cell carcinoma looks like a small pearly nodule. After some time, it begins to get wet, and a crust begins to form on the surface, through which the ulcerated surface can be discerned.

There is no pain or discomfort. Such nodules can appear in whole groups and then merge into one whole. As a result, an angiitis plaque is formed with a lobulated surface. This is what basal cell carcinoma is.

Feature

A characteristic feature is that telangiectasis signs appear on the surface of the plaque, that is, streaks formed by small capillaries. After some time, a bubble edging forms around the perimeter of the formation, which then turns into a edging of a dense structure. It is this ridge that is a characteristic feature of basal cell carcinoma. If you try to stretch the skin at the site of the tumor, you will clearly see a red ring of inflammation.

The breakdown of tissue on the surface of the tumor provokes an erosive or ulcerative process. If you remove the crust covering the ulcer, underneath it will reveal a crater-shaped depression or an uneven bottom. Such tumors may partially scar and become crusty, but despite this, they continue to grow slowly without causing any discomfort.

Slow growth makes it possible to detect the disease in 80% of patients. Moreover, if the disease is detected in a timely manner, the prognosis is very favorable: in 98% of cases, the disease can be completely cured.

Treatment of basal cell carcinoma on the face folk remedies is used, but only at the initial stage and in combination with other methods.

Late period of disease development

The late period of carcinoma development is characterized by its growth into the deep layers of the skin, resulting in the formation of a crater-shaped depression. The structure of the ulcerations becomes dense and ceases to move to the side upon examination. The bottom of the wound becomes fat 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 growth in depth rather than in area. In this regard, after treatment of basal cell carcinoma in the later stages, patients are left with a very noticeable cosmetic defect, which is difficult to correct in the future.

In many patients, carcinoma is recurrent.

The danger of basal cell carcinoma and the need for its removal

The long process of tumor development provokes its penetration deep into the body, resulting in damage and destruction. soft fabrics, bones and cartilage. The cellular 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 will affect not only tissue structures.

Complications

Basalioma can disfigure and deform the nose and ears as a result of the destruction of bone and cartilage tissue. The course of the disease can be aggravated by a purulent process, which may be associated with various infections. In addition to this it is possible:

• damage to the mucous membranes in the nose;
• transition of the tumor process to the oral cavity;
• damage and destruction of the bone tissue of the skull;
• damage to the orbits;
• the occurrence of blindness and deafness.

Particular danger is fraught with the introduction of a tumor into the skull, which occurs through natural cavities and openings.

In such cases, brain damage and subsequent death of the patient become inevitable. Despite the fact that basal cell carcinoma is considered a non-metastasizing tumor, there are about two hundred described cases in which it did metastasize.

Let's look at how basal cell carcinoma is treated on the face.

Treatment of basal cell carcinoma

Treatment methods include:

• Drug therapy using local chemotherapy using cytostatic drugs, for example, Cyclophosphamide. It is also possible to use applications with the drugs “Fluorouracil” and “Methotrexate”.
• Surgery. Facial basal cell carcinoma is completely removed. In this case, adjacent tissues are captured by approximately 1-2 centimeters. In the event that damage has occurred cartilage tissue, then it is also subject to resection.

What ointment to use for basal cell carcinoma of the face?

At the initial stage or in case of relapse of the pathology, the following ointments can be used:

• "Omain ointment."
• "Solcoseryl".
• "Curaderm cream"
• "Iruksol".
• "Metvix".

Other treatments

Contraindications to surgery - complex background pathology, advanced age, inability to use anesthesia:

• Cryodestruction. Allows you to remove basalioma using liquid nitrogen. The destruction of tumor tissue occurs as a result of exposure to too low a temperature. This technique is suitable exclusively for the destruction of small tumors located on the legs or arms. If the tumor is large, deeply infiltrated, or located on the face, this method is contraindicated.
• Radiation therapy for basal cell carcinoma of the face. Can be used as an independent method of treatment, or in combination with others. It can be used to remove formations no larger than 5 centimeters in size and located on the surface. In this case, the period of development should be early, but localization does not matter. This technique is acceptable when treating elderly patients and in cases of advanced forms of the disease. Therapy can be complex, mixed with medication.
• Removal with carbon dioxide or neodymium laser. The use of this technique is possible if the tumors are small in size. The method is highly effective, the effectiveness reaches 85%.
• Photodynamic therapy. It is carried out by exposing basalioma to laser radiation. The patient must first be given a photosensitizer.

What is photodynamic therapy?

The mechanism of action of the latter method is as follows: tumor cells accumulate a photosensitizer, and as a result of exposure to a laser, it provokes the development of necrosis of basal cell carcinoma tissue. Cancer cells die without causing damage connective tissues. This method in modern medicine is the most popular and widespread. It is often used to remove both primary tumors and recurrent ones, 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 positive result succeeds in 80% of cases. If the neoplasm has a local and not advanced form, then timely diagnosis and initiation of therapy can cure it completely.

In this article we looked at what basal cell carcinoma is.

Cancerous tumors appear more and more often every year. Skin basal cell carcinoma (basal cell carcinoma, basal cell epithelioma) is the most common representative among slow-growing tumors. A distinctive feature of basal cell carcinoma is the spread of growing tissue to other organs and surrounding tissues, while their structure and functions are destroyed. In addition, basal cell carcinoma tends to recur, but does not metastasize.

Cutaneous basal cell carcinoma is formed from the epithelium of the skin and appears as a scaly pink spot, most often on the face. This disease most often affects older people with light skin tones (types 1 and 2), as well as those who abuse sunbathing (sunbathe too much, go to the solarium, and spend a long time in the open sun) and do not use sunscreen. . In addition, the development of basal cell carcinoma can be provoked by X-ray radiation and contact with substances that contain a high concentration of carcinogens. Genetic factors, disorders immune nature, as well as skin pathology (senile keratosis, nevi, radiodermatitis, tuberculous lupus, psoriasis, etc.) can cause skin basal cell carcinoma. It should be noted that basal cell carcinoma can occur even on intact skin. It must be said that children and adolescents are not at risk of developing basal cell carcinoma. However, it has been proven that abuse of the sun's rays in childhood can, many years later, come back to haunt you with the appearance of this tumor.

Symptoms of basal cell carcinoma.
In practice, there are two types of skin basal cell carcinoma – superficial and invasive. In both cases, the onset of the disease is characterized by the appearance of one dense nodule of a flat or hemispherical shape measuring three to five millimeters in diameter. The neoplasm has the color of normal skin or a pinkish tint, resembling a small pimple in appearance. The disease at this stage of development does not bother patients at all. As it grows, the period of which can be from several months or even years, the nodule reaches a diameter of one to one and a half centimeters, sometimes more. In this case, the nodule or nodules become yellowish-gray or dull white and are accompanied by minor itching. Growing together, the nodules form a basal cell carcinoma. In the center, against the background of superficial decay, a thin bloody crust forms, under which a superficial, painlessly bleeding erosion or ulcer appears. A narrow ridge is visible along its circumference, which sometimes looks like a thin, barely noticeable “mother-of-pearl” border.

The superficial type of basal cell carcinoma occurs in a superficial, nodular, pigmented, micronodular, scleroderma-like and tumor form, and the invasive type occurs in an ulcerative form.

Nodular form.
This form of the disease occurs with the appearance of a pinkish or white papule, shaped like a dome, accompanied by slight itching, ulcerates and bleeds. As a result, crusts form. As the tumor grows, telangiectasia or spider veins become more pronounced, and an oval-shaped lesion appears, consisting of an abundance of lobules.

Micronodular form.
By clinical signs similar to the nodular form of the disease, however, when examined under a microscope, tumor cells are visible that extend beyond the boundaries of the lesion. This form of basal cell carcinoma often recurs.

Surface form.
This form of basal cell carcinoma can be successfully cured. The neoplasm has a reddish-brown color, with slight signs of peeling and roller-like edges. Upon closer examination, spider veins are clearly visible. In the case of the superficial form of the disease, basalioma, the tumor grows slowly, while the resulting lesion is superficial and does not affect the deep layers. A bloody crust forms on the ulcer itself, which is prone to complete or partial scarring while the tumor slowly disintegrates. It is the ability to spontaneous scarring that helps diagnose basal cell carcinoma from skin cancer. This form is considered the least aggressive and is most often observed on the limbs and surface of the body.

Flat shape.
This form of the disease manifests itself in the form of a rough, scaly plaque of a reddish color, with clear ridge-like edges. Sometimes when the scales separate, the plaque may bleed. If tissue destruction is mild, a superficial pink plaque of a flat shape, the size of a palm (sometimes larger), is formed, with signs of peeling of the surface and with a border in the form of a thin ridge, reminiscent of plaques of psoriasis or eczema (extramamillary Paget's cancer or Bowen's disease (squamous cell carcinoma)).

Pigmented form.
With this form, the ridge around the plaque or erosion turns dark brown or black in areas. Basalioma looks like a smooth and shiny plaque with a dense consistency. This form of basalioma is similar to melanoma (superficial or nodular), only with a dense consistency, and is also similar to the nodular form, the only difference is that in this case the pigment melanin is present (melanocytes are dispersed among the basaloid cells in the tumor areas). During differential diagnosis, it is necessary to remember the likelihood of a combination of basal cell carcinoma with melanocytic nevus or melanoma.

Sclerodermiform form.
As the pale nodule grows, it transforms into a flat, rough plaque with clear edges and a dense consistency. The surface of the plaque is prone to ulceration.

Tumor form.
This form of basalioma is characterized by a slow growth rate, during which a transparent nodule in the form of an oval or circle, a papule or an irregular mushroom-shaped tumor is formed above the skin, which practically does not spread in depth. It is colored pink, red or skin color, has a dense consistency, and has clearly defined boundaries.

Ulcerative form.
With the invasive development of basalioma, the ulcer destroys both superficial and deep tissues, including affecting the bones. The whole process takes place with strong painful sensations. The ulcer often has a crust on the surface, the edges are roll-shaped, smooth, dense, with visible spider veins. This form of basal cell carcinoma can exist for decades without metastasizing. If the disease is neglected, death occurs due to bleeding, re-infection and other random causes.

Complications of basal cell carcinoma.
This disease tends to spread to tissues that are nearby, causing their destruction. Complications, including death, are observed in cases where basal cell carcinoma spreads to the eyes, lining of the brain, bones, etc.

Diagnosis of basal cell carcinoma.
To make an accurate diagnosis, cytological and histological examination scraping or smear from the surface of the tumor. During microscopic examination, clusters of cells have a spindle-shaped or oval shape and are surrounded by a thin layer of cytoplasm. In general, the histological picture of the tumor can be varied, so differential diagnosis with other skin diseases is important.

It is important to distinguish flat superficial basalioma from lupus erythematosus, lichen planus, seborrheic keratosis and Bowen's disease. The sclerodermiform form of basal cell carcinoma must be distinguished from scleroderma and psoriasis, and the pigmented form from melanoma. If necessary, prescribe additional research, the purpose of which is to exclude diseases that are similar to basal cell carcinoma.

Treatment of basal cell carcinoma.
Therapy for skin basal cell carcinoma (basal cell carcinoma) is aimed at removing the tumor without damaging the healthy tissue that surrounds it. Most often, cryodestruction is used as a treatment method. During this treatment method, the tumor is exposed to liquid nitrogen. The procedure does not cause any discomfort, is absolutely painless and safe. Typically, anesthesia is not used during cryodestruction. The advantage of this technique is that the remaining scars as a result of treatment are practically invisible. This procedure is effective only for the superficial form of basal cell carcinoma, while the likelihood of disease recurrence remains.

Another type of tumor treatment is radiation therapy. During the procedure, the affected area of ​​the skin is irradiated with short-focus X-rays in combination with external gamma therapy. This type of therapy is effective only at the initial stage of the disease. In more serious cases of the disease, radiotherapy is supplemented with surgical treatment.

The most effective and progressive treatment method is the laser method. Laser treatment is painless and recommended for older people because surgery for them it is fraught with complications. It is also used in cases where basal cell carcinoma is located on the face, as it gives a good cosmetic effect.

The surgical treatment method is used only in cases of small basal cell carcinoma, or on surfaces or areas of basal cell carcinoma where postoperative scars will be invisible. The resistance of basal cell carcinoma to radiation therapy or the likelihood of its recurrence is an indication for surgical excision of the tumor.

Drug treatment for a tumor can only be prescribed by a doctor. Prospidin, kolhamin, and glyciphone ointments are prescribed as external agents.

Local chemotherapy of the tumor is carried out by applying applications of cytostatics to the localization sites.

In each specific case, the method of treating basal cell carcinoma is selected individually, taking into account the size of the tumor, its location, clinical form and type, and the degree of spread to neighboring tissues. In addition, the primary nature of the tumor or its recurrence is of great importance. Experts also take into account the patient’s age, the results of previous treatment, as well as concomitant diseases.

Disease prevention.
For older people, it is important to observe preventive measures, in particular, avoid exposure to the sun during its hours highest activity(11:00 - 16:00). In addition, during summer periods, use sunscreen and protect your face and neck. It is very important to eat right, including as much plant proteins as possible in your diet, respectively, reducing animal proteins. Give preference to fruits and vegetables. In addition, trauma to old scars should be avoided, especially if they are in areas of constant friction with clothing or other exposure. If there are wounds on the body that do not heal well, you should seek help, since harmless injuries can cause the development of basal cell carcinoma.

Recovery prognosis.
Due to the fact that basal cell carcinoma does not metastasize, the prognosis of the disease is favorable. However, in advanced cases (tumor more than 20 mm in diameter) and without appropriate treatment, the prognosis can be very negative, even death. The timing of therapy is important for complete cure. The earlier treatment was started, the higher the chances of a complete cure. When the tumor spreads to surrounding tissues, significant cosmetic defects remain as a result of treatment.

Basalioma of the facial skin or basal cell carcinoma is considered one of the most common malignant neoplasms of epithelial nature. Statistics say that this skin disease ranks third after lung and stomach cancer. According to WHO qualifications in the disease registry, this neoplasm is designated as cutaneous basal cell carcinoma ICD-10.

This type of skin cancer develops from the epidermis, namely from its follicular or atypical basal cells and is localized in open areas on the face, neck or head. On the face, the temples, area around the eyes, wings of the nose, nasolabial folds and upper lip are most often affected. The disease is diagnosed with equal frequency in men and women and usually develops in adulthood (after 50 years). This type of tumor is more treatable than others and with timely diagnosis in most cases, it is possible to achieve a complete cure, since the cancer does not metastasize.

The risk group mainly includes older people with fair skin who spend a long time in the sun, since ultraviolet radiation is the impetus that triggers the pathological process. We list the main provoking factors:

• Long-term exposure to the sun. The more intense the exposure to ultraviolet radiation, the higher the risk of developing skin cancer.
• Genetic factor. Hereditary diseases associated with increased sensitivity to sunlight, cases of basal cell carcinoma in close relatives, freckled and light skin significantly increase the risk of malignancy.
• Age factor. The incidence of basal cell carcinoma increases significantly with age. In 90% of cases, skin cancer is diagnosed in people over 60 years of age.
• Professional factor. Work associated with constant contact with toxic chemicals (petroleum products, resins, arsenic).
• Long-term mechanical damage to certain areas of the skin.
• Exposure to radioactive radiation, x-rays, or radiation therapy.
• Decreased immunity associated with taking certain medicines or immunodeficiency conditions (HIV, PID).

Children and adolescents are not at risk, but you should always remember that excessive sunbathing in childhood and adolescence can subsequently have a very negative impact on skin health.

Basalioma grows slowly (up to 5 mm) per year and does not metastasize, which determines a favorable prognosis, since with timely treatment the tumor responds well to treatment. The main danger is that in the early stages the symptoms of the disease are smoothed out and few people pay attention to small nodules on the skin. Meanwhile, the tumor slowly progresses and grows into the deep layers of the epidermis, destroying muscles, bone and cartilage structures. Tumor cells spread along the nerve trunks, in the muscles and along the periosteum.

If the tumor is located on the face next to natural openings, then the risk of destruction of the cartilage and bone structure of the nose, eye sockets or ear increases greatly, which leads to their deformation and facial disfigurement. If complications arise and erosions appear and open wounds, there is a high probability of infection and purulent abscesses. The tumor can move from the wings of the nose to the oral mucosa, destroy the bones that form the eye socket, which leads to loss of vision, and if the process affects auricle– to hearing loss.

The main danger is that through natural openings the tumor can penetrate into the cranial cavity and affect the brain, which can be fatal.

Types of basal cell carcinomas and characteristic symptoms

Experts distinguish several types of basal cell carcinomas, each of which has its own characteristics:

Nodular-ulcerative. This is the most common form of the disease, from which all other formations are then formed. Basalioma looks like a round, slight compaction pink in color, resembling a nodule or pimple that is slightly itchy. There is a noticeable depression in the center of such a nodule; outwardly it looks like a transparent, waxy pearl. There may be several such tubercles; over time, they merge and form a small plaque with a lobulated surface. The size of the plaque at the initial stage does not exceed 1 cm, spider veins (telangiectasia) can be seen on it, the formation bleeds easily at the slightest damage, and ulcers form, which are subsequently covered with a dry crust.

As the disease progresses further, a ridge of transparent vesicles forms around the tumor, which over time becomes dense and forms a reddish ring, inside which there is constantly inflammatory process and purulent necrotic crusts form at the bottom. The erosive surface gradually grows and in places of ulceration the color of the basal cell carcinoma changes. However, these processes do not cause discomfort or pain.

At the last stages of development, the disease passes into the ulcerative-infiltrative stage. In the center of the tumor, the ulcerative formation becomes covered with a crust, which can create the illusion of healing. But this is impossible with a malignant process. The crust easily falls off, but then forms again, and with each subsequent rejection the ulcer deepens more and more, taking the form of a crater, the bottom of which is covered with a gray, purulent crust. In this case, nearby tissues are affected, and a purulent infection is often associated.

Superficial. This form of cancer is the easiest to treat. The formation looks like a smooth, shiny pink plaque with a diameter of 3-4 cm with raised waxy edges. The favorite location is the chest and limbs, and multiple formations often appear on the body. Superficial basilioma can exist for decades, as it practically does not grow or develop. Its surface is atrophied in such a way that it resembles a mosaic, as it has areas of different pigmentation. There are no infiltrative manifestations.

Flat (scar). It is a neoplasm in the form of a plaque, bordered by a raised, clearly visible ridge. Appearance the neoplasm resembles a dark brown or black flat mole. Basal cell carcinoma grows over a long period of time, gradually increasing in size, and its central part begins to ulcerate, forming a flat ulcer. As the ulcers heal, a characteristic scar is formed; as a result, the neoplasm takes the form of a dark spot with cicatricial changes in the center. It is located below the level of healthy skin and is constantly growing and increasing in size.

Diagnostics

During the appointment, a dermatologist or oncologist will perform a visual examination and palpation lymph nodes. To clarify the diagnosis, you will need to do a scraping or biopsy and send the material for histological examination.

Additional research methods - ultrasound, CT ( CT scan) will allow us to identify and clarify the size, structure of the tumor and the depth of its penetration into the tissue, which is important when determining the tactics of subsequent treatment.

Treatment

Timely seeking qualified help allows you to stop the development of the tumor at an early stage and achieve a favorable prognosis. Today, there are several main methods of treating skin basal cell carcinoma:

• Surgical intervention (excision of basal cell carcinoma with a scalpel);
• Laser therapy (destruction of a tumor with a laser beam);
• Cryodestruction (freezing with liquid nitrogen);
• Radiation therapy (irradiation of the tumor);
• Electrocoagulation (cauterization with high frequency current);
• Phototherapy (the tumor is destroyed by light flashes after the introduction of a photosensitizer);
• Chemotherapy (treatment of tumors with special chemicals).

An important role when choosing a tumor removal method is played by its location. So, if the formation is in the facial area, surgical methods treatment is not used, since this can lead to facial disfigurement, especially in cases where basal cell carcinoma of the skin of the nose is diagnosed. On the facial areas, the most popular methods remain radiation therapy and modern laser techniques.

Skin cancer basal cell carcinoma in advanced cases grows to large sizes and grows deep into the tissue, destroying muscles and bone structures. In such cases, experts recommend combined removal methods. For example, cryotherapy sessions and local chemotherapy are used simultaneously, or radiation is combined with surgery.

Facilities traditional medicine cannot eliminate the tumor, but can slow down its growth and development, therefore, in agreement with the attending physician, they can be used in addition to the main treatment. To treat basalioma, you can use medicinal plants, the juice of which has a cauterizing effect.

• Celandine juice It is poisonous, so when collecting the plant you should wear gloves and carry out the procedure with caution, otherwise you may get burned. Traditional healers recommend simply breaking the stem of the plant and treating the surface of the basalioma with the released juice 3-4 times a day.
• Golden mustache juice has similar properties. To obtain it, you need to pass the plant stems through a meat grinder, then squeeze out the juice using gauze. Fresh plant juice is used for compresses. To do this, soak a cotton swab in it, apply it to the tumor, secure it with a bandage and leave it for several hours.

Forecast

The prognosis for basal cell carcinoma is favorable in most cases. If the tumor is removed at an early stage, when its size is small and it has not grown into the subcutaneous tissue, then, according to experts, the ten-year survival rate reaches almost 98%. Basal cell tumors do not metastasize, so this type of skin cancer is highly treatable and has a low mortality rate.

The prognosis worsens in cases where treatment is started at an advanced stage, when the tumor is located close to vital organs, is large in size and grows deeply, destroying surrounding tissue. In such cases, the risk of relapse of the disease increases significantly, since its course is more aggressive. Experts recommend closely monitoring the condition of the skin and promptly seeking qualified help if suspicious growths appear.

Basalioma (basal cell skin cancer) is a malignant tumor that originates from the superficial layer of the skin. Neoplasic cells are similar to those of the basal layer squamous epithelium, for which the tumor got its name. In terms of prevalence, basal cell carcinoma ranks almost first in the world, ahead of breast, stomach, and lung cancer. About 2.5 million new cases of the disease are diagnosed every year, and basal cell carcinoma accounts for up to 80% of all malignant skin tumors.

The diagnosis of basal cell carcinoma does not cause as much emotion and fear as other types of cancer, mainly due to the slow growth of the tumor. Basalioma is not prone, for a long time it does not cause any inconvenience except cosmetic defect, therefore, patients are in no hurry to visit a doctor; at best, they simply ignore the fact of the presence of a neoplasm, and sometimes even self-medicate. Hoping that the tumor will go away on its own, patients bide their time, delaying their visit to a specialist for years. Such carelessness leads to the diagnosis of advanced forms of basal cell carcinoma, which could easily be cured even at the earliest stages of its development.

Basilioma (basal cell skin cancer = basal cell carcinoma)

Extremely rare metastasis does not exclude this tumor from being malignant, and the ability to grow into surrounding tissues and destroy them often leads to dire consequences. There are known cases where elderly patients, not trusting doctors, were treated at home with folk remedies or even household chemicals in the form of aggressive cleaning products (yes, yes, this happens!). The tumor grew, although slowly, but quickly ulcerated, destroyed the surrounding tissues, blood vessels, and nerves, so the doctors were powerless, and the tragic outcome was a foregone conclusion.

Basal cell carcinoma can be classified as one of those types of cancer that are not only treatable, but can be completely cured if diagnosed in a timely manner. It is also important to note that even in the later stages, the prognosis for life after tumor removal can be good, but the operation that the surgeon will be forced to perform can be crippling and disfiguring.

Some time ago, basalioma was given an intermediate position between malignant and benign neoplasms, and dermatologists and surgeons could treat it. IN last years The approach has changed, and patients with this type are referred to an oncologist.

Among the patients, elderly people predominate; men and women are equally susceptible to the tumor. Basal cell carcinoma is more often diagnosed in fair-skinned, blue-eyed people who tan in solariums and in the open sun. The opportunity to travel south to the sea for residents of the northern regions not only gives them the opportunity to bask in the sun, but also poses the danger of excess ultraviolet radiation, which increases the risk of skin cancer significantly. The favorite localization of the tumor is exposed areas of the body - face, neck, eyelids.

Causes of basal cell carcinoma

The skin is the largest organ of the human body, constantly in contact with the external environment and experiencing the full range of adverse effects. With age, the likelihood of skin tumors increases, so the vast majority of patients have crossed the 50-year mark. In children and adolescents, basalioma practically does not occur, and cases of its diagnosis are most often associated with the presence congenital anomalies(Gorlin-Goltz syndrome, including basal cell carcinoma and other malformations).

The factors leading to the appearance of skin basal cell carcinoma are:

• Exposure to ultraviolet radiation.
• Ionizing radiation.
• Carcinogenic and toxic substances.
• Injuries, skin burns, scar changes.
• Pathology of immunity.
• Viral infections.
• Hereditary predisposition.
• Elderly age.

Among all risk factors, the greatest importance is given to exposure to ultraviolet radiation, be it solar radiation or solarium lamps. Prolonged exposure to the sun, especially during hours of maximum activity, and work in the open air have a detrimental effect on the surface layer of the skin, causing damage and mutations in it, which becomes the background for a cancerous tumor. A decrease in the density of the ozone layer leads to the penetration of more solar radiation, which is why the number of diseases is expected to increase in the future.

Fair-skinned people who lack the protective pigment melanin are especially susceptible to sunburn. The closer the region is to the equator, the higher the incidence of tumors, especially in predisposed individuals. People of Celtic descent are thought to have a higher chance of getting the disease than others.

Since basalioma appears from the influence external reasons, then, as a rule, exposed areas of the skin are affected - the face, neck, corner of the eye. It has been noticed that in the UK population, basal cell carcinoma often grows on the right side of the body, while in residents of many other countries it grows on the left. This unusual pattern is explained by uneven tanning when driving a car.

Ionizing radiation leads to damage to the chromosomal apparatus of skin cells, increasing the risk of cancer. External carcinogens and toxic substances (hydrocarbons, arsenic, soot) upon contact with the skin have an irritating and damaging effect on its cells, so persons who are forced to come into contact with such substances due to their professional activities need to be extremely careful.

Scars, chronic ulcers, hereditary anomalies, such as albinism and xeroderma pigmentosum, make the skin very vulnerable, and the risk of cancer in such patients is very high. In addition, the state immunosuppression caused by congenital causes, taking antitumor drugs or radiation is often accompanied by the appearance of basal cell and other types of skin cancer.

various precancerous changes and skin tumors

A certain value is assigned and viral infection when the microorganism itself lives in skin cells and causes their mutations, as well as in cases of HIV infection in the stage of developed immunodeficiency.

Manifestations of basal cell skin cancer

The manifestations of basal cell carcinoma when a tumor is formed are quite characteristic, which allows a fairly accurate diagnosis to be made already upon examination of the patient. External signs are determined by the type of tumor.

At the initial stage, basal cell carcinoma may look like an ordinary “pimple” that does not cause any inconvenience. Over time, as the tumor grows, the formation takes the form of a node, ulcer or dense plaque.

localizations typical for various tumors

Forms of basalioma:

1. Nodular-ulcerative.
2. Superficial.
3. Ulcerative.
4. Warty.
5. Scar-atrophic.
6. Pigmented.

In accordance with the International Classification, it is customary to distinguish three types of tumor growth:

• Surface.
• Scleroderma.
• Fibrous-epithelial.

The most common type of basalioma is the nodular variant, manifested by the appearance of a small painless pinkish nodule on the surface of the skin. As the nodule grows, it tends to ulcerate, so a depression covered with a crust appears on the surface. The tumor slowly increases in size, and the appearance of new similar structures is also possible, which reflects the multicentric superficial type of tumor growth. Over time, the nodules merge with each other, forming a dense infiltrate that penetrates deeper into the underlying tissue, involving not only the subcutaneous layer, but also cartilage, ligaments, and bones. The nodular form most often develops on the skin of the face, eyelid, and in the area of ​​the nasolabial triangle.

types of basalioma: superficial, nodular, cicatricial-atrophic, pigmentary, ulcerative

Nodal form is also manifested by the growth of neoplasia in the form of a single node, but, unlike the previous version, the tumor does not tend to grow into the underlying tissue, and the node is oriented outward.

Superficial growth option characteristic of dense plaque-like forms of the tumor, when the lesion spreads 1-3 cm in width, has a red-brown color, and is equipped with many small dilated vessels. The surface of the plaque is covered with crusts and can be eroded, but the course of this form of basal cell carcinoma is favorable.

Warty (papillary) basalioma It is characterized by superficial growth, does not cause destruction of underlying tissues and is similar in appearance to cauliflower.

Pigmented variant of basal cell carcinoma contains melanin, which gives it a dark color and similarity to another very malignant tumor -.

Cicatricial atrophic basalioma (scleroderma-like) resembles an outwardly dense scar located below the skin level. This type of cancer occurs with alternating scarring and erosion, so the patient can observe both already formed tumor scars and fresh erosions covered with crusts. As the central part ulcerates, the tumor expands, affecting new areas of skin along the periphery, while scars form in the center.

Ulcerative form of basalioma quite dangerous because it tends to quickly destroy the underlying and surrounding tissues of the tumor. The center of the ulcer is sunken, covered with a gray-black crust, the edges are raised, pinkish-pearly, with an abundance of dilated vessels.

The most common and, at the same time, the most dangerous places for localization of basal cell carcinoma are the corners of the eyes, eyelids, nasolabial folds, hairy part heads.

The main symptoms of basal cell carcinoma boil down to the presence of the structures described above on the skin, which do not bother you for a long time, but still an increase in their size, even over several years, the involvement of surrounding soft tissues, vessels, nerves, bones and cartilage in the pathological process is very dangerous. In the late stage of the tumor, patients experience pain, dysfunction of the affected part of the body, possible bleeding, suppuration at the site of tumor growth, and the formation of fistulas in neighboring organs. Tumors that destroy the tissues of the eye and ear, penetrate into the cranial cavity and grow into the membranes of the brain pose a great danger. The prognosis in these cases is unfavorable.

differences between skin tumors: 1 - normal mole, 2 - nevus dysplasia (moles), 3 - actinic keratosis, 4 - squamous cell carcinoma, 5 - basal cell carcinoma (basalioma), 6 - melanoma

Tumor metastases are extremely rare, but possible. The growth of neoplasia into soft tissues and the lack of clear boundaries can create certain difficulties when removing it, so relapse of basal cell carcinoma is not a rare phenomenon.

Diagnosis of basal cell carcinoma

Since basalioma is located superficially, there are no great difficulties in diagnosis. As a rule, a visual examination of the tumor is sufficient for this. Laboratory confirmation is carried out using cytological and histological methods.

For cytological diagnostics a fingerprint smear or scraping is taken from the surface of the neoplasia, in which characteristic cells neoplasms. At histological examination Using a tissue fragment, it is possible not only to accurately determine the type of neoplasia, but also to differentiate it from other types of skin diseases.

If the tumor spreads deep into the tissues, it can be carried out ultrasonography, CT, radiography, allowing to find out the depth and degree of involvement of bones, cartilage, muscles in the pathological process.

Video: specialist on skin cancer detection

Treatment of basal cell carcinoma

The choice of treatment tactics is determined by the location of the tumor, the nature of the damage to the underlying tissues, the age of the patient and concomitant pathology. It is also important to know whether the process is primary or a relapse, since basal cell carcinoma tends to recur after its removal.

Most effective way The treatment for basal cell carcinoma is surgical removal. However, the surgeon may encounter significant obstacles on the path, mainly due to the location of the basal cell carcinoma. Thus, damage to the tissues of the eyelid and corners of the eyes often does not make it possible to completely remove the tumor due to consequences that are incompatible with the normal functioning of the eyes subsequently. In such cases, only early diagnosis and timely referral of the patient to an oncologist can make it possible to radically remove the tumor without a cosmetic defect.

Radical excision of the tumor allows for its morphological examination and is indicated for more aggressive forms, when the risk of recurrence is high. When the lesion is localized on the face, in some cases, during surgery, a surgical microscope is used, which allows one to clearly control the necessary boundaries of the intervention.

If it is necessary to very carefully remove basal cell carcinoma with maximum preservation of unaffected tissue, the Mohs method is used, when during the operation a sequential histological examination of tumor sections is performed, which allows the surgeon to “stay” in time.

Radiation therapy is used as part of a combination treatment for advanced forms of the disease, and also as an adjuvant treatment after tumor excision to prevent relapses. If it is impossible to perform the operation, oncologists also resort to radiation. For this purpose, X-ray therapy or external irradiation is used for large lesions.

The method is effective, but one should take into account the high risk of radiation dermatitis and the growth of other tumors that occur after irradiation of basal cell carcinoma, so in all cases it is worth carefully weighing the feasibility of this type of treatment.

Chemotherapy for basal cell carcinoma it can only be used topically in the form of applications (fluorouracil, methotrexate).

tumor cryodestruction

Currently widespread gentle techniques tumor treatment - cryodestruction, electrocoagulation, curettage, laser therapy, which are successfully carried out by dermatologists.

Cryodestruction involves removing the tumor using liquid nitrogen. The procedure is painless and easy to perform, but is only possible for small superficial tumors and does not exclude the possibility of relapse.

Laser treatment is very popular in dermatology, but it is also used quite successfully in oncology. Due to its good cosmetic effect, laser therapy is applicable when the tumor is localized on the face, and in elderly patients, in whom surgery may be associated with various complications, such treatment is preferable.

The effectiveness of photodynamic therapy and the introduction of interferons into tumor tissue continues to be studied, but the use of these methods is already showing good results.

In all cases, it is worth considering the possible cosmetic consequences of tumor removal, so oncologists are always faced with the task of choosing the most gentle treatment method. Given the high frequency of advanced cases, it is not always possible to remove a tumor without a visible defect.

Due to the distrust of many patients in traditional medicine and the tendency to get carried away folk recipes, Separately, it is worth pointing out the inadmissibility of treating any type of malignant skin tumor with folk remedies. Basalioma is no exception, although it grows slowly and most often has a favorable course. The tumor itself tends to ulcerate, and various lotions and lubricants can further aggravate this process and cause inflammation with the addition of infection. After such self-medication, the doctor finds himself faced with the need to carry out radical and disfiguring operations, and in the worst case, the patient may not have time to see a specialist at all.

To prevent tumors, you should take care of your skin, avoid excessive sun exposure, and think carefully before visiting a solarium. During periods of solar activity, on the beach, or while relaxing in the open sun, you should always use sunscreen, and sunglasses will help protect your eyes and eyelids from harmful influences.

If basalioma does appear, then you should not despair, This tumor is a completely curable type of skin cancer, but only subject to timely detection and adequate treatment. More than 90% of patients who consult a doctor on time are completely cured of neoplasia.

Video: basal cell carcinoma in the “Live Healthy!” program

The author selectively answers adequate questions from readers within his competence and only within the OnkoLib.ru resource. Face-to-face consultations and assistance in organizing treatment are not provided at this time.