The Many Faces of Basal Cell Carcinomas (BCCs)

Our new series, “The Many Faces of”, showcases side-by-side images of some of the most commonly seen dermatology conditions in an array of skin tones and briefly highlight nuances in clinical presentation.  All images featured in the series are part of The Full Spectrum of Dermatology: A Diverse and Inclusive Atlas, a resource developed by co-editors Misty Eleryan, MD, MS, and Adam Friedman, MD, and published by SanovaWorks and Educational Testing & Assessment Systems.

We continue our series with a look at Basal cell carcinomas (BCCs).

Basal cell carcinomas (BCCs) have a wide variation in presentation ranging from pearly pink papules to deep erythematous brown nodules with central ulceration or even variegated brown-gray plaques with rolled borders.

Basal cell carcinoma is the most common type of skin cancer, usually occurring on sun-exposed areas of the skin. The nodular variant, which accounts for over half of BCCs, classically presents as a pearly pink papule with prominent arborizing vessels. Rolled borders and ulceration are characteristic features seen in all subtypes of BCCs.

Nuances to Highlight

BCCs in darker skinned patients are often pigmented and nodular, leading to misdiagnosis as seborrheic keratoses, melanoma, or nevus sebaceous. Given less prominent vasculature, identification of darker pigment within or throughout a pearly nodule or papule can aid in differentiating BCCs in this population.

Further Reading

If you would like to learn more about diagnosing Basal Cell Carcinomas, check out the following articles published in the Journal of Drugs in Dermatology:

Characteristics of Superficial Basal Cell Carcinomas Containing More Aggressive Subtypes on Final Histopathologic Diagnosis

Identifying Areas for Improvement in Remote Skin Cancer Management: Surveillance, Diagnostics, and Skin of Color

Acknowledgements

We thank co-editors Misty Eleryan, MD, MS, and Adam Friedman, MD for reviewing the content of this article.

Reference

Eleryan, Misty, and Adam Friedman. The Full Spectrum of Dermatology: A Diverse and Inclusive Atlas. SanovaWorks, 2021.

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