Sclerodermiform basal cell carcinoma
Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
ICD11: -
Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
ICD11: -
Keloid basal cell carcinoma, fibrosing basal cell carcinoma, morpheaant basal cell carcinoma, morpheiform basal cell carcinoma, sclerosing basal cell carcinoma.
Clinically "scarring" aspect, with a more pronounced therapeutic approach usually recommended.
Particularly the nose, forehead or cheeks.
A connective tissue, fibromatous reaction surrounds the tumour cell clusters. Unlike other forms of BCC, the typical palisading is mostly absent.
Therapy of 1st choice according to Lebwohl |
Evidence level |
Curettage and electrodesiccation |
B |
Surgical excision |
B |
Moh's surgery (micrographically controlled) |
B |
Cryotherapy |
B |
Therapy of the 2nd choice after Lebwohl |
|
Radiation therapy |
B |
Therapy of the 3rd choice according to Lebwohl |
|
Interferon intralesional |
B |
Retinoids |
D |
Imiquimod |
A |
Photodynamic therapy |
A |
5-Fluorouracil |
A |
CO² laser |
D |
PEG-interleukin 2 |
D |
NSAIDs |
D |
Ingenol mebutate |
D |
Vismodegib |
A |
Intralesional interleukin application |
D |
Systemic chemotherapy |
D |
Operative therapy
BCC Ø < 2 cm |
Infiltrative BCC |
||||
Safety distance |
3 mm |
4-5 mm |
3 mm |
5 mm |
13-15 mm |
Likelihood of tumour remnants remaining |
15% |
5% |
34% |
18% |
5% |
Source: Hauschild, A. (2016). Long version of the guideline "Basal cell carcinoma of the skin". Awmf.org. Retrieved 30 May 2016, from http://www.awmf.org/leitlinien/detail/ll/032-021.html
Experimental therapies
- Imiquimod cream 5% daily 5x/week for a total of 6 weeks.
- Useful in superficial and in Gorlin syndrome.
- Laser therapy
- Photodynamic therapy
- Cryotherapy
- Especially infiltrative growing and sclerodermiform basal cell carcinomas should be surgically excised.
- In the case of incomplete resection, re-excision should be performed except in well justified cases.
- Cure rate depends on tumour diameter, histological type and safety margin.
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