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J Am Acad Dermatol. 2018 Mar;78(3):540-559. doi: 10.1016/j.jaad.2017.10.006. Epub 2018 Jan 10.

Guidelines of care for the management of basal cell carcinoma.

Author information

1
Department of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois.
2
Section of Plastic and Reconstructive Surgery, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan.
3
Department of Radiation Oncology, Northwestern University, Chicago, Illinois.
4
Plastic/Head/Neck Surgery, Department of Otolaryngology, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan.
5
Department of Internal Medicine, Ohio State University, Columbus, Ohio.
6
Department of Family Medicine, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan.
7
Department of Dermatology, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan.
8
Department of Dermatology, University of Colorado, Denver, Colorado.
9
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
10
Case Western Reserve University School of Medicine, Cleveland, Ohio.
11
Department of Dermatology, University of Rochester, Rochester, New York.
12
Dermatopathology, Memorial Sloan Kettering Cancer Center, New York, New York.
13
Department of Dermatology, University of California Davis, Sacramento, California.
14
Private practice, Chicago, Illinois.
15
Private practice, Kissimmee, Florida.
16
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
17
Department of Pathology, University of South Florida, Tampa, Florida; Department of Pathology, Moffitt Cancer Center, Tampa, Florida.
18
Private practice, Yorba Linda, California.
19
Private practice, Towson, Maryland.
20
Dermatology Section, NEOMED, Rootstown, Ohio.
21
Geisinger Medical Center, Danville, Maryland.
22
Memorial Sloan Kettering Cancer Center, New York, New York.
23
Basal Cell Carcinoma Nevus Syndrome Life Support Network, Burton, Ohio.
24
Mayo Clinic, Phoenix, Arizona.
25
Stanford School of Medicine, Stanford, California.
26
Dermatologic Surgery and Laser Center, University of California San Francisco, San Francisco, California.
27
Department of Dermatology, University of Alabama, Birmingham, Alabama.
28
American Academy of Dermatology, Schaumburg, Illinois.
29
American Academy of Dermatology, Schaumburg, Illinois. Electronic address: wsmithbegolka@aad.org.
30
Department of Dermatology, Northwestern University, Chicago, Illinois.

Abstract

Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.

KEYWORDS:

basal cell carcinoma; biopsy; curettage; metastasis; phototherapy; radiotherapy; staging; surgery; surveillance; topical therapy

PMID:
29331385
DOI:
10.1016/j.jaad.2017.10.006
[Indexed for MEDLINE]

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