Oncological Dermatology • ICD-11: 2C32

Basal Cell Carcinoma (BCC): Dermoscopy Hallmarks, Subtypes & Mohs Micrographic Surgery

Author: Mallikarjun R (Founder) & Medicus Labs Medical Team • Review: 13 min read • ✓ Peer-Referenced

1. Incidence & Ultraviolet Mutagenesis

Basal Cell Carcinoma (BCC) is the most frequently diagnosed malignant neoplasm in humans, accounting for over 75% of non-melanoma skin cancers. Driven by cumulative and intermittent UV radiation, oncogenesis involves inactivating mutations in the PTCH1 gene, causing aberrant constitutively active Sonic Hedgehog (SHH) signaling.

2. Clinical Subtypes & Dermoscopy Patterns

  • Nodular BCC: Translucent pearly papule with telangiectasias and rolled border; arborizing vessels on dermoscopy.
  • Superficial BCC: Erythematous, scaly patch on trunk resembling eczema; shiny white lines and short fine telangiectasias.
  • Infiltrative / Morpheaform BCC: Indurated, scar-like whitish plaque with ill-defined aggressive borders.

3. Surgical Management

Mohs Micrographic Surgery provides the highest cure rate (>99% for primary lesions) via complete peripheral and deep margin microscopic inspection, particularly indicated for facial high-risk "H-zone" tumors.