From the academy
Guidelines of care for the management of basal cell carcinoma

https://doi.org/10.1016/j.jaad.2017.10.006Get rights and content

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.

Key words

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

Abbreviations used

AAD
American Academy of Dermatology
AJCC
American Joint Committee on Cancer
ALA
aminolevulinic acid
BCC
basal cell carcinoma
C&E
curettage and electrodessication
5-FU
5-fluorouracil
MAL
methylaminolevulinate
MM
malignant melanoma
MMS
Mohs micrographic surgery
NCCN
National Comprehensive Cancer Network
NMSC
nonmelanoma skin cancer
PDT
photodynamic therapy
PI
principal investigator
RCT
randomized controlled trial
cSCC
cutaneous squamous cell carcinoma
SMO
smoothened (inhibitors)
STEVIE
Safety Events in Vismodegib

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Funding sources: None.

The management of conflict of interests for this guideline series complies with the Council of Medical Special Societies' Code of Interactions with Companies. The authors' conflict of interest/disclosure statements appear at the end of this article.

Reprint requests: [email protected].

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