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Basal cell carcinoma

Basal cell carcinoma is the most common skin malignancy. It is a slow-growing tumour that is invasive but rarely metastasises. It usually occurs on sun-exposed skin, especially of the head and neck.

Suggested approach to basal cell carcinoma osce station

Describing lesions

  • Lesion
    • ‘There is a skin-coloured papule/nodule present on the left cheek. It has a pearly rolled edge and there is surface telangiectasia.’
    • ‘It is approximately 13mm in diameter.’
    • ‘There is no ulceration, necrosis or secondary features (such as crusting, scaling or erosion).’
    • ‘On palpation, it is firm and not hot or tender.’
    • ‘This lesion is characteristic of a basal cell carcinoma.’

Differential diagnosis

  • Squamous cell carcinoma
  • Seborrhoeic keratosis
  • Malignant melanoma


  • First line
    • Conventional surgery
    • Mohs surgery (cancerous skin removed in layers and examined microscopically until only non-cancerous skin remains)
  • Other treatment options
    • Curettage and electrodessication
    • Cryotherapy
    • Topical therapies (e.g. imiquimod, fluorouracil)
    • Radiotherapy