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

Management

  • First line
    • Conventional surgery
    • Mohs surgery
  • Other treatment options
    • Curettage and electrodessication
    • Cryotherapy
    • Topical therapies (e.g. imiquimod, fluorouracil)
    • Radiotherapy

Here are some viva questions!

What is the differential diagnosis for a BCC?

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What is Mohs surgery?

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What is the biggest risk factor for development of BCC?

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Dermatological skin exam OSCE station

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