Centro Studi GISED

Basalioma – Basal cell carcinoma or Basal cell epitelioma

Basaliomas (also known as Basal cell carcinomas or basal cell epiteliomas) are local malignant tumours of the skin, almost never metastasized, composed of cells similar to those of the basal layer of the epidermis (from which it gets its name). This tumour can be easily treated in different ways: surgical removal, electrodesiccation, laser photodynamic therapy or cryotherapy. It is important that the treatment takes place before the lesion bursts.

Dear Sir, I’m a young 27 year-old who has been diagnosed with a superficial basalioma. Having read that it’s a type of tumour that normally presents itself in adulthood and old age, I would like to know if this fact is symptomatic of danger and how will I have to be after it’s surgical removal? Is it necessary to have a more in-depth examination? I thank you. A guy a bit scared.

Dear (…) a basalioma (also called basal cell carcinoma) is a tumour of the skin which grows locally. In general, surgical removal solves the problem and no examinations are necessary except for a histological examination of the piece removed. It has been shown that those who are diagnosed with their first basalioma have a high risk of being diagnosed with subsequent basaliomas in the ensuing 5 years and the diagnosis of a first basalioma in subjects young-of-age further highlights the possibility of others developing. It is useful, therefore, to have total skin check-ups periodically (annually) over the next 5 years. Don’t worry too much even so, despite it’s name, a basalioma is a tumour essentially benign and secondary locations are really rare. A basalioma is a tumour associated with exposure to the sun, particularly strong at infancy and is more common in blond or red-headed subjects with pale skin that reddens easily to sunlight. Therefore, it’s important to protect yourself from the sun. Best regards. Dr Luigi Naldi – GISED.

I’m (…) and I’m contacting you from... because I need to find information on basaliomas. In particular I would like to know with precision: 1) What is it? 2) What are the techniques or treatments most effective in order to definitively resolve the problem? 3) What are the consequences that come with it and what are the side-effects (if any exist). 3a) Recovery times. (Obviously approximate). 4)Chances of recovery (%) 5) Who’s interested in this particular pathology? 6) Where does he/she disclose his/her work? 7) If necessary, is there someone nearer to my city? I thank you in advance for your clear and prompt response. Best regards.

Dear Writer, you will find the answers to your first two questions at the introduction to this page. Regarding the others I shall respond in brief: 3) If left untreated, the tumour can just keep growing (although in general, very slowly), until it become of inoperable proportions and carries with it the possibility of destroying the entire surrounding skin. Metastases are very rare. The recovery times after intervention are clearly proportional to the dimensions of the tumour and where it’s situated. Even so, the recovery time is usually short. 4) The percentage chance of recovery is around 100% and possible relapses in the same area are easily treated. 5) In the first instance it is the dermatologists who are interested in this particular pathology, but in certain instances other medics as well (Surgeons, plastic surgeons, oncologists, radiotherapists and ophtalmologists etc.). 6) In Lombardy. 7) We advise you to go and visit your general practitioner who will be able to refer you to a specialist dermatologist in the health service or alternatively will contact a trusted dermatologist in your area. Best regards. Dr. Lorenzo Peli – GISED

I would like some information on how to care for myself after the removal of a basalioma in the frontal region under my hair.

A basalioma is a tumour of the skin observed rather frequently. You can get rid of it relatively easily with suitable treatment. Usually it is removed surgically. If the removal is complete, it is sufficient to undergo periodical check ups with your dermatologist who will confirm the absence of a relapse. Best regards. Dr Lorenzo Peli – GISED.

Dear Doctor, I’m a girl of 26 years and I don’t write to you for myself, but as a result of my father’s diagnosis last week due to a mark of roundish appearance, which appeared on his face (in left frontal area, between his eyebrow and his hairline to be precise) more or less around the middle of august and has continued to develop quite rapidly. The diagnosis was basal cell carcinoma curable with it’s removal. What I wanted to know was, is it possible to give a diagnosis that precise before it has been removed and examined by an anatomo-pathologist and what are the main differences between a keratoacanthoma (benign) and basal cell carcinoma? Recently, where it has eroded in the centre, a keratinose-like substance has been discharged and it is peeling slightly at the outline. From the moment that I read various articles, even on spino-cellular carcinomas, I would like to know what difference there is between that type of tumour and basal cell carcinomas and if a good dermatologist at first glance can exclude spino-cellular carcinoma before it’s removal and before an anatomo-pathological diagnosis and what if it proves to be a tumour much more worrying than a basalioma? In anticipation of your prompt reply I give you my most distinguished regards.

Dear Writer, thank you for your message. Cutaneous epithelial tumours, at times inaccurately grouped (mainly by English and American authors) into the category of “non-melanoma cutaneous tumours,” comprising principally of spino-cellular carcinomas and basal cell carcinoma or basalioma. They are, in general, tumours that grow in one region and very occasionally, and only in exceptional cases, metastasise. In general, these happen to be lesions that have been overlooked, which then reach a considerable size and/or are in unusual places, like the genitals and oral cavity. Complete surgical removal of the lesions is carried out in the recovery clinic. At times, particularly in cases of basaliomas that can have obscured edges, they are possibly only partially removed with subsequent relapses. It is, therefore, important to follow the patient’s progress over time after surgical removal of the lesion. The principle risk factor in tumours like these, is sun exposure in subjects with pale skin. Basaliomas are more influenced by intense sun exposure in infancy that have led to sunburns. Instead, for spino-cellular carcinomas, chronic exposure is crucial and the dose of solar radiation accumulated over time. Subjects who develop a primary cutaneous epithelial tumour have a higher risk of developing a second epithelial tumour independent of the first, in the years after the first has been diagnosed. This is another reason to follow the patients progress over time. In many cases, expert dermatologists are able to make a clinically precise decision with reliability. Nevertheless, errors are possible and histological confirmation is recommendable. Keratoacanthomas are epithelial tumours with a peculiar clinical behaviour and a characteristic histological form. It’s a symmetrical nodule with a central depression often surrounded by a scab that grows very rapidly and then regresses spontaneously in around one month. It’s appearance is similar to that of the spino-cellular carcinoma but it’s benign. Even if benign, it’s generally advisable to completely remove the lesion to allow a reliable histological diagnosis to be made. I hope I have responded to your queries satisfactorily, yours sincerely. Luigi Naldi - Coordinatore Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

Hi, I wanted to ask for some information. A little while ago I was sunburned. Afterwards my skin started peeling, but I noticed that a little patch has remained on my chest for more than a month. I wanted to understand what it could be: I have already fixed an appointment with a dermatologist but looking on the internet I read about basaliomas and, maybe I’m wrong, but could it be that? The patch is about a cm in size, and all pink with a red spot in the centre…what could it be? Do I need to worry?? I wait avidly for a response. Thank you for your attention.

Dear Writer, excessive sun exposure can provoke, as in your case, burns. In the long run, with excessive sun exposure, the skin loses it’s elasticity and definable brown patches appear like freckles. With excessive sun exposure prolonged over time cutaneous tumours can also appear. More commonly, basaliomas, but also melanomas and spino-cellular carcinomas. It’s difficult to judge the nature of the lesion based on what you have described. It seems to me that it would certainly be useful to go for a medical check up. Best regards, Dr. Luigi Naldi coordinatore Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

Dear Colleague, I would be grateful to you if you would send me the latest data on incidences of basal cell carcinomas in Italy, to complete a dermatology thesis on such a subject. Thanking you for your kind cooperation I send my most distinguished regards.

Dear Colleague, Thank you for the message. Reliable data on incidences of cutaneous epithelia tumours is very difficult to obtain. Tumours can be treated in outpatients of which sometimes a histological examination isn’t even carried out. There are very few population registries that have concentrated their attentions on these tumours. One is the tumour registry of the province of Trento, which has started to produce it’s primary data (Boi S, Cristofolini M, Micciolo R, Polla E, Dalla Palma P. Epidemiology of Skin Tumours: Data from the Cutaneous Cancer Registry in Trentino, Italy. J Cutan Med Surg. 2003 Jul 28 [Epub ahead of print]. On the basis of this data, the incidences of basaliomas are equal to 87.9 per 100 000 per year. Another tumour registry with a strong interest in cutaneous tumours is that of the canton of Vaud in Switzerland (Int J Cancer 1988; 42:811-6). The register clearly indicates that basaliomas are more frequent in men than women (51.6 vs 38.0 per 100 000 per year) and progressively increases with age (595.2 in men and 359 in women over 85 years of age). Finally, a further data source is that of our study, PraKtis, which estimates that the cumulative rate of incidents in subjects 45 years and over is equal to 0.9%. Best regards, Luigi Naldi Coordinatore Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).