Initially, your oncologist will ask you questions about your medical history. In addition, he will perform a physical examination looking for clinical signs of basal cell carcinoma. This examination will help him detect not only the tumor but also the type of cancer you have. Depending on the appearance of the tumor and the results of microscopic examination, basal cell carcinoma is divided into many subtypes; the most common include:
- Cicatricial basal cell carcinoma: also called morpheaform basal cell carcinoma or morphoeic basal cell carcinoma, this subtype of basal cell carcinoma develops as small papular and translucent patch, which gradually spreads and turns into a central white scar-like patch covered with small hemorrhagic crusts.
- Rodent ulcer: also known as a Jacobi ulcer, rodent ulcer is a form of basal cell carcinoma characterized by a slow growing ulceration of the skin that usually appear on the face. Although named “rodent ulcer”, the tumor is not caused by rodents.
- Nodular basal cell carcinoma – this subtype of basal cell carcinoma is often called “classic basal cell carcinoma”. It tends to develop as a waxy, translucent papule with central depression and a few small erosions. The papule has a smooth surface with small dilated blood vessels (telangiectasia).
- Cystic basal cell carcinoma: cystic basal cell carcinoma is often mistakenly taken for nodular basal cell carcinoma; they have almost the same characteristics. The tumor ischaracterized by dome-shaped, blue-gray cystic nodules. Usually, the center of the lesion contains a clear mucin that has a gelatin-like consistency.
- Basal cell carcinoma Pigmented: this type of carcinoma is characterized by brown-blacklesions that are clinically closed to those of melanoma and seborrheic warts. In general, the lesions are numerous and pigmented.
- Superficial basal cell carcinoma: this subtype of basal cell carcinoma is characterized by multiple circumscribed erythematosus patches that tend to develop on the upper trunk or shoulders. The patches grow slowly, and can develop on any area of the skin, unlike most basal cell carcinomas.
After typical signs of basal cell carcinoma have been found, your oncologist will take a skin sample in the affected area to be examined under a microscope. The biopsy will be performed by a skilled pathologist who is able to confirm if you have basal cell carcinoma or not.