Basal cell carcinoma and genetic predisposition

Skin cancer is one of the most common types of cancer that exist. It usually appears in the areas of the skin most exposed to the sun, such as the head, neck or back, although it can appear anywhere on the body. Skin cancer is mainly classified into three types: basal cell carcinoma, squamous cell carcinoma and melanoma. Among non-melanoma skin cancers, basal cell carcinoma is the most common. 

The main reason for the appearance of this type of cancer is DNA damage caused by ultraviolet exposure, both natural and artificial. But, in addition, genetic studies have associated the appearance of this type of cancer with genetic variants that predispose to the disease. If you want to know what is and what types exist, keep reading.

What’s basal cell carcinoma?

A basal cell carcinoma is a type of skin cancer that begins in the basal cells, located at the base of the outermost layer of the skin, the epidermis. It is the most common skin cancer, accounting for 80% of the cases diagnosed with this disease [1]. 

Because its slow growth, its prognosis is usually good and most are cured when detected early. However, basal cell carcinoma can become invasive if left untreated and the lesions are allowed to grow uncontrollably, becoming misshapen and dangerous.

Although it’s unlikely that a basal cell carcinoma will spread by metastasizing, there are some rare but very aggressive cases in which the cancer spreads to other parts of the body. In some even rarer cases, this type of cancer can even be mortal [2].

Types of basal cell carcinoma

The first indication that we may have a basal cell carcinoma is a skin lesion. This can have different looks, so we should be aware of any change we detect in our skin, such as lumps or wounds that don’t heal. Its most frequent manifestations are divided into the following five types or clinical variants [3,4,5,6]:

– Nodular basal cell carcinoma: This is the most frequent form of this type of cancer. It usually presents as small translucent nodules or bumps, shiny in appearance. They may be reddened or pearly white or pink in fair skin. In darker-skinned people, these lesions are usually shiny brown or black. These bumps sometimes bleed and crust over.

– Superficial multicentric basal cell carcinoma: This accounts for 30% of basal cell carcinomas. Lesions in this type are usually red or pink, thin papules or plaques with distinct borders. They occur most frequently on the torso.

– Sclerodermiform basal cell carcinoma: In this type, which accounts for no more than 10% of cases, the plaques are flat with no defined borders, scarred and indurated. They are often flesh-colored or light red.

– Pigmented basal cell carcinoma: It exists in different colorations such as blue, brown or black. The lesions usually have a smooth and shiny surface and their pigmentation is due to the melanin that accumulates in the malignant cells and around the tumor.

– Ulcerated carcinoma: It is composed of ulcers that usually crust over, with a translucent, pearly, raised rim of firm consistency.

In most patients, the carcinoma begins as a shiny papule that increases in size to show a shiny pearly border with blood vessels and a central ulcer over time. Typical lesions of this cancer may crust over and alternate periods when they appear to be healed with periods when they appear freshly made again.

Basal cell carcinoma and the 24Genetics health test

With the 24Genetics health DNA test, you’ll learn your predisposition to developing this type of skin cancer at some point in your life. Our experts will analyze your DNA to determine the presence or absence of mutations related to this carcinoma that affects, to a greater extent, men and whose onset usually occurs after the age of 40 [5]. 

Also find your genetic predisposition to suffer from many other diseases, beyond cancer, with our genetic health test. The laboratories where we work use the best sequencing technology to achieve reliable and accurate results. Contact us for more information.

Bibliography

[1] What are basal cell and squamous cell skin cancers? – American Cancer Society [updated Jul. 2019; accessed Jan. 2023] Available from: https://www.cancer.org/es/cancer/cancer-de-piel-de-celulas-basales-y-escamosas/acerca/que-es-cancer-de-piel-de-celulas-basales-y-escamosas.html

[2] Basal Cell Carcinoma – The Skin Cancer Foundation [updated 2020; accessed Jan. 2023] Available from: https://www.skincancer.org/international/el-carcinoma-basocelular-carcinoma-de-celulas-basales/

[3] Basal Cell Carcinoma – Mayo Clinic [published Oct. 2021; accessed Jan. 2023] Available from: https://www.mayoclinic.org/es-es/diseases-conditions/basal-cell-carcinoma/symptoms-causes/syc-20354187

[4] Signs and symptoms of basal cell and squamous cell skin cancers – American Cancer Society [updated Jul. 2019; accessed Jan. 2023] Available at: https://www.cancer.org/es/cancer/cancer-de-piel-de-celulas-basales-y-escamosas/deteccion-diagnostico-clasificacion-por-etapas/senales-y-sintomas.html

[5] A patient with… Differential diagnosis of pigmented basal cell carcinoma – Revista Clínica de Medicina de Familia vol.8 no.2 Barcelona. 

[published Jun. 2015; accessed Jan. 2023] Available at: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1699-695X2015000200014#:~:text=The%20carcinoma%20basocellular%20is%20the,%2C%20pigmented%2C%20sclerosing%20and%20superficial.

[6] Basal cell carcinoma – Gregory L. Wells , MD, Ada West Dermatology and Dermatopathology – MSD Handbook practitioner version [revised Sep. 2022; accessed Jan. 2023] Available from: https://www.msdmanuals.com/es-es/professional/trastornos-dermatol%C3%B3gicos/c%C3%A1nceres-cut%C3%A1neos/carcinoma-basocelular