Difficult to diagnose skin cancer--the 'aggressive' BCC

Basal cell carcinomas (BCCs) are common, and are regularly diagnosed and managed by Australian general practitioners.

This article summarises the types, clinical features, treatment and follow up of BCCs. Two cases histories are also presented that highlight the difficulties with diagnosing and treating aggressive BCC.

Aggressive BCCs can invade widely before exhibiting obvious clinical signs. Suspicious skin lesions should have an adequate biopsy taken to guide management options. Complete BCC excision is usually the best treatment, but particular care should be taken when treating lesions on cosmetically or functionally sensitive areas. Recurrent disease can also be difficult and disfiguring to treat. Specialist involvement will be needed for the management of some BCCs. Basal cell carcinomas can recur years after treatment. Regular skin checks are important for high risk patients.