[Management of basal cell carcinoma in 2025]

Basal cell carcinoma (BCC) is the most common skin tumor, with an incidence varying across Europe, reaching up to 400 cases per 100,000 inhabitants in certain regions. It occurs more frequently in men, with an average age of diagnosis around 70 years. This type of cancer, primarily caused by chronic UV exposure, has a low risk of metastasis (less than 0.05%) but can cause significant local damage. Clinically, BCC presents as erythematous and shiny lesions, with several subtypes: superficial, nodular, and infiltrative. The classification of BCC varies based on its risk of recurrence and treatment complexity, with recommendations regarding surgical margins to be adhered to during excision. The primary treatment is surgical, using conventional or Mohs micrographic techniques depending on the complexity of the tumor. Medical treatments are reserved for low-risk forms or when surgery is not feasible. For advanced BCCs, multidisciplinary discussions are essential to establish the best treatment plan, which may include Sonic Hedgehog pathway inhibitors or radiotherapy for palliative purposes.