Basal cell and squamous cell carcinomas. Clinico-histological features

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most prevalent skin cancers, primarily affecting sun-damaged skin in older individuals.
• BCC originates from follicular germinative cells, characterized by local tissue invasion but rare metastasis.
• Actinic keratosis and Bowen's disease are intraepidermal proliferations that can progress to SCC; SCCs from chronic injury sites have a higher metastatic risk.

Purpose of the Study:

• To provide an overview of the clinico-pathologic characteristics of common skin neoplasms.
• To differentiate between basal cell carcinoma and squamous cell carcinoma, including their precursors and metastatic potential.
• To describe the distinct subtypes of basal cell carcinoma and the nature of keratoacanthoma.

Main Methods:

• Review of clinico-pathologic features of basal cell carcinoma and squamous cell carcinoma.
• Classification of basal cell carcinoma into five subtypes: nodulo-ulcerative, superficial, morpheiform, fibroepithelial, and infundibulo-cystic.
• Discussion of the progression of actinic keratosis and Bowen's disease to squamous cell carcinoma.

Main Results:

• Basal cell carcinoma exhibits five distinct clinico-pathologic types.
• Squamous cell carcinoma can develop from actinic keratosis and Bowen's disease, with increased metastatic risk from chronic injury sites.
• Keratoacanthoma is a rapidly growing keratinocyte tumor that may be a self-healing form of squamous cell carcinoma.

Conclusions:

• Understanding the diverse presentations and behaviors of BCC and SCC is crucial for diagnosis and management.
• The distinction between BCC and SCC, along with their precursor lesions, informs prognosis and treatment strategies.
• Keratoacanthoma's potential for spontaneous resolution warrants consideration in its classification and clinical approach.