Basalioma

Definition of a basalioma

Basalioma is a certain type of skin cancer. This (semi) malignant tumor originates from the so-called basal cells of the epidermis.
It is usually caused by intense solar radiation. 80 percent of basaliomas occur in the face and neck area. Metastases (Daughter tumors) this tumor forms extremely rarely, which means that it is medically classified as semi-malignant, i.e. semi-malignant.

More information can be found here: White Skin Cancer

Initial stage of basalioma

It is a skin tumor that develops from the basal cells of the epidermis. The tumor does not form daughter ulcers, so-called metastases. This is why this skin tumor is called semimalignant (semi-malignant).

In the early stages, the tumor is usually not noticed at all or is simply mistaken for a bump in the skin. In the beginning, there are usually small, grayish, glassy-looking nodules that have a slight sheen and look like papules. Often small tortuous blood vessels can already be seen on the surface and at the edge (telangiectasias).

A so-called marginal wall, which is arranged like a string of pearls around the knot, is also typical of a basalioma. Scratching or after shaving can cause crusts to form on the nodules, which occasionally start to bleed easily.

In the initial stages, the tumor is always limited to the skin. After months to years, the surface of the nodule sinks in the middle, creating a small central dent. Starting from this dent, the tumor begins to attack the underlying tissue as well as the surrounding cartilage and bone structures, to grow into them and to destroy them. Therefore, new skin changes should be carefully observed.

Read more on this topic at: Initial stage of a basalioma

Frequency (epidemiology)

Occurrence in the population

In the fair-skinned population, the basalioma is around 80,000 new cases per year the most common malignant skin tumor.
These tumors occur more or less frequently, depending on the geographical location of the location.
In Central Europe, for example, around 60 out of 100,000 inhabitants are affected, while in Australia 250 out of 100,000 inhabitants have this form of Skin cancer suffer. The frequency has increased steadily in recent years. Men get sick slightly more often than women.

Causes of a basalioma

As mentioned above, basaliomas arise from the basal layer of the epidermis. In this layer there are so-called basal cells. These cells usually divide several times before moving to the top layers of cells in the epidermis (the top layer of the skin). Here it loses its ability to divide and becomes horny.
A basalioma now arises from such a degenerate basal cell. In contrast to the healthy basal cell, this cell does not keratinize in the uppermost layers of the epidermis. She doesn't have that ability. Instead, it can continue to divide.

Although the risk factors for the development of skin cancer are largely known, the mechanism by which the tumor develops is not fully established.

The main risk factor for the development of basaliomas is chronic, intense exposure to the sun. People with fair skin and skin sensitive to the sun are particularly affected. Usually they arise in places that are often and a lot exposed to the sun.
In addition to UV radiation, chemicals (e.g. arsenic) also play a role. From a physical point of view, burns and X-rays can be dangerous. There may also be a genetic predisposition to develop basaliomas. In this case, there is a gene mutation that initially benign (benign) tumors and, after puberty, gives rise to malignant basal cell carcinomas. This disease is called Gorlin-Goltz Syndrome. In rarer cases, this type of skin cancer can also arise from chronic wounds.

Symptoms of basalioma

Basalioma usually grows very slowly. However, they are clearly visible on the skin, but are often not noticed.

The original basalioma is a nodule that is about the size of a pinhead, skin-colored and coarse.
The pearl-like edge wall is typical. The small vessels that grow into the tumor and feed it are just as typical (Telangiectasia). This makes it appear reddish shimmering through.
At a later stage, the tumor is more likely to grow inward and break down.

Basal cell carcinoma can resemble a rash (eczema) outside of the face with reddening and scales.

There are different forms of basalioma. Their manifestations range from flat to nodular to ulcer-like. Flat and nodular forms have a pearl-like border wall and small ingrown vessels (Telangiectasia) on. Ulcer-like basaliomas are reminiscent of an abrasion that does not want to heal.

Basaliomas do not originally appear on the mucous membranes, but can grow into them.
Basaliomas can also grow into bones and cartilage. Especially if they are discovered late. This ingrowth usually leads to disfigurement, because the basaliomas mostly occur on the face (lip rims, eyelids, nasal framework).

Read more on the topic: Basalioma symptoms

Where are basaliomas common?

Basalioma of the eye

Also on the eye can Basaliomas ("White skin cancer") arise. The eyes belong just like that nose or also the Ears to the skin areas that frequently and especially over long periods of sun exposure and with it that UV light are exposed as they not covered by protective clothing become. Therefore, they are at a higher risk of developing basaliomas.

In the area of ​​the eye it happens most Involvement of the eyelids. Because the symptoms very unspecific will be Basalioma mostly only through cosmetic changessuch as skin imperfections on the lid surface.

The Change in skin is not painful, but if the Eyelids to become one slowly developing impairment of movement of Eye to lead. This can lead to a Limitation of the field of vision and above all that Eyesight come. Patients usually complain that it is no longer possible for them to do that to close the affected eye completely and often one develops steadily increasing swellingwhich in turn can lead to impaired vision.

The Removal of a basalioma at the eye is not always through surgery possible. If the Eyelids may need the lid after surgical removal reconstructed using a skin flap so that the Closure of the eye can be guaranteed. This is what you try for larger findings that are in a bad location Basalioma with local creams with subsequent irradiation or by a icing (Cryotherapy) to be eliminated. However, surgical removal is still the gold standard.

Basalioma on the face

Basaliomas tend to develop in the face and head and neck area, as these parts of the body are particularly easily accessible to the sun's UV radiation.

About 80% of all basaliomas are localized on the face and the area from the corners of the mouth up to the forehead is particularly often affected. However, basaliomas can also be found on the eyes, ears, neck and head.

Patients between the ages of 60 and 70 are particularly affected, as the tumor develops very slowly after initial skin damage caused by UV radiation or certain harmful substances. In addition to cosmetic damage, significant complications can arise, especially in the facial area. It can lead to functional limitations, proliferating open areas and nerve injuries, which can lead to paralysis or failure symptoms. In the case of surgical removal, skin reconstructions may be necessary, with which large scars, wound healing disorders and cosmetic blemishes can be associated.

Read more on the topic: Basalioma on the face

Basalioma on the nose

The nose is very often affected by a basalioma. Often they are The wings of the nose, the bridge of the nose or the tip of the nose infested. A nodular one forms tumorwhich is covered by a raised edge. There are also basaliomas ulcerated grow or what that scar-like appear and have an edge that looks like a string of pearls.

The most important factor responsible for developing a basal cell carcinoma of the nose is one long-term high stress of the skin through the UV radiation the sun. People who spend long periods of time in areas with intense solar radiation are particularly affected, and staying in the solarium is also said to promote the development.

Since the tumor also the deep-set tissue, such as cartilage - and Bone structures of the nose can afflicted, one should the diseased Tumor tissue Surgically remove it early to counteract greater damage. Possible complications of the basalioma nose for example the loss of the Olfactory ability or on the bottom of the Tumor developing infections that can spread to the surrounding structures or the whole body.

Basalioma on the ear

The Ears are as appendages not just exposed to the coldbut also exposure to sunlight. The long and intense exercise of the skin through the UV radiation leads to the degeneration of the basal cell layer of the epidermis.

In the field of Ears are most of the basaliomas on the auricle or in front of the ear localized. The Basaliomas on the auricle about 15% of the total of occurring basaliomas. Changes in the skin occur that nodular appear and a glassy surface exhibit. Form on the edge small blood vessels from (telangiectasias) that bleed easily.

If the degenerated cells grow deeper, it can become significant in the area of ​​the auricle Damage to the cartilage come. This is broken down by the infestation and its structure is destroyed. Large-scale inflammatory processes can arise as complications.

Since in the area of ​​the auricle some important nerves that are important for the innervation of certain areas of history Failures and also Injuries this come

At a Basaliomathat on ear is localized should also be a first-line therapy surgical removal be sought. Early treatment is important because the auricle can be infested and decomposed particularly quickly Cartilage structures can come.

The forms of a basalioma

Nodular basalioma

The most common is the nodular, solid form of the basalioma. This spherical or hemispherical basalioma often becomes glassy to translucent over time. The so-called telangiectasias are particularly typical of this type of basalioma, but occur in principle in all forms of this tumor. These are the smallest hair vessels which, due to their enlargement, become visible as reddish to bluish serpentine vascular drawings on the edge of the tumor.

Ulcerous basal cell carcinoma

In addition, an "ulcer-like" basalioma occurs frequently. This creates a clear injury to the skin, which is usually covered in the middle by a crust that can sometimes ooze. In its appearance it resembles a non-healing abrasion. Distinguishing this type of basalioma from a wound is often not easy. A relatively clear indication of the presence of a tumor is the so-called “pearl cord-like” border (which often only develops later), i.e. small nodules that grow around the basalioma and sometimes also contain telangiectasias. However, this also means that the basalioma grows into the surrounding skin, i.e. it ulcerates. One then speaks of a "Rodent ulcer“, A gnawing ulcer.

Scleroderma basalioma

There is also the scleroderma basalioma. This type is characterized by the fact that it grows very flat and over a large area. As it is often difficult to distinguish it from healthy skin or scar tissue, it is not infrequently overlooked for a long time. In addition, removal is therefore difficult. The superficial, multicentric basalioma shows a similar growth pattern, although in many cases it takes on a slightly reddish color. Therefore, it can easily happen that it is misdiagnosed as eczema or psoriasis.

Destructive basal cell carcinoma

The most dangerous is the destructive (destructive) growing basalioma, the basalioma (or Ulcer) terebrans, the boring ulcer. It grows very quickly and aggressively in depth, whereby it can also destroy bone and cartilage tissue, among other things. This is why this basalioma is particularly feared in the eye or nose areas.

Complications of a basalioma

If a basalioma is discovered late, it may already have grown in deeply and even reached cartilage and bones. The result is disfigurement, since most basaliomas occur on the face. If the basalioma is located on the edge of the eyelid, where it occurs quite often, late detection can even result in loss of the eye.

There is almost no metastasis. As a rule, the tumor does not spread any further tumor cells via blood or lymph vessels into other body tissue.

diagnosis

Usually the changes are so typical that the dermatologist (doctor for dermatology) recognize them right away. A string of pearls and telangiectasias (small vessels) are typical features of basal cell carcinoma. A confirmation of the diagnosis by means of a tissue sample, which is to be examined more closely under the microscope (fine tissue examination), is certainly sensible and necessary.

Early detection of a basalioma is also a regular one Skin cancer screening makes sense.

Therapy basalioma

The therapy for a confirmed diagnosis of basalioma depends on the size, type and location of the tumor. You usually have a choice between one surgery and radiotherapy.

Cutting out the tumor is particularly useful in the case of basaliomas on the face, or if it occurs repeatedly. Medically, this is called "excision in a healthy state". This means that the tumor has to be removed with a certain safety margin. An approximately 4 mm area around the tumor around, i.e. healthy tissue, is also removed. This operation is of course performed under local anesthesia by the dermatologist (doctor for dermatology).

Radiation of the tumor is used if the location of the tumor or the age of the patient do not allow an operation. For example, a critical situation is close to eyeas the organ could be damaged. In particular, superficial tumors that have not (yet) grown in depth can be treated in this way. A type of freezing (cryotherapy) can also be used here.

The following other therapies are also used:

• Laser surgery
• radiotherapy
• Photodynamic Therapy
• Local immunotherapy

Removing a basalioma

The standard for removing the Basalioma is the operative therapy.

Surgical removal takes place without any remaining residue of Tumor, the rate for a new formation (relapse) is the lowest. The surgical treatment is done by the dermatologist in local anesthesia performed. The skin incision is made around the tumor with a Safety distance of about 5 millimeters.
Then the edges of the removed piece of skin are under the microscope carefully examinedso you can be sure that all cancer cells have been removed. Are still in the margins Tumor cells present, then must in a second follow-up operation a little more skin around the site where the basal cell carcinoma was located. A New formation of the tumor however, can never be completely ruled out.

For example, leaves the Location of the tumor, especially on eye, or the age of the patient to have an operation complete removal not too, then there are other therapy options that can be used.
An alternative is, for example, a radiotherapy on. There come High energy x-rays used, which damage the cancer cells and cause them to die. It can be done with this method similarly good cure rates can be achieved and the result is cosmetically better, since none Skin parts removed. However, one is radiotherapy always associated with side effects.

Lately you can also do one special cream with the active ingredient Imiquimod use that on the Basalioma is applied and that body's immune system stimulates to recognize the cancer cell and to fight it.

There are also other alternatives laser surgical measures or the Phototherapy. Here the cancer cells are through Irradiation damaged with a special light.

prophylaxis

Basal cell carcinomas can be prevented by reducing exposure to the sun and using sun creams with a high sun protection factor.
Particularly when you are on holiday in southern countries, caution is required, as the sun shines more intensely here than here. In addition, the sun's rays are reflected by the water, so staying on the beach or the swimming pool is a risk.

The frequent and intense sunburn must be avoided.

Self-exam can also be helpful. You should pay attention to changes and new phenomena, observe them and pay attention to non-healing skin injuries. In these cases, you should consult a dermatologist (dermatologist). He can provide certainty.

Growth of a basalioma

Generally, note the following:

• Basaliomas do not cause pain,
• they don't itch and
• also grow very slowly.

If they are not discovered and removed, all the more so!

forecast

The forecast is generally Well. Because these skin tumors malicious though are so grow destructively into the depths, nearly never scatter, they usually can well removed become.
At more than 90% of the sick, the further course is favorable. If the tumor Detected at an early stage and surgically removed at an early stage, there is the possibility of a complete healing, as it only forms in about 0.3% of patients Daughter ulcers (metastases), in other organs, comes.

The Distance in itself do if a Basalioma for example in Corner of the eye or directly on the eye is a hard-to-reach place. These are the most common malicious ones Eyelid tumor.

That is particularly important Follow-up checkwhich should be carried out at regular intervals by the dermatologist. Became the Tumor removed by surgery, tumor-like changes can occur again in the area of ​​the scar, but also in other places, so-called recurrences, occur. As a rule, these new formations arise within the first three years after treating the first Tumor.

The treatment takes place only in late stages, serious complications can occur. Of the tumor grows into the deeper tissue layers and attacks and destroys them surrounding bones - and Cartilage structures. This can do that Basalioma on the head with complicated and severe disfigurements of facial structures and in rare cases it can infest and injure vital structures, especially in the area of head and neck, come.

Usually, however 95 percent of the patients cured become.

Read more about basalioma prognosis.

Summary

The Basalioma, also light skin cancer called, grows locally (locally limited) and here destroys the skin structure. The positive thing about this type of tumor is that it almost never metastasizes (Daughter tumors puts).
A spread of its tumor cells to other organs or tissues almost never happens. That is why it is also referred to as semi-malignant, i.e. semi-malignant. It occurs preferentially on the face and in areas exposed to the sun skin.
People in southern countries are more often affected than people in northern Europe. The Exposure to sunlight So it plays an important role.

Basaliomas arise - as the name suggests - from the basal cells of the epidermis (Epidermis).
Usually these keratinize on the surface. In basaliomas, however, they continue to divide.

The manifestations of the Tumor are diverse. Nodules form and grow deeper. However, bleeding wounds can also occur over time.

Samples are taken to confirm the diagnosis. The basalioma is then removed using various methods. In addition to the operation, i.e. cutting out the tumor, a radiotherapy etc. can be applied.

About 80 percent the basaliomas are in face. The area from an imaginary horizontal line along the angle of the wound to the forehead - the area around the eyes is left out - is most often affected.

It can be prevented by avoiding intense sunlight. You should also check yourself every now and then for skin changes.
If skin changes appear suspicious, please consult a doctor.