Scalp Basal Cell Carcinoma: A Different Entity?

January 2019 in “ Dermatologic Therapy ”

António Castanheira, Paula Soares, Paula Boaventura

scalp basal cell carcinoma BCC pilosebaceous follicles UV exposure nodular subtype genetic studies Mohs micrographic surgery Vismodegib scalp BCC Mohs surgery

TLDR Scalp basal cell carcinoma may be more aggressive and harder to treat than other types, requiring special attention and further research.

The document reviews scalp basal cell carcinoma (BCC), highlighting its unique clinical and pathological characteristics, risk factors, and treatment challenges. It emphasizes that scalp BCC may be more aggressive and difficult to treat than BCC in other locations, potentially due to the scalp's high number of pilosebaceous follicles, protection from UV exposure, and other host-related factors or the irradiated environment. The nodular subtype is the most common histological form of scalp BCC, with a significant recurrence rate of 12-25% for primary tumors. Genetic studies, such as those by Tessone et al., found no differences between scalp BCCs from irradiated and non-irradiated patients, suggesting other factors contribute to their aggressiveness. Treatment options include surgery, with Mohs micrographic surgery having a 5.7% recurrence rate after 5 years, and Vismodegib for advanced cases. The document concludes that the potential aggressiveness and difficulty in treatment of scalp BCCs warrant special consideration, and it calls for further research into their distinct nature.

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