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Cited by 499Nonmelanoma Skin Cancer StudiesCancer and Skin LesionsHedgehog Signaling Pathway Studies

Guidelines of care for the management of basal cell carcinoma

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Bichakjian, Christopher, Armstrong, April, Baum, Christian, Bordeaux, Jeremy S., Brown, Marc, Busam, Klaus J., Eisen, Daniel B., Iyengar, Vivek +23 more·2018·Journal of the American Academy of Dermatology
DOI 10.1016/j.jaad.2017.10.006
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Abstract

Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.

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  • Several guidelines indicate Mohs micrographic surgery as the first-choice treatment for cutaneous carcinomas at the ear.

    “several guidelines indicate Mohs micrographic surgery (MMS) as the first-choice treatment for cutaneous carcinomas at this site.2, 3, 4”

    From Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases (2021) · cites this paper as [4]

    The risk-classification passage (section “No Yes”; page unavailable) lists the ear as a high-risk location for basal cell carcinoma, and Table VIII in “Mohs Micrographic Surgery” gives MMS a strong recommendation for high-risk BCC. The guideline does not establish MMS as the first-choice treatment for all cutaneous carcinomas of the ear; its recommendations concern BCC. (LLM, conf=0.86)

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Research works printed but not linked: 2

  1. Tromovitch TA, Stegman SJ. Microscopie-controlled excision of cutaneous tumors: chemosurgery, fresh tissue technique. Cancer. 1978;41(2):653-658.
  2. Ashby MA, Smith J, Ainslie J, McEwan L. Treatment of nonmelanoma skin cancer at a large Australian center. Cancer. 1989;63(9):1863-1871.

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Authors
Bichakjian, C., Armstrong, A., Baum, C., Bordeaux, J. S., Brown, M., Busam, K. J., Eisen, D. B., Iyengar, V., Lober, C., Margolis, D. J., Messina, J., Miller, A., Miller, S., Mostow, E., Mowad, C., Nehal, K., Schmitt-Burr, K., Sekulic, A., Storrs, P., Teng, J., Yu, S., Huang, C., Boyer, K., Begolka, W. S., Alam, M., Kim, J. Y. S., Kozlow, J. H., Mittal, B., Moyer, J., Olencki, T., & Rodgers, P.
Affiliations
  • Northwestern University (US)
  • University of Michigan (US)
  • University of Rochester Medicine (US)
  • Memorial Sloan Kettering Cancer Center (US)
  • University of California Davis Medical Center (US)
  • University of Pennsylvania (US)
  • University of South Florida (US)
  • Northeast Ohio Medical University (US)
  • Geisinger Medical Center (US)
  • Stanford Medicine (US)
  • University of California, San Francisco (US)
  • University of Alabama at Birmingham (US)
  • American Academy of Dermatology (US)
  • The Ohio State University (US)
Corresponding author
Begolka, Wendy Smith
ORCID
Venue
Journal of the American Academy of Dermatology
Publisher
Elsevier BV
Published
2018-03
Volume
78
Issue
3
Pages
540-559
ISSN
0190-9622 (ISSN-L)
DOI
10.1016/j.jaad.2017.10.006
OpenAlex
W2783973185
Cited by
499
References
139
Citations by year
2026: 43 · 2025: 73 · 2024: 57 · 2023: 63 · 2022: 87 · 2021: 63 · 2020: 56 · 2019: 34 · 2018: 22
FWCI
34.02
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Academy of Dermatology (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Amgen
  • Pfizer
  • Sanofi
  • Massachusetts General Hospital
  • Celgene
  • Regeneron Pharmaceuticals
  • DUSA Pharmaceuticals
  • Valeant Pharmaceuticals International
  • Astellas Pharma
Topics
  • Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
  • Health Sciences › Medicine › Dermatology › Cancer and Skin Lesions
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Hedgehog Signaling Pathway Studies
Keywords
basal cell carcinoma, biopsy technique, histopathologic interpretation, recurrence risk stratification, topical agents, surgical excision, systemic therapy, skin cancer prevention, follow-up care
MeSH terms
Imiquimod, Administration, Cutaneous, Aminoquinolines, Anilides, Antineoplastic Agents, Basal Cell Carcinoma, Humans, Neoplasm Staging, Photochemotherapy, Pyridines, Radiotherapy, Skin Neoplasms, United States, Neoplasms, Second Primary, Photosensitizing Agents, Early Detection of Cancer, Neoplasm Grading, Dermatologic Surgical Procedures

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