Comprehensive Insights Into Basal Cell Carcinoma: Causes, Presentation, Prevention, and Modern Therapeutic Approaches

Sep 23, 2026

Uploaded by OmBimo

Basal cell carcinoma (BCC) is the most common skin cancer worldwide, representing about 80% of skin malignancies, with varied presentation across racial and ethnic groups. This review synthesizes peer-reviewed evidence and dermatology practice insights on BCC causes, clinical presentations, and prevention, including ultraviolet-driven risk and the roles of genetics and environment. It highlights diagnostic advances such as dermoscopy and reflectance confocal microscopy and surveys surgical and non-surgical treatments, including systemic sonic hedgehog and PD-1 inhibitors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Causes of BCC

Clinical Presentation

Cancer Medicine | REVIEW OPEN ACCESS
Comprehensive Insights Into Basal Cell Carcinoma: Causes, Presentation, Prevention, and Modern Therapeutic Approaches
Sophia Levit1 | Joshua Shoykhet2 | Eyal Levit3
1Georgetown University, Washington, District of Columbia, USA | 2CUNY Hunter College, Bachelor of Arts, New York, New York, USA | 3Columbia
University College of Physicians & Surgeons, New York, New York, USA Correspondence: Eyal Levit ([eyallevit@gmail.com](eyallevit@gmail.com))
Received: 10 November 2024 | Revised: 17 November 2025 | Accepted: 25 November 2025
Keywords: dermatoscopy | nicotinamide prophylaxis | nonmelanoma skin cancer | skin of color | sonic hedgehog inhibitors | | --- | | ABSTRACT
Background: Basal cell carcinoma (BCC) is the most common skin cancer worldwide, accounting for approximately 80% of all skin cancers. Although more prevalent among Caucasians, BCC affects individuals of all racial and ethnic groups and may present atypically in skin of color, contributing to delayed diagnosis.
Aims: This review aims to examine the causes, clinical presentations, prevention strategies, and treatment options for BCC, with an emphasis on recent advancements and ongoing challenges in management.
Materials and Methods: This review integrates current peer-reviewed literature with clinical insights derived from dermatologic practice, including the evaluation of representative, deidentified patient cases. Observations from clinical experience were incorporated to contextualize diagnostic approaches, management strategies, and treatment outcomes across diverse patient populations. All patient information was anonymized, and no identifiable data were included.
Results: Ultraviolet (UV) radiation remains the leading cause of BCC in fair-skinned populations, whereas genetic predispositions and environmental factors play a larger role in darker-skinned individuals. Diagnostic advances, including dermoscopy and reflectance confocal microscopy, have improved detection, particularly for pigmented lesions that may mimic benign conditions. Preventative strategies include broad-spectrum physical sunscreens, protective clothing, lifestyle modifications, and supplementation such as nicotinamide, which has demonstrated potential in reducing UV-induced skin damage. Treatment options range from Mohs micrographic surgery, considered the gold standard for high-risk and cosmetically sensitive areas, to simple excision, electrodessication and curettage, radiation therapy, and advanced systemic therapies including sonic hedgehog and PD-1 inhibitors for locally advanced or metastatic disease.
Discussion: Emerging diagnostic tools and expanding therapeutic modalities have enhanced the ability to tailor BCC management to individual patient risk profiles and tumor characteristics. Non-surgical and combination approaches continue to evolve, offering effective alternatives for select cases.
Conclusion: By integrating prevention, early diagnosis, and personalized treatment strategies, modern approaches to BCC management are improving patient outcomes and addressing the complexities of care across diverse populations, underscoring the importance of multidisciplinary and individualized management. | | | | Sophia Levit—co-author. | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. | Cancer Medicine, 2025; 14:e71448 1 of 9 [https://doi.org/10.1002/cam4.71448](https://doi.org/10.1002/cam4.71448) 1 | Introduction The first recorded case of skin cancer was in a 24-year-old mummy found in Peru [1] . Today, as was likely in past human history, skin cancer remains the most common type of cancer worldwide, with 3.5 million new cases diagnosed annually in the U.S. alone [1]. Of those, a

FAQs

What are the main causes and risk factors of basal cell carcinoma (BCC)?

Ultraviolet radiation is the leading cause in fair-skinned populations, while genetic predispositions and environmental factors contribute more in darker-skinned individuals. Additional risk factors include scarring or trauma, immunosuppression, and carcinogen exposures such as arsenic.

How can BCC present differently across skin tones?

In Caucasians, BCC often appears as a pearly or telangiectatic nodule with ulceration. In darker-skinned individuals, it may appear as pigmented lesions, which can delay diagnosis.

Which diagnostic tools and prevention strategies are emphasized?

Dermoscopy and reflectance confocal microscopy improve detection, especially for pigmented lesions that can mimic benign conditions. Prevention includes broad-spectrum physical sunscreens, protective clothing, lifestyle modifications, and nicotinamide supplementation to reduce UV-induced skin damage.

Sep 23, 2026

Uploaded by OmBimo