Indian Journal of Dermatology
: 2016  |  Volume : 61  |  Issue : 2  |  Page : 236-

Superficial basal cell carcinoma on the face is a diagnostic challenge

Joydeep Singha, Naval Patel 
 Department of Dermatology, Institute of Post Graduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India

Correspondence Address:
Naval Patel
Department of Dermatology, Institute of Post Graduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, 242, AJC Bose Road, Kolkata, West Bengal


Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. The incidence of BCC is rising. The nodular, superficial spreading, and infiltrating variants are the three most commonly encountered types of BCC in descending order of prevalence. Superficial spreading basal cell carcinoma (SSBCC) accounts for 15-26% of all cases of BCC. It usually occurs on the trunk and upper extremities, but may be seen on the face. Surgical excision is the most commonly used treatment for BCC. Topical chemotherapy agents such as imiquimod or 5-fluorouracil (5-FU) may be various alternatives or adjuvants in the treatment of SSBCC. characteristically shows areas of uninvolved skin between tumor nests.[7]

How to cite this article:
Singha J, Patel N. Superficial basal cell carcinoma on the face is a diagnostic challenge.Indian J Dermatol 2016;61:236-236

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Singha J, Patel N. Superficial basal cell carcinoma on the face is a diagnostic challenge. Indian J Dermatol [serial online] 2016 [cited 2021 Dec 7 ];61:236-236
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A 50-year-old woman with no significant medical history presented at the outpatient department (OPD) with a red, slightly scaly, and well demarcated patch [Figure 1]. A punch biopsy was performed and the histopathology slide showed multiple nests of tumor cells with palisading basaloid cells from the dermo-epidermal junction [Figure 2] and [Figure 3]. The cells had darker nuclei. However, cleft-like retraction spaces were not seen between the tumor nests and mucinous stroma. Such cleft-like spaces, although characteristic of basal cell carcinoma (BCC), are often not seen in superficial spreading basal cell carcinoma (SSBCC). Histology images suggested SSBCC in this patient and the diagnosis was made.{Figure 1}{Figure 2}{Figure 3}

The patient was given topical 5-fluorouracil (5-FU) 5% cream. After washing the entire affected area with soap she used a match stick to apply the medicine. She applied enough medicine each time to cover the area with a thin layer.

She used the 5% cream on the affected areas of 3 × per week (alternate days) [Figure 4].{Figure 4}


BCC is generally a low-grade neoplasm. Although it can be locally invasive and destructive, it rarely metastasizes and is readily amenable to excisional management. However, facial BCC is particularly of concern because it is considered malignant. It can cause significant destruction and disfigurement by invading surrounding tissues. It also has one of the highest recurrence rates of any BCC. Therefore, appropriate diagnosis and therapy are essential.

SSBCC appears as a scaly and well-defined area. It can resemble a patch of dermatitis and can be confused with eczema, psoriasis, lichen planus, or Bowen's disease.[3],[8]

Thus, the clinical features alone may not point to the appropriate diagnosis. Histopathology is the most reliable diagnostic modality for SSBCC.


A cluster of basaloid cells palisading at the border, budding downward from the basal layer within the dermo-epidermal junction, is the hallmark of SSBCC.


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