International scientific journal
“Interpretation and researches”
Volume 2 issue 2 (24) | ISSN: 2181-4163 | Impact Factor: 8.2
191
DIFFERENTIAL DIAGNOSIS OF BASAL CELL CARCINOMAS
D.A. Umarova
Republican Specialized Scientific and Practical Medical Center For Dermatovenerolo
gy and Cosmetology, Tashkent, Uzbekistan.
А.Sh. Inoyatov
Doctor of science
Republican Specialized Scientific and Practical Medical Center For
Dermatovenerology and Cosmetology, Tashkent, Uzbekistan.
Abstract:
Basal cell epithelioma can be localized on all areas of the skin, with
the exception of the palms and soles. The favorite place, however, is the face,
especially the periorbital region. The mucous membranes are never affected.
Gistogenesis. There are several theories about the origin of basal cell
epithelioma. Krompecher, who first described basal cell epithelioma in 1903,
considered this tumor as a cancer of the basal cells of the epidermis, since, in his
opinion, the tumor tends to form glandular formations reminiscent of embryonic
glandular formations of basal cells. Usually, basal cell epithelioma manifests itself in
single foci, however, it is not uncommon to observe multiple elements. In exceptional
cases, the number of basal cell epitheliomas may exceed a hundred. [Nobland,
Nisbet, Potrie]. Clinically, there are four forms of basal cell epithelioma: 1) nodular
ulcerative basal cell epithelioma (including ulcus rodens), 2) pigmented basal cell
epithelioma, 3) fibrous (scleroderma-like) basal cell epithelioma, 4) superficial basal
cell epithelioma. The most common form is nodular-ulcerative. Initially, a small
warty nodule appears, often with several telangiectatic vessels on the surface. The
nodule gradually enlarges and undergoes central ulceration. A typical element is a
slowly progressing ulcer, on the edges of which there are “jewels”. This is the so-
called ulcus rodens. Pigmented basal cell epithelioma differs from the nodular-
ulcerative form only in the dark pigmentation of the element.
Scleroderma-like or fibrosing epithelioma appears as a slightly raised, dense,
yellowish plaque with poorly defined borders. For a long time the overlying skin
remains unchanged, but eventually ulceration occurs. Superficial basal cell
epithelioma presents as one or more erythematous, scaly, slightly infiltrated plaques
surrounded by delicate, filamentous, pearly margins. Plaques usually have small areas
of superficial ulceration and crusting; Smooth atrophic scars may be observed in the
center.
Key words:
Basal cell carcinoma, ulcus rodens, nodular ulcerative basal cell
epithelioma, pigmented basal cell epithelioma, scleroderma-like, superficial basal cell
epithelioma, histological examination, dermatoscopy.
International scientific journal
“Interpretation and researches”
Volume 2 issue 2 (24) | ISSN: 2181-4163 | Impact Factor: 8.2
192
INTRODUCTION
Basal cell carcinoma of the skin (basal cell carcinoma) belongs to the group of
non-melanoma skin neoplasms and arises from skin epithelial cells. In the World
Health Organization (WHO) International Histological Classification of Tumors,
cutaneous basal cell carcinoma is classified as a localized epithelial tumor with a high
recurrence rate.[3] Cutaneous basal cell carcinoma is a slow-growing precancerous
condition characterized by various clinical forms. Basalioma occurs in cosmetically
important areas - the skin of the face (80%), the skin of the nose and ears (20%) [4].
Basal cell carcinoma of the skin is characterized by significant erosion of bone
structures in the localization zone. When the number of disease recurrences increases,
the rate of metastasis also increases [11]. There are superficial, nodular, ulcerative
and scleroderma-like forms of cutaneous basal cell carcinoma [5,7,18], which differ
in their course and require a differential approach to treatment.
The aim of the research is t
o study risk factors and the frequency of clinical
variants of skin basal cell carcinoma among the Tashkent population.
MATERIALS AND METHODS
Until December 2023, the number of patients who applied to the clinic of the
Republican Center for Dermatology, Venereology and Cosmetology with basal cell
carcinoma was 30, of which 14 were men and 16 were women.(Fig.1.) Their average
age is 23 - 77 years. Of the research methods used were clinical, gistological and
dermatoscopic features and
immunohistochemical staining (Кi-67).
Fig. 1. Distribution of patients by sex.
In the development of basalioma, great importance is attached to genetic factors,
the presence of xeroderma pigmentosum, immune disorders, adverse external
influences - intense insolation, contact with carcinogenic substances, arsenic
compounds, previous radiation therapy, increased photosensitivity, work with sources
of ionizing radiation, contact with petroleum products, resins, local mechanical
trauma. The main importance is given to excessive insolation. The greatest danger is
posed by ultraviolet radiation, especially UV rays type A. A special risk group is
people with fair skin and low melanin content (type I and II skin). Currently, various
International scientific journal
“Interpretation and researches”
Volume 2 issue 2 (24) | ISSN: 2181-4163 | Impact Factor: 8.2
193
methods of treating BCC are used, which include: surgical excision, laser therapy,
photodynamic therapy, cryodestruction, radiation therapy, electrocoagulation. In our
study, we found that the factors in the skin are important in the development of basal
cell carcinoma: solar radiation, phototherapy, photosensitizing factor, arsenic,
genetics, immunosuppression, and others. (Fig.2.) Solar radiation is the most
proportionally risk factor.
Fig. 2. Distribution of disease risk factors.
When examining the patients for somatic diseases, the following were
identified: hypertensive disease 9 patients, stomach and intestinal disease in 7
patients. No somatic diseases were detected in the remaining 14 patients.
When the localization of the wound was analyzed, it was found in the head and
face of all patients. According to the data of histological examination, the solid form
was diagnosed in all patients.
Based on the clinical types of basal cell carcinoma, we divided the patients into
the following groups. And in our region, our group of nodular lesions showed a high
rate, scleroderma-like and superficial basal cell types were 10% and 6.7%
respectively.
Fig. 2. Distribution of clinical features.
International scientific journal
“Interpretation and researches”
Volume 2 issue 2 (24) | ISSN: 2181-4163 | Impact Factor: 8.2
194
CONCLUSION.
As follows from the results of the study, upon the onset of basalioma disease,
the burn factor showed a result (53%). This once again confirmed that our land was
inhabited by a people, with a large number of meetings in the 2nd and 3rd types of
Fitzpatrick skin color. The fact that basal cell carcinoma tends to increase in our
country shows that we need to study this disease in more depth, make a correct
diagnosis, and carry out the correct treatment tactics.
References.
1.
Саpinus V.N. ФДТ рецидивов базальноклеточного рака кожи после
лучевой терапии / Саpinus V.N., М. А. Caplan // Biomedical Photonics. – 2016. –
Т. 5, № S1. – С. 28-29.
2.
Klyuchareva S.V. and etc. Лечение базальноклеточного рака кожи
//Вестник дерматологии и венерологии. – 2018. – Т. 94. – №. 6. – С. 15-21.
3.
Kozlov S.V. and etc. Оптимизация медицинской помощи больным с
базальноклеточным
раком
кожи
в
условиях
специализированного
консультативно-диагностического отделения //Современные проблемы науки и
образования. – 2018. – №. 4. – С. 219-219.
4.
Совершенствование методов ранней диагностики базально-клеточного
рака кожи / О. А. Lapasov, А. А. Sidiqov, B. S. Azizov, S. S. Agzamxodjayeva //
Перспективы развития новых технологий в диагностике и лечении в
дерматовенерологии и дерматоонкопатологии: сб.тез. – Фергана: Б. и., 2022. –
С. 73-74.
5.
Дерматоскопические критерии пигментной формы базальноклеточного
рака кожи у представителей азиатской расы в Ташкенте / М. N. Solmetova, А.
Sh. Vaisov, М. А. Gafur-Ахunov, М. D. Аllayeva // Дерматовенерология.
Косметология. – 2021. – Т. 7, № 4. – С. 325-336.
6.
Тitоv K. S. and etc. Роль цитологического метода в современной
диагностике базальноклеточного рака кожи //Медицинский алфавит. – 2022. –
№. 8. – С. 92-95.
7.
Lapasov О. А., Latipov I. I. Базальноклеточный рак кожи. Исторические
аспекты, актуальные достижения и проблемы на современном этапе //Central
Asian Journal of Medical and Natural Science. – 2022. – Т. 3. – №. 5. – С. 381-391.
