Guidelines of care for the management of basal cell carcinoma - 28/02/18

Doi : 10.1016/j.jaad.2017.10.006

Work Group
Christopher Bichakjian, MD ^a : Co-Chair, April Armstrong, MD, MPH ^b, Christian Baum, MD ^c, Jeremy S. Bordeaux, MD, MPH ^d, Marc Brown, MD ^e, Klaus J. Busam, MD ^f, Daniel B. Eisen, MD ^g, Vivek Iyengar, MD ^h, Clifford Lober, MD, JD ⁱ, David J. Margolis, MD, PhD ^j, Jane Messina, MD ^k,^l, Alexander Miller, MD ^m, Stanley Miller, MD ⁿ, Eliot Mostow, MD, MPH ^o, Christen Mowad, MD ^p, Kishwer Nehal, MD ^q, Kristi Schmitt-Burr ^r, Aleksandar Sekulic, MD, PhD ^s, Paul Storrs, MD ^h, Joyce Teng, MD, PhD ^t, Siegrid Yu, MD ^u, Conway Huang, MD ^v, Kevin Boyer, MPH ^w, Wendy Smith Begolka, MBS ^w,^⁎ , Murad Alam, MD ^x : Co-Chair
^a Department of Dermatology, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan
^b Department of Dermatology, University of Colorado, Denver, Colorado
^c Department of Dermatology, Mayo Clinic, Rochester, Minnesota
^d Case Western Reserve University School of Medicine, Cleveland, Ohio
^e Department of Dermatology, University of Rochester, Rochester, New York
^f Dermatopathology, Memorial Sloan Kettering Cancer Center, New York, New York
^q Memorial Sloan Kettering Cancer Center, New York, New York
^g Department of Dermatology, University of California Davis, Sacramento, California
^h Private practice, Chicago, Illinois
ⁱ Private practice, Kissimmee, Florida
^j University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
^k Department of Pathology, University of South Florida, Tampa, Florida
^l Department of Pathology, Moffitt Cancer Center, Tampa, Florida
^m Private practice, Yorba Linda, California
ⁿ Private practice, Towson, Maryland
^o Dermatology Section, NEOMED, Rootstown, Ohio
^p Geisinger Medical Center, Danville, Maryland
^r Basal Cell Carcinoma Nevus Syndrome Life Support Network, Burton, Ohio
^s Mayo Clinic, Phoenix, Arizona
^t Stanford School of Medicine, Stanford, California
^u Dermatologic Surgery and Laser Center, University of California San Francisco, San Francisco, California
^v Department of Dermatology, University of Alabama, Birmingham, Alabama
^w American Academy of Dermatology, Schaumburg, Illinois
^x Department of Dermatology, Northwestern University, Chicago, Illinois

^∗Correspondence to: Wendy Smith Begolka, MBS, American Academy of Dermatology, 930 East Woodfield Rd, Schaumburg, IL 60173.American Academy of Dermatology930 East Woodfield RdSchaumburgIL60173

Invited Reviewers
John Y.S. Kim, MD ^y, Jeffrey H. Kozlow, MD, MS ^z, Bharat Mittal, MD ^aa, Jeffrey Moyer, MD ^bb, Thomas Olencki, DO ^cc, Phillip Rodgers, MD ^dd
^z Section of Plastic and Reconstructive Surgery, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan
^bb Plastic/Head/Neck Surgery, Department of Otolaryngology, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan
^dd Department of Family Medicine, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan
^y Department of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois
^aa Department of Radiation Oncology, Northwestern University, Chicago, Illinois
^cc Department of Internal Medicine, Ohio State University, Columbus, Ohio

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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Key words : basal cell carcinoma, biopsy, curettage, metastasis, phototherapy, radiotherapy, staging, surgery, surveillance, topical therapy

Abbreviations used : AAD, AJCC, ALA, BCC, C&E, 5-FU, MAL, MM, MMS, NCCN, NMSC, PDT, PI, RCT, cSCC, SMO, STEVIE

Plan

	Funding sources: None.
	The management of conflict of interests for this guideline series complies with the Council of Medical Special Societies' Code of Interactions with Companies. The authors' conflict of interest/disclosure statements appear at the end of this article.
	Reprint requests: guidelines@aad.org.

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Vol 78 - N° 3

P. 540-559 - mars 2018 Retour au numéro

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Guidelines of care for the management of basal cell carcinoma - 28/02/18

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