Basal cell carcinoma

Background

• Most common skin malignancy
• Rarely a metastatic process

Risk Factors

• UV radiation
• Chronic arsenic exposure
• Ionizing radiation
• Immunosuppression

Clinical Features

• Slow growing
• Usually head and neck
• Only where hair follicles exist
• Pearly nodule with telangiectatic vessels, rolled border and central ulceration

Differential Diagnosis

Other Rash

• Acute generalized exanthematous pustulosis
• Allergic reaction
• Aphthous stomatitis
• Atopic dermatitis
• Coxsackie
• Dermatitis herpetiformis
• Exfoliative erythroderma
• Impetigo
• Pellagra
• Pityriasis rosea
• Serum Sickness
• Tinea capitus
• Tinea corporis
• Vitiligo

Evaluation

• Clinical examination by trained clinician (dermatology referral)
• Skin biopsy

Management

• Not typically managed within ED

Disposition

• Discharge with derm follow up