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What Is The Difference Between Basal And Squamous Cell Carcinoma

Basal Cell Carcinoma: The Most Common Skin Cancer

Dr G discusses the differences between basal cell carcinoma and squamous cell carcinoma

Basal cell carcinoma, which is also called basal cell skin cancer, is the most common form of skin cancer, accounting for about 80 percent of all cases.

Rates of basal cell carcinoma have been increasing. Experts believe this is due to more sun exposure, longer lives, and better skin cancer detection methods.

This type of cancer begins in the skins basal cells, which are found in the outermost layer, the epidermis. They usually develop on areas that are exposed to the sun, like the face, head, and neck.

Basal cell carcinomas may look like:

  • A flesh-colored, round growth
  • A pinkish patch of skin
  • A bleeding or scabbing sore that heals and then comes back

They typically grow slowly and dont spread to other areas of the body. But, if these cancers arent treated, they can expand deeper and penetrate into nerves and bones.

Though its rare, basal cell carcinoma can be life-threatening. Experts believe that about 2,000 people in the United States die each year from basal cell carcinoma or squamous cell carcinoma.

Some risk factors that increase your chances of having a basal cell carcinoma include:

  • Being exposed to the sun or indoor tanning
  • Having a history of skin cancer
  • Being over age 50
  • Having chronic infections, skin inflammation, or a weakened immune system
  • Being exposed to industrial compounds, radiation, coal tar, or arsenic
  • Having an inherited disorder, such as nevoid basal cell carcinoma syndrome or xeroderma pigmentosum

The Difference Between Squamous Cells And Basal Cells

The outer layer of the skin is made up of layers of flat cells known as squamous cells. Your body is constantly growing and shedding these cells as they make their way to the outer layer and die. When your skin is dry and itchy in the winter months, it is because your squamous cells are drying out and flaking away. Squamous cells do not divide they are instead replaced over time.

Basal cells are deeper in the skin at the lowest level of the epidermis . As these round cells divide and multiply, they push up the next layer of cells toward the surface. These cells then flatten out and become squamous cells. Basal cells are separated from the lower levels of the skin by a thin membrane.

Tissue Types And Subtypes Of Sarcomas

Unlike carcinomas, there are over 50 different subtypes of sarcomas. Examples of sarcoma based on tissue type include:

  • Bone
  • Fat : liposarcoma
  • Cells surrounding nerves: neurofibrosarcomas, malignant Schwammomas
  • Connective tissue in the brain: glioma, astrocytoma
  • Digestive tract: gastrointestinal stromal tumors
  • Primitive embryonic tissue: myxosarcoma
  • Combination of cell types: undifferentiated pleomorphic sarcoma

The most common sarcomas in childhood are rhabdomyosarcomas. In adults, the most common sarcomas are soft tissue sarcomas, including undifferentiated pleomorphic sarcoma, liposarcomas, and leiomyosarcomas.

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Infiltrated Basal Cell Carcinoma

This version of basal cell carcinoma is presented as thin bundles of basaloid cells with nest-like configuration located between the collagenous fibers on the dermis and infiltrating in the depth. Clinically, it is a whitish, compact, not-well defined plaque . The most common localization is in the upper part of the trunk or the face. Seldom had the paresthesia or hyperesthesia as a symbol of perineural infiltration appeared, especially when the tumor is localized on face. This clinical version is often underestimated when the borders of surgical excision are estimated. Histologically this variant is presented as thin, nest-like bundles of basaloid cells infiltrating in the dermal collagenous fibers .

Infiltrated basal cell carcinoma. Thin bundles of basaloid cells invade the dermis

Superficial Basal Cell Carcinoma

What is the Difference Between Basal Cell and Squamous ...

This version occurs as erythematous plaque with different sizes . It is about 10-30% of basal cell carcinoma and occurs on the body skin. There is an erythematous squamous plaque with clear borders, pearl-shape edge, superficial erosion, without tendencies for invasive growth . The regression areas are presented as pale sections with fibrosis. The differential diagnosis includes Bowen disease, psoriasis, or eczema. The numerous superficial BCC are met often in case of arsenic exposure. Histology showed nests of basaloid cells located subepidermally, with clear connection with the basal layer of the epidermis and no infiltration of tumor cells in the reticular dermis .

Superficial basal cell carcinoma. Several nests of basaloid cells are located subepidermally with clear connection with the basal layer of the epidermis

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Summary Of Basal Cell Versus Squamous Cell Carcinoma

  • Basal cell and squamous cell carcinomas are both types of skin cancers.
  • Basal cell carcinoma is primarily a skin cancer, whereas squamous cell carcinomas can occur in other organs and tissue types.
  • Basal cell carcinoma tumors are more translucent in character than squamous cell carcinoma tumors. Basal cell carcinoma tumors can also have many pigmentations about them, and are most likely to be nodular. Squamous cell carcinoma tumors are also nodular in nature.
  • Both types of skin cancers are rarely metastatic, but squamous cell carcinomas are more likely than basal cell carcinomas to be metastatic.
  • Basal cell carcinomas are the most common form of nonmelanomas, with squamous cell carcinomas coming in second.

What Is Skin Cancer

Basal cell carcinoma begins in the basal cell layer of the skin. Squamous cell carcinoma begins in the squamous layer of the skin. Melanoma begins in the melanocytes, which are the cells that make melanin, the pigment that gives skin its color.

Basal cell carcinoma begins in the basal cell layer of the skin. Squamous cell carcinoma begins in the squamous layer of the skin. Melanoma begins in the melanocytes, which are the cells that make melanin, the pigment that gives skin its color.

The skin is the bodys largest organ. Skin has several layers, but the two main layers are the epidermis and the dermis . Skin cancer begins in the epidermis, which is made up of three kinds of cells

  • Squamous cells: Thin, flat cells that form the top layer of the epidermis.
  • Basal cells: Round cells under the squamous cells.
  • Melanocytes: Cells that make melanin and are found in the lower part of the epidermis. Melanin is the pigment that gives skin its color. When skin is exposed to the sun, melanocytes make more pigment and cause the skin to darken.

Basal and squamous cell carcinomas are the two most common types of skin cancer. They begin in the basal and squamous layers of the skin, respectively. Both can usually be cured, but they can be disfiguring and expensive to treat.

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Surgery For Basal And Squamous Cell Skin Cancers

Surgery is a common treatment for basal cell and squamous cell skin cancers. Different surgical techniques can be used. The options depend on the type of skin cancer, how large the cancer is, where it is on the body, and other factors. Most often the surgery can be done in a doctors office or hospital clinic using a local anesthetic . For skin cancers with a high risk of spreading, surgery sometimes will be followed by other treatments, such as radiation or chemotherapy.

How To Spot A Bcc: Five Warning Signs

Dermatology – basal cell carcinoma and squamous cell carcinoma

Check for BCCs where your skin is most exposed to the sun, especially the face, ears, neck, scalp, chest, shoulders and back, but remember that they can occur anywhere on the body. Frequently, two or more of these warning signs are visible in a BCC tumor.

  • An open sore that does not heal, and may bleed, ooze or crust. The sore might persist for weeks, or appear to heal and then come back.
  • A reddish patch or irritated area, on the face, chest, shoulder, arm or leg that may crust, itch, hurt or cause no discomfort.
  • A shiny bump or nodule that is pearly or clear, pink, red or white. The bump can also be tan, black or brown, especially in dark-skinned people, and can be mistaken for a normal mole.
  • A small pink growth with a slightly raised, rolled edge and a crusted indentation in the center that may develop tiny surface blood vessels over time.
  • A scar-like area that is flat white, yellow or waxy in color. The skin appears shiny and taut, often with poorly defined borders. This warning sign may indicate an invasive BCC.
  • Please note: Since not all BCCs have the same appearance, these images serve as a general reference to what basal cell carcinoma looks like.

    An open sore that does not heal

    A reddish patch or irritated area

    A small pink growth with a slightly raised, rolled edge and a crusted indentation in the center

    A shiny bump or nodule

    A scar-like area that is flat white, yellow or waxy in color

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    Sarcoma Vs Carcinoma: Differences And Similarities

    There are a number of differences between sarcomas and carcinomas, though individual cancers within each category can vary tremendously. Carcinomas account for the majority of cancers with only 1% of cancers in adults being sarcomas. In children, however, sarcomas account for over 15% of cancers, making research critical. Carcinomas arise out of epithelial cells that line the surface and organs of the body, whereas sarcomas arise from connective tissues such as bone, cartilage, fibrous tissue, blood vessels, and nerves. Learn about the similarities and differences with regard to subtypes, symptoms, causes, diagnosis, treatments, and prognosis.

    Diagnosis And Treatment Of Basal Cell And Squamous Cell Carcinoma

    JONATHON M. FIRNHABER, MD, East Carolina University, Brody School of Medicine, Greenville, North Carolina

    Am Fam Physician. 2012 Jul 15 86:161-168.

    Nonmelanoma skin cancer, which includes basal cell carcinoma and squamous cell carcinoma, is the most common cancer in the United States. Approximately 80 percent of nonmelanoma skin cancers are basal cell carcinoma and 20 percent are squamous cell carcinoma. Although the National Cancer Institute does not formally track the incidence and prevalence of nonmelanoma skin cancers, multiple longitudinal studies indicate that the incidence has risen sharply over the past two decades.1

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    So How Do You Tell The Difference

    The takeaway is that its not easy to tell the difference between AK and SCC. They look very similar and are both very variable in appearance they appear on similar areas of the body, and an AK lesion can develop into SCC. So do get any worrying bump, spot, wart or lesion checked out by a doctor, especially if you fall into the high risk group.

    See our article What Is The Best Treatment For Actinic Keratosis? for more details about preventing and treating actinic keratosis.

    Although actinic keratosis isnt something you can treat with emollients, moisturising your skin with intensive, non-irritant creams or salves can help keep skin in good, healthy condition before and after treatment, and can help ease the uncomfortable symptoms of itchy skin.

    We advise customers not to apply oil-based balms like Skin Salvation to skin exposed to direct sunlight, as the high oil content can cause burning and we dont add sunscreens to our products. Apply last thing at night instead!

    Pigment Basal Cell Carcinoma

    The Difference Between Basal Cell and Squamous Cell Skin ...

    The pigmentation can be found in different clinical versions of basal cell carcinoma including nodular, micronodular, multifocal and superficial BCC, and the color varies from dark brown to black . Histology showed nests of basaloid cells, abundance of melanin and melanophages, and moderate inflammatory infiltrate. The melanocytes are located among tumor nests, while the melanophages are present in the stroma. The differential diagnosis has to be made with malignant melanoma.

    An irregular, periphery spreading erosive pigmented plaque on head of a 78 years old woman

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    Can Biopsy Remove Basal Cell Carcinoma

    For some basal cell and squamous cell skin cancers, a biopsy can remove enough of the tumor to eliminate the cancer. Most biopsies can be done right in the doctors office using local anesthesia. Before the biopsy, the doctor or nurse will clean your skin. They may use a pen to mark the area that will be removed.

    Overlap Between Sarcomas And Carcinomas

    The region of the body does not always distinguish sarcomas and carcinomas. For example, breast sarcomas arise in the connective tissue of the breasts rather than milk ducts or lobules. Most “colon cancers” are adenocarcinomas, but 1% to 2% of tumors in this region are leiomyosarcomas of the colon and rectum.

    Some tumors may have characteristics of both carcinomas and sarcomas and may be referred to as carcinosarcomas or sarcomatoid carcinomas.

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    Where Do Skin Cancers Start

    Most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer:

    • Squamous cells: These are flat cells in the upper part of the epidermis, which are constantly shed as new ones form. When these cells grow out of control, they can develop into squamous cell skin cancer .
    • Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skins surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Skin cancers that start in the basal cell layer are called basal cell skin cancers or basal cell carcinomas.
    • Melanocytes: These cells make the brown pigment called melanin, which gives the skin its tan or brown color. Melanin acts as the bodys natural sunscreen, protecting the deeper layers of the skin from some of the harmful effects of the sun. Melanoma skin cancer starts in these cells.

    The epidermis is separated from the deeper layers of skin by the basement membrane. When a skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers.

    Surgical Excision Is The Treatment Of Choice For Both Scc And Bcc

    From solar keratosis to squamous cell carcinoma – exploring the architecture of squamous dysplasia

    There is no clear evidence-based recommendation regarding the minimum excision margin. Factors such as risk status of the tumour, surgical accessibility, patient age, co-morbidities and wound-healing capacity should be considered when deciding on the excision margin.

    Clinical guidelines are regularly communicated and updated in publications and at conferences. Regardless of the guidelines followed by the clinician, it is important to note, that due to tissue shrinkage, the reported histological margins may be as little as half of the clinical margin measured at the time of surgery.

    The histological report indicates the clearance of margins in the planes of section examined rather than representing an absolute guarantee of complete excision of the tumour. Re-excision, with the same recommended clinical margins as in the initial excision, should be attempted when involved margins are reported.

    In approximately 50% of cases where a tumour was present at the edges of the biopsy, or at the margins of the excision in the initial specimen, there will be no further residual tumour in the re-excised specimen. This is explained by the fact that a minimal amount of residual tumour at the edge of the initial biopsy has been eradicated by the immune response and the regenerative process leading to repair and scarring following the initial surgical intervention.

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    S Prior To Removing Scc/bcc

    Prior to the excision of the tumour, the diameter should be measured and recorded. Tumour measurement after excision is not accurate due to tissue shrinkage, which occurs after excision and during specimen fixing and processing. The plane of section examined histologically is relevant to the distance from the tumour to the nearest margin, hence, it does not necessarily represent the greatest tumour dimension.

    Merkel Cell Carcinoma: A Rare Skin Cancer On The Rise

    Merkel cell carcinoma is a rare type of skin cancer that affects about 2,000 people in the United States each year.

    Though its an uncommon skin cancer, cases of Merkel cell carcinoma have increased rapidly in the last couple of decades.

    This type of cancer starts when cells in the skin, called Merkel cells, start to grow out of control.

    Merkel cell carcinomas typically grow quickly and can be difficult to treat if they spread.

    They can start anywhere on the body, but Merkel cell carcinomas commonly affect areas exposed to the sun, such as the face, neck, and arms.

    They may look like pink, red, or purple lumps that are firm when you touch them. Sometimes, they can open up as ulcers or sores.

    Risk factors include:

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    When To Seek Medical Care For Skin Cancer

    Many people, especially those who have fair coloring or have had extensive sun exposure, periodically check their entire body for suspicious moles and lesions.

    Have your primary health care provider or a dermatologist check any moles or spots that concern you.

    See your health care provider to check your skin if you notice any changes in the size, shape, color, or texture of pigmented areas .

    If you have skin cancer, your skin specialist or cancer specialist will talk to you about symptoms of metastatic disease that might require care in a hospital.

    Early Detection Is The Key

    What Is Basal Cell Carcinoma

    The sooner skin cancer is detected, the better the chance for successful treatment. The goal of any skin cancer treatment is to remove the cancerous area before it can spread deeper into the body. If you see any unusual patches on your skin, be sure to call Dr. Bairds office for an appointment right away. You can schedule a skin cancer screening in Farmington by calling or filling out our online form.

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    What Is Squamous Cell

    A squamous cell is a type of cell that occurs in the outermost layers of the epidermis. Hence, it is a component of the stratified squamous epithelium. Also, squamous cells are thin and flat. They look like fish scales. Furthermore, the skin constantly shed these cells and the new cells produced by the basal cell layer replace the loss. The main function of the squamous cells is to protect the body from abrasion.

    Figure 2: Stratified Squamous Epithelium

    Besides, the squamous cell carcinoma is another type of skin cancers that occur in sun-exposed areas. Sometimes, these cancers begin with the actinic keratosis, a pre-invasive skin condition caused by the excessive exposure to the sunlight. Unlike basal cell carcinoma, squamous cell carcinoma tends to spread into the underneath layers of the skin very easily.


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