 Hello everyone, welcome back to another session in dentistry and more today. We have basal cell carcinoma BCC which is also known as rodent ulcer Which is a malignant condition in? epithelial origin And it most commonly seen on the exposed surface of skin. So let's learn basal cell Carcinoma and its detail. So rodent ulcer, which is most frequently develops on the exposed surface of the skin face and scalp, okay skin face and scalp in the age group of middle or elderly so middle or elder age group and Also, it is peculiar in Fair skinned people, okay So it is a malignant condition or carcinoma which is seen on the exposed surface of skin face and scalp in middle or elderly people and Especially in the fair skinned group of people it is a slow growing and The metastasis is very rare, okay This is slow growing malignancy and metastasis is very rare in this Malignancy but can cause a significant local destruction So the most common etiology is UV light exposure. That is chronic sundry exposure people who work or people who are exposed to the sunlight every day or very chronic manner and the ionizing radiation like x-rays those who are exposed to ionizing radiation and Chemicals such as arsenic people who are exposed to the chemical those were in industrial area or industrial Job where the arsenic is involved and people with immunosuppression Immunocompromised people are at risk of this malignancy and Also syndromes like 0 derma pigment or some and nevoid basal cell carcinoma syndrome Nevoid BCC syndrome and 0 derma pigment or some 0 derma pigment or some all these are etiology of BCC So BCC is thought to arise from pluripotent stem cells of the basal cell layer That is why that peculiar name basal cell carcinoma Which is arising from the basal cell layer of epidermis as well as the follicular structures such as hair follicle stem cells Well moving on to the clinical features. It is most frequently in the fourth decade of life First fourth decade and male to female ratio is 2 is to 1 most calm in male group than female and It is mostly affecting the Middle third of the face Okay, middle third not the upper third or lower third. It is affecting the middle third of the face And it does not arise from the oral mucosa. So it is not seen intra orally Except for invasion from the adjacent skin surface to the intraoral. So it is not seen on Or it is not erasing from the oral mucosa. So intraoral lesions are very rare So there are sub types of basal cell carcinoma. One is nodular nodular basal cell carcinoma Which is most common So this nodular basal cell carcinoma it begins as a slightly elevated papule With a central depression with a central depression Which ulcerates heels over and then breaks down again So very mild trauma may cause bleeding eventually the crusting ulcer Which appears superficial which develops a smooth rolled border representing Tumor cells spreading laterally beneath the skin. So there will be lateral spreading beneath the skin and There will be Pigmented type which is the second one pigmented basal cell carcinoma the second type Pigmented basal cell carcinoma. Okay, so pigmented basal cell carcinoma is in addition to the features seen in the Nodular type this type contains black or brown pigmentation Black or brown pigmentation. So almost clinical features are same as nodular type with a papule with a central depression ulceration and the Lateral spreading beneath the epithelium along with black and brown pigmentation And it is more commonly seen in dark skinned people Next we have Cystic basal cell carcinoma Cystic basal cell carcinoma which may contain translucent blue gray cystic nodule blue gray cystic nodule and Which mimic benign cystic lesions Okay That is cystic basal cell carcinoma. Now we have superficial that is a fourth type superficial BCC Which presents as a scaly patches or Papules commonly on the trunk that are pink to red brown in color pink to red brown in color Often with central clearing and a thread like border Okay, that is superficial BCC now We have micro nodular BCC micro nodular Micro nodular BCC This micro nodular BCC which is very aggressive type which is less prone to ulceration It may appear as yellow white when stretched and is firm to touch It may have a seemingly well-defined border. Okay, and And the last type is Infiltrating BCC Morphe form and infiltrate Morphe form and Infiltrating type Infiltrating BCC morphiform and infiltrating type these are aggressive types with the sclerotic Papule or plagues, which may be mistaken for scar tissue Border is usually not well defined and often extends well Beyond the clinical margins. There will be ulceration bleeding and crusting. Okay, so these are the six types So the first one was nodular then pigmented cystic then superficial Micro nodular morphiform and infiltrating BCC. These are the six types of BCC. Now in histological features in nodular and pigmented types the tumor cells called BACYLOMA cells BACYLOMA cells Okay, in these two types the BACYLOMA cells typically have large oval hyperchromatic nuclear with little cytoplasm, okay large Nuclear that is hyperchromatic nuclear with a little cytoplasm And these are arranged in well demarcated islands which appear to erase from the BACYL layer and Overlying epidermis and which invades into the underlying epidermis underlying dermis, sorry Whereas in pigmented type the benign melanocytes in and around the tumor which produce large amount of melanin Okay, so there will be melanocytes Which is present in and around the tumor and The superficial type the lobules of tumor cells drop from the epidermis in a multifocal pattern. Okay, and and the morphiform type which Exhibit infiltrating thin strands of tumor cells in a dense fibrous trauma so these strands of infiltrating type are thicker and Have a spiky irregular appearance The micronodular type which appears as a small nodular aggregates of baseloid cells Okay, so when this baseloid cell carcinoma is mixed with squamous cell carcinoma Which is known as baso squamous carcinoma baso Squamous Carcinoma so those are the Histology explanation of the various types Now let's move on to the treatment part of Baseloid cell carcinoma the small lesions such as less than one centimeter lesions We go for surgical excision or laser ablation or electro dissection and cure at age With 5 mm margins of normal appearance skin. So if it is a 1 centimeter So we take a 5 mm Normal tissue also for the excision. So if it is a large lesion, we need to go for radical surgery or radiation therapy for sclerotic type or recurrent lesions we need to Use a micro graphic surgery Which uses like frozen section Evaluation of Specially mapped and marked surgical specimen to determine whether tumor tissues has been left behind. So that is micro graphic surgery Micro graphic surgery it defines the borders very clearly because of the frozen section evaluation and Prognosis is good since recurrence is very It's not common and metastasis is very rare and death If occurs is usually the result of patients negligence and local invasion tend to the vital structures So that is all about the baseloid cell carcinoma or rodent ulcer. So we talked about the clinical features the six types its differentiation between clinical features and the histological features and finally The treatment part, okay, so I'll come up with a new topic in the industry and more. Thank you