Basal cell carcinoma nose is a malignant skin disease known as basal cell carcinoma or epithelioma. The term white skin cancer is also commonly used. In basal cell carcinoma, only the cells of the skin epithelium are affected. This tumor is one of the most common tumors in the USA.

Peculiarities Of Basal Cell Carcinoma Nose

Basal cell carcinoma is very often found mainly on the nose. This is unfavorable because they are correspondingly noticeable and disturbing at this central place of the face and because the operation of a basal cell carcinoma on the nose is always difficult. One wants to avoid the patient’s ability to smell diminished following surgery.

On the other hand, it is crucial to act quickly, especially in the case of basal cell carcinoma located on the nose. Suppose it is an aggressive basal cell carcinoma that grows superficially and in-depth. In that case, it can happen relatively soon that bony or cartilaginous structures in the surrounding area are affected by the tumor tissue and thus destroyed, leading to various complications.

In rare, severe cases, skin transplantation or even reconstruction of the face with prostheses may be necessary following therapy.

Symptoms Of Basal Cell Carcinoma Nose

The basal cell carcinoma nose symptoms are very non-specific and usually do not cause pain. A skin change resembles a string of pearls laid in a circle that forms in the affected area. Basal cell carcinoma is often undetectable early or mistaken for common skin blemishes.

Localization Of Basal Cell Carcinoma

It is assumed that the UV radiation of light is mainly responsible for developing basal cell carcinoma. This assumption lies in the exposure sites, i.e., the areas frequently affected by basal cell carcinoma. It is mainly the skin regions of the human body that are frequently exposed to sunlight. Particularly parts of the face are commonly affected by basal cell carcinoma.

The forehead and temple region and the region at the wings of the nose should be mentioned. But also, arms, hands, and skin in the area of the scalp and the hair follicles can be affected by basal cell carcinoma. It is assumed that the incident of UV radiation repeatedly damages numerous cells.

An endogenous repair system passes over the defective cells millions of times and repairs them. This repair system sometimes does not work for unclear reasons, so the faulty cells are not fixed and can continue to divide unchecked. This results in a tumor of malignant cells forming.

Causes Of Basal Cell Carcinoma Nose

The most critical risk factor for basal cell carcinoma development is long-term skin exposure to UV radiation in sunlight. Consequently, this type of tumor develops mainly in those areas on the skin that are regularly exposed to a lot of the sun: 80% of basal cell carcinomas form on the face, and most of them are located in the strip that runs from the hairline over the nose to the upper lip.

Diagnosis

A dermatologist usually makes the diagnosis of basal cell carcinoma nose. In advanced stages, sometimes a visual diagnosis is possible or is indicative. In any case, however, a biopsy must be taken and examined in a pathology laboratory. Since the risk of cell spreading is very high, the entire conspicuous skin area is usually taken and sent in.

Regular skin cancer screening is also helpful for the early detection of basal cell carcinoma nose.

Biopsy

How can I recognize basal cell carcinoma nose in its early stages? Since basal cell carcinoma grows very slowly, it generally has a good chance of being cured. It is essential to distinguish basal cell carcinoma from a pimple or skin appendage. The appearance of a basal cell carcinoma can vary. For example, in the beginning, a bright lump may appear on the nose or in the corner of the nose. 

On the other hand, the nodule may also be reddish. Furthermore, basal cell carcinoma sometimes appears as a red spot on the skin. These nodes or spots continue to spread slowly. In some cases, there is a central indentation. The basal cell carcinoma may bleed during its course. A crust then forms on this bleeding area.

Treatment Of Basal Cell Carcinoma Nose

Once the diagnosis of basal cell carcinoma has been made, photodynamic irradiation of the nose can be performed in addition to surgical removal. Recurrences are always possible, but the prognosis is generally reasonable.

Surgery for basal cell carcinoma nose

Surgery is the first choice therapy for treating basal cell carcinoma nose. For this purpose, the degenerated epithelial cells of the nose are surgically removed, usually under local anesthesia or, if desired, under general anesthesia. The surgeon uses a scalpel to cut around the degenerated area at a safe distance and, if possible, removes all the degenerated cells.

Since, on the one hand, the degenerated area is usually relatively small. On the other hand, its location in the face makes exact surgery necessary, and the surgeon operates with a microscope.

This is usually attached to the surgeon’s head and allows high magnification. This way, unnecessarily large excisions can be prevented, and the basal cell carcinoma nose can be removed entirely.

Laser surgery, cryosurgery, and radiation using X-rays are also available as an alternative to classical surgery. This may be necessary in some cases, especially in older patients, when invasive surgery cannot be performed. In laser surgery, removal is done using a high-energy laser.

Cryosurgery refers to a surgical procedure in which basal cell carcinoma is destroyed by exposure to cold. However, the latter approaches promise success only in small and superficial basal cell carcinomas.

As a rule, basal cell carcinoma is treated by surgical intervention. After the operation, a bandage must be worn for a few days to weeks to prevent infection. The tissue typically grows within weeks to months, filling the excised gap.

The excised tissue is always kept for follow-up and sent to pathology for examination and proper grading. Grading is a classification of the tumor, the areas excised, and an assessment of benignity or malignancy.

Although basal cell carcinoma is a semi-malignant or “semi-malignant” tumor, its low metastasis rate means an excellent prognosis can be expected with complete surgical excision. Also, basal cell carcinoma nose growing slowly over months to years is conducive to a favorable outcome. However, one should not wait too long for an operation because even a semi-malignant tumor can degenerate malignantly with enough time.

Skin graft

Skin grafting is performed after surgical removal of basal cell carcinoma nose. It depends on the size of the basal cell carcinoma and how far it has spread into the surrounding area. If the wound cannot be closed due to its size, a skin graft must be performed to cover the damage.

The shift-swing flap technique can be used when tissue defects develop. Here, the surgical wound is covered with healthy skin from the surrounding area. The wound edges and the skin graft edges are sutured together. Depending on how deep the surgical wound is, only superficial or deeper skin layers are taken to close the skin defect.

Another option is the so-called rotational flap plasty, in which the skin flap is prepared and rotated into the skin defect. Here, too, the edges are sutured.