TAKE-HOME LEARNING POINTS
• Nonhealing lesions on sun-exposed skin are considered to be skin cancers until proven otherwise by biopsy.
• Basal cell carcinomas (BCCs) are the most common skin cancer.
• BCCs typically grow very slowly.
• BCCs, if allowed to remain in place, can become extensive, invasive, destructive, and—in exceptional circumstances—can even metastasize.
• The differential for BCC includes squamous cell carcinoma, which has considerably more potential for metastasis than BCC, especially when it’s near an orifice.
• Quite frequently, it’s next to impossible to differentiate visually between BCC and SCC.
• BCCs and SCCs can take on several different morphologies, so any changing lesion needs to be biopsied to establish its identity, particularly since both are so common.