Basal Cell Carcinoma (BCC) ICD-10: C44.91

Skin cancer

Often searched as: pearly bump on face, shiny bump on nose or ear, skin sore that won't heal, translucent bump skin, sore that keeps scabbing over, pink bump with blood vessels, skin cancer on face, most common skin cancer…

Clinical urgency level

lowmediumhigh

Systems Affected

skinlocal soft tissue and bone (in advanced local invasion)distant organs (extremely rare — metastatic BCC)

Severity Levels

mild

Small (<2cm), nodular or superficial BCC on a low-risk site (trunk, extremities) — highly curable with standard excision or topical treatment (imiquimod, PDT).

moderate

Larger lesion, high-risk location (nose, ear, eyelid, temple, scalp), or recurrent BCC — requires Mohs micrographic surgery for maximum cure and tissue preservation.

severe

Locally advanced BCC invading deep tissues (muscle, bone, cartilage), or rare metastatic BCC — requires hedgehog pathway inhibitors (vismodegib, sonidegib) and multidisciplinary oncologic care.

Red Flags

A pearly or shiny bump on the face, ear, or scalp that is slowly growing
A sore that bleeds, forms a scab, heals, then bleeds again repeatedly
A flat, scar-like lesion on the face with no known history of injury (morpheaform BCC — subtle but aggressive)
Rapid growth of a previously known skin lesion
Lesion near the eye, nose, or ear — risk of deep invasion affecting function
Pink waxy bump with visible blood vessels on the surface (classic nodular BCC)

Clinical Presentation

Nodular basal cell carcinoma — pearly translucent papule with telangiectasia on the nose

Source: Wikimedia Commons (CC BY-SA 3.0 )

Basal cell carcinoma image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

See a dermatologist promptly for any non-healing sore, pearly bump, or growing translucent lesion on the face, ears, scalp, or neck — especially with a history of significant sun exposure. BCC is the most common cancer in humans but is almost always curable when treated early. Never ignore a spot that keeps coming back after healing.

Differential Diagnosis

Squamous cell carcinoma (less pearly, more scaly/ulcerated — biopsy key)
Sebaceous hyperplasia (central pore, yellowish — benign oil gland)
Intradermal nevus (flesh-colored papule — no blood vessels, stable)
Actinic keratosis (rough, scaly — precancerous SCC precursor)
Scar tissue (morpheaform BCC mimic — history of trauma helps)
Merkel cell carcinoma (rare, aggressive — firm, red-purple, grows fast)

Comorbidities

Actinic keratosis (field cancerization — same UV damage origin)
Previous BCC or SCC (highest risk factor for new BCC)
Xeroderma pigmentosum (rare — extreme UV sensitivity)
Gorlin syndrome (Basal Cell Nevus Syndrome — multiple BCCs from early age)
Immunosuppression (transplant, HIV — higher BCC risk and more aggressive behavior)
Albinism

Prognosis

BCC has a cure rate exceeding 95% when treated early and appropriately. Mohs micrographic surgery achieves the highest cure rates (99% for primary BCC) with maximum tissue preservation — ideal for facial lesions. Topical treatments (imiquimod, 5-FU) and photodynamic therapy (PDT) are effective for superficial BCC. BCC virtually never metastasizes, but locally advanced cases can cause significant tissue destruction, disfigurement, and functional impairment. Lifelong annual skin checks are essential as the risk of new BCCs remains elevated.

Detailed Overview

Causes, Symptoms, and When to Take Action Basal cell carcinoma (BCC) is the most common type of skin cancer among light-skinned populations. It typically grows slowly and rarely spreads to other parts of the body, but keeping an eye on any changes is essential. How It Looks Texture: Usually appears as a smooth or slightly raised bump, often with a pearly or translucent quality Color: Can be pink, brown, skin-colored, or slightly bluish Shape: May have visible blood vessels (telangiectasia) and sometimes a central indentation or ulceration Location: Commonly develops on sun-exposed areas like the face, ears, scalp, and neck Why Does It Appear? Ultraviolet (UV) exposure — cumulative sun damage is a leading cause. Individuals with fair skin or a family history of skin cancer face higher risk. Should You Be Concerned? BCC is rarely life-threatening, but it can cause local tissue damage if left untreated. Watch for any lesion that grows rapidly, bleeds, fails to heal, or changes in shape, color, or texture. Can You Prevent It? Use sunscreen and protective clothing, conduct regular skin checks, and get regular dermatologic exams particularly if at high risk. 👉 How Piel AI Can Help Piel AI assists in tracking skin lesion appearance over time. Though not diagnostic, it can help you detect changes in shape, size, or color, and support discussions with your dermatologist. Summary Basal cell carcinoma is the most common skin cancer, slow-growing and unlikely to metastasize. It often appears as pearly, raised lesions on sun-exposed skin. Monitoring for changes and protecting the skin from UV damage are key. Professional evaluation is advised for suspicious or evolving lesions.

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