Basal cell carcinoma sclerodermiformes C44.L

Special variant of basal cell carcinoma with formation of a strong, connective tissue tumour stromas and clinically "scar-like" aspect.

Especially nose, forehead, cheeks.

Largely at skin level, waxy or ivory-coloured, only vaguely distinguishable from the surroundings, rough, shiny infiltrate plate with telangiectasia. Edge accentuation in the form of a nodule seam may be present, but is often missing.

In most cases, a blurred epithelial tumor consisting of disordered, narrow, sometimes only 2-3 cell layers thick, mostly branched basaloid epithelial strands. The typical palisade position is almost always missing. The epithelial strands are embedded in a compact, fibrous, connective tissue stroma (cirrhotic aspect). The relation to the surface epithelium is often only detectable in serial sections.

Clinic, demarcation before surgery using reflected light microscopy and high-frequency 20 MHz sonography.

Scar (important differential diagnosis, palpation findings different, usually not increased in consistency).

Elastosis actinica (important differential diagnosis)

benign adnexal tumors

microcystic adnexal carcinoma (rare).

S.u. Basal cell carcinoma. Due to the high recurrence rates, excision must be performed by means of microscopically controlled surgery in specialised centres.

Higher risk of recurrence than with the other basal cell carcinoma types.

1. Eklind J et al (2003) Imiquimod to treat different cancers of the epidermis. Dermatol Surge 29: 890-896
2. Lodde JP et al (1998) Sclerodermiform basal cell carcinoma. Speaking of a study of 83 cases. Ann Chir Plast Esthet 43: 373-382

3. Monroe JR (2012) A facial lesion concerns an at-risk patient. Sclerosing basal cell carcinoma
   . JAAPA 25:16

4. Sellheyer K et al (2013) The immunohistochemical differential
   diagnosis of microcystic adnexal carcinoma, desmoplastictrichoepithelioma
   and morpheaform basal cell carcinoma using BerEP4 and stem cellmarkers
   . J Cutan catheter 40:363-370

5. Wortsman X et al (2014) Ultrasound as predictor of histologic subtypes linked
   torecurrence in basal cell carcinoma of the skin. J Eur Acad Dermatol Venereol doi: 10.1111/jdv.12660.