Cancer Skin Cancer Diagnosis Basal Cell Carcinoma Pictures What this form of skin cancer can look like By Timothy DiChiara, PhD Timothy DiChiara, PhD Timothy J. DiChiara, PhD, is a former research scientist and published writer specializing in oncology. Learn about our editorial process Updated on April 22, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Douglas A. Nelson, MD Medically reviewed by Douglas A. Nelson, MD LinkedIn Douglas A. Nelson, MD, is double board-certified in medical oncology and hematology. He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. Learn about our Medical Expert Board Print Basal cell carcinoma (BCC) is the most common form of skin cancer. It originates in basal cells, which are located in the epidermis, which is the outermost layer of the skin, that are responsible for producing new skin cells and pushing them to the surface. Due to the location of these cells, BCC typically develops on areas of skin that are regularly exposed to sunlight and other forms of ultraviolet radiation. BCC tends to grow slowly and develop on sun-exposed areas such as the face, ears, neck, scalp, chest, shoulders, and back. The lesions commonly appear as painless, raised nodules, often shiny with tiny blood vessels running through them. BURGER/PHANIE/Canopy/Getty Images Even so, BCC can vary in its size and appearance and may develop on parts of the body that are not sun-exposed. By recognizing the different manifestations of BCC, you may be able to spot them early and seek immediate treatment. The early diagnosis and treatment of BCC is associated with a disease-free cure rate of between 85 and 95%. How Basal Cell Carcinoma Is Treated Nodular Basal Cell Carcinoma This photo contains content that some people may find graphic or disturbing. See Photo SkarmoutsosV / Wikimedia Commons Nodular basal cell carcinoma is one of the three main subtypes of BCC. It appears as a small, dome-shaped nodule populated by tiny branch-like blood vessels (referred to as telangiectasias). Nodular BCC is the most common BCC subtype, accounting for over 50% of all BCC cases. The lesions predominate on the head, especially the cheeks, forehead, eyelids, and nasolabial folds (the "smile lines" that run from the corner of the nose to the corner of the mouth). The lesions often appear skin-colored, pinkish, or pearly white. Common Signs and Symptoms of Skin Cancer Non-Ulcerated Nodular BCC This photo contains content that some people may find graphic or disturbing. See Photo jax10289 / Getty Images Nodular BCC can change over time—a general warning sign that cancer is involved—and may suddenly enlarge, crust over, and form a central depression. Bleeding with mild trauma is common. At this stage, the non-ulcerated lesion will be similar in appearance to conditions like molluscum contagiosum, sebaceous hyperplasia, amelanotic melanoma, and intradermal melanocytic nevus (also known as a common mole). Skin Cancer Healthcare Provider Discussion Guide Get our printable guide for your next healthcare appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Ulcerated Nodular BCC This photo contains content that some people may find graphic or disturbing. See Photo James Hellman, MD / Wikimedia Commons Eventually, the center of the non-ulcerated BCC lesion may suddenly ulcerate, forming an open sore with a well-defined rolled border. Nodular lesions that have ulcerated are often referred to as "rodent ulcers" because the edges of the sore often look ragged and gnawed upon. Rodent ulcers tend to be more aggressive. They often develop on the nasal ala (the lateral surface of the nose that flares out to form the nostrils), where they can cause extensive damage to tissues. Ulcerated BCC lesions are often difficult to distinguish from another type of skin cancer, called squamous cell carcinoma, which can also ulcerate. The Facts About Sun Safety and Skin Cancer Micronodular Basal Cell Carcinoma This photo contains content that some people may find graphic or disturbing. See Photo Dr. P. Marazzi / Science Photo Library / Getty Images Micronodular basal cell carcinoma is an aggressive subtype of nodular BCC. It is characterized by multiple small nodules that can be extremely small and uniform with well-defined borders. Micronodular BCC lesions are skin-colored to slightly greyish and may appear a whitish-yellow when stretched. The lesions occur most commonly around the eyes and are often firm to the touch. Unlike nodular BCC, micronodular BCC is less prone to ulceration. Even so, micronodular BCC is more likely to recur, because the lesions are so easily missed. Oftentimes, there are as many unseen lesions—that are either too small or are flat to the surface of the skin—as visible ones. Causes and Risk Factors for Skin Cancer Superficial Basal Cell Carcinoma This photo contains content that some people may find graphic or disturbing. See Photo National Cancer Institute Superficial basal cell carcinoma is the second most common type of BCC, accounting for around 15% of cases. As per its name, superficial BCC is characterized by a flat, distinct area of discoloration, referred to as a macule. It is usually pink-to-red in color with well-defined edges and a scaly appearance. Some superficial BCC lesions have a thin rolled border or irregular crusty edges. Areas of the lesion can suddenly regress, leaving behind a lightened (hypopigmented) area of thinned skin. Unlike nodular BCC, superficial BCC tends to favor the trunk and extremities but can also occur on the face. It is more frequently seen in fair-skinned adults under 50 but can occur in people as young as 20. The flaky appearance of superficial BCC is easily mistaken for noncancerous conditions like psoriasis and nummular eczema as well as precancerous conditions such as actinic keratosis. Prevention and Early Detection of Skin Cancer Pigmented Basal Cell Carcinoma This photo contains content that some people may find graphic or disturbing. See Photo jax10289 / Getty Images Pigmented basal cell carcinoma is a variant of BCC that can occur with nodular and superficial BCC. It is distinguished by its darkened (hyperpigmented) coloration but is otherwise the same as its non-pigmented counterpart. The color is usually quite homogeneous, ranging from a dark brown to a bluish-black. Because of its coloring and propensity for easy bleeding, pigmented nodular BCC is often mistaken for invasive melanoma, which shares many of the same features and characteristics. A pigmented nodular BCC lesion is typically well-demarcated and can grow quickly in the way that invasive melanoma can. Pigmented nodular BCC cannot be distinguished from invasive melanoma by appearance alone. A newer, non-invasive diagnostic tool, called reflectance confocal microscopy (RCM), is an alternative to biopsy that can help differentiate the two based on close-up images of the skin created with low-powered laser beams. How the 4 Types of Melanoma Differ Morpheaform Basal Cell Carcinoma This photo contains content that some people may find graphic or disturbing. See Photo sdigital / Getty Images Morpheaform basal cell carcinoma is the third most common subtype of BCC, accounting for between 5% and 10% of cases. Also known as sclerodermiform BCC because of its resemblance to the connective tissue disease scleroderma, morpheaform BCC lesions are pink-to-ivory in color with poorly defined borders and areas of induration (thickening and hardening of tissues). The lesions will often manifest as a waxy depression in the skin, making them look more like a scar than a lesion, and are most commonly found around the middle of the face. Morpheaform BCC tends to be more aggressive than nodular or superficial BCC and is notorious for being missed during a skin examination. Morpheaform BCC is sometimes referred to as infiltrative or infiltrating BCC because the lesion can sometimes penetrate the epidermis and infiltrate the lower layer of skin, called the dermis. Because of this, there is a higher risk of recurrence compared to the other BCC subtypes. Skin Cancer Healthcare Provider Discussion Guide Get our printable guide for your next healthcare appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Tanese K. Diagnosis and management of basal cell carcinoma. Curr Treat Options Oncol. 2019;20(2):13. doi:10.1007/s11864-019-0610-0 PDQ Adult Treatment Editorial Board. Skin cancer treatment (PDQ): Health professional version. In: PDQ Cancer Information Summaries [Internet]. Chung S. Basal cell carcinoma. Arch Plast Surg. 2012;39(2):166-70. doi:10.5999/aps.2012.39.2.166 Marzuka AG, Book SE. Basal cell carcinoma: Pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med. Ryu TH, Kye H, Choi JE, Ahn HH, Kye YC, Seo SH. Features causing confusion between basal cell carcinoma and squamous cell carcinoma in clinical diagnosis. Ann Dermatol. 2018;30(1):64-70. doi:10.5021/ad.2018.30.1.64 McDaniel B, Badri T. Basal cell carcinoma. In: StatPearls. Mackiewicz-Wysocka M, Bowszyc-Dmochowska M, Strzelecka-Węklar D, Dańczak-Pazdrowska A, Adamski Z. Basal cell carcinoma - diagnosis. Contemp Oncol (Pozn). 2013;17(4):337-42. doi:10.5114/wo.2013.35684 Singha J, Patel N. Superficial basal cell carcinoma on the face is a diagnostic challenge. Indian J Dermatol. 2016;61(2):236. doi:10.4103/0019-5154.177802 Ciążyńska M, Narbutt J, Woźniacka A, Lesiak A. Trends in basal cell carcinoma incidence rates: A 16-year retrospective study of a population in central Poland. Postepy Dermatol Alergol. 2018;35(1):47-52. doi:10.5114/ada.2018.73164 Casari A, Pellacani G, Seidenari S, et al. Pigmented nodular basal cell carcinomas in differential diagnosis with nodular melanomas: Confocal microscopy as a reliable tool for in vivo histologic diagnosis. J Skin Cancer. 2011;2011:406859. doi:10.1155/2011/406859 East E, Fullen DR, Arps D, et al. Morpheaform basal cell carcinomas with areas of predominantly single-cell pattern of infiltration: Diagnostic utility of p63 and cytokeratin. Am J Dermatopathol. 2016;38(10):744-50. doi:10.1097/DAD.0000000000000541