Basal Cell Carcinoma : Rodent Ulcer

Basal cell carcinoma is a tumor of the elderly population, usually seen after the age of 60 years. However, in the setting of xeroderma pigmentosum, albinism, nevoid basal cell carcinoma syndrome, and Bazex syndrome as well as in sunny climates, it may present at a much younger age.

The tumor is related to excessive exposure to sunlight and is most frequently seen on face. Less common sites include neck, trunk, and upper extremities.

Five main clinical subtypes of basal cell carcinoma have been described.

• nodular/ulcerative type (Rodent Ulcler)
• diffuse (infiltrating & morpheaform)
• pigmented
• superficial
• fibroepithelioma of Pinkus

The ulcerative types starts a small translucent, pink or pearly papule. The epidermis is stretched thin over the lesion and eventually breaks down creating a non-healing ulcer. The ulcer has characteristic rolled edges and can progress with extensive destruction of facial structures (Rodent ulcer) as illustrated in this image.