From the aforementioned symptoms or manifestations, we come-up to a diagnosis that this condition is

a type of skin cancer called Basal cell carcinoma (BCC) or also known as basal cell epithelioma. This a
common type of skin cancer which begins in the basal cells (which are found at the bottom of the
epidermis or the outermost layer of skin, and a type of cell within the skin that produces new skin cells
when the old ones die.

Bsically, BCC is caused by repeated and unprotected skin exposure to UV rays or ultraviolet rays from
sunlight, as well as from man-made sources such as tanning beds. When we say tanning bed, it is a
device that emits ultraviolet radiation to give people a tan skin or (make their skin darker). Without
knowing that UV rays can damage the DNA inside skin cells.

Next slide please.

So, (BCC) is the most common skin malignancy with estimated annual incidences of 1 million in USA,
Europe and Australia, respectively. Furthermore, more than 60% of all skin cancers in the Philippines are
BCC or basal cell carcinoma. And this made this disease or this condition very common.

Next slide please.

 A slow-growing, locally invasive malignant epidermal tumor, it infiltrates tissues in a three-

dimensional contiguous fashion through the irregular growth of sub-clinical finger like
outgrowths. It rarely metastasizes, with morbidity related to local tissue invasion and
destruction.

So basically, BCC grows slowly. As also mentioned, it is an invasive MALIGNANT epidermal tumor
meaning it is cancerous But it rarely metastasizes, meaning the possibility of the cancer cells present on
this condition is rare or really not that common But it can invade and destruct local tissues. Because as
what I can remember, we have this process called Metastasis, it is the spread of cancer cells to new
areas of the body through lymphatic system or the bloodstream.

Next slide please.

 A basal cell carcinoma is a common, slow-growing tumor that rarely metastasizes. These lesions
can occur at sites subject to chronic sun exposure and in lightly pigmented people. They present
as pearly papules often containing prominent, dilated sub-epidermal blood vessels (or
telangictasias). Some contain melanin pigment and appear similar to nevi or melanomas.
Advanced lesions may ulcerate, and extensive local invasion of facial tissues, including bone may
occur (hence the old term "rodent ulcer" for this kind of carcinoma) (Dai J, et.al.,2018).

As mentioned earlier some symptoms of having BCC is the presence of lesions (or damage or abnormal
change in the tissue) and we also have pearly papules containing prominent dilated sub-epidermal blood
vessels. Some also contain melanin pigment (these are pigments that gives color) and appear to nevi or
melanomas. Nevi or nevus is actually benign, meaning it is non-cancerous but it can develop malignant
melanoma which is a deadly cancer. As the BCC grows, the central area often ulcerates (or to develop
into skin ulcer or open wound), resulting in its characteristic rolled edge, which can also cause extensive
facial tissues and bone invasion. And this type of carcinoma is called Rodent ulcer, the old term for
nodular basal cell carcinoma.