Basal Cell Carcinoma vs Melanoma
Basal Cell Carcinoma and Melanoma are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Basal Cell Carcinoma vs Melanoma at a glance
- Basal Cell Carcinoma: Most common human cancer; slow-growing locally invasive tumor of basal keratinocytes driven by UV-induced PTCH/Hedgehog mutations.
- Melanoma: Malignancy of melanocytes; deadliest common skin cancer; early detection by ABCDE criteria saves lives.
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Side-by-side comparison
| Feature | Basal Cell Carcinoma | Melanoma |
|---|---|---|
| At a glance | Most common human cancer; slow-growing locally invasive tumor of basal keratinocytes driven by UV-induced PTCH/Hedgehog mutations. | Malignancy of melanocytes; deadliest common skin cancer; early detection by ABCDE criteria saves lives. |
| Classic presentation | Pearly translucent nodule with rolled border, telangiectasias, and central ulcer on a sun-exposed area of an older fair-skinned adult.; Often asymptomatic;… | ABCDE positive pigmented lesion + ugly duckling; for acral/subungual — Hutchinson sign (periungual pigment extension).; New or changing pigmented lesion… |
| Workup / key labs | Histopathologic confirmation of basaloid tumor cells in palisading nests with retraction artifact and myxoid stroma.; Tissue diagnosis required — skin biopsy… | Histopathology + AJCC 8th edition staging based on Breslow depth, ulceration, mitotic rate (T), nodal status (N), distant metastases and LDH (M).; EXCISIONAL… |
| Imaging | CT/MRI only for advanced or recurrent tumors with suspected perineural invasion or deep tissue involvement; Routine imaging not indicated for typical primary… | Stage IA-IIA: typically no imaging if asymptomatic; Stage IIB-IIIA: consider chest X-ray, CT chest/abdomen/pelvis; brain MRI for stage IIIC+; PET/CT for stage… |
| First-line treatment | Surgical excision with 4 mm margins for low-risk primary BCC (cure rate ~95%); Mohs micrographic surgery (preferred for high-risk BCC): face (especially… | Wide local excision based on Breslow depth (AAD/NCCN):; • In situ — 5-10 mm margins; • ≤1.0 mm — 1 cm margins; • 1.01-2.0 mm — 1-2 cm margins; • >2.0 mm — 2… |
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