الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
BCC is the most frequent skin cancer type and tends to appear on sun-exposed skin. Most BCCs are slow growing, locally invasive and destructive to the surrounding tissues but with low metastatic potential.
Etiology of BCC is a multifactorial combination of genotype, phenotype, and environmental factors. UV radiation exposure, ionizing radiation exposure and immunosuppression are the most important factors in the disease’s pathogenesis. There are four major clinical subtypes that include nodular, superficial, morpheaform and fibroepithelioma of Pinkus.
The dermoscopic aspects of pigmented BCC are based on the absence of pigment network and presence of at least one of six positive morphological features. The most important are, ulcerations, arborising telangectatic vessels and multiple blue-gray globules. Microscopically, BCC is formed of basaloid tumor masses extending from the epidermis into the dermis with peripheral palisading of the nuclei, retraction spaces and stromal mucin deposition.
The goal of treatment for BCC is the cure of the tumor and the maximal tissue preservation. Standard excision represents the gold standard treatment for low risk BCCs. Mohs micrographic surgery (MMS) is the best surgical technique for high-risk and recurrent BCCs.
The aim of this study was to compare standard surgical excision of BCC using 4-mm versus 2-mm surgical margins. The study was conducted on adult patients with primary well defined non-aggressive subtypes of BCC less than 2 cm in diameter. Patients were randomly split into two equal groups.
After surgical excision of BCC lesions in both treatment groups, every patient was evaluated regarding the assessment of rate of complete tumor excision as proven with histopathological evaluation of frozen sections, the size of primary defect and method of defect closure. Every patient underwent regular follow up visits over one year period to assess early postoperative complications of the procedure, scar assessment as regard scar length, facial asymmetry, rate of recurrence after treatment, cosmetic outcome and patient satisfaction.
Study looked at 30 patients with head and neck BCCs. Average age was 57.53, mean tumor size was 1.25 cm in diameter. Complete tumor eradication group I (4 mm excision margin) was 100% while in group II (2 mm excision margin) was 93.3%.The size of primary surgical defect was larger in group I than group II. 6.7% of group I patients and 66.7% of group II pateints required direct closure so more tissue conservation was obtained in group II. Scar length and total VSS score after one year in group I were larger than group II. 33.3% of patients in group I developed mild facial asymmetry, while 0 % in group II.The overall cosmetic outcome and patient satisfaction in group II were higher than in group I. And after one year period of follow up, only one case of recurrence detected in group I and further excision was done.