Like MM, BCC is also divided into four main histologic sub-types: nodular, superficial, morpheaform, and pigmented (or metatypical) (Table 97-1). BCC has indolent growth characteristics, with a very low metastatic rate, ranging from 0.0028% to
0.55%. Paradoxically, BCCs can cause extensive local destruction and significant disfigurement.
SCCs are more aggressive than BCCs (Table 97-1). The rate of metastasis for SCC is 2% to 6% and may be as high as 10% to 14% in high-risk sites such as the ear and lip and 30% in the genital area.18 SCCs are preceded by leukoplakia, actinic keratosis,
radiation damage, or sun damage to the skin. Actinic keratosis, a small papule that appears on areas of sun damage on the skin, has a 1 in 400 risk of transforming to
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