Dr. Shane Chapman, MD discusses Skin Cancer Basal Cell Carcinoma Treatment. See more at www.dermnet.com PLEASE RATE AND COMMENT!!! There are several factors to consider before choosing the best treatment modality. Options depend on the location, histologic type and patient concerns. Nodular and superficial BCCs are the least aggressive and can be completely removed by electrodesiccation and curettage or by simple surgical excision. Superficial BCC can be treated with every other day application of imiquimod cream. This immune modulating agent induces an intense inflammatory reaction and the tumor clears without scarring. The histologic helps to determine therapy. The micronodular, infiltrative, and morpheaform BCCs have a higher incidence of positive tumor margins after excision and have the greatest recurrence rate. Clinically, BCCs with these patterns have poorly defined borders and are not apparent during physical examination. They subtly extend into surrounding tissue and are easily missed by blind treatment techniques such as surgical excision. These tumors need more aggressive treatment with wide excision or microscopically controlled surgery. Tumor size is important consideration. Electrodesiccation and curettage afford excellent results for small (less than 2 cm) nodular BCCs located on the forehead and cheeks. Nodular BCCs on the forehead and cheek that are larger and have well-defined margins should be excised and closed; electrosurgery for large tumors may …