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derm.basal-cell-carcinoma.core.v1PRODUCTION
derm.basal-cell-carcinoma.core.v1

Basal cell carcinoma

dermatologysubacutechronicadult
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12/12 authored

Canonical 12-phase frame with authored status for this dossier.

Current phase

Frame

Detailed

Frame BCC as the most common cancer in fair-skinned populations — locally destructive, rarely metastatic. The dermatology engine owns recognition, biopsy, NCCN risk stratification, definitive local therapy (Mohs / excision / ED&C / topical / RT) AND the locally advanced/metastatic systemic ladder (HHI → cemiplimab), routing only the rare bona-fide visceral metastatic / skull-base disease to multidisciplinary care. Gorlin syndrome and field cancerisation overlap with SCC and melanoma are recognised here.

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derm-owned scope set; sibling routes (SCC, AK-NMSC, melanoma) noted

Patient inputs (12)

Arborising telangiectasia, blue-grey ovoid nests, leaf-like areas, spoke-wheel structures, in-focus dots and ulceration support BCC and pivot pigmented BCC vs melanoma (NCCN BCC 2025; AAD 2019 PMID 30392755)

Multiple synchronous BCC, palmar/plantar pits, odontogenic keratocysts, calcified falx, hypertelorism, medulloblastoma history → Gorlin (PTCH1) — gates lifelong surveillance, HHI for diffuse disease and AVOID ionising radiation (NCCN BCC 2025)

Subtype recognition (nodular / superficial / morphoeic-infiltrative-sclerosing / pigmented / fibroepithelioma-of-Pinkus / basosquamous) is the master variable — drives both biopsy choice and risk stratification (NCCN BCC 2025)

Perineural invasion (PNI; pain, paraesthesia, motor weakness, named-nerve deficit) is a NCCN high-risk feature and may indicate deep / skull-base disease — imaging + multidisciplinary care (NCCN BCC 2025)

NCCN high-risk H zone (mask of face, ears, genitalia, hands/feet/areola) drives Mohs / margin-assessed excision selection regardless of size (NCCN BCC 2025)

Size thresholds by zone (H any size; M ≥1 cm; L ≥2 cm) and ill-defined borders elevate to NCCN high-risk and Mohs/margin-assessed pathways (NCCN BCC 2025)

Recurrent disease, immunosuppression (transplant, haematologic malignancy, HIV), and tumour arising in previously irradiated skin are NCCN high-risk and shift to Mohs / definitive surgery (NCCN BCC 2025)

Vismodegib and sonidegib are EMBRYOFETAL TOXIC (boxed warning) — pregnancy testing + contraception are mandatory before HHI; gates the systemic arm (NCCN BCC 2025; ERIVANCE PMID 22670903)

CT/MRI for locally advanced / suspected bone or orbital invasion / PNI; CT chest-abdomen for metastatic disease — not for routine low-risk BCC (NCCN BCC 2025)

Baseline before HHI / cemiplimab; cemiplimab irAE workup baseline (NCCN BCC 2025; Stratigos PMID 34000246)

Baseline + on-treatment for HHI hepatic monitoring and cemiplimab immune-hepatitis surveillance (NCCN BCC 2025)

Race-free eGFR (CKD-EPI 2021) for renal-dose context if cemiplimab + iodinated-contrast staging imaging needed in advanced disease (NCCN BCC 2025; Inker NEJM 2021)

* = hard-required. Engine cannot meaningfully run until these are filled.

Severity triggers (7)

7 need judgement
  • informationallife_threateningsevere_cemiplimab_irae
    Grade 3-4 immune-related adverse event on cemiplimab (colitis / hepatitis / pneumonitis / myocarditis / endocrine crisis) (Stratigos PMID 34000246)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalseverelocally_advanced_or_metastatic_bcc
    BCC not amenable to surgery or radiation (unresectable / unacceptable morbidity) OR bona-fide regional nodal / distant metastatic disease (NCCN BCC 2025; ERIVANCE PMID 22670903)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalsevereperineural_invasion_named_nerve
    Symptoms or imaging consistent with perineural invasion of a named nerve (pain, paraesthesia, motor weakness, facial palsy) (NCCN BCC 2025)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalseverepregnancy_with_hhi_indication
    Female of reproductive potential with locally advanced / metastatic BCC requiring HHI therapy (NCCN BCC 2025; ERIVANCE PMID 22670903)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalmoderategorlin_basal_cell_nevus_syndrome
    Patient with PTCH1 / basal-cell-nevus (Gorlin) syndrome: multiple BCC, palmar/plantar pits, odontogenic keratocyst history, calcified falx, medulloblastoma family history (NCCN BCC 2025)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalmoderatepigmented_bcc_vs_melanoma_uncertainty
    Pigmented lesion with mixed BCC and melanoma dermoscopy features where the diagnosis is not clear (NCCN BCC 2025; AAD 2019 melanoma PMID 30392755)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalmoderaterecurrent_bcc_after_mohs
    Recurrence at a previously Mohs-excised BCC site, or recurrent BCC after any prior therapy (NCCN BCC 2025)
    Trigger could not be auto-evaluated — needs clinician judgement.

Workflow calculators

Run this disease's risk and dosing calculators inline.

TREATMENToptionalDrives dose adjustment
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Recommended regimen

BCC — risk-directed treatment ladder (NCCN BCC 2025; ERIVANCE / BOLT / Stratigos)
axis: bcc_risk_directed_ladderstep 1 - Step 1 — Low-risk BCC: surgical or topical local therapy (dermatology-owned)
Selected step "Step 1 — Low-risk BCC: surgical or topical local therapy (dermatology-owned)" — NCCN low-risk BCC: trunk/extremity <2 cm (L zone), well-defined borders, primary, immunocompetent, non-aggressive histologic subtype, no PNI
  • standard_surgical_excision_4mm_margin
    first line
    definitive_surgery
    triggers: biopsy_confirmed_low_risk_bcc
    NCCN BCC 2025 — 4-mm clinical margin standard excision achieves ~95% cure in low-risk primary BCC.
  • electrodesiccation_and_curettage
    first line
    destructive_procedure
    triggers: superficial_or_nodular_low_risk_trunk_extremity, not_terminal_hair_bearing
    NCCN BCC 2025 — ED&C for low-risk superficial/nodular BCC on non-terminal-hair-bearing skin; avoid on scalp / beard area (deeper follicular extension).
  • cryosurgery
    second line
    destructive_procedure
    triggers: superficial_low_risk_when_surgery_declined
    NCCN BCC 2025 — cryosurgery is an option for selected superficial low-risk BCC when surgery is declined / unfeasible.
  • imiquimod
    second line
    topical_immune_response_modifier
    5% cream • topical • 5x/week x 6 weeks (max: per tolerance / site reaction)
    triggers: superficial_bcc_only, cosmetically_sensitive_site, patient_declines_surgery
    NCCN BCC 2025 — topical imiquimod 5% for superficial BCC only (NOT nodular / infiltrative); clearance ~75-80% at 12 wk; brisk inflammation expected.
    rxcui 59943
  • fluorouracil
    second line
    topical_antimetabolite
    5% cream • topical • BID x 3-6 weeks (max: per tolerance / site reaction)
    triggers: superficial_bcc_only, patient_declines_surgery
    NCCN BCC 2025 — topical 5-FU 5% for superficial BCC only; lower clearance than imiquimod and surgery; expect erosion / inflammation.
    rxcui 4492
  • definitive_radiotherapy
    second line
    radiotherapy
    triggers: non_surgical_candidate, cosmetic_or_functional_preservation_priority
    NCCN BCC 2025 — definitive RT for non-surgical candidates or selected cosmetic sites; AVOID in Gorlin (radiosensitive — risk of new BCC and secondary malignancy) and in young patients.

outpatient playbook — drug actions (5)

  1. 1. standard surgical excision 4-mm margin (low-risk) or Mohs micrographic surgery (high-risk)
    4-mm clinical margin standard excision; Mohs to clear margins • surgical • single definitive procedure
    trigger: Biopsy-confirmed BCC, risk tier assigned (NCCN BCC 2025)
    Risk-directed local therapy is curative for the great majority of BCC
  2. 2. imiquimod 5% (superficial BCC only) OR 5-FU 5% (superficial BCC only)
    rxcui 59943
    5% cream • topical • imiquimod 5x/wk x 6 wk; 5-FU BID x 3-6 wk
    trigger: Superficial BCC where surgery declined / not preferred (NCCN BCC 2025)
    Topical option for superficial BCC only — NOT for nodular / infiltrative; lower clearance than surgery
  3. 3. vismodegib 150 mg PO daily (advanced/metastatic; first-line HHI)
    rxcui 1242987
    150 mg • PO • once daily continuous
    trigger: Locally advanced / metastatic / recurrent-after-Mohs (ERIVANCE PMID 22670903)
    Hedgehog-pathway inhibition — ORR 43% laBCC, 30% mBCC; embryofetal toxic boxed warning
  4. 4. cemiplimab 350 mg IV q3wk (HHI-refractory / -intolerant)
    rxcui 2058826
    350 mg • IV • q3wk
    trigger: Progression on / intolerance to HHI (Stratigos PMID 34000246)
    Anti-PD-1 second-line for laBCC after HHI; ORR 31%
  5. 5. nicotinamide 500 mg PO BID (chemoprevention for high-risk patients)
    rxcui 7405
    500 mg • PO • BID
    trigger: Multiple prior NMSC / organ-transplant / dense actinic field (ONTRAC PMID 26488693)
    Reduces new NMSC ~23% at 12 mo; safe, OTC

Auto-drafted A&P note

outpatient

Subjective

- Possible entry pathways: Pearly papule with arborising telangiectasia ± rolled border ± central ulceration on chronically UV-exposed skin (NCCN BCC 2025; AAD 2019); Non-healing, recurrently bleeding or crusting skin lesion ("the lesion that will not heal") — classic BCC story (NCCN BCC 2025); Atrophic, scar-like, ill-defined plaque on the face/forehead — morphoeic/sclerosing/infiltrative BCC (high-risk histologic pattern, NCCN BCC 2025).

Objective

- No vitals, labs, or imaging entered for this encounter.

Assessment

**Basal cell carcinoma** (derm.basal-cell-carcinoma.core.v1).
Phenotype framing: Terminal differential with named pivots: BCC vs squamous-cell carcinoma (hyperkeratotic firm plaque + tender + faster growing — route derm.squamous-cell-carcinoma-skin.core.v1) vs actinic keratosis (rough hyperkeratotic macule on UV-damaged field — route derm.actinic-keratosis-nmsc.core.v1) vs sebaceous hyperplasia (yellowish umbilicated papule, crown-vessels dermoscopy pivot) vs intradermal nevus (soft skin-coloured papule, no telangiectasia pivot) vs molluscum contagiosum (central umbilication, often multiple pivot) vs pigmented seborrheic keratosis (stuck-on, milia-like cysts pivot) vs MELANOMA (asymmetric network, blue-white veil — route derm.melanoma.core.v1 if any doubt — pigmented BCC is the principal melanoma-mimic) vs fibrous papule (firm conical papule, nose) vs Merkel-cell carcinoma (rapidly growing, red-purple, immunosuppressed-elderly — high suspicion → urgent biopsy + MDT). Field cancerisation means BCC + SCC + AK frequently co-exist.
Scope: Frame BCC as the most common cancer in fair-skinned populations — locally destructive, rarely metastatic. The dermatology engine owns recognition, biopsy, NCCN risk stratification, definitive local therapy (Mohs / excision / ED&C / topical / RT) AND the locally advanced/metastatic systemic ladder (HHI → cemiplimab), routing only the rare bona-fide visceral metastatic / skull-base disease to multidisciplinary care. Gorlin syndrome and field cancerisation overlap with SCC and melanoma are recognised here.

No severity triggers fired against current inputs.

Plan

Regimen axis: **BCC — risk-directed treatment ladder (NCCN BCC 2025; ERIVANCE / BOLT / Stratigos)** — step "Step 1 — Low-risk BCC: surgical or topical local therapy (dermatology-owned)".
1. standard_surgical_excision_4mm_margin (definitive_surgery, first line) — NCCN BCC 2025 — 4-mm clinical margin standard excision achieves ~95% cure in low-risk primary BCC.
2. electrodesiccation_and_curettage (destructive_procedure, first line) — NCCN BCC 2025 — ED&C for low-risk superficial/nodular BCC on non-terminal-hair-bearing skin; avoid on scalp / beard area (deeper follicular extension).
3. cryosurgery (destructive_procedure, second line) — NCCN BCC 2025 — cryosurgery is an option for selected superficial low-risk BCC when surgery is declined / unfeasible.
4. imiquimod 5% cream topical 5x/week x 6 weeks (topical_immune_response_modifier, second line) — NCCN BCC 2025 — topical imiquimod 5% for superficial BCC only (NOT nodular / infiltrative); clearance ~75-80% at 12 wk; brisk inflammation expected.
5. fluorouracil 5% cream topical BID x 3-6 weeks (topical_antimetabolite, second line) — NCCN BCC 2025 — topical 5-FU 5% for superficial BCC only; lower clearance than imiquimod and surgery; expect erosion / inflammation.
6. definitive_radiotherapy (radiotherapy, second line) — NCCN BCC 2025 — definitive RT for non-surgical candidates or selected cosmetic sites; AVOID in Gorlin (radiosensitive — risk of new BCC and secondary malignancy) and in young patients.

Setting playbook (outpatient) — Recognise BCC by subtype morphology + dermoscopy, biopsy to confirm, assign NCCN low/high/locally-advanced/metastatic risk tier, deliver risk-directed local therapy (Mohs / excision / ED&C / topical / RT) or systemic Hedgehog-pathway-inhibitor ladder for advanced disease, and establish lifelong total-body skin surveillance (NCCN BCC 2025; ERIVANCE PMID 22670903; BOLT PMID 25981810; Stratigos PMID 34000246)
7. standard surgical excision 4-mm margin (low-risk) or Mohs micrographic surgery (high-risk) 4-mm clinical margin standard excision; Mohs to clear margins surgical single definitive procedure — Biopsy-confirmed BCC, risk tier assigned (NCCN BCC 2025) (Risk-directed local therapy is curative for the great majority of BCC)
8. imiquimod 5% (superficial BCC only) OR 5-FU 5% (superficial BCC only) 5% cream topical imiquimod 5x/wk x 6 wk; 5-FU BID x 3-6 wk — Superficial BCC where surgery declined / not preferred (NCCN BCC 2025) (Topical option for superficial BCC only — NOT for nodular / infiltrative; lower clearance than surgery)
9. vismodegib 150 mg PO daily (advanced/metastatic; first-line HHI) 150 mg PO once daily continuous — Locally advanced / metastatic / recurrent-after-Mohs (ERIVANCE PMID 22670903) (Hedgehog-pathway inhibition — ORR 43% laBCC, 30% mBCC; embryofetal toxic boxed warning)
10. cemiplimab 350 mg IV q3wk (HHI-refractory / -intolerant) 350 mg IV q3wk — Progression on / intolerance to HHI (Stratigos PMID 34000246) (Anti-PD-1 second-line for laBCC after HHI; ORR 31%)
11. nicotinamide 500 mg PO BID (chemoprevention for high-risk patients) 500 mg PO BID — Multiple prior NMSC / organ-transplant / dense actinic field (ONTRAC PMID 26488693) (Reduces new NMSC ~23% at 12 mo; safe, OTC)

Non-pharmacologic actions:
- Diagnostic shave or punch biopsy of the most representative area (full-thickness for any pigmented lesion where melanoma is possible) (NCCN BCC 2025)
- Electrodesiccation-and-curettage for selected low-risk superficial/nodular BCC on non-hair-bearing skin (NCCN BCC 2025)
- Definitive radiotherapy for non-surgical candidates (AVOID in Gorlin syndrome)
- Multidisciplinary tumour-board referral for locally advanced / PNI / orbital-bony invasion / metastatic disease
- Genetics referral for suspected Gorlin syndrome (≥2 BCCs <30 y, ≥5 BCC lifetime, palmar pits, falx calcification, medulloblastoma family history)
- Photoprotection + skin self-examination + nicotinamide chemoprevention counselling for high-risk patients (NCCN BCC 2025; ONTRAC PMID 26488693)

AVOID / contraindication checks:
- Vismodegib sonidegib embryofetal toxic boxed warning (NCCN BCC 2025 — pregnancy testing + effective contraception MANDATORY before HHI; continue contraception 24 months post vismodegib, 20 months post sonidegib, no pregnancy during or for 7 months post in male partners; do not donate blood/semen during or for 24 months post)
- Avoid ionising radiation in gorlin syndrome (PTCH1 patients are radiosensitive — RT can induce new BCC and secondary malignancies; reserve RT only when no alternative)
- Topical imiquimod and 5fu only for superficial bcc (NOT for nodular / infiltrative / morphoeic / pigmented — lower efficacy and risk of treating only superficial component of a deeper tumour)
- Edc not on terminal hair bearing sites (deeper follicular extension defeats ED&C on scalp / beard / pubic area)
- Cemiplimab irae recognition and emergent management (Grade 3 4 immune colitis / hepatitis / pneumonitis / myocarditis / endocrinopathy → hold drug, systemic corticosteroids per oncology pathway, multidisciplinary review)
- Do not biopsy shave a lesion suspected to be melanoma (pigmented BCC vs melanoma — when doubt exists use a full thickness biopsy or route to derm.melanoma.core.v1 to preserve Breslow staging)

Monitoring

Regimen monitoring:
- lifelong total-body skin exam every 6-12 months (60-90% lifetime risk of a second BCC after a first; intensified in Gorlin / transplant / prior RT) (NCCN BCC 2025)
- HHI on-treatment: serum LFT baseline + periodic; muscle cramps / spasm assessment (consider serum CK if severe); weight; dysgeusia; alopecia (ERIVANCE PMID 22670903; BOLT PMID 25981810)
- HHI pregnancy / contraception status surveillance for women of reproductive potential throughout therapy and post per labelling
- cemiplimab on-treatment: routine irAE surveillance — skin, thyroid (TSH every cycle), hepatitis (LFT), colitis (symptoms), pneumonitis (cough/dyspnoea), hypophysitis, myocarditis (Stratigos PMID 34000246)
- photoprotection adherence + skin self-examination habit reinforcement at every visit (NCCN BCC 2025)

Setting (outpatient) monitoring:
- Lifelong total-body skin exam every 6-12 months (60-90% second-BCC risk) (NCCN BCC 2025)
- HHI: LFT, muscle-cramp / weight / dysgeusia / alopecia surveillance; pregnancy/contraception status throughout therapy (ERIVANCE PMID 22670903)
- Cemiplimab: routine irAE surveillance (skin, thyroid, hepatitis, colitis, pneumonitis, myocarditis) (Stratigos PMID 34000246)

Follow-up plan: Lifelong derm continuity: photoprotection (broad-spectrum SPF ≥30, sun-protective clothing, behavioural avoidance), skin self-examination education, family / Gorlin counselling, chemoprevention discussion (nicotinamide 500 mg BID — ONTRAC trial NEJM PMID 26488693 reduced new NMSC ~23% in high-risk patients; consider for those with multiple BCC / SCC / dense field). Organ-transplant recipients receive intensified surveillance and individualised immunosuppression review with transplant team. Recurrence at the prior site → re-biopsy + escalate to Mohs / margin-assessed excision; new advanced / metastatic disease → re-enter systemic ladder.
- Close-out criterion: photoprotection + self-exam + chemoprevention + surveillance schedule documented

Monitoring phase: Surveillance: total-body skin exam every 6-12 months for life (60-90% lifetime risk of a second BCC after a first; rises further in Gorlin, organ transplant, prior RT). On HHI: monitor for muscle spasm / cramps (manage with hydration, magnesium, dose holds; serum CK if severe), alopecia, dysgeusia, weight loss, hepatic transaminases (LFT), and pregnancy status in any female of reproductive potential (contraception during + 24 months after vismodegib, 20 months after sonidegib per labelling). On cemiplimab: immune-related adverse events (skin, thyroid, hepatitis, colitis, pneumonitis, hypophysitis, myocarditis).

Disposition

Current setting: outpatient — Recognise BCC by subtype morphology + dermoscopy, biopsy to confirm, assign NCCN low/high/locally-advanced/metastatic risk tier, deliver risk-directed local therapy (Mohs / excision / ED&C / topical / RT) or systemic Hedgehog-pathway-inhibitor ladder for advanced disease, and establish lifelong total-body skin surveillance (NCCN BCC 2025; ERIVANCE PMID 22670903; BOLT PMID 25981810; Stratigos PMID 34000246)

Disposition criteria:
- Low-risk BCC fully excised / treated → routine surveillance (NCCN BCC 2025)
- High-risk BCC → Mohs / margin-assessed excision ± adjuvant RT; surveillance
- Locally advanced / metastatic disease → systemic HHI ± cemiplimab + MDT shared-care
- Gorlin / transplant / high-risk field → intensified surveillance + chemoprevention

Escalation triggers (move to higher acuity):
- Perineural invasion symptoms (named-nerve pain / paraesthesia / motor weakness) → cross-sectional imaging + MDT (NCCN BCC 2025)
- Locally advanced / unresectable / orbital-bony invasion → systemic HHI + MDT
- Bona-fide regional / distant metastasis → systemic ladder + MDT
- Severe cemiplimab irAE (Grade 3-4) → hold drug + systemic corticosteroids per oncology pathway
- Suspected basosquamous histology → manage with SCC-grade aggression (route derm.squamous-cell-carcinoma-skin.core.v1)

Earlier-Return Triggers

Return-precaution thresholds (watch for):
- [LIFE_THREATENING] Grade 3-4 immune-related adverse event on cemiplimab (colitis / hepatitis / pneumonitis / myocarditis / endocrine crisis) (Stratigos PMID 34000246)
- [SEVERE] BCC not amenable to surgery or radiation (unresectable / unacceptable morbidity) OR bona-fide regional nodal / distant metastatic disease (NCCN BCC 2025; ERIVANCE PMID 22670903)
- [SEVERE] Symptoms or imaging consistent with perineural invasion of a named nerve (pain, paraesthesia, motor weakness, facial palsy) (NCCN BCC 2025)

Citations

- NCCN Basal Cell Skin Cancer v.1.2025 (NCCN.org) + AAD/ACMS/ASDSA/ASMS appropriate-use criteria for Mohs micrographic surgery + ERIVANCE (Sekulic NEJM 2012; PMID 22670903, DOI 10.1056/NEJMoa1113713) + BOLT primary (Migden Lancet Oncol 2015; PMID 25981810, DOI 10.1016/S1470-2045(15)70100-2) + BOLT 42-month final (Dummer JAAD 2020; PMID 33358380, DOI 10.1016/j.jaad.2020.08.042) + Cemiplimab post-HHI laBCC (Stratigos Lancet Oncol 2021; PMID 34000246, DOI 10.1016/S1470-2045(21)00126-1) + Nicotinamide chemoprevention ONTRAC (Chen NEJM 2015; PMID 26488693, DOI 10.1056/NEJMoa1506197) + AAD 2019 cutaneous melanoma for the pigmented-BCC-vs-melanoma pivot (Swetter JAAD 2019; PMID 30392755) [PMID:22670903](https://pubmed.ncbi.nlm.nih.gov/22670903/)
- Cited evidence (PMID 25981810) [PMID:25981810](https://pubmed.ncbi.nlm.nih.gov/25981810/)
- Cited evidence (PMID 33358380) [PMID:33358380](https://pubmed.ncbi.nlm.nih.gov/33358380/)
- Cited evidence (PMID 34000246) [PMID:34000246](https://pubmed.ncbi.nlm.nih.gov/34000246/)
- Cited evidence (PMID 26488693) [PMID:26488693](https://pubmed.ncbi.nlm.nih.gov/26488693/)

Last reconciled with current guidelines: 2026-05-26.
References
  • NCCN Basal Cell Skin Cancer v.1.2025 (NCCN.org) + AAD/ACMS/ASDSA/ASMS appropriate-use criteria for Mohs micrographic surgery + ERIVANCE (Sekulic NEJM 2012; PMID 22670903, DOI 10.1056/NEJMoa1113713) + BOLT primary (Migden Lancet Oncol 2015; PMID 25981810, DOI 10.1016/S1470-2045(15)70100-2) + BOLT 42-month final (Dummer JAAD 2020; PMID 33358380, DOI 10.1016/j.jaad.2020.08.042) + Cemiplimab post-HHI laBCC (Stratigos Lancet Oncol 2021; PMID 34000246, DOI 10.1016/S1470-2045(21)00126-1) + Nicotinamide chemoprevention ONTRAC (Chen NEJM 2015; PMID 26488693, DOI 10.1056/NEJMoa1506197) + AAD 2019 cutaneous melanoma for the pigmented-BCC-vs-melanoma pivot (Swetter JAAD 2019; PMID 30392755) — PMID:22670903
  • Cited evidence (PMID 25981810) — PMID:25981810
  • Cited evidence (PMID 33358380) — PMID:33358380
  • Cited evidence (PMID 34000246) — PMID:34000246
  • Cited evidence (PMID 26488693) — PMID:26488693