Tumor is a degenerative disease that we should care about it. Do you ever heared epithelioma? Yes, it is a type of skin cancer. Then the topic here is basal cell epithelioma nursing care, could be useful for those who care this tumor.
Basal cell epithelioma is a destructive skin tumor and it grows slowly, usually appear in 40 years old people. This disease usually occur in light skin people than dark skin and it is the most deathly tumor for light skin people.
Basal cell epithelia changes decrease maturation and normal keratinization. Basal cell division makes wadding. This tumor consist of three types; noduloucerative lesion, superficial basal cell epithelioma, and sclerosis basal cell.
As we know that tumor main causes are still unknown, some factors could contribute the tumor formation as follows:
- Arsenic accumulation
- Burning wound
- Sun light exposure for long time
- Radiation exposure
Sign and Symptoms
In basal cell epithelioma nursing care, a nurse should do anamnesis, as a first step of the nursing care. Different type, different nursing care.
- The most common location for this lesion are on face, especially forehead, eyelid margin, and nasolabial curve
- First lesion: small papule, smooth, red color, and light perforated; telangiectasia vessels cross on surface; sometime pigmented
- Late lesion: retracted into center lesion, clear and dull margin
- Ulceration and local invasion at last (rodent ulcer; seldom metastases, but if it does not handle well, it can spread to vital area and infected; it makes massive hemorrhage if it spreads to main blood vessels)
Superficial basal cell epithelioma
- It is many on chest and back
- Oval form or irregular form, transparent plaque with light pigment, clear margin, look like a thread
- Scaly with small atopic area in the middle like psoriasis or eczema, it is usually chronic but it tends to attack other areas
- Link to arsenic ingestion or arsenic exposure
Sclerosis basal cell epithelioma
- Sclerotic, waxed plaque, yellowish to white color without clear margin, it usually appear on head and neck. Sometime it looked like small tartan scleroderma.
Second step of basal cell epithelioma nursing care, nurses should collaborate with other health profession in diagnosis the tumor. Incisional or excisional biopsy and histology study help determine tumor type and histology subtype.
- Curettage and electrodessication give better cosmetic result for small lesion
- Topical fluorouracil is used for superficial lesion. This medication makes local irritation or inflammation in involved tissues, but no systemic effect for this medicine
- Excision through microscopic controlled surgery will cut the lesion carefully until no tumor found. Skin graft is needed after big tumor excision
- Irradiation is used if local tumor needs it or for elder patient that can be tolerated in surgery
- Cryotherapy with fluid nitrogen will freeze and kill the cells
- Chemosurgery is needed for persistent and recurrent lesion. This chemosurgery consist of fixation paste (zinc chloride) periodically and excreting the pathology tissues. The treatment is still continued until no tumor found.
Basal Cell Epithelioma Nursing Care
Then, plan the nursing care intervention could help the patient get maximum care to reach maximum health. Here are some of nursing care plan that could be your guideline;
- Ask patient to consume high protein diet. Suggest patient the fluid with egg extraction, thick foods, protein liquid supplement if lesion attacked mouth cavity and the patient difficult to swallow
- Inform patient to prevent disease recurrence, he/she needs to avoid sun light exposure and use sun block to protect the skin from damaging ultraviolet
- Suggest patient to compress the lesion with ice compress or corticosteroid cream to reduce the local inflammation which is caused by topical fluorouracil
- Ask patient with noduloulcerative basal cell epithelioma to wash his/her face softly if there is ulceration and keratinization. Washing face roughly can increase the bleeding of lesion.