Japanese Dermatological Association Guidelines: Clinical Questions of Guidelines for Basal Cell Carcinoma 2025

In accordance with the advancement of therapies for skin malignancies, the Japanese Dermatological Association and Japanese Skin Cancer Society updated guidelines for skin malignancies to reflect current clinical practices. Basal cell carcinoma (BCC) is one of the most ordinary malignant cutaneous tumors and its incidence continues to grow in many countries. Clinically, BCCs in East Asian populations are usually pigmented, and 88.3% of total BCCs in Japanese patients are pigmented. However, a low proportion of BCCs in Western populations are pigmented. Therefore, diagnosis and tumor border evaluation of BCCs in Western populations are relatively difficult. From these characteristics, clinical guidelines for East Asian BCCs should differ from those for Western BCCs. This revised Japanese clinical guideline for BCC was also undertaken by a committee comprising experts across relevant fields who meticulously reviewed and systematized a wide range of literature on BCC to develop comprehensive, evidence-based guidelines. Literature searches were conducted by the Japan Medical Library in accordance with the Minds Clinical Practice Guideline Creation Manual 2020, ver. 3.0. Four clinical questions (CQs) were established, and corresponding recommendation statements were provided for each CQ. There are about the reduced margin resection for pigmented BCCs, the radiotherapy for the recurrent BCCs, the topical immune response modifiers, and the systemic therapy using immune checkpoint inhibitors. This Japanese clinical guideline for BCC will help clinicians select suitable therapies for BCCs in East Asia.