Characteristics and outcomes of nonmelanoma skin cancer (NMSC) in children and young adults

Abstract

Background: Pediatric and young adult nonmelanoma skin cancer (NMSC) is rare and traditionally associated with predisposing heritable or congenital conditions. Clinical characteristics, outcomes, and iatrogenic risk factors have not been well described.

Objectives: We sought to characterize clinical features, potential risk factors, and gaps in care associated with NMSC in children and young adults.

Methods: This was a retrospective chart review of children and young adults with squamous and basal cell carcinoma.

Results: We identified 28 patients with a total of 182 NMSC tumors. Of patients, 50% had predisposing conditions, and 46% had exposure to iatrogenic risk factors of prolonged immunosuppression, radiation therapy, chemotherapy, voriconazole use, or a combination of these. Of patients with iatrogenic risk factors, 62% developed subsequent cancerous or precancerous skin lesions. No patient was found to have chemotherapy or voriconazole exposure as a sole risk factor. Mean time to diagnosis of NMSC was 948 days with initial misdiagnosis in 36% of patients. The majority of patients underwent surgical excision.

Limitations: This was a retrospective single institution study with a small number of cases.

Conclusions: Physicians should be aware of risk factors associated with NMSC in children and young adults to provide appropriate counseling and early diagnosis and treatment.

Keywords: basal cell carcinoma; nonmelanoma skin cancer; pediatric dermatology; prolonged immunosuppression; radiation therapy; squamous cell carcinoma.