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. 2024 Mar 14:11:1381492.
doi: 10.3389/fmed.2024.1381492. eCollection 2024.

Basal cell carcinoma-a clinical indicator of immunosuppression

Lucian G Scurtu  1 , Marian Petrica  2   3 , Francesca Scurtu  4 , Anca Angela Simionescu  4 , Marco I Popescu  5 , Olga Simionescu  1
Affiliations

Basal cell carcinoma-a clinical indicator of immunosuppression

Lucian G Scurtu et al. Front Med (Lausanne). .

Abstract

Background: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are skin-derived carcinomas. The literature strongly connects SCC with acquired immunosuppression. Current data regarding BCC's association with immunosuppressive comorbidities are vague. The primary objective of this study was to establish the correlations between BCC and immunosuppressive comorbidities of patients. Materials and methods: We conducted a retrospective cohort study on 275 patients with a histopathological proven diagnosis of BCC from October 2019 to October 2023. Demographic data, BCC characteristics, and patients' comorbidities were analyzed. Comorbidities were classified as non-immunosuppressant and immunosuppressant (primary and secondary immunodeficiencies).

Results: We recorded 292 BCCs from 275 patients (142 females, 133 males), with equally distributed skin phototypes. 66.44% of the BCCs were detected in patients with various comorbidities (p < 0.001), of which 81.44% had immunosuppressive comorbidities (p < 0.001). All the immunosuppressive comorbidities were secondary and included diabetes mellitus (47.55%), history of solid or hematogenous cancer in the last 5 years (26.57%), chronic kidney disease (8.39%), chronic infections (9.09%), and antirheumatic immunosuppressive therapies (8.39%) (p < 0.001). BCC patients with immunosuppressive comorbidities did not develop larger BCCs (p = 0.2577) or more aggressive subtypes (p = 0.4269) and BCC did not arise earlier in their life (p < 0.001). BCC on the nasal pyramid was frequent in cancer history patients (p = 0.008). The ulcerated form of BCC is more confined to patients with chronic kidney disease (p = 0.006). Multiple BCCs are more frequent in patients with secondary immunodeficiencies (p = 0.027).

Conclusion: BCC represents a clinical indicator of secondary immunodeficiency. Further research should establish if cancer screening campaigns may be beneficial in BCC patients.

Keywords: basal cell carcinoma; cancer; carcinoma; diabetes mellitus; immunosuppression; skin cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of cancer history among BCC patients. Breast, thyroid, prostate, and lung cancer represented the most encountered malignancies.
Figure 2
Figure 2
Comorbidities distribution among IPs. Diabetes mellitus type II was found in almost half of the IPs, a history of cancer in a quarter of the IPs, and each of the other three categories in approximately a tenth of the IPs. DM, diabetes mellitus; CKD, chronic kidney disease.
Figure 3
Figure 3
BCC anatomical distribution upon gender and comorbidities in IPs. The most frequent (1) and second most frequent (2) localizations are displayed. BCC localizations are represented for each comorbidity. The most representative gender is shown for each comorbidity.
See this image and copyright information in PMC

References

    1. Marzuka AG, Book SE. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med. (2015) 88:167–79. PMID: - PMC - PubMed
    1. Cameron MC, Lee E, Hibler BP, Barker CA, Mori S, Cordova M, et al. . Basal cell carcinoma: epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol. (2019) 80:303–17. doi: 10.1016/j.jaad.2018.03.060 - DOI - PubMed
    1. Iwasaki JK, Srivastava D, Moy RL, Lin HJ, Kouba DJ. The molecular genetics underlying basal cell carcinoma pathogenesis and links to targeted therapeutics. J Am Acad Dermatol. (2012) 66:e167–78. doi: 10.1016/j.jaad.2010.06.054, PMID: - DOI - PubMed
    1. Jayaraman SS, Rayhan DJ, Hazany S, Kolodney MS. Mutational landscape of basal cell carcinomas by whole-exome sequencing. J Invest Dermatol. (2014) 134:213–20. doi: 10.1038/jid.2013.276, PMID: - DOI - PubMed
    1. Prieto-Granada C, Rodriguez-Waitkus P. Basal cell carcinoma: epidemiology, clinical and histologic features, and basic science overview. Curr Probl Cancer. (2015) 39:198–205. doi: 10.1016/j.currproblcancer.2015.07.004, PMID: - DOI - PubMed