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Basal Cell Carcinoma (BCC)

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Basal cell carcinoma is the most common (more than 1 million cases diagnosed in the U.S. per year) and least aggressive cancer in humans. If left untreated, it becomes a disfiguring problem but it rarely spreads internally or causes death.

Risk Factors

  • Light hair (blonde or red), eyes (blue or green), or skin color
  • History or solid organ or bone marrow transplant
  • Exposure to tanning beds, ionizing radiation, ultraviolet light, arsenic, coal tar
  • Smoking
  • Having a genetic predisposition such as Basal Cell Nevus Syndrome, Bazex-Dupre-Christol syndrome, Rombo syndrome, Xeroderma Pigmentosum, Albinism

References: Rubin et al, Basal Cell Carcinoma, New England Journal of Medicine, 2005.
Cameron et al, Basal cell carcinoma: Epidemiology; pathophysiology…Journal of the American Academy of Dermatology, 2018.

Squamous Cell Carcinoma

There are many different types of squamous cell carcinoma that affect humans. This article will only describe the features of cutaneous squamous cell carcinoma (cSCC) since this cancer is diagnosed and treated by dermatologists.

How Common is This Condition?

It is the second most common skin cancer, closely behind BCC in its incidence. A study from the Mayo Clinic reported a 263% rise in cSCC cases between 1976-1984 and 2000-2010. cSCC is not tracked in US national tumor registries, making it hard to determine precise incidence and mortality rates. In Europe, age-standardized incidence ranges from 9 to 96 per 100,000 men and 5 to 68 per 100,000 women (2002-2007 estimates). In Australia, rates are higher, with 499 per 100,000 men and 291 per 100,000 women (2002 estimates).

References:

  • Que et al. Cutaneous squamous cell carcinoma: Incidence, risk factors, diagnosis, and staging. Journal of the American Academy of Dermatology, 2018.
  • https://www.visualdx.com

Risk Factors

  • Top risk factors: Sun exposure, age, fair skin, immunosuppression
  • Common in: Individuals with light skin, men (3:1 ratio), people over age 60
  • Minority populations are important: Though less common in Hispanic, Black, and Asian individuals, it remains the most common skin cancer in these groups
  • Immunosuppression: Solid organ transplant recipients (SOTRs) have 65 times higher risk
  • Risk increases with the number of immunosuppressive drugs taken
  • Higher risk in heart and lung transplants vs. renal transplants
  • Chronic lymphocytic leukemia patients have an 8-10 times higher risk
  • Human papillomavirus (HPV) involvement: HPV types 16, 18 (nail, genital), and types 8, 9, 15 (SOTRs)
  • Environmental exposures: Arsenic, hydrocarbons, nitrosamines (tobacco smoke), alkylating agents (chemotherapy), ionizing radiation

Rare genetic syndromes: Linked to photosensitivity or defective DNA repair, predisposing to diagnosis of cSCC at a young age

Reference: Que et al, Cutaneous Squamous Cell Carcinoma… Journal of the American Academy of Dermatology, 2017.

Who We Are

Katherine Hunt, MD, FAAD

Dr. Hunt grew up in Hoover, Alabama and attended Hoover High School. She started her career in business and engineering at the University of Alabama.

As an undergraduate, she gained national attention and was named "USA Today National Academic All-Star" for creating a self-sustaining peer mentoring program which measurably improved students' computer science performance at Alabama.

Her extensive work experience at Huron Consulting Group and GE Healthcare helped her realize that she would be most fulfilled in the field of medicine, helping patients one-on-one.

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