• 102

Male patient, 67 years old, is a diving instructor. The patient has a
difficult-to-heal nodular skin lesion in the cheek area that has lasted for about 10
years. In the past year, the lesion grew rapidly and became thicker than before.

After being excised, the pathology results showed Nodular basal cell carcinoma.
The prime etiological factor in the development of basal cell carcinoma is exposure to
UV light, particularly the UVB wavelengths, but UVA wavelengths can also be a
factor. A detailed review of the literature with meta-analysis and sensitivity analysis
show a significantly higher risk for outdoor workers, with an inverse relationship
between occupational UV exposure and BCC risk with latitude. The Fitzpatrick skin
type is a good predictor of the relative risk of BCC among White race individuals.

Cumulative UV dose and skin type are not sole predictors; exposure duration and
intensity, particularly in early childhood and adolescence, also plays a role in BCC
development. Recreational sunlight exposure and the use of indoor tanning salons are
a contributing factor for the development of BCCs. UV light therapy may also lead to
BCC occurrence. Intermittent intense sun exposure, as identified by prior sunburns; a
positive family history of BCC; a fair complexion, especially red hair; easy
sunburning (skin types I or II); and blistering sunburns in childhood are also risk
factors for the development of BCC.

Ultraviolet light exposure is not the only risk factor as 20% of BCC arise on non–sun-
exposed skin. BCCs also occur due to various other factors such as ionizing radiation
exposure, arsenic exposure, immunosuppression, and genetic predisposition. Some
genetic syndromes associated with an increased risk of BCCs are xeroderma
pigmentosum, basal cell nevus syndrome (also known as Gorlin syndrome),
Bazex–Dupre–Christol syndrome, and Rombo syndrome.

There is no association with diet, but smoking also appears to be a risk factor in

For more information, please visit : https://stamfordskin.com/en/dermatology/skin-

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