Superficial basal cell carcinomas of the head and neck.

BACKGROUND: Superficial basal cell carcinomas (BCC) are often considered a non-aggressive form of skin cancer, most often found on the trunk in younger patients.

OBJECTIVE: To determine the characteristics of superficial BCC of the head and neck.

MATERIALS AND METHODS: A retrospective review of patients undergoing Mohs micrographic surgery (MMS) for the treatment of a purely superficial BCC on the head and neck region was performed.

RESULTS: Superficial BCC occurred more commonly in women (66.5%) than men (33.5%), most often on chronically sun-exposed skin such as the central face and nose. Women developed superficial BCC at a younger age than men (58 vs 63 years old, p = 0.02). The clinical sizes of the tumors were significantly smaller than the final Mohs defects for all locations on the head and neck, excluding ears and scalp. Recurrence rates after MMS were 3.6% despite negative histologic margins at the time of surgery.

CONCLUSION: Superficial BCC are a unique subtype of BCC that tend to occur in younger patients, particularly women. Mohs surgeons need to be familiar with these tumors on the head and neck given their propensity for skip-lesions, higher recurrence rates, and significantly larger defect sizes than would be expected clinically.