Discordance between facial wrinkling and the presence of basal cell carcinoma.

BACKGROUND During routine surgical treatment of basal cell carcinomas (BCCs), we observed an apparent inverse relationship between the presence of a BCC and significant wrinkling of the face. To ascertain the veracity of this observation, we performed a clinical and questionnaire-based case-referent study. OBSERVATION One hundred eighteen successive white patients (mean +/- SD age, 71.9 +/- 9.5 years) attending the hospital for surgical treatment of a BCC and 121 control (no skin cancer) patients (mean +/- SD age, 69.1 +/- 10.8 years) were assessed for grade of facial wrinkling using a previously validated photonumeric scale of photoaging and completed a questionnaire about sun exposure. Despite being older (P =.03), patients with a BCC were found to have a lower mean grade of wrinkling than controls (P =.001). Using logistic regression, increasing grade of wrinkling was associated with a progressive reduction in risk of developing a BCC. CONCLUSION Mechanisms responsible for the production of facial wrinkles may either be separate to or mitigate against the development of a BCC of the face.