Nemer Kathleen M, Bauman Tyler M, Boyd Alan S
Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri.
Division of Dermatology, Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee.
Dermatol Surg. 2018 Nov;44(11):1373-1378. doi: 10.1097/DSS.0000000000001541.
Basal cell carcinoma (BCC) is the most common malignancy in the United States and is more prevalent in older populations.
The aim of this study was to investigate BCC risk factors in male patients younger than 40 years.
A consecutive series of male patients with pathology-proven BCC and younger than 40 years at time of diagnosis were retrospectively identified along with matched controls. Phone interviews were conducted using a structured questionnaire, and differences between patients with and without BCC were investigated.
A total of 50 patients with BCC and 27 controls were included in this study. Compared with controls, patients with BCC worked outdoor jobs for longer lengths of time (43.2 vs 15.6 months; p = .04), were more likely to have a family history of skin cancer (66% vs 44%; p = .02), and were more likely to use sunscreen heavily after biopsy (p = .02). Patients with multiple BCCs (n = 20) were more likely to have a history of substantial recreational sun exposure (p = .01) than patients with solitary lesions (n = 30).
The authors conclude that outdoor sun exposure in patients with underlying genetic susceptibility is the most likely mechanism of BCC formation in young male patients.
基底细胞癌（BCC）是美国最常见的恶性肿瘤，在老年人群中更为普遍。
本研究旨在调查40岁以下男性患者的基底细胞癌风险因素。
回顾性确定一系列经病理证实为基底细胞癌且诊断时年龄小于40岁的男性患者以及匹配的对照组。使用结构化问卷进行电话访谈，调查有和没有基底细胞癌患者之间的差异。
本研究共纳入50例基底细胞癌患者和27例对照组。与对照组相比，基底细胞癌患者从事户外工作的时间更长（43.2个月对15.6个月；p = 0.04），更有可能有皮肤癌家族史（66%对44%；p = 0.02），并且活检后更有可能大量使用防晒霜（p = 0.02）。与单发基底细胞癌患者（n = 30）相比，多发基底细胞癌患者（n = 20）更有可能有大量休闲日光暴露史（p = 0.01）。
作者得出结论，在具有潜在遗传易感性的患者中，户外阳光暴露是年轻男性患者基底细胞癌形成的最可能机制。
