By Katherine Kozlowski, medical author and contributor to Vein News and VeinsVeinsVeins.com
Basal Cell Carcinoma (BCC) is responsible for about 90% of skin cancers, and is the most common human malignancy.
Only 1.7-4.5% of BCC occurs on the lower extremities, but BCC that does occur on the lower limbs is more common in women. Moreover, chronic venous insufficiency (CVI) is also more common in women.
Researchers from Brazil wanted to evaluate the role of CVI in the development and progression of BCC in the legs.
METHODS:
149 cases of patients diagnosed with BCC in the leg between January 1993 and December 2017 were included (46M:103F).
RESULTS:
71 patients in the cohort were diagnosed with CVI (47.6%).
Of these 71 patients diagnosed with BCC AND CVI, the clinical size of the tumors was larger than that of patients diagnosed with BCC but no CVI (average 28 mm vs 18 mm, respectively; p = .0024).
93.7% (15/16) of patients with recurrence of basal cell carcinoma were diagnosed with chronic venous insufficiency (p < .0001).
There is an association between CVI and histological (microscopic) findings of:
- Follicular induction of epidermis (differentiation/changes in follicular cells) and
- Sweat duct hyperplasia (enlargement of sweat ducts).
These two findings are known to be in association with more aggressive BCC.
CONCLUSIONS:
Many authors attribute the higher incidence of basal cell carcinoma in women to be resulting from gender-specific clothing styles and thus increased sunlight exposure to the legs.
As chronic venous insufficiency can result in stasis dermatitis, skin changes, and lymphatic dysfunction, it may be considered that these changes may have a relationship to the development of skin cancer. But, there is not enough evidence to support this conclusion and further research is warranted to investigate this.
However, the study concludes that CVI is most likely associated with more aggressive subtypes of BCC and there could be a relationship between CVI and BCC recurrence in the legs.
Reference:
Sala A. C. A., Crespo A. C. F, Stelini R. F. et al. Chronic Venous Insufficiency as a Predisposing Factor for Basal Cell Carcinoma on Legs. Ann Vasc Surg 2020; 68: 185-191.