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Do Wrinkles Protect Against Basal Cell Carcinoma?
Basal cell carcinomas (BCCs) are associated with extensive cumulative exposure to ultraviolet radiation, as are significant rhytids. The authors of this English study noticed that patients with BCC seemed to have smooth, unwrinkled skin. They compared 118 consecutive white patients who presented with BCC to one hospital's dermatology clinic and 121 white control subjects who were seen in other hospital departments with diagnoses other than BCC. The mean age of the BCC patients was 72 and of the controls, 69.
Although older, patients with BCC had lower mean grades of wrinkling than controls did. After adjusting for age, sex, and smoking history, the investigators found that a higher wrinkling grade was associated with a lower likelihood of developing BCC. The maximum protective effect was observed in subjects whose wrinkle grade was 5, of a maximum grade of 8. These patients were 90 percent less likely to have a BCC than were subjects with lower wrinkle scores.
Comment: The inverse relation between wrinkling and BCCs seems counterintuitive but confirms what dermatologists have seen in practice. Many factors may contribute to these findings, including control-group selection and differences in genetic tendency, UVA versus UVB exposure, and sun damage repair mechanisms. The validity of these findings awaits confirmation by additional controlled studies. At least we can now give both our wrinkled patients and our BCC patients some good news.
GJ Hruza
Published in Journal Watch Dermatology August 1, 2001
Citation(s):
Brooke RCC et al. Discordance between facial wrinkling and the presence of basal cell carcinoma. Arch Dermatol 2001 Jun 137 751-754.
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