Basal cell carcinoma and its subtypes in Iraqi population

Background: Basal cell carcinoma (BCC) is the most common skin malignancy; accounting for up to 80% of all cancers arising from the epidermis. And it is the most common malignancy in the white population worldwide, Accounts for approximately 75% of all skin cancers (1). BCC is a slow-growing and locally invasive skin tumor which rarely metastasizes, derived from cells of the basal layer of the epidermis (2). Objective: to show the incidence of the basal cell carcinoma and which common type in Iraqi patients. Patients and methods: Thirty nine patients with basal cell carcinoma were enrolled in Department of Dermatology&Venereology-Baghdad Teaching Hospital, Medical City, Baghdad, Iraq, from January 2010 to October 2011. A history was taken from each patient regarding the following: age, sex, occupation, smoking, alcoholic intake, and duration of the lesions and their number, recurrence of the lesion, history of previous therapy, family history, past medical history, past surgical history, past radiation history, drug history, and association conditions. Detailed history and Close physical examination was performed including location, size, number, type and color of the lesion, regional lymphadenopathy, and photodamaged skin. Shave, incision or punch biopsies were done for all patients at the first visit for Histological examination, and Serial-section skin biopsies were stained with hematoxylin& eosin. Results: Thirty nine patients with basal cell carcinoma were enrolled in this study proved clinically and Histological; 32 (82%) males and 7 (18%) females with males to females ratio 4:1, their ages ranged from 30-87 with a mean and SD of 64.114 ± 12.68 years, and the duration of the disease ranged from 2 months to 30 years. The total number of the lesions was 62 lesions as follow: pigmentonodular BCC 33 (53.2%), pigmented BCC 17 (27.42%), superficial BCC 4 (6.45%), ulcerative BCC 3 (4.83%) asosquamous carcinoma 2 (3.22%), ulcerative BCC 2(3.22) and morpheaform BCC 1 (1.6%). Eighty eight percent of the lesions of BCC were located on the head: face 45 (72.6%) ,scalp 10 (16.12%) of the total lesions and the rest of the lesions 7 (11.3%) distributed on the different sites of the body: (neck 2 lesions, back 2 lesions, chest 1lesion forearm 1 lesion, dorsum of the hand 1 lesion). Conclusion: pigmentonodular (53.2%) and pigmented BCC (27.42%) are the most common subtypes of BCC in Iraqi patients.In general, there is an increase in incidence of skin cancers in Iraqi population in last few years. Nonetheless, the most reliable way to reduce the chronic effects of solar radiation is limit the exposure. The regular use sunscreen has been suggested to reduce the UVB-induced skin changes as well as the number of nonmelanoma skin cancers.