IntcrnaticHial Journal of Dermatology, Vol. 34, No. .3, March 1995 REPORT AGE AND SITE PREVALENCE OF HISTOLOGIC SUBTYPES OE BASAL CELL CARCINOMAS ROBERTO BETTI, M.D., ELENA INSELVINI, M.D., MAURO CARDUCCI, M.D., AND CARLO CROSTI, M.D. Abstract Background. Basal cell carcinomas (BCC) are the most fre- quently diagnosed skin cancers. The relationships between some clinical parameters, such as sex, age, and location of the tumor, and the histologic patterns play an important role as factors predictive of recurrence and treatment implications. Methods. A total of 693 patients with BCC, divided accord- ing to sex, age, and location of the tumor were studied. The histologic patterns considered were nodular, superficial, and morpheiform BCC and fibroepithelioma. The correlation between clinical and histologic parameters was analyzed. Results. All histologic patterns considered were most com- monly represented in the 7th and 8th decades. There were no sex differences. A prevalence of a superficial pattern for sun- unexposed areas and of a nodular pattern for sun-exposed areas was observed. The morpheiform pattern showed no correlation with any body site. The fibroepithelioma showed an absolute prevalence for the lumbosacral region. Conclusions. Age does not seem to be a discriminant or permissive factor for a particular histologic pattern of BCC. The prevalence of some subtypes for a particular body area may be explained on the basis of local predisposing condi- tions affecting the histologic development of the tumor. Int J Dermatol 1995; 34:174-176 Basal cell carcinomas (BCC) are the most frequent skin cancers,''^ comprising approximately 65% of all epi- thelial tumors. There is much confusion and debate re- garding their clinical or histologic classification. Some classifications are inadequate or deficient because of difficulties in their uniform application to clinical, der- mopathologic, and therapeutic purposes. We have adopted a simplified classification according to accept- ed histopathologic criteria' and have attempted to de- fine the relationships between some clinical parameters (i.e., location, sex, and age) and the histologic variants of BCC hoping to obtain additional information on their possible correlations. From the Dermatology Clinic IV, Hospital S. Paolo, Milan, Italy. Address for correspondence: Roherto Betti, M.D., Clinica Dermatologica IV, Ospedalc S. Paolo, Via di Rudini 8, 20142 Milano, Italy. Materials and Methods A total of 693 consecutive patients (aged 11-100 years) with primary BCC were studied in our clinic over a 5-year period. All tumors were histologically proven BCCS. The patients were di- vided into seven age groups by decades. According to site, the lesions were grouped into those of the head and neck, fur- ther divided into scalp, forehead, eyelid, temple, nose, cheek, chin, jaw, lip, and ear; torso; extremities; genitalia, and peri- anal region. Histologic patterns were defined according to simplified criteria and assigned on the basis of the consensus among the authors. The patterns recorded were: nodular type (including micronodular) (Fig. 1), superficial type (Fig. 2), mor- pheic type (including infiltrative) (Fig. 3), and fibroepithelioma (Fig. 4). The mixed type, consisting of variable combinations of the histologic patterns described above, was assigned ei- ther to the nodular or the morpheic type, according to its Figure 1. Nodular basal cell carcinoma. Masses of various sizes composed of basaloid cells. A peripheral palisade arrange- ment of the cells is seen. A cleft is also present, (hematoxylin and eosin, original magnification x 100) 174