Histologic patterns of basal cell carcinoma based upon patient immunostatus

Dermatol Surg. 1995 Jul;21(7):611-4. doi: 10.1111/j.1524-4725.1995.tb00516.x.


Background: The biologic behavior of basal cell carcinoma (BCC) seems to be dictated by the histologic subtype. Moreover, BCCs in immunosuppressed patients appear to show a more aggressive biologic behavior.

Objective: The purpose of this study was to retrospectively investigate different histologic subtypes of BCC to determine whether a particular subtype would predominate in immunosuppressed patients.

Methods: The histologic patterns of 112 primary BCCs from 77 immunosuppressed patients and 60 primary BCCs from 46 patients who are endogenously immunocompromised, due to diabetes mellitus and/or chronic renal failure, were examined. The results were compared with 488 primary BCCs of 318 immunocompetent patients.

Results: The nodular subtype was the predominant pattern among all patients. However, a statistical difference was found in the immunosuppressed patients in that there was a lower percentage of nodular pattern (P = .0038), and a higher percentage of infiltrative pattern (P = .0002). The higher frequency of the infiltrative pattern in the immunosuppressed group was particularly prominent among chronic alcoholics.

Conclusion: In immunosuppressed patients, the higher frequency of the infiltrative subtype of BCC, particularly among chronic alcoholics, may have a predictive role in the management of these cases.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Alcoholism / immunology
  • Carcinoma, Basal Cell / classification
  • Carcinoma, Basal Cell / immunology
  • Carcinoma, Basal Cell / pathology*
  • Connective Tissue Diseases / immunology
  • Diabetes Mellitus / immunology
  • Female
  • HIV Seropositivity / immunology
  • Humans
  • Immunocompetence
  • Immunocompromised Host*
  • Immunosuppression Therapy
  • Kidney Failure, Chronic / immunology
  • Lymphoproliferative Disorders / immunology
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasms / immunology
  • Retrospective Studies
  • Skin Neoplasms / classification
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology*