Skin tumors in patients aged 90 years and older

The aging of the population in the developed world is an accepted fact. Consequently, the number of patients aged 90 years or over with cutaneous cancer will increase in coming years.

The objective was to determine the nature of skin lesions amenable to dermatologic surgery in patients aged 90 years or more.

We studied the clinical histories of 52 outpatients in their 90 s, who had had histopathologic studies made of their skin tumors when attended in the Hospital General de Alicante (Spain) between January 1999 and July 2002. We studied sex, age, type of tumor, site, associated disorders, regular medications, type of anesthesia, and type of treatment given.

The average age of the patients was 92.4 years. Thirty-six patients were women and 16 were men. Altogether the 52 patients had a total of 72 lesions. The most frequent diagnosis was basal cell carcinoma with 36 lesions, followed by 20 squamous cell carcinomas. The overall ratio of basal cell carcinoma to squamous cell carcinoma was 1.8. Patients had an average of 1.5 comorbid medical conditions and were taking an average of 2.3 regular medications.

Dermatologists often attend patients aged 90 years or over with nonmelanoma skin cancer. The most important decision is as to what is the best management of these patients.