Facial Basal Cell Carcinoma: A Study of Causative Factors and Site-based Algorithm for Surgical Reconstruction

Area of Science:

• Dermatology
• Surgical Oncology
• Plastic Surgery

Background:

• Basal cell carcinoma (BCC) is a common skin cancer with varied treatments.
• Sun exposure is a primary cause, but demographics like age, gender, and occupation influence incidence.
• Facial BCC requires specialized surgical management and reconstruction.

Purpose of the Study:

• To characterize patients undergoing surgical treatment for facial BCC at a tertiary hospital.
• To develop a decision-making algorithm for surgical management of facial BCC based on lesion location.
• To evaluate the outcomes of reconstructive procedures for facial BCC.

Main Methods:

• Retrospective chart review of facial BCC patients from 2018-2019.
• Data collected included demographics, sun exposure, occupation, residence, and surgical outcomes.
• Analysis of reconstructive techniques and patient outcomes.

Main Results:

• Facial BCC predominantly affected females (58.8%) and individuals from rural areas (70.6%).
• Fitzpatrick skin type 4 was significantly more common (P < 0.001).
• V-Y advancement flaps were most common (32.4%), with excellent outcomes and no flap failures or recurrence at 1 year.

Conclusions:

• A correlation exists between BCC incidence and factors like age, gender, and sun exposure in the Indian population.
• Local flaps provide excellent results for facial reconstruction in non-composite defects.
• The developed algorithm assists in surgical decision-making for facial BCC.