Discordance between facial wrinkling and the presence of basal cell carcinoma

Background: During routine surgical treatment of basal cell carcinomas (BCC s), we observed an apparent inverse relationship between the presence of a BCC and significant wrinkling of the face. To ascertain the veracity of thi s observation, we performed a clinical and questionnaire-based case-referen t study. Observation: One hundred eighteen successive white patients (mean+/-SD age, 71.9+/-9.5 years) attending the hospital for surgical treatment of a BCC a nd 121 control (no skin cancer) patients (mean+/-SD age, 69.1+/-10.8 years) were assessed for grade of facial wrinkling using a previously validated p hotonumeric scale of photoaging and completed a questionnaire about sun exp osure. Despite being older (P=.03), patients with a BCC were found to have a lower mean grade of wrinkling than controls (P=.001). Using logistic regr ession, increasing grade of wrinkling was associated with a progressive red uction in risk of developing a BCC. Conclusion: Mechanisms responsible for the production of facial wrinkles ma y either be separate to or mitigate against the development of a BCC of the face.