Fuad Ahmad Khan Niazi, Muhammad Afzal Khan Niazi.
Periocular basal cell carcinoma: characteristics and distribution among patients.
J Rawal Med Coll Jan ;7(2):63-8.

Background: To identify various demographic and environmental risk factors in the causation of basal cell carcinoma and to document the various morphological characteristics of lesions seen in these cases. Methods: This retrospective study was conducted in the Department of Ophthalmology, Holy Family Hospital (HFH), Rawalpindi Medical College. Looking at past records from 1999 to 2003, 46 patients with BCC were identified. Data was collected on presentation, history, profile (age/sex), clinical features/types/sites of involvement/extent, treatment of the lesion, reconstruction, recurrence, cosmetic results and surgical complications. The lesions were treated by simple surgical excision with a tumor free margin based on clinical judgment of 3-5 mm. This was preceded by an incisional biopsy that included, if possible, a sample of both the margin and base of the lesion. Histopathology of this formed the basis of the initial diagnosis. Results: Of the 46 cases of BCC, 30 were males and 16 females. Regarding the clinical type of BCC, in 10 cases it was nodular, in 30 patients it was nodulo-ulcerative and in 6 patients morphoeic. The lower lid and adjacent lateral nasal skin was involved in 36 patients, the upper lid in 4 patients and medial canthus in 6 patients. None of the patients had BCC involving the lateral canthus. Ultra violet rays, fair colour and hot, dusty or dry environment were the common risk factors identified. Conclusions: Periocular Basal cell carcinoma in our region is a frequently diagnosed condition, which more commonly involves the older male population. It has a very likely association with increased exposure to sun and dry, dusty hot weather and fair color. People with agricultural background seem to be at increased risk. Lower lid involvement is the highest followed by the medial canthal region and the upper lid. Simple excisional biopsy with a 3-5mm clinically tumor free margin, followed by reconstruction and meticulous follow up is a good and safe method of treatment.

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