Topographic analysis of head skin cancers: eight-year observations

Introduction
Keratinocyte carcinomas (KCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are common skin malignancies with a growing incidence in Poland.

Aim
The aim is to generate a face map involving topography and frequency of KCs in particular anatomical areas.

Material and methods
A group of 649 patients with 786 head skin cancers treated at the Department of Plastic, Reconstructive, and Aesthetic Surgery (Lodz, Poland) were enrolled in 2017–2024. The following variables were analysed: sex, age, type of skin cancer, BCC subtype, SCC grading, and anatomical location of the lesions.

Results
Facial skin cancers were located primarily in the nasal (n = 205, 26.1%), orbital (n = 175, 22.3%) and cheek area (n = 154, 19.6%). BCC was the most common skin cancer (n = 664, 84.5%), and the nodular subtype was dominant (n = 503 cases, 75.8%). SCC was diagnosed in 111 (14.1%) cases, and grade 1 was the most frequent (n = 42, 37.8%). SCC was significantly more frequent than BCC in the auricular, cheek and scalp area. BCC predominated significantly over SCC in the nasal and orbital area. The lower eyelid was the most frequently affected orbital subregion (63.4% of BCCs and 72.7% of SCCs).

Conclusions
BCC is the most common skin cancer on the face. Among facial KCs, BCC is more frequent in nasal and periorbital areas, while SCC has a predilection for auricular and scalp regions. These findings underscore the importance of the anatomical site in the clinical assessment and diagnosis of skin cancers.