Iatrogenic exposure, predisposing condition common among kids, teens with NMSC
Iatrogenic exposure or having a predisposing condition often correlates with nonmelanoma skin cancer (NMSC) in children or young adults, reports a recent study.
The multicentre, retrospective, case-control study included 124 paediatric NMSC patients (median age, 13.2 years; 53 percent male), most of whom had basal cell carcinoma (BCC; n=95; median age, 12.2 years; 54 percent female). Those with squamous cell carcinoma (SCC; n=40) were just as likely to be female (55 percent) but were older (median age, 14.1 years).
Most of the participants (70 percent; n=87) had at least one identifiable risk factor, such as a genetic condition (44 percent), skin lesion (10 percent) and/or iatrogenic exposure (29 percent), while the remaining 30 percent did not. The most common genetic conditions in the BCC and SCC subgroups were basal cell nevus syndrome and xeroderma pigmentosum, respectively.
In terms of iatrogenic risk factors, SCC patients were significantly more likely to have undergone prolonged immunosuppression (30 percent vs 0 percent; p=0.0002) or received voriconazole (15 percent vs 0 percent; p=0.026) than age- and sex-matched controls. In the BCC subgroup, radiation therapy (20 percent vs 1 percent; p≤0.0001) or chemotherapy (20 percent vs 1 percent; p<0.0001) were significantly more common than in matched controls.
There were six deaths overall: three in the SCC group and two in the BCC group. One patient with both SCC and BCC died. Skin cancer-related or associated therapies were responsible for one death. Survival rate was significantly lower in those who were treated with voriconazole (p=0.001).