title: Histologic patterns of basal cell carcinoma based upon patient immunostatus.
abstract: BACKGROUND
  The biologic behavior of basal cell carcinoma (BCC) seems to be dictated by the histologic subtype. Moreover, BCCs in immunosuppressed patients appear to show a more aggressive biologic behavior.
  
  
  OBJECTIVE
  The purpose of this study was to retrospectively investigate different histologic subtypes of BCC to determine whether a particular subtype would predominate in immunosuppressed patients.
  
  
  METHODS
  The histologic patterns of 112 primary BCCs from 77 immunosuppressed patients and 60 primary BCCs from 46 patients who are endogenously immunocompromised, due to diabetes mellitus and/or chronic renal failure, were examined. The results were compared with 488 primary BCCs of 318 immunocompetent patients.
  
  
  RESULTS
  The nodular subtype was the predominant pattern among all patients. However, a statistical difference was found in the immunosuppressed patients in that there was a lower percentage of nodular pattern (P = .0038), and a higher percentage of infiltrative pattern (P = .0002). The higher frequency of the infiltrative pattern in the immunosuppressed group was particularly prominent among chronic alcoholics.
  
  
  CONCLUSIONS
  In immunosuppressed patients, the higher frequency of the infiltrative subtype of BCC, particularly among chronic alcoholics, may have a predictive role in the management of these cases.
authors.affiliation: Department of Dermatology, VA Medical Center, Houston, Texas, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Oram
authors.forename: I
authors.initials: I
authors.lastname: Orengo
authors.forename: R D
authors.initials: RD
authors.lastname: Griego
authors.forename: T
authors.initials: T
authors.lastname: Rosen
authors.forename: J
authors.initials: J
authors.lastname: Thornby
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000276:immunology; D002280:Basal Cell Carcinoma / Q000145:classification / Q000276:immunology / Q000473:pathology*; D003240:Connective Tissue Diseases / Q000276:immunology; D003920:Diabetes Mellitus / Q000276:immunology; D005260:Female; D006679:HIV Seropositivity / Q000276:immunology; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009369:Neoplasms / Q000276:immunology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000145:classification / Q000276:immunology / Q000473:pathology*