title: Discordance between facial wrinkling and the presence of basal cell carcinoma.
abstract: BACKGROUND
  During routine surgical treatment of basal cell carcinomas (BCCs), we observed an apparent inverse relationship between the presence of a BCC and significant wrinkling of the face. To ascertain the veracity of this observation, we performed a clinical and questionnaire-based case-referent study.
  
  
  METHODS
  One hundred eighteen successive white patients (mean +/- SD age, 71.9 +/- 9.5 years) attending the hospital for surgical treatment of a BCC and 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 photonumeric scale of photoaging and completed a questionnaire about sun exposure. 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 regression, increasing grade of wrinkling was associated with a progressive reduction in risk of developing a BCC.
  
  
  CONCLUSIONS
  Mechanisms responsible for the production of facial wrinkles may either be separate to or mitigate against the development of a BCC of the face.
authors.affiliation: Dermatology Centre, Hope Hospital, The University of Manchester, Salford, Manchester M6 8HD, England.
authors.forename: R C
authors.initials: RC
authors.lastname: Brooke
authors.forename: S A
authors.initials: SA
authors.lastname: Newbold
authors.forename: N R
authors.initials: NR
authors.lastname: Telfer
authors.forename: C E
authors.initials: CE
authors.lastname: Griffiths
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D004739:England / Q000453:epidemiology; D005153:Facial Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D015595:Skin Aging / Q000473:pathology*; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires