Characteristics and outcomes of nonmelanoma skin cancer (NMSC) in children and young adults.
BACKGROUND
Pediatric and young adult nonmelanoma skin cancer (NMSC) is rare and traditionally associated with predisposing heritable or congenital conditions. Clinical characteristics, outcomes, and iatrogenic risk factors have not been well described.


OBJECTIVE
We sought to characterize clinical features, potential risk factors, and gaps in care associated with NMSC in children and young adults.


METHODS
This was a retrospective chart review of children and young adults with squamous and basal cell carcinoma.


RESULTS
We identified 28 patients with a total of 182 NMSC tumors. Of patients, 50% had predisposing conditions, and 46% had exposure to iatrogenic risk factors of prolonged immunosuppression, radiation therapy, chemotherapy, voriconazole use, or a combination of these. Of patients with iatrogenic risk factors, 62% developed subsequent cancerous or precancerous skin lesions. No patient was found to have chemotherapy or voriconazole exposure as a sole risk factor. Mean time to diagnosis of NMSC was 948 days with initial misdiagnosis in 36% of patients. The majority of patients underwent surgical excision.


CONCLUSIONS
This was a retrospective single institution study with a small number of cases.


CONCLUSIONS
Physicians should be aware of risk factors associated with NMSC in children and young adults to provide appropriate counseling and early diagnosis and treatment.
Harvard Medical School, Boston, Massachusetts.
Hasan
H
Khosravi
Harvard Medical School, Boston, Massachusetts; Department of Pathology, Boston Children's Hospital, Boston, Massachusetts.
Birgitta
B
Schmidt
Harvard Medical School, Boston, Massachusetts; Dermatology Program, Division of Allergy and Immunology, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: Jennifer.huang@childrens.harvard.edu.
Jennifer T
JT
Huang
D000293:Adolescent; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D055815:Young Adult
basal cell carcinoma; nonmelanoma skin cancer; pediatric dermatology; prolonged immunosuppression; radiation therapy; squamous cell carcinoma