BackgroundBasal cell carcinoma (BCC) is the most common type of human cancer. Despite the high prevalence of these tumors, there is a lack of reliable epidemiological data in some regions including Iran.ObjectiveTo assess the relationship between BCC subtypes and anatomical distribution in the Iranian population.MethodsThere were 876 patients with a single BCC enrolled in this study (March 2007 to March 2010; Razi Dermatology Center, Tehran, Iran).ResultsAmong 876 patients, 544 were males and 332 females. Of the lesions, 43% were nodular, 32.4% mixed type, 3% superficial and rest of other subtypes. In the lesion location, 58.2% were on the face, 29.2% on scalp, 6.2% on ears, 2.3% on neck, 1.7% on trunk and 1.3% on the extremities. There was no significant difference between male and female in the BCC subtypes, but anatomical distribution of the tumor was different (p=0.002). Most of the trunk-arising BCCs were superficial, and most of the facial BCCs were nodular subtype. Also, most of the BCC subtypes occurred in patients between 40 to 80 years old and mostly on the face and scalp (p=0.04). However, superficial BCCs mostly occurred in younger patients over others (p=0.001).ConclusionSubtype is associated with a site, independent of gender or age. Also BCCs occurring on the trunk are mostly of the superficial subtype.

Background:There are limited data exploring the characteristics of mixed type basal cell carcinoma (BCC).Objectives:To explore different characteristics of mixed type BCC.Design:Cross sectional study.Materials and Methods:825 patients with BCC enrolled in this study.Results:Among 825 patients, 512 (62%) were male. Three hundred and fifty five (43%) presented with nodular subtype, 267 (32.4%) with mixed subtype, 25 with superficial and the 178 remaining presented with other subtypes. Four hundred and eighty three (58.6%) of the lesions were on the face, 243 (29.5%) on scalp, 52 (6.3%) on ears, 20 (2.4%) on neck, 15 (1.8%) on trunk and 12 (1.4%) on extremities. Anatomic distribution of mixed type was as follows: 137 on face, (51.4%), 100 (37.3%) on scalp, 19 (7%) on ear, 6 (2.1%) on neck, 4 (1.5%) extremity and 1 (0.7%) on trunk, which the difference from non mixed types was statistically significant (P = 0.002). The mean diameter of the mixed types and non mixed type BCCs were significantly different (2.7 ± 2.1 cm vs. 2.2 ± 1.6 cm; P = 0.01. The prevalence of necrosis in mixed type BCC was two times higher than non mixed type BCCs (OR = 2.3, CI 95% 1.3-3.9, P = 0.001). The most frequent combined subtypes were nodular-infiltrative (P < 0.001).Conclusion:Mixed type BCC has differences with other BCC subtypes in anatomical distribution and tumor diameter. Indeed, mixed type BCCs are frequently composed of aggressive subtypes than nonaggressive subtypes.

IntroductionSystemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis.Case presentationA 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis.ConclusionConsidering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.