Scalp Lesions Referred For Surgical Procedures: Single-Center 5-year Experience in Southwestern Poland

Abstract

Background/Aim: The head is a body site with a particular predisposition to skin malignancies due to exposure to UV radiation. The aim of the study was to better elucidate the characteristics of skin lesions that develop on the scalp. Patients and Methods: A retrospective review of all excised and histologically assessed lesions of the scalp at a single dermatosurgery unit throughout a fiveyear period was performed. Demographic features and lesion characteristics were compiled and analyzed. Results: Among 5,601 procedures during the analyzed period, 293 were performed on lesions on the scalp area (5.2%) with a mean patient age of 66±19.7 years. The defects were closed, mainly using primary closure, followed by skin grafts, and, least often, flaps (65.1%, 28.5%, 4.9%, respectively). Two thirds of the excised scalp lesions were histologically confirmed as malignant scalp tumors (mostly basal cell carcinomas followed by squamous cell carcinomas). Conclusion: The vast majority of scalp lesions referred for surgical procedures appeared to be malignant. Therefore, dermatologists should pay special attention to the scalp by examining it thoroughly, as the lesions may be hidden by hair. The head is a body site with a particular predisposition to skin malignancies (1-3). This is due to its frequent exposure to ultraviolet radiation (UV). Tumors in the area of the scalp may be overlooked due to long hair or their occipital or postauricular location. Additionally, UV exposure of the frontal area as well as other scalp areas in patients with androgenetic alopecia is very high (1, 3). This study aimed to provide the characteristics of a group of subjects treated at the Dermatosurgery Unit of the Department of Dermatology, Venereology and Allegrology of Wroclaw Medical University in Poland for scalp lesions with particular reference to age, sex, amount, location and surgical methods of treatment.

Spectrum of malignant scalp tumours and its impact on management—a tertiary care cancer centre experience

“…The most common histology in this study was SCC, followed by sarcoma. Melanoma is one of the most commonly detected scalp malignancies in Western populations, but none was seen in this study group [ 8 , 9 ]. We found that scalp tumours are more common in middle-aged adults than in older people, according to Western literature [ 7 ].…”

“…The most common malignancies in Western populations are cutaneous malignancies, particularly BCC and SCC [ 2 , 7 , 8 ]. The most common histology in this study was SCC, followed by sarcoma.…”

Basal cell carcinoma of the scalp shows distinct features from the face in Asians

“…Some studies explained the male predominance of scalp BCC with a higher incidence of androgenetic alopecia among males 14 , 19 . According to the recent study conducted by Chlebicka et al, skin lesions on the scalp including BCC mainly occurred in the frontal, temporal, and apex area of the scalp in Caucasian population, which are the commonly affected areas by androgenetic alopecia 20 . Thus, a lower prevalence of androgenetic alopecia among Korean males compared with Caucasians might also partially explain this result 21 .…”

Dyed basal cell carcinoma: A peculiar clinical and histopathological case

“…Moreover, BCC is usually the most frequent type of scalp cancer in epidemiological analysis. 2 The main risk factors for the development of BCC include chronic sun exposure, radiation therapy, and immunosuppression. So far, the relationship between the use of hair dye and the presence of BCC has not been proven; however, many of aromatic amide derivates contained in these products are known to have mutagenic effect.…”