Korean J Dermatol.  2021 Dec;59(10):735-741.

Clinicopathological Characteristics of H-Zone and Non-H-Zone Basal Cell Carcinoma in the Head and Neck Region

• Shon U
• Yeom K
• Yun DK
• Kim MH
• Choi MS
• Park BC

Abstract

Background
Basal cell carcinoma (BCC) is the most common type of skin cancer. However, limited comparative data on the characteristics and prognosis of BCC in the H-zone and non-H-zone exist.
Objective
We aimed to compare the clinical, histopathological, and surgical characteristics of BCCs in the head and neck region between the H- and non-H-zones.
Methods
We retrospectively reviewed the clinical and histopathological characteristics of 292 head and neck BCC lesions in 275 patients and the characteristics of Mohs micrographic surgery (MMS) of 252 BCC lesions in 239 patients.
Results
In the H-zone, 226 lesions (77.4%) were found. Clinically, patients with H-zone BCC, compared to those with non-H-zone, were significantly older (71.6±11.4 years vs. 64.6±13.5 years) and smaller in diameter (10.1±7.1 mm vs. 12.4±9.9 mm). The noduloulcerative type was more frequent in the H-zone, while the superficial and morpheaform types in the non-H-zone. Histopathologically, the infiltrative subtype was particularly noted in the H-zone than the non-H-zone (7.5% vs. 1.5%). Out of 37 BCC patients with prior treatment history, 31 (83.8%) were in the H-zone. Two out of 252 lesions (0.8%) recurred after MMS at our institution. The mean stages of MMS were comparable between the H- and non-H-zones (1.59 vs. 1.45, p=0.135).
Conclusion
H-zone BCCs were associated with older age and smaller tumor size compared to the non-H-zone BCCs. The noduloulcerative clinical and nodulocystic pathologic subtypes were the most common in both H-zone and non-H-zone BCCs.

Keyword

Basal cell carcinoma; Head and neck neoplasms; H-zone; Mohs micrographic surgery