Korean J Dermatol.  2024 Feb;62(2):77-81.

Clinical and Histological Features of Basal Cell Carcinoma in Patients Exposed to Agent Orange during the Vietnam War

• Lee D
• Baek J
• Kim A
• Kang HJ

Abstract

Background
Agent Orange, an herbicide sprayed during the Vietnam War, is a known carcinogen. However, there have been no studies on its association with basal cell carcinoma (BCC) or the nature of BCC in defoliant-exposed patients.
Objective
To determine the clinical and histological characteristics of BCC in patients exposed to defoliants.
Methods
Chart analysis was performed on patients diagnosed with BCC at Veterans Health Service Medical Center from January 2011 to December 2020. The clinical data were compared between the defoliant-exposed and non-exposed groups. Histopathological characteristics were compared according to histological subtype and presence of pigmentation.
Results
Of 227 patients with BCC, 117 were defoliant-exposed and 110 were unexposed. The mean age at diagnosis of skin cancer was 73.9 years. The age at diagnosis was significantly lower in the defoliant-exposed group than in the unexposed group (71.3 years vs. 76.7 years, p＜0.001). In most cases, BCC was identified as pigmented papules and nodules on the face. Nonpigmented lesions were observed more frequently in the defoliant-exposed group than in the unexposed group; however, this difference was not statistically significant. Histologically, the nodular type was the most common subtype in both groups. Additionally, 33.3% of the defoliant group and 25.9% of the control group showed melanin pigmentation, and no statistically significant difference was observed in tumor depth between the two groups.
Conclusion
As veterans of the Vietnam War advance in age, dermatologists should continuously pay attention to BCC in defoliant-exposed patients, and early diagnosis and proper management should be ensured.

Keyword

Agent Orange; Basal cell carcinoma; Skin neoplasms