Abstract
Purpose :
Basal cell carcinoma (BCC) is the most frequent malignant tumor of the eyelid. Basal cell carcinoma, morphea-type (sclerosing type) has a rate of recurrence much higher than the other histopathological types of this particular tumor. The frequency of BCC is more prevalent in the lower eyelid compared to the upper eyelid. UVA radiation penetrates deep through the epidermis and provokes actinic degeneration, particularly in the fibroblasts of the superficial dermis of the lower eyelid. This study aims to address the relationship between UV radiation and basal cell carcinoma of the eyelid.
Methods :
A total of 1464 patients from Canada, Brazil, Mexico, Chile and Venezuela with BCC of the eyelids were studied and location of the tumor was recorded (lower and upper eyelid). From this cohort of 1464, 1000 patients with the pathological diagnosis of basal cell carcinoma of the lower eyelid were evaluated for histopathological type of the BCC and extension of the actinic damage. A total of 493 benign lesions of the eyelid were also evaluated for the extension of the actinic damage. The actinic damage was graded in 0 (absence), 1 (mild) and 2 (intense). In all histopathological slides of BCC, the presence of in-situ BCC was evaluated.
Results :
In Canada, 80-87% of the 813 BCC were located in lower eyelid. Similarly, 88% of the 384 BCC from Mexico and 81-85% of the 267 BCC from South America were located in the lower eyelid. Of the 1000 lower eyelid BCC, 89% had severe actinic damage and 11% had moderate actinic damage. In comparison, 93% of the 493 benign lesions of the eyelid had no actinic damage and 7% had mild actinic damage. In all cases of BCC, in-situ phase of this tumor was not observed.
Conclusions :
These results confirm that basal cell carcinoma of the lower eyelid is a UV induced cancer. The Actinic damage in Basal cell Carcinoma resulting in DNA damage of the fibroblasts of the dermis is the hallmark feature for the development of invasive BCC, in particular BCC sclerosing type in the lower Eyelid (ABCDE concept).
This is a 2020 ARVO Annual Meeting abstract.