Sex-specific differences in patients with nonmelanoma skin cancer of the pinna

Sex Disparity for Patients with Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review

The incidence of head and neck cutaneous squamous cell carcinoma (HNcSCC) is unevenly distributed between men and women. At present, the mechanism behind this disparity remains elusive. This study conducted a systematic review and meta-analysis of proportions to investigate the disparity between sexes for patients with HNcSCC. PubMed, Scopus, EMBASE, MEDLINE, Emcare and CINAHL were searched in November 2021 and June 2022 (N > 50, English, human), and studies which examined the association between sex and HNcSCC were included. Analysis was conducted using RStudio with data and forest plots displaying males as a proportion of total patients with HNcSCC. Two independent researchers performed study selection, data extraction, data analysis and risk of bias. Eighty-two studies (1948 to 2018) comprising approximately 186,000 participants (67% male, 33% female) from 29 countries were included. Significantly more males had HNcSCC overall (71%; CI: 67−74). Males were also significantly more affected by cSCC of the ear (92%; CI: 89−94), lip (74%; CI: 66−81), and eyelid (56%; CI: 51−62). This study found HNcSCC disproportionately affected males overall and across all subtypes. Improving our understanding of sex-specific mechanisms in HNcSCC will better inform our preventive, therapeutic and prognostic practices.

Malignant lesions of the ear

The dermatologic lesions of the external ear are quite protean and they encompass pre-malignant, malignant and inflammatory entities. The ear is endowed with functional and cosmetic importance and it is part of the "H-zone", which is the area of the head that generally presents tumors that can be considered high risk regardless of their size. As a matter of fact, skin malignancies of the ear tend to have a less benign course compared to the ones located on other areas of the body and complete excision has proven to be challenging. This mini-review provides an overview on the malignant cutaneous lesions of the external ear with a focus on their dermoscopic and reflectance confocal microscopy features. The most prevalent neoplasms of the auricle are squamous cell carcinoma and basal cell carcinoma followed by melanoma. These malignant lesions appear to be more common in men and to have a worse prognosis compared to when they arise from other body districts. There is a relative dearth of large studies centered on the clinical, dermoscopic and reflectance confocal microscopy features of skin cancers of the ear. Hence, further research inquiring into the specific dermoscopic and reflectance confocal microscopy characteristics of the cutaneous malignant lesions of the external ear, if any, are warranted for the future.

Sex-specific differences in patients with nonmelanoma skin cancer of the pinna

Background

Generally, it is known that men are affected more frequently by nonmelanoma skin cancer (NMSC) than women. The aim of our study was to investigate the effect of sex on the characteristics of NMSCs of the pinna at the population that our center serves and to compare it with the international data.

Methods

We analyzed retrospectively the data of 225 patients with NMSC of the pinna. Sex‐specific differences were investigated for basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) subgroups.

Results

The ratio of BCC to cSCC was determined in male patients at 1:1.3, in contrast in females it was identified at 4:1 (P = .001).

Conclusion

In our study, a new aspect of the sex‐dependent distribution of cSCC and BCC of the pinna was demonstrated. Women are affected four times more frequently by BCC than by cSCC, whereas in men this ratio is approximately equal.