View 2019 Abstracts

Basal cell carcinoma (BCC) is the most common skin tumour of the head and neck typically affects the elderly. We aim to highlight the features of disease of periocular BCC in those under the age of 40 with respect to histological subtype and recurrence. Furthermore, we demonstrate the efficacy of managing this cohort of patients within a Mohs micrographic service in a multidisciplinary approach.

A retrospective case notes review of all patients under the age of 40 undergoing periocular BCC excision and reconstruction over a 5 year period. All patients underwent excision under the same dermatological surgeon. Once all surgical margins were histologically clear of tumour all patients same day reconstruction under the oculoplastic service.

Over a 5 year period a total of 11 patients under the age of 40 (average age 32) were identified with periocular BCC who underwent excision and reconstruction within our Mohs service. Nine patients (81%) were found to have a nodular histological subtype with one patient found to have both nodular and infiltrative and one patient infiltrative only. One patient had no residual tumour following punch biopsy. There were no reported cases of recurrence with an average follow up of 8.5 months.

Previous series in the literature from the UK have reported a BCC recurrence rate as high as 23.1% in their under 40 years cohort. 81% of tumours in this age group are of nodular subtype that are often well circumscribed with well defined borders. In such cases excising tumours with less than 3mm surgical margins is common practice. Managing this cohort of patients within a Mohs service results in negligible recurrence rates and also results in cost saving of greatly reduced follow up.