INTRODUCTION Similar rates were reported in a population-based

study in Olmsted County, Minnesota 7, while higher

Basal cell carcinoma is the most common skin
cancer occurring four to five times as frequent as
squamous cell carcinoma1.
It often presents as a pink, pearly macule,
papule, nodule or plaque with rolled borders and
accompanying telangiectasias on sun-exposed skin of
older adults, particularly involving the head, neck,
trunk or less frequently the proximal extremities.
Although fair skinned individuals are most commonly
affected, it can occur in darker skin types.
Interestingly, it has been observed that BCCs
vary with geography: research suggests that the
closer that Caucasians live to the equator, the greater
the risk of developing BCCs2.
Estimates of the incidence of BCC are
imprecise since in most countries there is no cancer
registry that collects data on BCC 3. The American
Cancer society estimates that in 2012, 5.4 million
cases of nonmelanoma skin cancers (NMSCs) were
diagnosed in 3.3 million people, of which
approximately 8 in 10 cases would have been BCC 4. A
population-based study estimated that 3.5 million
NMSCs were treated in the United States in 2006 5.
One study using data from a commercially insured
population in the United States estimated an age-
adjusted incidence and prevalence of BCC of 226 and
343 per 100,000 persons per year, respectively 6.
1
Clay Cockerell, Martin C. Mihm Jr., Brian J. Hall Cary Chisholm, Chad Jessup,
Margaret Merola; with contributions from: Jerad M. Gardner,Talley Whang:
Dermatopathology Clinicopathological Correlations, 2014, pp 307
2
Diepen TL, Mahler V. The epidemiology of skin cancer. Br J Dermatol.
2002;146 Suppl 61:1-6.
3
Verkouteren JAC, Ramdas KHR, Wakkee M, Nijsten T, Br J Dermatol:
Epidemiology of basal cell carcinoma: scholarly review, 2017;177(2):359, pub
2017 Feb 20.
4 7
American Cancer Society. Key Statistics for Basal and Squamous Cell Skin
Cancers. https://www.cancer.org/cancer/basal-and-squamous-cell-skin-
cancer/about/key-statistics.html (Accessed on October 22, 2021).
5 Population-Based Study in Olmsted County, Minnesota, 2000 to 2010.
Rogers HW, Weinstock MA, Harris AR, Hinckley MR, Feldman SR, Fleischer
AB, Coldiron BM: Incidence estimate of nonmelanoma skin cancer in the
United States, 2006, PubMed
6 Wu S, Han J, Li WQ, Li T, Qureshi AA Am J Epidemiol: Basal-cell carcinoma
Goldenberg G, Karagiannis T, Palmer JB, Lotya J, O'Neill C, Kisa R, Herrera V,
Siegel DM, J Am Acad Dermatol. Incidence and prevalence of basal cell
carcinoma (BCC) and locally advanced BCC (LABCC) in a large commercially
insured population in the United States: A retrospective cohort study,
2016;75(5):957. Epub 2016 Jul 26. PubMed
rates were estimated in the Nurses' Health Study
(1986 to 2006) and Health Professionals Follow-up
Study, where the age-adjusted BCC incidence rates
were 519 cases per 100,000 person-years in females
and 606 cases per 100,000 person-years in males.
Over a 20-year follow-up period, the incidence of BCC
increased to 1019 cases per 100,000 person-years
and 1488 cases per 100,000 person-years in female
and male patients, respectively 8.
In this study, we aimed to reveal our data in
Sivas Cumhuriyet University, Medical Faculty,
Depeartment of pathology for pre-covid19 and post-
covid19 over a period of 14 months according to skin
tumors location, age, and their ratio to genders.
Material and Methods
There are 322 bbbbbb b cases was diagnosed
as skin tumors. One hundred and fifty-three patients
with basal cell carcinoma who had surgical operations
or incisional and excisional biopsies between January
2019 and May 2021 were included. From a statistical
point of view, referring only to the esantion from the
Sivas Cumhuriyet Üniversitesi , our findings were
evaluated from SCÜ de archivesretrose. Regarding
women, we notice a decrease in the percentage from
41% before the pandemic to 37% after the pandemic.
The situation does not change in the case of men, the
number of cases being very close to the value before
the pandemic (Fig.1).
Muzic JG, Schmitt AR, Wright AC, Alniemi DT, Zubair AS, Olazagasti Lourido
JM, Sosa Seda IM, Weaver AL, Baum CL Mayo Clin Proc: Incidence and Trends
of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma: A
2017;92(6):890. Epub 2017 May 15. PubMed
8
incidence and associated risk factors in U.S. women and men,
2013;178(6):890. Epub 2013 Jul 4. PubMed

1
 In a more detailed analysis of the cases from the
point of view of the gender related to time intervals
The number of cases is observed as follows (Fig.3,4).
before and after the pandemic

female male The number of cases pre-pandemic depending on

50 gender + general
45 47 35
46
40 30 29
35 25
30 32 20 19
25 28 15
15 13 12
20 10 10
15 10 7 8
5 4 5 5 7
10 5
5 0 3 2 2
0 030-39
0 0 40-49 50-59 60-69 70-79 80-89 90-100
0
pre-pandremic post-pandemic years years years years years years years

Fig. 1 - The number of cases before and after the pandemic

male female general

Results Fig.3 - The number of cases pre-pandemic depending on

gender + general
Following the analysis of the esantion of
patients from the SCÜ Pathology Department, several
Before the pandemic, from the gender perspective, it
results findings as follows.
is observed there is a predilection for male patients
The number of cases before and after the pandemic comparing to female. At the same time, the diagnosis
did not register a significant change, the esantion was most common for both women and men in the
being very close, respectively 78 were diagnosed 70-79 age range, with an increasing trend for the age
before the pandemic and 75 received the diagnosis of ranges of 50-59 and 60-69 years old (Fig.3,4). We
basal cell carcinoma after the pandemic (Fig.2). note that the most common age in this type of
interval is 76 years old.
The number of cases
before and after the pandemic
The number of cases post-pandemic depending on
post- gender + general
pan-
demic 30 28
pre-
49% pan- 25
demic 19
51% 20
16 16
15 12
10 9 10
10 7
6
5 4 4 3
101 22
000
Fig.2- The number of cases before and after the pandemic 0
30-39 40-49 50-59 60-69 70-79 80-89 90-100
years years years years years years years

From the point of view of gender distribution, male female general

a marked presence of the diagnosis can be observed
Fig.4 - The number of cases post-pandemic depending on
in the case of male persons with a percentage of 59%
gender + general
and 62% both before and after the pandemic (Fig.1).

2
 The situation does not change even after the Regarding the location of tumors, certain
pandemic, we observe this both from the perspective locations are evident both before and after the
of gender and age. The diagnosis is again with a pandemic, including: the dorsal part of the nose, the
predilection for men and in the same age ranges, the alar nose, the auricular area, canthus area.
highest incidence being between 70-79, again with an Before the pandemic, it can be observed that
increasing trend in 50-59, 60-69. In this case, the most tumors are located at the level of the dorsal
most diagnosed people were 71 years old. parts of the nose 13%, and auricular area 17%.
Post-pandemic we observe the presence of a
single male patient in the age range of 30-39 years, The situation after the pandemic changes, so
which is interesting from the perspective of this type the main locations are of the dorsal parts of the nose
of cancer, it being found with a predilection for the but in a much more significant percentage ,24%, also
older people (Fig.4). in the alar nose area 15%.
au-
ricu- the
Tumor localizations pre-pandemic
lar dorsal can-
area part thus
scalp alar noseof the
18% 8% 10% nose area
12%
13%
nose
tip
4%
other
parts
- thaigh
- eyebrow
- maxillary
-gluteal
-perianal
other un- -back
parts malarupper
dereyforeheadnasolabial
- eyelid
8% es 5% 5% 9% lip
5%
4%
Fig.5 - Tumor localizations pre-pandemic

Post-pandemic BCC localizations

Medial
Canthus
Auricular ScalpAlar Nose5%
Fore-had
Other
8% 4% 15%
10% 7%

Cervical
Region
Under-
5%
eye
Lateral
5%
Eyebrow
Eyelid
4%
4%
Nose Tip Dorsal
4% Nasalabial part of
5% nose
Other
24% -dorsal hand
Fig.6 - Post-pandemic BCC localizations-maxillary area
- thigh
-labium major
-upper lip
- arm
- back
3
 Discussions
These tumors have been referred to as
"epitheliomas" because of their low metastatic
potential. However, the term carcinoma is
appropriate since they are locally invasive,
aggressive, and destructive of skin and the
surrounding structures, including bone9.

It rarely occurs in children, but when present

is often associated with a syndrome (basal cell nevus
syndrome, Bazex syndrome, Rombo syndrome,
xeroderma pigmentosum) or nevus sebaceous10.
The incidence is unfortunately increasing,
with the overall incidence significantly rising across
the globe by about 3 to 10% annually 11. Squamous
cell carcinomas represent about 20%, and BCCs
represent 80% of non-melanoma skin cancers. The
development of BCC is strongly linked to exposure to
ultraviolet radiation, with the UV exposure resulting
in cumulative DNA damage and gene mutations. The
rising incidence of BCCs has also been attributed to
increased longevity12.

9
Peggy A Wu, MD, Section Editors: Robert S Stern, MD, June K Robinson, MD,
Deputy Editor:Rosamaria Corona, MD, DSc: Epidemiology, pathogenesis, and
clinical features of basal cell carcinoma, 2022, UpToDate
10
Clay Cockerell, Martin C. Mihm Jr., Brian J. Hall Cary Chisholm, Chad Jessup,
Margaret Merola; with contributions from: Jerad M. Gardner,Talley Whang:
Dermatopathology Clinicopathological Correlations, 2014, pp 307
11
Ruben AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med.
2005;353(21):2262-29.
12
Epidemiology of BCC,www.dermatologytimes.com, 17.08.2015