Clinical characterization of recurring basal cell carcinoma in the dermatology department of the Hospital de Clínicas (2020 – 2024)

Abstract

Introduction: Basal cell carcinoma (BCC) is the most prevalent type of non-melanoma skin 
cancer, primarily associated with chronic exposure to ultraviolet (UV) radiation. Additional 
determinants—such as histopathological subtype and the adequacy of initial therapeutic 
intervention—play a critical role in disease progression and recurrence. Methodology: A cross
sectional, observational, and descriptive study was conducted involving 18 patients with 
recurrent BCC, identified from a cohort of 239 medical records of individuals who underwent 
BCC surgery between 2020 and 2024 at the Hospital de Clínicas. Variables analyzed included 
demographic characteristics (sex, age), tumor features (anatomical site, histological subtype), 
treatment modalities (primary and secondary), and adherence to postoperative follow-up. 
Descriptive statistical analyses were performed. Results: The study population had a mean 
age of 61.3 years, with a predominance of male patients (55.6%) and urban residents (83.3%). 
Nodular BCC was the most common subtype (55.6%), with the nasal region being the most 
frequently affected site (27.8%). The most frequently employed primary surgical technique was 
direct closure (61.1%), with an average interval of 2.63 years between procedures. Only 27.8% 
of patients adhered to postoperative follow-up protocols. Conclusion: The higher incidence 
of BCC in urban populations may be attributed to differential environmental exposures and 
improved access to healthcare services. The observed recurrence rate highlights the necessity 
for effective initial interventions—such as Mohs micrographic surgery for high-risk cases—
alongside structured, long-term monitoring. The anatomical location and histological subtype 
of BCC demand a personalized, multidisciplinary treatment strategy, especially for facial tumors 
due to their functional and aesthetic relevance.