Factors associated with a higher risk of recurrence

There are several factors that may have an effect on recurrence rate including histological sub-type, other histological features, site, and other patient and tumour features.

Histological sub-type

• morphoeic – linear groups of cancer cells with surrounding scarring; clinically this causes a thickened and hardened skin
• infiltrating – like morphoeic but with less scarring
• micronodular – very small groups of cancer cell
• basosquamous carcinoma – a skin cancer with both basal and squamous elements

Histological features

• perineural invasion
• invasion below dermis

Sites

• nose and paranasal folds
• periocular
• ears
• scalp and temples
• lips

Other factors

• size > 2 cm
• immunosuppression
• genetic disorders such as Gorlin’s syndrome
• previously treated lesion

Reference:

1. NICE (February 2006).CSG Improving Outcomes for People with Skin Tumours including Melanoma: The Manual