The numbers are indisputable: Skin cancer is rising at an alarming rate. In 2007 more than 1,000,000 individuals were diagnosed with non-melanoma skin cancer and approximately 60,000 were diagnosed with melanoma. It is estimated that 1 in 5 Americans will develop some form of skin cancer in their lifetimes.
Currently, non-melanoma skin cancer (NMSC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is the most common form of cancer in the United States. With these rising rates, it is imperative that the public learns how to prevent the development of and recognize lesions suspicious for skin cancer.
Patients commonly ask “What do I look for?” but they should also be asking “Where do I look for it?” There are certain high-risk areas, such as the nose, where skin cancer is more common and aggressive. Recognizing that these areas are more prone to develop cancer and ensuring that they are protected from the sun is the first step in preventing the development of malignant skin lesions.
In a recent study of 194 BCCs of the head and neck region, the nose was the most common location for skin cancer, comprising one third of all cases. Another investigation found that 40 percent of BCCs on the head and neck were on or adjacent to the nose. To better assess the particular areas on the nose where skin cancer is most prevalent, we prospectively evaluated 111 patients with nasal skin cancer in our practice. The specific type of cancer, the exact location on the nose and the gender of the patient were documented.
Our study population consisted of 99 people with BCCs and 12 with SCCs. There were 46 males and 65 females included in the study. Figure 1 exhibits the normal anatomy of the nose and figure 2 shows the distribution of skin cancers in our study. The most common location for skin cancers on the nose was the alae (n=42) — the outer flaring walls atop the nostrils — followed by the tip (n=35). There were no significant differences between gender and type of skin cancer or location. Our results are similar to previously published distributions of skin cancer on the nose. For example, in a recent study of BCCs in China, 52 percent were located on the alae, 22 percent on the dorsum (the nose’s external ridge), 16 percent on the tip and 10 percent in other locations.