Does chronic exposure to lacrimal fluid predispose for periorbital basal cell carcinoma?

Basal cell carcinoma (BCC) is not only the most common cutaneous malignancy but also the most common form of cancer seen in all body. Ultraviolet radiation (UVR) is the most important etiologic factor and thus BCCs occur most frequently on the sun-exposed areas of the body. Approximately 5-10% of BCCs occur in periocular region, especially, in lower eyelid and inner canthus. Despite this common occurrence, inner canthus is a relatively light-protected zone where UVR cannot easily access. Tear fluid is a known irritant of the skin. Prolonged exposure to tear in epiphora leads to chronic irritation of the skin; and repetitive trauma induced by the patient due to itching of the area. We believe that lacrimal fluid contact in, especially, chronic epiphora patients may have a contributive effect in the development of periorbital BCC.