[Basal cell carcinomas of the scalp. Review of 77 patients with 81 tumors].

Out of 3,000 consecutive basal cell carcinoma 81 (2.7%) were located on the scalp of 77 patients (41 males, 36 females). The age at diagnosis was 50.8 +/- 14 years. Seventy five patients had a single lesion, one had 2 and another 4. Significant etiological factors were organoid nevi (11), syringocystadenoma papilliferum (1), androgenic alopecia (5), wound scar (1) and radiodermatitis (1). Out of 29 patients who answered a specific enquiry 10 admitted to having been treated by X-ray epilation for tinea capitis in childhood and 4 to have taken arsenic containing medicines. The evolution of the tumors varied from several months to more than 10 years. They were mostly nodular, pigmented and, less commonly, ulcerated with a pearly border, pendunculated or sclerosing in type. Histologically they were mainly solid or adenoid, with 2 sclerosing and 1 keratotic in type. In two cases there was underlying bone involvement. Treatment was by conventional surgery (54), Mohs' surgery (24) and cryotherapy (3). Four lesions recurred but the follow-up was below 5 years in most cases. We cannot confirm the impression of a more aggressive behaviour often suggested in the literature.