Characteristics of basal cell carcinoma of the lip treated using Mohs micrographic surgery

Background: There is a lack of U.S-based studies on basal cell carcinoma (BCC) of the upper lip treated using Mohs micrographic surgery (MMS).

Objective: To explore characteristics of BCC of the upper lip treated using MMS.

Methods: We performed a chart review of BCC cases from 2005 to 2011.

Results: Two hundred eighty-one cases were identified. There was a slight female predominance (55%). Men had a larger initial (p < .01) and final (p = .03) defect size. Infiltrative tumors had larger initial (p < .01) and final areas (p < .01). Ten percent of tumors were designated recurrent after previous treatment. Recurrent lesions (p < .001) and older age (p = .03) were associated with larger initial size. Complex reconstruction was required: 44% by local flap or graft and 13% by plastic surgery.

Conclusion: There was a 1.2:1 female to male ratio, in contrast to the previously reported female predominance of 3.5:1. This cohort showed a higher recurrence rate than reported in the literature. Men and elderly patients were also found to have significantly larger initial lesion size. Thirteen percent of patients required repair by plastic surgery, reflecting heightened levels of cosmetic concern. These findings suggest that MMS is important in delineating subclinical tumor spread and providing complex repairs.