Nonmelanoma skin cancer of the ear: frequency, patients' knowledge, and photoprotection practices
Abstract
BACKGROUND: Nonmelanoma skin cancer (NMSC) is the most common cancer in the world. Information about NMSC on the ear and photoprotection practices of the ear is limited. OBJECTIVE: To determine the frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) at precise anatomical sites, with a special focus on the ear. To evaluate dermatology patients' knowledge about skin cancer, photoprotection practices, and use of photoprotection on the ear. METHODS: At a dermatology practice in Fresno, California, a retrospective chart review of 643 patients diagnosed with NMSC was performed and categorized into detailed anatomical sites. An anonymous questionnaire was given to patients aged 18 and older seen at this private practice. RESULTS: One thousand three hundred eleven NMSCs were biopsied and histologically confirmed. Of these, 538 were BCC (41%) and 773 (59%) were SCC. Seven hundred sixty-five tumors (58.4%) were on the head. The ear was the fifth most common site for NMSC on the head. The male:female ratio for NMSC of the ear was 17:1. There were 269 survey responses; 72.8% used sunscreen, but only 26.0% of those who used sunscreen always apply it to their ears. CONCLUSION: Directed public education about the ear as a high-risk, common site for NMSC is needed. The authors have indicated no significant interest with commercial supporters.
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SCC of the ear tends to be more aggressive and occurs more frequently with higher rates of local recurrence and metastasis than basal cell carcinoma.
“Between the two, SCC of the ear tends to be more aggressive and occurs more frequently with higher rates of local recurrence and metastasis.3,4,[7][8][9]”
From Ear Reconstruction following Mohs Micrographic Surgery (2024) · cites this paper as [4]
The ear has a high risk of developing skin cancer because its prominence lends itself to significant sun exposure.
“The ear has a high risk of developing skin cancer since its prominence lends itself to significant sun exposure.3,4”
From Ear Reconstruction following Mohs Micrographic Surgery (2024) · cites this paper as [4]
Cites
Variations of basal cell carcinomas according to gender, age, location and histopathological subtype
Scrivener, Y., Grosshans, E., & Cribier, B. (2002) · British Journal of Dermatology · doi:10.1046/j.1365-2133.2002.04804.x · Cited by 459 · see citing works
Trends in sun exposure knowledge, attitudes, and behaviors: 1986 to 1996\
Robinson, J. K., Rigel, D. S., & Amonette, R. A. (1997) · Journal of the American Academy of Dermatology · doi:10.1016/s0190-9622(97)80122-3 · Cited by 259 · see citing works
Basal cell carcinoma: histological classification and body-site distribution
Raasch, B., Buettner, P. G., & Garbe, C. (2006) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2006.07234.x · Cited by 225 · see citing works
McCormack, C. (1997) · Archives of Dermatology · doi:10.1001/archderm.133.5.593 · Cited by 206 · see citing works
Differences in Age and Body Site Distribution of the Histological Subtypes of Basal Cell Carcinoma
McCormack, C. J. (1997) · Archives of Dermatology · doi:10.1001/archderm.1997.03890410049006 · Cited by 179 · see citing works
Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population
Demers, A. A., Nugent, Z. J., Mihalcioiu, C. L. D., Wiseman, M., & Kliewer, E. V. (2005) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2005.03.043 · Cited by 144 · see citing works
Ridky, T. W. (2007) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2007.01.033 · Cited by 115 · see citing works
Frequency of Facial Basal Cell Carcinoma Does Not Correlate With Site-Specific UV Exposure
Heckmann, M. (2002) · Archives of Dermatology · doi:10.1001/archderm.138.11.1494 · Cited by 95 · see citing works
Nonmelanoma Skin Cancer Mortality in the United States, 1969 Through 1988
Weinstock, M. A. (1993) · Archives of Dermatology · doi:10.1001/archderm.1993.01680310056009 · Cited by 92 · see citing works
Defining patients with high‐risk cutaneous squamous cell carcinoma
Veness, M. (2006) · Australasian Journal of Dermatology · doi:10.1111/j.1440-0960.2006.00218.x · Cited by 87 · see citing works
Pless, J. (1976) · Scandinavian Journal of Plastic and Reconstructive Surgery · doi:10.3109/02844317609105202 · Cited by 65 · see citing works
Epidemiology of basal cell carcinoma and squamous cell carcinoma of the pinna
Ahmad, I., & Gupta, A. R. D. (2001) · The Journal of Laryngology & Otology · doi:10.1258/0022215011907497 · Cited by 61 · see citing works
Raasch, B., MacLennan, R., Wronski, I., & Robertson, I. M. (1998) · Mutation research. Fundamental and molecular mechanisms of mutagenesis · doi:10.1016/s0027-5107(98)00194-8 · Cited by 50 · see citing works
Betti, R., Radaelli, G., Mussino, F., Menni, S., & CROSTI, C. (2009) · Dermatologic Surgery · doi:10.1111/j.1524-4725.2008.34410.x · Cited by 44 · see citing works
Nikolaou, V. A., Stratigos, A., Antoniou, C., Sypsa, V., Avgerinou, G., Danopoulou, I., Nicolaidou, E., & Katsambas, A. (2009) · Photodermatology Photoimmunology & Photomedicine · doi:10.1111/j.1600-0781.2009.00424.x · Cited by 30 · see citing works
Duffy, K. L., McKENNA, J. K., HADLEY, M. L., & Tristani‐Firouzi, P. (2008) · Dermatologic Surgery · doi:10.1111/j.1524-4725.2008.34379.x · Cited by 25 · see citing works
Busick, T. L., Uchida, T., & Wagner, R. F. (2006) · Dermatologic Surgery · doi:10.1111/j.1524-4725.2005.31040 · Cited by 18 · see citing works
Preventing Ultraviolet Light Lip Injury
Busick, T. L., Uchida, T., & Wagner, R. F. (2005) · Dermatologic Surgery · doi:10.1097/00042728-200502000-00010 · Cited by 10 · see citing works
Cac, N. N., Walling, H. W., Vest, C. D., & Ting, W. W. (2008) · International Journal of Dermatology · doi:10.1111/j.1365-4632.2008.03348.x · Cited by 9 · see citing works
Bhambri, S., & Rosso, J. Q. D. (2010) · Yearbook of Dermatology and Dermatologic Surgery · doi:10.1016/s0093-3619(09)79408-0 · Cited by 7 · see citing works
Ronai, Z. A., Polotskaya, A., Gradia, S., Amin, S. G., & Hecht, S. S. (1996) · International Journal of Cancer · doi:10.1002/(sici)1097-0215(19960703)67:1 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Brazilian Consensus on Photoprotection
Schalka, S., Steiner, D., Ravelli, F. N., Steiner, T. A., Terena, A. C., Marçon, C. R., Ayres, E. L., Addor, F. A. S., Miot, H. A., Ponzio, H. A. S., et al. (2014) · Anais Brasileiros de Dermatologia · doi:10.1590/abd1806-4841.20143971 · Cited by 195 · see citing works
Nonmelanoma Skin Cancer: Disease-Specific Quality-of-Life Concerns and Distress
Radiotis, G., Roberts, N., Czajkowska, Z., Khanna, M., & Körner, A. (2013) · Oncology nursing forum · doi:10.1188/14.onf.57-65 · Cited by 45 · see citing works
Photoprotective habits of patients with cutaneous lupus erythematosus
Yang, S. Y., Bernstein, I. H., Lin, D. Q., & Chong, B. F. (2013) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2012.11.016 · Cited by 22 · see citing works
Skin Cancers of the Auricle: A Retrospective Analysis of 41 Patients
Özgür, E., Kamiloğlu, U., Temız, P., & Eskiizmir, G. (2020) · Turkish Archives of Otorhinolaryngology · doi:10.5152/tao.2020.5701 · Cited by 16 · see citing works
Nonmelanoma skin cancer in women
Heaton, H., & Lawrence, N. (2018) · International Journal of Women’s Dermatology · doi:10.1016/j.ijwd.2018.08.007 · Cited by 12 · see citing works
Lee, K. C., Higgins, W. H., Lajevardi, N., Cruz, A. P., & Dufresne, R. G. (2012) · Dermatologic Surgery · doi:10.1111/j.1524-4725.2012.02581.x · Cited by 10 · see citing works
Navarro‐Bielsa, A., Gracia‐Cazaña, T., Almagro, M., Meira, S. D. L. F., Flórez, Á., Yélamos, O., Montero‐Vílchez, T., González‐Cruz, C., Diago, A., Abadías‐Granado, I., et al. (2023) · Photodermatology Photoimmunology & Photomedicine · doi:10.1111/phpp.12878 · Cited by 8 · see citing works
Anatomic Features of Head and Neck Keratinocyte Cancer in Virginia
Karlin, J. N., Engelhard, S. B., Russell, M. A., & Kirzhner, M. (2020) · Dermatologic Surgery · doi:10.1097/dss.0000000000002370 · Cited by 8 · see citing works
Colao, B., & Khachemoune, A. (2024) · Archives of Dermatological Research · doi:10.1007/s00403-024-03127-5 · Cited by 6 · see citing works
Tolkachjov, S. N. (2017) · Dermatologic Surgery · doi:10.1097/dss.0000000000001244 · Cited by 5 · see citing works
Shahwan, K. T., Amon, G. J., Archibald, L. K., Bakker, C., Mattox, A. R., Alam, M., & Maher, I. A. (2022) · Archives of Dermatological Research · doi:10.1007/s00403-022-02373-9 · Cited by 4 · see citing works
Sajic, D., Archibald, J. D., & Murray, C. (2014) · Journal of Cutaneous Medicine and Surgery · doi:10.2310/7750.2013.13057 · Cited by 4 · see citing works
Patel, T. R., Prince, A. D. P., Benjamin, W. J., & Basura, G. J. (2023) · Laryngoscope Investigative Otolaryngology · doi:10.1002/lio2.1171 · Cited by 3 · see citing works
Fagan, E., Herold, M., Kent, S., & Kent, D. E. (2025) · Dermatologic Surgery · doi:10.1097/dss.0000000000004627 · Cited by 2 · see citing works
Atypical Fibroxanthoma Resected without Auricular Deformity in an Elderly Patient: A Case Study
Sim, J.-Y., Lee, D. H., Jang, B. G., & Suh, M. J. (2022) · Ear Nose & Throat Journal · doi:10.1177/01455613221084072 · Cited by 2 · see citing works
Técnicas de reconstrucción básicas del pabellón auricular por padecimiento dermatooncológico
Martínez, K. M., Pérez, A. L. C., Cardona-Hernández, M. Á., Bojórquez, A. M., Pérez, D. A., González, S. T., Trejo, J. R., Pérez, M. B., & Arteaga, D. A. G. (2015) · Cited by 2 · see citing works
Official publication of the Brazilian Society of Dermatology
de Souza, N. N., de Souza, B. A., Zampier, V., & Souza, D. (2014) · Cited by 1 · see citing works
The Frequency of Auricular Cartilage Invasion by Nonmelanoma Skin Cancer
Carter, Z. A., Jacobson, R. K., Godsey, T., & Gloster, H. M. (2019) · Dermatologic Surgery · doi:10.1097/dss.0000000000001834 · Cited by 2 · see citing works
Malignant epithelioid hemangioendothelioma of the ear
Senaratne, R., Casey, M., & Kelly, J. L. (2022) · Journal of Surgical Case Reports · doi:10.1093/jscr/rjac062 · Cited by 2 · see citing works
Epithelial and nonepithelial tumors of the external ear
Baykal, C., & Atcı, T. (2026) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2026.05.012 · Cited by 1 · see citing works
Cirugía dermatológica básica de la oreja
Fierro‐Arias, L., Castellanos, A. I. P., & Olivera, R. M. P. (2013) · Cited by 1 · see citing works
Chemotherapy for Temporal Bone Cancer
Ferrarotto, R., & Kies, M. S. (2018) · Springer eBooks · doi:10.1007/978-3-319-74539-8_31 · Cited by 1 · see citing works
Antihelical Rotation Flaps for the Repair of Surgical Defects of the Auricular Antihelix
Dyson, M. E., Griffith, J. L., Mitkov, M. V., Goldberg, L. H., & Kimyai‐Asadi, A. (2020) · Dermatologic Surgery · doi:10.1097/dss.0000000000002346 · Cited by 1 · see citing works
Ear Reconstruction following Mohs Micrographic Surgery
Mohan, V. C., Owens, W. R., Schmidt, J. L., Burns, H. R., & Buchanan, E. P. (2024) · Seminars in Plastic Surgery · doi:10.1055/s-0044-1791830
Non-Melanoma Skin Cancers of Pinna: Retrospective Assesment of 51 Cases
Çiloğlu, S., Duran, A., Yigit, A., Büyükdoğan, H., & Keskin, E. (2015) · Turkish Journal of Dermatology · doi:10.4274/tdd.2584
Park, C. K., Shahwan, K. T., Rismiller, K. P., & Carr, D. R. (2021) · Dermatologic Surgery · doi:10.1097/dss.0000000000003102
Dermatoses of the External Ear
Kennedy, C., & Sharma, A. K. (2024) · doi:10.1002/9781119709268.rook106
(2025) · American Registry of PathologyArlington, Virginia eBooks · doi:10.55418/9781933477619-8
- Authors
- RAGI, J. M., PATEL, D., MASUD, A., & RAO, B. K.
- Affiliations
- University of Medicine and Dentistry of New Jersey (US)
- Cornell University (US)
- Corresponding author
- RAGI, JENNIFER M.
- RAO, BABAR K.
- ORCID
- RAO, BABAR K.
- Venue
- Dermatologic Surgery
- Published
- 2010-08
- Volume
- 36
- Issue
- 8
- Pages
- 1232-1239
- ISSN
- 1076-0512 (ISSN-L)
- OpenAlex
- W2024402448
- Cited by
- 29
- References
- 21
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 1
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dermatologic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- non-melanoma skin cancer, ear, basal cell carcinoma, squamous cell carcinoma, anatomical site distribution, photoprotection, sunscreen use, patient knowledge, public health education, head and neck skin cancer
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, California, Basal Cell Carcinoma, Carcinoma, Squamous Cell, Ear Neoplasms, Head and Neck Neoplasms, Humans, Middle Aged, Retrospective Studies, Skin Neoplasms, Prevalence, Young Adult
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