基底细胞癌组织病理类型与性别、年龄及部位的相关性分析

目的 分析基底细胞癌(BCC)组织病理类型与性别、年龄及部位的相关性.方法 回顾性分析2000年1月到2009年4月共243例BCC的临床病理资料,应用SPSS 13.0软件对资料进行分析.结果 243例BCC中,男118例,女125例,男女比例为0.94:1;平均年龄(65.16±12.62)岁;好发于头颈部,占77.4%;结节型是最常见的病理类型,占53.9%,其次为浅表型和浸润-硬化型,分别占18.9%和18.5%.女性患者就诊年龄早于男性(P＜0.05).不同组织病理类型BCC的性别构成差异无统计学意义(P＞0.05).浅表型BCC好发于躯干部位,就诊年龄早于非浅表型,女性就诊年龄早于男性,差异均有统计学意义(P＜0.05).结节型、浸润-硬化型及微小结节型BCC好发于头颈部,就诊年龄较晚,男女患者就诊年龄无差异(P＞0.05).结论 不同组织病理类型BCC的临床特征不同,可能存在不同的发病机制.

Abstract：

Objective To analyze the relationship of histopathological subtypes of basal cell carcinoma (BCC) with gender,age and anatomical location of skin lesions.Methods The clinical and histopathological data on 243 cases of BCC collected from Jan 2000 to Apr 2009 were reviewed retrospectively.Data analysis was carried out by using SPSS 13.0 software.Results A total of 243 patients were included in this study,including 118 males and 125 females with the male/female ratio being 0.94:1.The average age of patients was 65.16 ± 12.62 years.Head and neck were the predilection (77.4%) sites of BCC in these patients.Nodular type (53.9%) was the most common type,followed by the superficial type (18.9%) and infiltrative-morphoeic (sclerosing) type (18.5%).The age at visit was younger in female patients than in male patients(P ＜ 0.05),no significant difference was observed in the gender composition among patients with different subtypes of BCC (P ＞ 0.05).Superficial BCC was more common on the trunk; the age at visit was younger in patients with superficial BCC than in those with other subtypes of BCC,and younger in female patients than in male patients (all P ＜ 0.05).Nodular,infiltrative-morphoeic and micronodular subtypes of BCC showed a predilection for the head and neck with an old age at visit,and no differences were observed in the age at visit between female and male patients with these subtypes of BCC (au P ＞ 0.05).Conclusions Different subtypes of BCC show different clinical features,which may be attributed to their different pathogenesis.     

Different Anatomical Distribution of Basal Cell Carcinoma Subtypes in Iranian Population: Association between Site and Subtype

Background

Basal cell carcinoma (BCC) is the most common type of human cancer. Despite the high prevalence of these tumors, there is a lack of reliable epidemiological data in some regions including Iran.

Objective

To assess the relationship between BCC subtypes and anatomical distribution in the Iranian population.

Methods

There were 876 patients with a single BCC enrolled in this study (March 2007 to March 2010; Razi Dermatology Center, Tehran, Iran).

Results

Among 876 patients, 544 were males and 332 females. Of the lesions, 43% were nodular, 32.4% mixed type, 3% superficial and rest of other subtypes. In the lesion location, 58.2% were on the face, 29.2% on scalp, 6.2% on ears, 2.3% on neck, 1.7% on trunk and 1.3% on the extremities. There was no significant difference between male and female in the BCC subtypes, but anatomical distribution of the tumor was different (p=0.002). Most of the trunk-arising BCCs were superficial, and most of the facial BCCs were nodular subtype. Also, most of the BCC subtypes occurred in patients between 40 to 80 years old and mostly on the face and scalp (p=0.04). However, superficial BCCs mostly occurred in younger patients over others (p=0.001).

Conclusion

Subtype is associated with a site, independent of gender or age. Also BCCs occurring on the trunk are mostly of the superficial subtype.     

Increases in invasive melanoma in England, 1979-2006, by anatomical site

Background National melanoma incidence trends with details of anatomical site have not been previously described for England. Objectives To describe site‐specific trends in cutaneous melanoma for England as a whole during the last three decades. Methods Anonymized data, 1979–2006, were obtained from national cancer registrations of all patients in England up to age 89 years with incident primary invasive cutaneous melanomas (n = 124 055). Sex‐specific age‐standardized incidence rates and average annual percentage change in rates were calculated for each broad anatomical site. Results Overall incidence rates of cutaneous melanoma in England, 1979–2006, were 81 and 100 per million, in males and females, respectively. Site‐specific rates were consistently highest on the lower limbs in females followed by the trunk in males. Greatest annual increases occurred on the trunk in both sexes over 45 years (males 9·9%, females 6·8%), then upper limbs (males 8·7%, females 6·8%). Incidence trends in males relative to females varied little across sites apart from a more rapid rise in head/neck melanomas in males than in females after the 1980s. Conclusions Invasive melanoma rates continue to rise in England, particularly on the trunk and arms, and in males on the head/neck. The steeper increases in melanoma rates among males are consistent with their greater sun exposure and poorer compliance with sun protection measures than females.     

Skin cancer trends in northern Jordan

Background The Jordan Cancer Registry was established in 1996, since which time all cases of cancer have been reported and registered. We have used this registry to perform the first analysis of skin cancer in northern Jordan and to compare our findings with those of published reports from other regions. Methods All histopathologically proven cases of skin cancer, reported during the years 1997 through 2001, were reviewed. Information regarding tumor type, age, gender, and anatomical location was collected. Results A total of 272 cases of malignant skin tumors were diagnosed between the years 1997 and 2001. Basal cell carcinoma (BCC) was the commonest type, representing 52.9% of all skin cancers. Females were more frequently affected than males, with age‐adjusted incidence rates of 23.3 and 19.7 per 100,000 of population, respectively. Squamous cell carcinoma (SCC) comprised 26.4% of the total, its age‐adjusted incidence rate per 100,000 of population being 14.2 for males and 6.18 for females. the incidence rate increased in males and decreased in females during the study period. The incidence of both BCC and SCC increased with age. The head and neck region was the commonest site affected by both types of cancer. Malignant melanoma (MM) comprised 11.39% of all skin cancer cases, with a female to male ratio of 1.2 : 1. The median age at onset for female patients was 49 years while that for males was 70 years, and the commonest site affected was the lower limbs, followed by the trunk. Conclusions In Jordan, sun‐related skin cancers have relatively low incidences and a rather stable pattern, compared with other areas with similar climate and skin phenotypes.     

Variations of basal cell carcinomas according to gender,age, location and histopathological subtype

BACKGROUND: Most published series of basal cell carcinomas (BCCs) do not take into account the histopathological subtype. Recent studies suggest that the nodular and superficial types could be induced by different causal factors. OBJECTIVES: To analyse the three major subtypes of BCC with regard to sex, age and anatomical distribution. METHODS: We retrospectively included all cases of BCC diagnosed at a single centre of dermatopathology during 1967-96. The diagnosis and subtype (nodular, superficial, morphoeiform) were confirmed by two dermatopathologists. Gender, age at excision, number of tumours and location were recorded, and analysed by histopathological subtype. RESULTS: We recorded 13 457 cases in 10 245 patients (M/F ratio 0.92) of mean age 65 years. Of the BCCs, 78.7% were nodular, 15.1% superficial and 6.2% morphoeiform. Nodular tumours occurred at a mean age of 66.3 years, whereas superficial tumours were excised earlier (63.0 years) and more frequently in women (M/F ratio 0.96). Patients with morphoeiform BCC had a mean age of 65.8 years and were predominantly women (M/F ratio 0.73). Both nodular and morphoeiform types predominated on the head (89.6% and 94.8%), whereas the trunk was the most common location for the superficial type (45.9%). Superficial carcinomas were predominantly located on the head in women (44.8% vs. 34.7% in men), whereas they predominated on the trunk in men (49.9% vs. 42% in women). Tumours of the trunk were excised earlier than those of the face, whatever their histological subtype, in both men and women. CONCLUSIONS: This is the largest series of BCCs in the literature, and shows striking differences in anatomical distribution, sex and mean age according to histological type. The results suggest that the tumours of the trunk, and not only those of the superficial type, could represent a particular subtype of BCC. The analysis also suggests that the hypothesis of chronic vs. intermittent sun exposure cannot be simply extrapolated to BCC. Other causal factors, such as a genetic predisposition, could be involved in the development of carcinomas located on the trunk.     

Trends in the incidence of basal cell carcinoma by histopathological subtype

Background As a result of the high prevalence, basal cell carcinoma (BCC) causes a significant and expensive health care problem. Objective In this study, we evaluate the proportional increase in BCC by histological subtype over the last two decades. Methods We retrospectively reviewed all primary histological confirmed BCCs diagnosed in the Maastricht University Medical Centre in The Netherlands in the years 1991, 1999 and 2007. Results An annual increase of the number of BCCs of 7% for both genders was shown. The age‐standardized incidence rates for BCC increased between 1991 and 2007 from 54.2 to 162.1 per 100 000 men and from 61.7 to 189.8 per 100 000 women. The proportion of superficial BCC increased significantly from 17.6% to 30.7%. Conclusion The incidence of BCC is continuing to increase this century. The observed shift to the superficial histological subtype, which can be treated non‐surgically, might reduce the workload in the busy dermatologists practice.     

Micronodular basal cell carcinoma: A distinct subtype? Relationship with nodular and infiltrative basal cell carcinomas

Micronodular basal cell carcinoma (BCC) may be more difficult to eradicate and prone to recurrence than nodular subtype. The aim of the study was to compare anatomical and histological characteristics of the basal cell carcinomas subtypes and the relationship of the micronodular BCC with other subtypes. Primary BCCs (n = 3074) were classified as superficial, nodular, micronodular, morpheic/infiltrative. The location was head/neck, limbs, chest/abdomen, back or genitals. Fifty‐one micronodular BCCs were matched randomly with nodular and infiltrative cases, by age, sex, and tumor site. A modified Clark level was used to classify the tumor depth. Micronodular, nodular and infiltrative BCC were prevalently located in the head/neck (P < 0.0001), while superficial in the other regions (P < 0.0001). The Clark level was comparable between micronodular and infiltrative BCC, while nodular BCC showed a more superficial level than micronodular (P < 0.001) and infiltrative (P < 0.001) BCC. No nodular BCC had level IV and only 37.3% level III, while 92% of both micronodular and infiltrative BCC were level III or IV. The percentage of level IV was 11.8% and 25.5% in micronodular and infiltrative BCC, respectively. In the mid‐face/periauricular region, 95.5% of micronodular and 100% of infiltrative cases of were level III or IV, compared to 50% of nodular BCC (P < 0.001). The Clark level of nodular subtype was higher for BCC of mid‐face/periauricular than other regions (P < 0.05). It can be concluded that micronodular BCC shows intermediate characteristics compared with nodular and infiltrative subtypes but appears to have a specific individuality making it a distinct subtype.     

Characteristics of Mixed Type Basal Cell Carcinoma in Comparison to Other BCC Subtypes

Background:

There are limited data exploring the characteristics of mixed type basal cell carcinoma (BCC).

Objectives:

To explore different characteristics of mixed type BCC.

Design:

Cross sectional study.

Materials and Methods:

825 patients with BCC enrolled in this study.

Results:

Among 825 patients, 512 (62%) were male. Three hundred and fifty five (43%) presented with nodular subtype, 267 (32.4%) with mixed subtype, 25 with superficial and the 178 remaining presented with other subtypes. Four hundred and eighty three (58.6%) of the lesions were on the face, 243 (29.5%) on scalp, 52 (6.3%) on ears, 20 (2.4%) on neck, 15 (1.8%) on trunk and 12 (1.4%) on extremities. Anatomic distribution of mixed type was as follows: 137 on face, (51.4%), 100 (37.3%) on scalp, 19 (7%) on ear, 6 (2.1%) on neck, 4 (1.5%) extremity and 1 (0.7%) on trunk, which the difference from non mixed types was statistically significant (P = 0.002). The mean diameter of the mixed types and non mixed type BCCs were significantly different (2.7 ± 2.1 cm vs. 2.2 ± 1.6 cm; P = 0.01. The prevalence of necrosis in mixed type BCC was two times higher than non mixed type BCCs (OR = 2.3, CI 95% 1.3-3.9, P = 0.001). The most frequent combined subtypes were nodular-infiltrative (P < 0.001).

Conclusion:

Mixed type BCC has differences with other BCC subtypes in anatomical distribution and tumor diameter. Indeed, mixed type BCCs are frequently composed of aggressive subtypes than nonaggressive subtypes.     

The incidence of basal cell carcinoma in the under-30s in the UK

Background. Basal cell carcinoma (BCC) is the commonest cancer in many countries, but the current incidence in young people from the UK is unknown. Aim. To ascertain a recent incidence of BCC in the under‐30 population in the UK. Methods. Cancer registry data from part of the Eastern Region of the UK was analysed for two periods: 1981–1989 and 1998–2006. Case notes were examined for a cohort of the patients from 1998 to 2006. Results. The incidence of BCC increased from 0.73 to 1.79 per 100 000 in those aged < 30 years over the study period. More than half (55%) of BCCs were on the head and neck, and the most common histological subtype was superficial BCC (38%). Conclusions. The reported incidence of BCC in those aged < 30 years has increased by 145% during this period, corresponding to an average annual increase of 8.53%. This may be partially due to earlier presentation and to increased use of surgical treatments.     

Basal cell carcinoma progression correlates with host immune response and stromal alterations: a histologic analysis

Neoplastic progression is characterized in part by escape from immune surveillance and formation of growth-permissive stroma. Basal cell carcinoma (BCC) can be subclassified into low- and high-risk types for local recurrence. To determine whether these types of BCC correlate with alterations in local host immune response and stroma and whether these changes follow stepwise histologic progression from low- to high-risk subtypes, we assessed the clinicopathologic features in 175 consecutive primary (nonrecurrent) BCC excision specimens. BCCs exhibited a significantly higher frequency of mixed rather than homogeneous growth patterns (76% vs. 24%, P=0.0001). Nodular (84%) was the most common pattern identified followed by superficial (77%), infiltrative (27%), morpheic (5%) and micronodular patterns (4%). Only superficial (12% of all BCC) and nodular (12%) patterns were identified in BCC with a homogeneous histologic phenotype. Micronodular and infiltrative-morpheic patterns were not identified together in mixed patterned BCCs, and these high-risk types were contiguous with nodular BCC. Superficial predominant BCC (major growth pattern) was significantly associated with trunk and extremity location (76%) and skin without solar elastosis (82%), whereas BCC harboring a nodular growth pattern component was significantly associated with a head and neck location (63%) and the presence of adjacent solar elastosis (all P< or =0.03). Significant correlations were identified for BCC subtypes with inflammatory and stromal alterations: superficial BCC with old regression and moderate to dense peritumoral lymphocytic infiltrates; high-risk types correlated with active regression; infiltrative and morpheic BCC with fibrosing tumor stroma; and micronodular BCC with loss of both host inflammatory and stromal tumor responses. Evaluating the theoretical histologic stepwise model of BCC progression (superficial-to-nodular-to-micronodular, or superficial-to-nodular-to-infiltrative-to-morpheic BCC types) revealed significant linear correlations with host response and alterations of tumor stroma (r=0.54, P=0.0001). BCC exhibit distinct epithelial-stromal-inflammatory patterns that correlate with BCC subtype and tumor progression. This ostensible pathway of diminishing host response and gain of permissive tissue environment highlights neoplastic evolution from low to high risk for local recurrence of BCC and implicates a histologic continuum reflecting dynamic host-BCC interactions.     

Incidence of basal cell carcinoma multiplicity and detailed anatomic distribution: longitudinal study of an Australian population

A proportion of individuals are affected multiple times by basal cell carcinoma (BCC), but the rate and extent to which this occurs is unknown. We therefore prospectively estimated BCC incidence in a subtropical Australian population, focusing on the rate at which persons develop multiple primary BCCs and the precise anatomic sites of BCC occurrence. Between 1997 and 2006, 663 BCCs were confirmed in 301 of 1,337 participants in the population-based Nambour Skin Cancer Study. The incidence of persons affected multiple times by primary BCC was 705 per 100,000 person years compared to an incidence rate of people singly affected of 935 per 100,000 person years. Among the multiply and singly affected alike, site-specific BCC incidence rates were far highest on facial subsites, followed by upper limbs, trunk, and then lower limbs. We conclude that actual BCC tumor burden is much greater in the population than is apparent from normal incidence rates. Anatomic distribution of BCC is consistent with general levels of sun exposure across body sites.     

Predictions of skin cancer incidence in the Netherlands up to 2015

BACKGROUND: Skin cancer is an important, growing public health problem among white caucasians, causing a heavy burden on dermatologists and general practitioners. OBJECTIVES: To predict the future incidence of skin cancer in the Netherlands up to 2015. METHODS: Expected numbers of skin cancer cases in the Netherlands up to 2015 were calculated by trend modelling of observed rates for melanoma and squamous cell carcinoma (SCC) between 1989 and 2000 obtained from the Netherlands Cancer Registry and for basal cell carcinoma (BCC) obtained from the Eindhoven Cancer Registry; these rates were then multiplied by the predicted age distributions. Incidence rates were fitted to four different models, and predictions were based on the best fitting model. RESULTS: An increase of 80% in the total number of skin cancer patients is expected in the Netherlands: from 20 654 in 2000 to 37 342 in 2015. The total number of melanoma cases is expected to increase by 99%, with the largest increase for males (males aged 35-64, 111%; males aged > or = 65, 139%). Numbers of patients with SCC will increase overall by 80%, mainly among older males and females (increase of 79%) and females aged 35-64 (increase of 93%). The number of cases of BCC will increase by 78%, with the largest increase for the combined groups, those aged 15-64 (males, 66% increase; females, 94% increase), especially for sites other than the head and neck. The contribution of demographic changes (ageing effect) was largest for males with BCC and SCC (35-44%). CONCLUSIONS: If incidence rates for skin cancers in the Netherlands continue to increase and population growth and ageing remain unabated, a rise in annual demand for care of more than 5% could occur, putting a heavy burden on general practitioners and dermatologists. In the absence of marked changes in current ultraviolet radiation exposure, these increases will probably continue after 2015.     

PIGMENTED BASAL CELL CARCINOMA SUCCESSFULLY TREATED WITH 5% IMIQUIMOD CREAM

Basal cell carcinoma (BCC) is the most common malignant skin tumor, amongst which the nodular, nodulo ulcerative and superficial types comprise nearly 80% of all BCCs. Topical Imiquimod, an immune response modifier has been found to be effective in superficial and nodular types of BCC with histological clearance rates of up to 100%. We report our experience of treatment a large pigmented BCC on the face with topical Imiquimod 5% cream.     

Imiquimod 5% cream for the treatment of superficial and nodular basal cell carcinoma: randomized studies comparing low-frequency dosing with and without occlusion

BACKGROUND: Imiquimod 5% cream has been investigated for non-surgical treatment of superficial and nodular basal cell carcinoma (BCC) tumours. OBJECTIVES: Two studies were conducted to examine the effect of occlusion at low dosing frequencies on the safety and efficacy of topical imiquimod 5% cream for the treatment of superficial and nodular BCC. PATIENTS AND METHODS: Both open-label studies were conducted in Europe. Patients diagnosed with BCC were enrolled into either the superficial (93 patients) or nodular (90 patients) study, depending on the histological confirmation of the patient's tumour subtype. Patients were randomized to one of four groups to apply imiquimod 5% cream 2 or 3 days per week either with or without occlusion. Six weeks following a 6-week treatment period, the entire target tumour area was excised and histologically examined for evidence of residual tumour. RESULTS: In both studies, the highest histologically complete response rate was seen in the 3 days per week with occlusion groups, with complete response rates of 87% and 65% for the superficial and nodular studies, respectively. Occlusion did not have a statistically significant effect on response rate at either dosing frequency. Response rates for superficial and nodular BCC tumours treated 3 days per week without occlusion were 76% and 50%, respectively. CONCLUSIONS: In the superficial study, the complete response rate of 87% in the 3 days per week with occlusion group was similar to that of daily and 5 days per week dosing without occlusion in a previous 12-week study and one study of daily dosing without occlusion for 6 weeks. All treatment groups had acceptable safety profiles in both studies. Occlusion did not have a statistically significant effect on efficacy for either superficial or nodular BCC tumours.     

Clinical and histopathological characteristics of extra‐facial basal cell carcinoma: Analysis of 35 patients at the Chonbuk National University Hospital in Korea

Basal cell carcinoma (BCC) primarily develops in the head and neck region, with 74–83 per cent of BCC occurring in this region. Unfortunately, most published studies on BCC were conducted in Caucasian populations, and analytic data on extra‐facial BCC in Asian and Korean patients, in particular, are not readily available. Here, we report on a retrospective analysis of extra‐facial BCC in Korean patients. Thirty‐five patients (16 men, 19 women) diagnosed with extra‐facial BCC at Chonbuk National University Hospital between January 1981 and December 2008 were evaluated. Their average age was 62.3 years and most of the patients (11 of 35, 31%) were in their fifties. The relative tumour density (RTD) was the highest in the genitalia (0.769), followed by the axilla (0.481). Other regions such as the trunk, buttocks and upper and lower extremities exhibited a much lower RTD (average: 0.1). Histopathological examinations showed that 16 tumours were nodular (46%), eight were superficial (23%) and seven were mixed (20%). Additionally, potential predisposing factors were identified in seven cases. In five patients the use of Asian medicine, including acupuncture and herbal medication, was ascertained. To the best of our knowledge, the present study is the first to analyse the clinical and histopathological characteristics of extra‐facial BCC in Korean patients. Our results indicate that the incidence of extra‐facial BCC is higher in the axilla and genitalia than at other locations, although these sites are frequently overlooked during routine skin examinations.     

Changes in the site distribution of common melanoma subtypes in Queensland,Australia over time: implications for public health campaigns

Background An examination of melanoma incidence according to anatomical region may be one method of monitoring the impact of public health initiatives. Objectives To examine melanoma incidence trends by body site, sex and age at diagnosis or body site and morphology in a population at high risk. Materials and methods Population‐based data on invasive melanoma cases (n = 51 473) diagnosed between 1982 and 2008 were extracted from the Queensland Cancer Registry. Age‐standardized incidence rates were calculated using the direct method (2000 world standard population) and joinpoint regression models were used to fit trend lines. Results Significantly decreasing trends for melanomas on the trunk and upper limbs/shoulders were observed during recent years for both sexes under the age of 40 years and among males aged 40–59 years. However, in the 60 and over age group, the incidence of melanoma is continuing to increase at all sites (apart from the trunk) for males and on the scalp/neck and upper limbs/shoulders for females. Rates of nodular melanoma are currently decreasing on the trunk and lower limbs. In contrast, superficial spreading melanoma is significantly increasing on the scalp/neck and lower limbs, along with substantial increases in lentigo maligna melanoma since the late 1990s at all sites apart from the lower limbs. Conclusions In this large study we have observed significant decreases in rates of invasive melanoma in the younger age groups on less frequently exposed body sites. These results may provide some indirect evidence of the impact of long‐running primary prevention campaigns.     

Differences in age and topographic distribution of the different histological subtypes of basal cell carcinoma,Taubaté (SP), Brazil

BACKGROUND

Basal cell carcinoma is the most common form of cancer in humans.

OBJECTIVES

To identify the epidemiology of basal cell carcinoma in Taubaté-SP and verify a possible association between topography and the different histological subtypes of this tumor.

METHODS

This was a cross-sectional study conducted at The University Hospital of Taubaté between 01/01/08 and 12/31/09. The study included patients with a confirmed diagnosis of basal cell carcinoma, of both genders, without age restrictions. The variables studied were incidence of basal cell carcinoma, topography, histological subtype, skin color, age and gender. We employed the chi-square test to identify the association between histological subtype and topography, and the student''s t test to compare the mean age of onset for the different histological subtypes.

RESULTS

The study included 239 individuals. The mean age of the sample was 68.0 years. Male subjects (57.7%) and whites (87.1%) predominated in the study. The predominant histological subtype was nodular (34.7%), followed by the superficial subtype. The most frequent sites of involvement were the head and neck (areas exposed to light), with predominance of the nasal region. The superficial subtype was an exception, as it showed a strong association with unexposed areas like the trunk. The mean age of onset of superficial basal cell carcinoma also differed from that of the other histological subtypes, 63.0 and 69.0 years, respectively.

CONCLUSION

The results of this study suggest an association of the superficial histological subtype with younger patients and unexposed areas of the body, linking this type of tumor with a pattern of intermittent sun exposure, more similar to the standard photocarcinogenesis of melanoma.     

Differentiation between basal cell carcinoma and trichoepithelioma by immunohistochemical staining of the androgen receptor: an overview

Clinical and histopathological differentiation between basal cell carcinoma (BCC) and trichoepithelioma (TE) is a frequent problem. Attempts have been made to identify immunohistochemical markers helpful in differentiating them. A correct diagnosis is important because the tumours are treated differently. Recent studies showed the absence of androgen receptor (AR) expression in benign hair follicle tumours like TE. This study examines whether AR immunostaining is a useful diagnostic test to differentiate between BCC and TE. We randomly selected 75 cases with histological diagnoses of either BCC (subtypes: superficial, nodular or infiltrative) or TE (subtypes: classic or desmoplastic) from the database of the pathology department of Maastricht University Medical Centre. The available haematoxylin & eosin (H&E) slides were reviewed by three independent investigators using predetermined characteristics. Fifty-six slides (38 BCC and 18 TE) with unequivocal histological characteristics of either tumour were used for immunohistochemistry with AR antibodies. Any nuclear expression within the tumour was considered positive. AR expression was present in 5/8 classic TE, 0/10 desmoplastic TE, 22/23 superficial or nodular BCC and in 10/15 infiltrative BCC. Immunohistochemical stain for AR is useful to differentiate between TE and BCC; particularly in desmoplastic TE versus infiltrative BCC (specificity and positive predictive value of 100%).