Head and neck region dermatological UV-related cancers are associated with exfoliation syndrome in a clinic-based population


Huang JJ, Geduldig JE, Jacobs EB, Tai TYT, Ahmad S, Chadha N, Buxton DF, Vinod K, Wirostko BM, Kang JH, Wiggs JL, Ritch R, Pasquale LR. Head and neck region dermatological UV-related cancers are associated with exfoliation syndrome in a clinic-based population. Ophthalmol Glaucoma 2022;

Date Published:

2022 Apr 22


OBJECTIVE: We assessed the relation between UV-associated dermatological carcinomas (basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)) and exfoliation syndrome with or without glaucoma (XFS/XFG). DESIGN: Case-control study. Subjects, participants, and controls:321 participants with XFS/XFG, primary open angle glaucoma (POAG), and control subjects (XFS/XFG = 98, POAG = 117, control = 106, ages 50-90) were recruited between 2019-2021. METHODS: Subjects were recruited for a cross-sectional survey assessing medical history, maximum known intraocular pressure, cup-to-disc ratio, Humphrey Visual Field 24-2 (HVF), propensity to tan or burn in early life, history of BCC and/or SCC and XFS/XFG diagnosis. We generated multivariable models adjusting for age, sex, medical history, eye color, hair color, and likeliness of tanning vs burning at a young age. MAIN OUTCOME MEASURES: History of diagnosed XFS/XFG. RESULTS: Any history of BCC/SCC in the head and neck region was associated with a 2-fold higher risk for having XFS/XFG versus having POAG or being a control subject (odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.04 - 3.89) in multivariable-adjusted analysis. Additionally, we observed a dose-response association where the chance of having XFS/XFG was higher by 67% per head and neck BCC/SCC occurrence (OR = 1.67, 95% CI = 1.09 - 2.56). When we excluded POAG participants, head and neck BCC/SCC was associated with 2.8-fold higher risk of XFS/XFG (OR = 2.80, 95% CI = 1.12 - 7.02) and each additional occurrence of head and neck BCC/SCC had a 2-fold higher risk for XFS/XFG (OR = 1.97, 95% CI = 1.09 - 3.58). The association between head and neck region BCC/SCC and POAG compared to control subjects was null (OR = 1.42, 95% CI = 0.58 - 3.48). When BCC/SCC located anywhere on the body was considered, there was a non-significant higher risk of XFS/XFG compared to having POAG or being a control subject (OR = 1.65, 95% CI = 0.88 - 3.09). CONCLUSIONS: Head and neck region BCC/SCCs are associated with a higher risk for having XFS/XFG. These findings support prior evidence that head and neck UV exposure may be a risk factor for XFS.

Last updated on 05/01/2022