Basal cell carcinoma of the head and neck: identification of the high risk patient.

While the majority of patients with basal cell carcinoma are cured by the initial therapeutic approach, high risk patients who have had recurrences of basal cell carcinoma have been identified. From April 1976 to November 1979, 811 patients with 1,271 cutaneous carcinomas were seen at the Mohs' Histographic Surgery Unit of the Cleveland Clinic Foundation. Of these, 496 represented recurrent basal cell carcinomas. Histologic subtype, location of the tumor, and age of the patient were studied in an attempt to identify factors which place patients at risk for persistent or recurrent carcinoma. The physician who first sees a patient with basal cell carcinoma should look for these risk factors and, after identifying such patients, consider an aggressive management with frequent follow-up.