Patients with basal cell nevus syndrome (BCNS) experience a substantially greater quality-of-life (QoL) impairment than those with high-frequency basal cell carcinoma (HF-BCC), according to a new questionnaire study.
The study, from researchers in the Netherlands, assessed QoL in 75 BCNS patients and 59 HF-BCC patients using the Skindex-29 questionnaire. HF-BCC was defined as having at least nine basal cell carcinomas (BCCs) within three years or six within ten years. BCNS patients were generally younger-median age 48 versus 74-and nearly half had experienced more than 100 BCCs.
Results showed that BCNS patients reported markedly worse QoL outcomes, especially in emotional and functional domains. Severe emotional impairment was reported by 36.0% of BCNS patients, while 22.7% experienced severe functional impairment. After adjusting for age and sex, overall scores remained significantly higher in the BCNS group by a mean of 10 points.
Importantly, increasing BCC burden was associated with poorer QoL among BCNS patients. Those with more than 100 BCCs reported substantially worse scores than those with fewer than 30 tumours. This relationship was not observed in the HF-BCC cohort, suggesting cumulative disease burden unique to BCNS carries psychosocial consequences.
Investigators noted that repeated treatments, lifelong surveillance, cosmetic concerns, and uncertainty surrounding future tumour development likely contribute to emotional strain. The findings support a more holistic approach to care, including routine assessment of emotional wellbeing and social functioning during dermatology consultations.