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Lines under the eyes: a large prospective case series of linear basal cell carcinomas


Basal cell carcinomas (BCC) are the most common form of cancer globally. Linear BCCs are an unusual variant which are generally defined by having a length three times longer than the width and exhibiting relatively straight edges. In this report, we describe the largest global cohort (n = 31) with this rare subtype. Within this cohort, 22 were in the periocular region, 27 underwent Mohs micrographic surgery and 12 involved oculoplastic reconstruction. These results suggest that, whilst this subtype is relatively rare, it may be more prevalent than previously thought. Dermatologists and other specialities managing skin cancer, particularly ophthalmologists, should, therefore, be aware of this subtype, as it is often more aggressive than other BCC subtypes, often requiring multi-disciplinary management.

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Fig. 1



Basal cell carcinoma


Mohs micrographic surgery


United Kingdom


  1. Reinau D, Surber C, Jick SS, Meier CR (2014) Epidemiology of basal cell carcinoma in the United Kingdom: incidence, lifestyle factors, and comorbidities. Br J Cancer.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Peterson SC, Eberl M, Vagnozzi AN, Belkadi A, Veniaminova NA, Verhaegen ME et al (2015) Basal cell carcinoma preferentially arises from stem cells within hair follicle and mechanosensory niches. Cell Stem Cell.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Grachtchouk M, Pero J, Yang SH, Ermilov AN, Michael LE, Wang A et al (2011) Basal cell carcinomas in mice arise from hair follicle stem cells and multiple epithelial progenitor populations. J Clin Invest.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dourmishev L, Rusinova D, Botev I (2013) Clinical variants, stages, and management of basal cell carcinoma. Indian Dermatol Online J.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lewis JE (1985) Linear basal cell epithelioma. Int J Dermatol.

    Article  PubMed  Google Scholar 

  6. Al-Niaimi F, Lyon CC (2011) Linear basal cell carcinoma: a distinct condition? Clin Exp Dermatol.

    Article  PubMed  Google Scholar 

  7. Lim KK, Randle HW, Roenigk RK, Brodland DG, Bernstein SC, Marcil I (1999) Linear basal cell carcinoma: report of seventeen cases and review of the presentation and treatment. Dermatologic Surg.

    Article  Google Scholar 

  8. Hussain W, Affleck A, Al-Niaimi F, Cooper A, Craythorne E, Fleming C et al (2017) Safety, complications and patients’ acceptance of Mohs micrographic surgery under local anaesthesia: results from the U.K. MAPS (Mohs Acceptance and Patient Safety) Collaboration Group. Br J Dermatol.

    Article  PubMed  Google Scholar 

  9. Brailey LL, Davis T, Kolker SE, Murry TC, Thomas D, Bale AE et al (2007) Congenital linear unilateral basal cell nevus: a case report with patched gene molecular studies. J Cutan Pathol 34(1):65–70

    CAS  Article  Google Scholar 

  10. Ward JM, Russell M (2019) Recurrence of linear basal cell carcinoma. Cutis 104:114

    PubMed  Google Scholar 

  11. Peschen M, Lo JS, Snow SN, Mohs FE (1993) Linear basal cell carcinoma. Cutis 51:287

    CAS  PubMed  Google Scholar 

  12. Noodleman FR, Pollack SV (1986) Trauma as a possible etiologic factor in basal cell carcinoma. J Dermatol Surg Oncol.

    Article  PubMed  Google Scholar 

  13. Sekulic A, Migden MR, Basset-Seguin N, Garbe C, Gesierich A, Lao CD et al (2017) Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: final update of the pivotal ERIVANCE BCC study. BMC Cancer 17(1):332.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. Frakulli R, Galuppi A, Cammelli S, Macchia G, Cima S, Gambacorta MA et al (2015) Brachytherapy in non melanoma skin cancer of eyelid: a systematic review. J Contemp Brachytherapy 7(6):497–502.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Rutkowski D, Littlewood Z, Touyz SJJ, Collier NJ, Madan V, Ghura HS et al (2022) Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital. Clin Exp Dermatol.

    Article  PubMed  Google Scholar 

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Correspondence to D. Rutkowski.

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Rutkowski, D., Collier, N.J., Telfer, N. et al. Lines under the eyes: a large prospective case series of linear basal cell carcinomas. Arch Dermatol Res (2022).

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