We read with interest the letter from Dr Corona and agree with her that epidemiological studies of photoaging and skin cancer are highly dependent on accurate recall of sun exposure by study subjects. This recall is highly subjective and in many cases unreliable. We did include Fitzpatrick skin type and smoking in our multivariate model, although neither of these factors showed significant differences between the BCC and non-BCC groups studied. For the Observation section of the ARCHIVES, we selected our table and figures to convey the main message of the article, ie, discordance between presence of wrinkles and BCC—particularly with specialist dermatologists in mind as opposed to those with deeper epidemiological experience. Our study was a pilot to initially verify the anecdotal clinical observation made not only by us but also other dermatologists actively involved in the surgical management of patients with BCC. The perplexing issue of whether there is a linear relationship between the presence of BCC and previous sun exposure undoubtedly requires a much larger, well-funded, epidemiological study well beyond the resources of our small pilot study.
Brook RCC, Griffiths CEM. Facial Wrinkling and Basal Cell Carcinoma—Reply. Arch Dermatol. 2002;138(2):268. doi:10.1001/archderm.138.2.266