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Research Letter
March 2014

Fluorouracil and Other Predictors of Morpheaform Basal Cell Carcinoma Among High-Risk Patients: The Veterans Affairs Topical Tretinoin Chemoprevention Trial

Michael Y. Xiong, BA1,2; Kaveri Korgavkar, BS1,2; John J. DiGiovanna, MD3; et al Martin A. Weinstock, MD, PhD1,2,4,5; for the Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial Group
Author Affiliations
  • 1Dermatoepidemiology Unit, VA Medical Center, Providence, Rhode Island
  • 2Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
  • 3DNA Repair Section, Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
  • 4Department of Dermatology, Rhode Island Hospital, Providence
  • 5Department of Epidemiology, Brown University, Providence, Rhode Island
JAMA Dermatol. 2014;150(3):332-334. doi:10.1001/jamadermatol.2013.5619

Although basal cell carcinoma (BCC) overall is less aggressive than other forms of skin cancer, the morpheaform subtype is particularly concerning because of its benign appearance and aggressive subclinical spread. We sought to evaluate risk factors for its development on the face or ears in a high-risk population of veterans with at least 2 prior keratinocyte carcinomas in the Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial.

The VATTC Trial included 1131 high-risk veterans followed up for 2 to 6 years, as described elsewhere.1 We determined risk factors for time to first morpheaform BCC (mBCC) within the entire study population via Cox regression (measured by hazard rate ratio [HRR]) and also compared the risk of developing mBCC relative to that of developing nonmorpheaform BCC (nmBCC) via logistic regression (measured by odds ratios [ORs]). All variables with P values <.15 in the univariate models were included in the multivariate backward stepwise regression models. The study was approved by multiple ethics and oversight committees; informed consent was obtained for this study.