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Basal Cell Carcinomas and Actinic Keratoses Seen in Dermatological Practice in France: A Cross-Sectional Survey

Background: Most actinic keratoses (AKs) and a number of basal cell carcinomas (BCCs) cannot be assessed by pathological records. Objective: To estimate prospectively the figures and characteristics of BCCs and AKs seen by French dermatologists, their medical load, and present a more realistic approach to their incidence. Methods: A cross-sectional study conducted in France in a representative sample of dermatologists (n = 215). Out-patients seen for 1 or more BCCs or AKs were recorded over 4 non-consecutive weeks. Results: Among 78,300 out-patients, 1,321 had 1 (or more) BCC, and 3,688 had 1 or more AKs (1 and 5% of consultations made by dermatologists). When extrapolating, the medical load in France was estimated at 248,000 and 693,000 consultations/year leading to a clinical diagnosis of BCC and AK, respectively. A total of 1,655 BCCs were diagnosed including 839 superficial (50.7%), 636 nodular (38.4%), 137 morpheiform (8.3%) and 43 other types (2.6%). Superficial and nodular BCCs were more frequently diagnosed with a small size (<10 mm) than morpheiform BCCs. Conclusion: Our study in France provides the first estimate of the clinical burden represented by AKs and BCCs in dermatology practice.