Episode 49 - Quality of life in patients with BCNS

In this episode of BJD Talks, Sam and Meera discuss the article ‘Health-related quality of life in patients with basal cell naevus syndrome and high-frequency basal cell carcinoma: a questionnaire study’ by Massella Patsea et al. The full article can be accessed at https://doi.org/10.1093/bjd/ljag212

 *This podcast was generated by an AI tool created by 67Bricks for the British Association of Dermatologists*

Transcript

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SPEAKER_00 0:00

Welcome to BJD Talks, the official podcast of the BJD. I'm Sam.

SPEAKER_01 0:04

And I'm Mira. In this episode, we will be discussing the article by Anna Macella Patsya Al, Health Related Quality of Life in Patients with Basal Cell Niver Syndrome and High Frequency Basal Cell Carcinoma, a questionnaire study. From May 2026 and included in the September 2026 issue.

SPEAKER_00 0:24

Let's get started. Basal cell carcinoma, or BCC, is known as the most common type of skin cancer worldwide, generally with a good prognosis. However, this study focuses on patients developing multiple BCCs, either due to basal cell Neva syndrome or BCNS, or as high frequency BCC cases without a genetic link. It highlights the differing psychological and social burdens these groups experience.

SPEAKER_01 0:51

It does. The contrast between BCNS and HFBCC patients is stark. This Dutch study found that BCNS patients experience a far worse quality of life, particularly in emotional and functional domains, as measured by the SkinDEX 29 questionnaire, which is validated for dermatology-specific quality of life assessments.

SPEAKER_00 1:11

And the disparity in numbers is striking. BCNS patients had a median age of 48 versus 74 for HFBCC patients. Nearly half of the BCNS group had over 100 BCCs in their lifetime, compared to just 2% of HFBCC patients. That's an immense physical and psychological burden.

SPEAKER_01 1:33

Indeed, BCNS patients reported significant emotional challenges, worrying about their condition worsening, scarring, and its impact on work, hobbies, and social relationships. Their mean emotional impact score on SkinDEX 29 was 32.2, over double the 15.5 recorded by HFBCC patients.

SPEAKER_00 1:55

Another key finding was the correlation in BCNS patients. The more BCCs they had, the greater their quality of life impairment across emotional, functional, and symptomatic categories. HFBCC patients, however, didn't show this correlation. Having more tumours didn't necessarily worsen their quality of life.

SPEAKER_01 2:14

It's intriguing. This suggests tumour burden interacts uniquely with syndrome-related factors for BCNS patients, like lifelong surgeries or concerns about passing the condition on genetically. It's more than just the physical burden of frequent lesions.

SPEAKER_00 2:29

Which underscores how clinicians might intervene. The authors recommend addressing emotional strain alongside physical symptoms. It's not just about lesion management. Patients face daily fears, functional struggles, and social challenges.

SPEAKER_01 2:44

Exactly. A holistic care approach is crucial. The study emphasizes that the number of BCCs can serve as a red flag for patients potentially needing additional psychosocial support.

SPEAKER_00 2:55

On methodology, participants were recruited through hospitals and Dutch patient associations, ensuring a broad demographic. The Skindex 29 assessed symptoms like itching and pain, as well as emotional and functional limitations, providing a comprehensive view of the condition's impact.

SPEAKER_01 3:13

Although the Skin Dex 29 does present a limitation, it captures issues over a one-week time frame. While precise, it may miss the long-term challenges BCNS patients face. Still, the study offers valuable insights, such as the importance of incorporating psychological support into routine care.

SPEAKER_00 3:33

And their findings hold up. Patients were tracked over six months to account for potential seasonal quality of life variations, and no substantial changes were reported, reinforcing the data's reliability.

SPEAKER_01 3:47

In conclusion, this study highlights BCNS as a condition of significant physical complexity and deep emotional strain. The connection between tumour burden and poor quality of life underpins the need for comprehensive care, including mental health support.

SPEAKER_00 4:03

Meanwhile, HFBCC patients, while also dealing with frequent tumours, face a fundamentally different set of challenges. The comparison reminds us to tailor care to each patient's unique circumstances.

SPEAKER_01 4:15

Well put, Sam. That's all for this episode of BJD Talks. Thanks for listening, and we'll see you next time.