Simultaneous Development of SCC of the head and BCC of the leg: Successful Surgical Approach in Bulgarian patient

Non-melanoma skin cancer (NMSC) is one of the most common cutaneous malignancies, with an ever-increasing incidence rate worldwide [1]. Studies have shown an association between intermittent and chronic sunlight exposure and the development of BCC and SCC respectively [2]. UV radiation is a known carcinogen that can induce mutations in the p53 gene, known also as the guardian of the genome [3]. This can lead to persistent damage and failure to eliminate dysplastic cells as subsequent mechanisms like p21 and p16 activation fail to arrest cell cycle. Proapoptotic proteins such as BAK and BAX are also unable to activate programmed cell death, ultimately leading to the formation of precancerous lesions and NMSC [3, 4].