Introduction: Non-melanoma skin cancers (NMSC) represent a significant global public health burden, particularly in highincome countries. The increasing incidence of head and neck NMSC contributes to rising morbidity and necessitates multi-disciplinary management. Objectives: This study aims to evaluate the incidence, demographic distribution, histological subtypes, and seasonal variation of NMSC over a five-year period at a tertiary center in Romania. Materials and Methods: A retrospective observational study was conducted from January 2020 to December 2024, including 180 patients diagnosed and treated for malignant skin lesions. Data were extracted from clinical and histopathological records. Chi-square tests assessed seasonal distribution, and Mann-Whitney U tests compared lesion depth and surface area between demographic groups. Results: A total of 388 malignant lesions were recorded. Basal cell carcinoma (BCC) was the most common subtype (n = 168), followed by squamous cell carcinoma (SCC) (n = 25). Most patients resided in urban areas, particularly Bucharest. Males presented with significantly deeper lesions (mean: 1.5 mm) compared to females (mean: 1.25 mm; p = 0.009). Seasonal analysis revealed a significant variation in incidence, with the lowest number of cases in spring (χ² = 10.31, p = 0.016). Conclusion: The incidence of malignant skin lesions increased from 2020 to 2023, followed by a decline in 2024. Seasonal and sex-related differences were observed, with the face being the most frequent site of involvement. While the sex distribution was relatively balanced, males exhibited significantly greater lesion depths compared to females.
Background: Head and neck keratinocyte carcinomas are frequently managed surgically; anatomic constraints may increase the risk of incomplete excision and influence reconstructive choices. Objectives: To describe the clinicopathological characteristics of head and neck non-melanoma skin cancers (NMSC) treated in a tertiary care dermatology department and to explore factors associated with resection status (R0 vs R1) and reconstructive approach after conventional excision. Methods: We performed a retrospective observational study of 117 patients undergoing excision of 134 primary head and neck NMSC between September 2025 and January 2026. Demographic, clinical, histopathological, and procedure-related variables were extracted from medical records and pathology reports. Margin status was assessed for conventionally excised lesions. Results: Most lesions were basal cell carcinomas (113/134, 84.3%) and were located on the cheek (31.3%) or nose (29.8%). Conventional excision was performed in 126/134 lesions (94%). Among conventionally excised lesions, 92% had complete resection (R0) and 8% had positive margins (R1), most commonly involving the lateral margin. Conclusions: In this single-center cohort, head and neck NMSC clustered in high-risk anatomic regions, and a small proportion of conventionally excised tumors showed positive margins. Clear reporting of margin involvement and reconstruction patterns may support quality improvement and guide future prospective follow-up.
