The most important risk factor for the development of basal cell carcinoma (BCC) is a prior history of the disease, according to an analysis of data from a study of more than 1100 people at high risk for the disease.

In addition, for the first time, a history of eczema has been linked to the disease.

Martin Weinstock, MD, professor of dermatology at Brown University and a clinician at the Veterans Affairs Medical Center in Providence, Rhode Island, and colleagues authored the study, which was published online July 19 in the Journal of Investigative Dermatology.

“Predictors of new BCCs on the face and ears among those at very high risk have not been studied in detail,” the authors note.

“In an attempt to better define risk factors for future BCCs in an important high-risk group, we studied predictors of BCCs among individuals who had at least two prior keratinocyte carcinomas (KCs) who participated in the Veterans Affairs Topical Tretinoin Chemoprevention (VATTC) Trial.”

That trial randomly assigned 1131 US military veterans, 97% of whom were men, to prophylactic treatment against BCC with either topical tretinoin or a topical placebo vehicle. Participants were also provided with sun protection factor 15 or greater sunscreen and were encouraged to use it during the study. Every 6 months, participants were examined by a study dermatologist.

Participants in the study tended to have heavily sun-damaged skin and, on average, 3.6 KCs during the 5 years preceding entry into the study.

Dr. Weinstock chaired this multicenter trial, which concluded last year, after a median follow-up of 3.6 years, but the results were disappointing: treatment with tretinoin failed to

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