{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:09:46Z","timestamp":1780981786650,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,1,28]],"date-time":"2024-01-28T00:00:00Z","timestamp":1706400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While ultraviolet radiation (UVR) present in sunlight is recognized as the main etiological agent of skin cancer, the most frequent form of which is basal cell carcinoma (BCC), other exposome factors like pollution, diet, and lifestyle may also contribute. This study aimed to investigate the association of BCC and exposome\u2010related factors in the Spanish population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BCC cases (<jats:italic>n<\/jats:italic>\u2009=\u2009119) and controls (<jats:italic>n<\/jats:italic>\u2009=\u2009127) with no history of skin cancer were recruited between April 2020 and August 2022 by 13 dermatologists throughout Spain in this prospective multicenter case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The BCC group had a higher proportion of outdoor workers, more years of UVR exposure, and a greater consumption of drugs (statins, ASA, hydrochlorothiazide, ACE inhibitors and omeprazole), <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05. Avoidance of sun exposure was the most used photoprotection measure in both groups. The use of hats or caps was higher in the BCC group (<jats:italic>P<\/jats:italic>\u2009=\u20090.01). The solar protection factor (SPF) used 15\u2009years previously was higher in the control group (<jats:italic>P<\/jats:italic>\u2009=\u20090.04). The control group had a higher daily screen time (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and practiced more relaxation activities (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). Higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with BCC (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Statistical significance for all the aforementioned variables was maintained in the multivariate analysis (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study found a significant association between BCC and multiple exposome\u2010related factors in addition to chronic sun\u00a0exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers, promoting sun\u2010safe behaviors and stress\u2010reducing activities, and also adequate skin photoprotection in patients on certain medications associated with increased BCC risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.17026","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T04:59:06Z","timestamp":1706504346000},"page":"907-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Exposome and basal cell carcinoma: a multicenter case\u2013control study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-6007","authenticated-orcid":false,"given":"Alba","family":"Navarro\u2010Bielsa","sequence":"first","affiliation":[{"name":"Department of Dermatology Hospital Universitario Miguel Servet, IIS Arag\u00f3n, Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Gracia\u2010Caza\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Miguel Servet, IIS Arag\u00f3n, Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Almagro","sequence":"additional","affiliation":[{"name":"Department of Dermatology Complejo Hospitalario Universitario A Coru\u00f1a  Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"De\u2010la\u2010Fuente\u2010Meira","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Cl\u00ednico Lozano Blesa  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngeles","family":"Florez","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Pontevedra  Pontevedra Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriol","family":"Y\u00e9lamos","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4035-7955","authenticated-orcid":false,"given":"Trinidad","family":"Montero\u2010Vilchez","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Virgen de las Nieves, Instituto de investigaci\u00f3n IBS  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Gonz\u00e1lez\u2010Cruz","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitari Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Diago","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Miguel Servet, IIS Arag\u00f3n, Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Abad\u00edas\u2010Granado","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital de Barbastro  Huesca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Fuentelsaz","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Royo Villanova  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Colmenero","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Costa del Sol  Marbella Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Ba\u00f1uls","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital General Universitario de Alicante, ISABIAL  Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Arias\u2010Santiago","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Virgen de las Nieves, Instituto de investigaci\u00f3n IBS  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Buend\u00eda\u2010Eisman","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Universidad de Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4350-401X","authenticated-orcid":false,"given":"Manuel","family":"Almenara\u2010Blasco","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Miguel Servet, IIS Arag\u00f3n, Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8469-1942","authenticated-orcid":false,"given":"Pedro","family":"Gil\u2010Pallares","sequence":"additional","affiliation":[{"name":"Department of Dermatology Complejo Hospitalario Universitario de Ferrol, Universidad de Santiago de Compostela  A Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Gilaberte","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Universitario Miguel Servet, IIS Arag\u00f3n, Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-05-0456"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2016.08.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.58"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2015.12.008"},{"key":"e_1_2_8_6_1","first-page":"1","article-title":"Solar and ultraviolet radiation","volume":"55","year":"1992","journal-title":"IARC Monogr Eval Carcinog Risks Hum"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2017-03230"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-7310(09)71906-4"},{"issue":"2020","key":"e_1_2_8_9_1","article-title":"Skin cancer prevalence in outdoor workers of ski resorts","volume":"28","author":"Gilaberte Y","year":"2020","journal-title":"J Skin Cancer"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114514004401"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1138741600006004"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2018.09.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2012.39.2.166"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19870701)60:1<118::AID-CNCR2820600122>3.0.CO;2-1"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14990"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3082"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15052"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2022.4374"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20939"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12826"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1533"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.20034"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2014.08.002"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12583"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.01.023"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvac017"},{"issue":"8","key":"e_1_2_8_28_1","first-page":"2745","article-title":"The use of HCT and\/or ACE inhibitors significantly increases the risk of non\u2010melanotic skin cancer in the periocular region","volume":"260","author":"Mehlan J","year":"2022","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.repc.2019.07.008"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2174\/1871520619666191029151545"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12388"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)12168-2"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-20-1765"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-0782"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm5020023"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cdp.2006.04.008"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28630"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000322"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.04.034"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2007.10.001"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2011.11.003"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.17026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T06:08:21Z","timestamp":1744006101000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.17026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,28]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/ijd.17026"],"URL":"https:\/\/doi.org\/10.1111\/ijd.17026","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,28]]},"assertion":[{"value":"2023-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}