Patients at risk of skin cancers can develop varying types of cutaneous malignancies. However, some subjects may develop only one type of lesion. In this cross-sectional study, the spectrum of premalignant (PM) and malignant skin lesions and their risk factors were studied. Therefore, 505 adult subjects (aged 21–79 years, 256 males and 249 females, 96 with immunosuppression) at risk of any type of skin cancer were examined for cutaneous malignancies, nevi, actinic keratoses, photodamage, and possible risk factors. First, 12 different groups were identified with a varying set of PM and/or malignant skin lesions. Next, 5 larger groups were formed from them: basal cell carcinoma (BCC) only, malignant melanoma (MM) only, squamous cell carcinoma (SCC) and/or PM, BCC + SCC and/or PM, and MM + keratinocyte carcinoma (KC) and/or PM. The groups with BCC or MM only were younger and showed less photodamage than the mixed groups, while SCC/PM showed similarity with them. In logistic regression analyses, the platelet-to-lymphocyte ratio was associated with an increased risk of concomitant KC (OR 1.028, p = 0.023) or SCC/PM (OR 1.009, p = 0.047) in subjects with MM or BCC, respectively. Actinic keratoses produced ORs 0.246–0.252 (p = 0.008–0.020) for BCC in subjects with SCC/PM. Interestingly, atypical mole syndrome decreased the risk of SCC/PM in subjects with BCC (OR 0.092, p = 0.001). Advanced age was a significant risk factor for an additional type of lesion in all 3 comparisons (ORs 1.088–1.388, p = 0.001). In conclusion, even though there are numerous patients with only one lesion type, advancing age may determine the final lesion multiplicity.

中文翻译：

---

505 名有皮肤癌风险的成人受试者的恶性和癌前皮肤病变谱

有皮肤癌风险的患者可能会患上不同类型的皮肤恶性肿瘤。然而，一些受试者可能仅出现一种类型的病变。在这项横断面研究中，研究了癌前 (PM) 和恶性皮肤病变的范围及其危险因素。因此，对 505 名有任何类型皮肤癌风险的成年受试者（年龄 21-79 岁，256 名男性和 249 名女性，96 名免疫抑制患者）进行了皮肤恶性肿瘤、痣、光化性角化病、光损伤和可能的危险因素的检查。首先，12 个不同的群体被鉴定出具有不同的 PM 和/或恶性皮肤病变。接下来，由它们组成 5 个较大的组：仅基底细胞癌 (BCC)、仅恶性黑色素瘤 (MM)、鳞状细胞癌 (SCC) 和/或 PM、BCC + SCC 和/或 PM、以及 MM + 角化细胞癌（ KC) 和/或 PM。仅具有 BCC 或 MM 的组比混合组更年轻且光损伤更小，而 SCC/PM 则与混合组相似。在逻辑回归分析中，血小板与淋巴细胞比率分别与 MM 或 BCC 受试者中伴随 KC（OR 1.028，p = 0.023）或 SCC/PM（OR 1.009，p = 0.047）的风险增加相关。在 SCC/PM 受试者中，光化性角化病对 BCC 产生的 OR 为 0.246–0.252 (p = 0.008–0.020)。有趣的是，非典型葡萄胎综合征降低了 BCC 受试者发生 SCC/PM 的风险（OR 0.092，p = 0.001）。在所有 3 项比较中，高龄是其他类型病变的重要危险因素（OR 1.088–1.388，p = 0.001）。总之，即使有许多患者只有一种病变类型，但年龄的增长可能决定最终病变的多样性。