Correlation of embryonic fusion planes with the anatomical distribution of basal cell carcinoma.

BACKGROUND: The clinical relevance of the anatomic distribution of basal cell carcinoma is not completely understood. Embryonic fusion planes--the regions of mesenchymal migration and fusion of the five primordial facial processes during the 5th to 10th weeks of human development--have been implicated in the pathogenesis of basal cell carcinoma. OBJECTIVE: This study sought to examine the predilection of midfacial basal cell carcinoma for cutaneous anatomical sites correlated to embryonic fusion planes. METHODS AND MATERIALS: Using archived digital images and a detailed anatomic diagram, cases of basal cell carcinoma were coded according to their specific location and were aggregated into two anatomic domains according to their correlation to embryonic fusion planes. The relative tumor densities were calculated. RESULTS: Of the 1,457 cases examined, 859 were located in the midface. Thirty-five percent of the midfacial lesions were located on the domain correlated to embryonic fusion planes, which represented 11.3% of the total surface area of the midface. The relative tumor density of lesions in the fusion plane domain was 3.06 compared to 0.74 for the remaining lesions (p< .001). CONCLUSIONS: Although there is no consensus about the importance of anatomic location in the pathogenesis of basal cell carcinoma, these data indicate that, after adjusting for surface area, basal cell carcinoma was more than four times more likely to occur on an embryonic fusion plane than on other regions of the midface. These data support the possibility of an embryologic role for the pathogenesis of basal cell carcinoma.

The differential effects of face-to-face and computer interview modes.

OBJECTIVES: This study assessed the differential effects of face-to-face interviewing and audio-computer assisted self-interviewing (audio-CASI) on categories of questions. METHODS: Syringe exchange program participants (n = 1417) completed face-to-face interviews or audio-CASI. The questionnaire was categorized into the groups "stigmatized behaviors," "neutral behaviors," and "psychological distress." Interview modes were compared for questions from each category. RESULTS: Audio-CASI elicited more frequent reporting of "stigmatized behaviors" than face-to-face interviews. Face-to-face interviewing elicited more frequent reporting of "psychological distress" than audio-CASI. CONCLUSIONS: Responding to potentially sensitive questions should not be seen as merely "providing data," but rather as an activity with complex motivations. These motivations can include maintaining social respect, obtaining social support, and altruism. Ideally, procedures for collecting self-report data would maximize altruistic motivation while accommodating the other motives.