Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing over the years. Risk factors for local recurrence and metastasis have been widely studied in highly sun-exposed areas of the body but less data exist about less sun-exposed ones. The main objective of this study is to compare the risk of local recurrence and metastases in patients with cSCC in highly sun-exposed areas compared to cSCC in less sun-exposed areas. Material and methods: A retrospective observational study was carried out, including 558 patients with histopathologically confirmed cSCC at the Reina Sofía University Hospital (HURS), Córdoba, during the period from 1 January 2017 to 31 December 2020. Demographic, clinical and anatomopathological data were collected. Results: Local recurrence occurs more often in highly sun-exposed areas (15.8%) compared to less sun-exposed ones (7.4%) (p < 0.05). However, no differences in the rate of metastases in both groups were found. The presence of affected surgical margins and tumor thickness were identified as independent risk factors for cSCC in low sun-exposure areas. Conclusions: cSCC located in anatomical areas of high sun exposure presented a greater risk of developing local recurrence in our population, which could suggest that these tumors have worse prognosis than those that lie in areas that do not receive chronic sun exposure.

Introduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm, and its incidence is on the rise. While most cSCCs have an excellent prognosis, certain risk factors, especially immunosuppression, have been associated with higher rates of local recurrence (LR), metastasis, and poor prognosis. This study aims to assess the risk factors for LR and metastasis development in cSCC among solid organ transplant recipients (SOTRs) and compare these rates with those in immunocompetent patients. Materials and Methods: A retrospective observational study included cSCC cases from the University Hospital Reina Sofía in Córdoba, Spain, between 2002 and 2019. Demographic, clinical, and histopathological data were collected. Local recurrence and metastasis rates were analyzed, along with progression-free survival. Univariate analyses were performed to identify prognostic factors in SOTRs. Results: Among 849 cSCC cases, we found higher rates of local recurrence and metastasis in tumors developed by SOTRs compared to those in immunocompetent individuals. However, no significant differences in local recurrence, metastasis, or progression-free survival were observed between the two groups. Risk factors for adverse outcomes in SOTRs included tumor size > 2 cm, depth > 4 mm, and a higher Clark level. A total of 34.4% of SOTRs developed a second primary cSCC during the follow-up. Conclusions: In our study, cSCCs in SOTRs did not exhibit statistically significant differences in the rates of adverse outcomes compared to immunocompetent patients. The prognosis of cSCCs in SOTRs may be more related to other tumor-dependent risk factors than to the immunosuppression status itself. Future studies are needed to refine risk stratification and follow-up protocols to ensure the optimal management of high-risk cSCC cases, particularly among immunosuppressed patients.

Central centrifugal cicatricial alopecia (CCCA) is the most common scarring alopecia among women of African descent and has been increasingly associated with systemic comorbidities, particularly cardiometabolic and fibroproliferative conditions. We conducted a PRISMA 2020 compliant systematic review and random-effects meta-analysis, prospectively registered in PROSPERO (CRD420250656067), to quantify pooled prevalence estimates and case–control associations for comorbidities in CCCA. MEDLINE and Embase were searched through 18 June 2025 for observational studies reporting comorbidities in CCCA. Twenty three studies, comprising 9,103 patients with CCCA, were eligible. Hypertension (51.9%, 95% CI 33.8–69.6), dyslipidemia (58.4%, 95% CI 29.0 82.8), obesity (37.1%, 95% CI 10.8–74.2) and uterine leiomyomas (28.0%, 95% CI 8.0–64.0) were frequently reported, with substantial heterogeneity across studies. In case–control analyses, CCCA was significantly associated with dyslipidaemia (OR 4.46, 95% CI 1.09–18.25), uterine leiomyomas (OR 2.25, 95% CI 1.10–4.58) and anxiety disorders (OR 3.27, 95% CI 1.22–8.79), whereas hypertension, obesity and thyroid disease were not consistently associated. Most included studies were retrospective and predominantly U.S.-based, contributing to methodological heterogeneity. These findings suggest that CCCA may be accompanied by a substantial burden of medically recorded systemic comorbidities and support holistic, individualized clinical assessment.