LAUSR

A66-year-oldCaucasianmale presented for treatment of 3 basal cell carcinomas (BCCs) located on the left side of his back. He had previously been treated for approximately 20 BCCs on the trunk as well as the upper and lower extremities. He was first diagnosed with BCC at 59 years of age. Interestingly, the patient had a history of left hemibody anhidrosis of unknown etiology, which he reported had been present since birth. The patient’s pattern of anhidrosis was most often seen during golf outings on hot days. He noted that the right side of his shirt became soaked with sweat, whereas the left side remained dry. The patient reported no associated symptoms and denied symptoms of autonomic instability such as orthostasis, rapid heart rate, and difficulty with urination. His medical history was notable for the absence of any diagnosed neurological disease or malignancies other than BCC. The patient did not have a history of traumatic spinal cord injuries, and he denied any previous spinal surgeries. He noted several sunburns during his childhood but no history of tanning bed use. Family history was negative for unilateral anhidrosis, BCC, or neurologic disease. His father had a history of squamous cell carcinoma, and his mother had been treated for breast cancer. Upon reviewing the patient’s history and performing a physical examination, the observation was made that all but one of the patient’s previous 20 skin cancers, all BCCs, presented on the left hemibody. This raised the question of an association between anhidrosis and increased occurrence of BCCs. After review of the literature, 2 conditions that can present with anhidrosis and/or multiple BCCs are Harlequin syndrome and Bazex–Dupre–Christol (BDC) syndrome.