Evaluation of digit ratio (2D:4D) and its relationship with skin sebum level in patients with basal cell carcinoma

• Published in: Archives of dermatological research Vol. 317; no. 1; p. 707
• Main Authors: Can, Ismail, Akyurek, Fatma Tuncez
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 12.04.2025; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Basal cell carcinoma; Carcinoma; Carcinoma, Basal Cell - metabolism; Carcinoma, Basal Cell - pathology; Dermatology; Female; Fingers - anatomy & histology; Hedgehog protein; Humans; Localization; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Patients; Sebum - metabolism; Sex differences; Sex Factors; Sex hormones; Skin; Skin - metabolism; Skin - pathology; Skin Neoplasms - diagnosis; Skin Neoplasms - metabolism; Skin Neoplasms - pathology; 2D:4D ratio; Skin sebum level; Basal cell carcinoma
• ISSN: 1432-069X; 0340-3696; 1432-069X
• DOI: 10.1007/s00403-025-04225-8

Introduction The main factor in the development of basal cell carcinoma (BCC) is UV (ultraviolet) exposure. In most cases of BCC there is upregulation of the ‘Sonic Hedgehog’ (SHH) pathway components. Some recent studies have shown that overactivity of the SHH pathway leads to an increase in the number of sebocytes in the skin. Sex differences in tumor formation suggest a possible role of sex hormones in the development of skin cancers. Objective We aimed to evaluate the 2D:4D ratio and its relationship with skin sebum level in patients with BCC. Methods Finger length measurements were made using digital calipers. Skin sebum levels were measured using sebumeter. Results The study included 64 patients with BCC(mean age 67) and 64 healthy subjects(mean age 71) aged 37–92 years. T score (average of sebum levels on forehead, nose and chin) and total sebum score (TSS) were higher in patients with BCC. U score (average of sebum levels of right and left cheeks) was similar in patients and control group. In male subjects, T score, U score and TSS were significantly higher in the patient group. In female subjects, there was no significant difference between the patient and control groups in T score, U score and TSS. The 2D:4D ratio in both hands was similar in the patient and control groups. When evaluated according to the localization of the lesions, the T score and the TSS were found to be higher in male subjects with BCC lesions in the T region than in the control group. In the female patient group, the T score was found to be significantly higher than in the control group. Conclusion There was no correlation between BCC and 2D:4D ratio. We found that skin sebum levels were higher in male patients with BCC compared to the control group. Defining the relationship between BCC and sebum levels may play an important role in the evaluation of the occurrence and prognosis of the disease.