This is a retrospective study designed to compare the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in the head and neck skin area with special reference to the pinna.

The results showed 426 patients had 460 cutaneous malignancies in the head and neck area, managed by four specialities (ENT, Dermatology, General Surgery and GPs) over the period 1994–99. The lesions comprised 375 (80.47 per cent) BCC and 85 (18.47 per cent) SCC. In cases of BCC the facial areas were commonly involved (88 per cent), whilst SCC was almost equally distributed between the most (face, forehead and nose) and least exposed areas (pinna and scalp). The overall ratio of BCC to SCC remained four to one in the head and neck area. In 41 patients with 51 lesions over the pinna there were 29 (56.8 per cent) BCC and 22 (43.1 per cent) SCC hence the ratio was 1.3 to 1 for this site.

We conclude that in the case of a suspicious lesion over the pinna, the risk of SCC is comparatively much higher. With increasing awareness of early and quick diagnosis of cancer cases, it is recommended that these patients should be referred urgently to prevent the significant morbidity associated with invasive SCC.