There is little evidence regarding the impact of COVID-19 lockdown on skin tumour burden. The COVID-19 lockdown resulted in a reduction in surgery for melanoma and cutaneous squamous cell carcinoma and an increase in the proportion of tumours with a worse prognosis. The increase was due to patient-dependent factors; in particular, fear of SARS-CoV-2 infection. Therefore, health education programmes targeting the general population are needed to ensure the prompt treatment of patients with skin cancer. The aim of this study was to compare tumour burden in patients who underwent surgery for melanoma and cutaneous squamous cell carcinoma during nationwide lockdown inSpain due to COVID-19 (for the period 14 March to 13 June 2020) and during the same dates in 2019 before the COVID-19 pandemic. In addition, associations between median tumour burden (Breslow thickness for melanoma and maximum clinical diameter for cutaneous squamous cell carcinoma) and demographic, clinical, and medical factors were analysed, building a multivariate linear regression model. During the 3 months of lockdown, there was a significant decrease in skin tumours operated on (41% decrease for melanoma (n = 352 vs n = 207) and 44% decrease for cutaneous squamous cell carcinoma (n = 770 vs n = 429)) compared with the previous year. The proportion of large skin tumours operated on increased. Fear of SARS-CoV-2 infection, with respect to family member/close contact, and detection of the lesion by the patient or doctor, were related to thicker melanomas; and fear of being diagnosed with cancer, and detection of the lesion by the patient or relatives, were related to larger size cutaneous squamous cell carcinoma. In conclusion, lockdown due to COVID-19 has resulted in a reduction in treatment of skin cancer.

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Darier disease at age 75 affecting her neck, upper back and limbs with no positive family history is the latest onset reported sporadic case of the condition to date. 5 Our case is an atypical one, but highlights the potential for Darier disease, a condition which most commonly presents in early life, to sporadically arise in the elderly.