SCC of the Nose and Metatypical BCC of the Shoulder Developing during Treatment with Valsartan/ Chlortalidone: Nitrosamine Contamination as Main Skin Cancer Triggering Factor

A 75-year-old male presented himself in the department with primary complaints of a slowly progressive formation in the area of the nose dating from about 6 months. A punch biopsy was taken before hospitalization which resulted in keratinizing squamous cell carcinoma G2 with deep infiltration to the level of the sweat glands, staged later as T1N0M0. No reported allergies or any malignancy in any family member. In 2020 the patient reported a surgical excision of a lesion located in the right shoulder area which resulted in the confirmation of the diagnosis metatypical BCC with clear resection lines. Comorbidities: gonarthrosis, combined otoneurological syndrome, bilateral sensorineural hearing loss. In 2013 the patient was diagnosed with arterial hypertension for which he was taking Valsartan 160 mg once daily for nine years (until 2022) and then the therapy was switched to Chlortalidone 12.5 mg once daily.