Basal cell carcinomas (BCCs) are the most frequent malignant tumors in humans, accounting for 75–80 % of non-melanoma skin cancers (NMSC), and typically involve chronically sun-exposed areas in elderly patients.1,2 In the elderly population, age-related immune system impairment (immunosenescence) may play a significant role in promoting the development of more aggressive, giant or difficult-to-treat BCCS, potentially influencing both tumor behavior and therapeutic response