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Olsen CM, Pandeya N, Ragaini BS, Neale RE, Whiteman DC. International patterns and trends in the incidence of melanoma and cutaneous squamous cell carcinoma, 1989-2020. Br J Dermatol 2024; 190:492-500. [PMID: 37890023 DOI: 10.1093/bjd/ljad425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) and melanoma have different associations with sun exposure. OBJECTIVES To compare trends in the incidence rates of cSCC and melanoma, to provide insight into changing patterns of exposure to ultraviolet radiation (UVR). METHODS We compared trends in the incidence of cSCC and melanoma in seven susceptible populations residing at mid-to-high latitudes: Finland, Norway, Sweden, Denmark, Scotland, the Netherlands and Tasmania (Australia). We fitted Joinpoint models to describe trends in age-standardized incidence rates for melanoma and cSCC and calculated the average annual percentage rate of change for the period 1989-2020 (1989-2018 for Tasmania). We calculated the incident rate ratio (IRR) as the ratio of the age-standardized rates (European Standard Population) for cSCC to melanoma and conducted age-period-cohort modelling to compare age, period and cohort effects. RESULTS The ratio of cSCC-to-melanoma incidence increased with proximity to the equator and over time. In the most recent time period, the incidence of cSCC was higher than the incidence of melanoma for men and women in all seven populations. While the ratio of cSCC-to-melanoma incidence was higher for men vs. women, in most countries the cSCC-to-melanoma IRR increased over time to a greater extent in women than in men. Melanoma incidence was higher among younger people and cSCC incidence was higher among older people; the age at which the incidence of cSCC overtook the incidence of melanoma was progressively younger with proximity to the equator. CONCLUSIONS Despite concerted international efforts to preserve the ozone layer over the past four decades resulting in significant reductions in surface ultraviolet B at mid-latitudes, the incidence of skin cancer, particularly cSCC, continues to rise in those regions. Our findings are consistent with a stronger association with age-associated cumulative sun exposure for cSCC vs. melanoma and suggest that women are currently receiving greater UV radiation exposure than in the past.
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Affiliation(s)
- Catherine M Olsen
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nirmala Pandeya
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Bruna S Ragaini
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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2
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Eggermont CJ, Eggermont AMM. Shifting landscape in skin cancer incidence: the rising tide of cutaneous squamous cell carcinoma and potential implications for prevention. Br J Dermatol 2024; 190:460-461. [PMID: 38099564 DOI: 10.1093/bjd/ljad480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/30/2023] [Indexed: 03/16/2024]
Affiliation(s)
- Celeste J Eggermont
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Alexander M M Eggermont
- University Medical Center Utrecht & Princess Maxima Center, Utrecht, the Netherlands
- Comprehensive Cancer Center München, Technical University München & Ludwig Maximilian University, Munich, Germany
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3
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Pihl C, Bjerring P, Andersen F, Haedersdal M, Lerche CM. Oral intake of bucillamine, carvedilol, metformin, or phenformin does not protect against UVR-induced squamous cell carcinomas in hairless mice. Photochem Photobiol Sci 2024; 23:517-526. [PMID: 38337129 DOI: 10.1007/s43630-024-00535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024]
Abstract
Squamous cell carcinoma represents the second most common type of keratinocyte carcinoma with ultraviolet radiation (UVR) making up the primary risk factor. Oral photoprotection aims to reduce incidence rates through oral intake of photoprotective compounds. Recently, drug repurposing has gained traction as an interesting source of chemoprevention. Because of their reported photoprotective properties, we investigated the potential of bucillamine, carvedilol, metformin, and phenformin as photoprotective compounds following oral intake in UVR-exposed hairless mice. Tumour development was observed in all groups in response to UVR, with only the positive control (Nicotinamide) demonstrating a reduction in tumour incidence (23.8%). No change in tumour development was observed in the four repurposed drug groups compared to the UV control group, whereas nicotinamide significantly reduced carcinogenesis (P = 0.00012). Metformin treatment significantly reduced UVR-induced erythema (P = 0.012), bucillamine and phenformin increased dorsal pigmentation (P = 0.0013, and P = 0.0005), but no other photoprotective effect was observed across the repurposed groups. This study demonstrates that oral supplementation with bucillamine, carvedilol, metformin, or phenformin does not affect UVR-induced carcinogenesis in hairless mice.
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Affiliation(s)
- Celina Pihl
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
- Department of Pharmacy, University of Copenhagen, 2400, Copenhagen, Denmark.
| | - Peter Bjerring
- Department of Dermatology, Aalborg University Hospital, 9100, Aalborg, Denmark
| | - Flemming Andersen
- Department of Dermatology, Aalborg University Hospital, 9100, Aalborg, Denmark
- Department of Dermatology, Private Hospital Molholm, 7100, Vejle, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2400, Copenhagen, Denmark
| | - Catharina M Lerche
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Pharmacy, University of Copenhagen, 2400, Copenhagen, Denmark
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4
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Nanz L, Keim U, Katalinic A, Meyer T, Garbe C, Leiter U. Epidemiology of Keratinocyte Skin Cancer with a Focus on Cutaneous Squamous Cell Carcinoma. Cancers (Basel) 2024; 16:606. [PMID: 38339357 PMCID: PMC10854623 DOI: 10.3390/cancers16030606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Keratinocyte skin cancer, consisting of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is by far the most common cancer in white-skinned populations, with rapid increases over the last 50 years. While the age-standardized incidence rates increase worldwide, the age-standardized mortality rates are variable. The incidence rates of keratinocyte skin cancer are much higher compared to those of melanoma, and are largely attributed to the raising exposure to ultraviolet (UV) radiation, the most important causal risk factor for skin cancer. Whereas the development of BCC is mainly due to intense UV exposure during childhood and adolescence, the development of SCC is related to chronic, cumulative UV exposure over decades. Although mortality rates are relatively low, SCC is an increasing problem for healthcare services, significantly causing morbidity, especially in older age groups. This review reports on the epidemiology of keratinocyte skin cancer, with a focus on SCC, in Australia, the United States, and the north of Europe, with an outlook on further challenges health systems will be confronted with in the next 20 years.
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Affiliation(s)
- Lena Nanz
- Center for Dermatooncology, Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany; (L.N.); (U.K.); (C.G.)
| | - Ulrike Keim
- Center for Dermatooncology, Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany; (L.N.); (U.K.); (C.G.)
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Maria-Göppert-Str. 22, 23562 Lübeck, Germany;
| | - Thomas Meyer
- Department of Dermatology, Venerology, and Allergology, University of Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
| | - Claus Garbe
- Center for Dermatooncology, Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany; (L.N.); (U.K.); (C.G.)
| | - Ulrike Leiter
- Center for Dermatooncology, Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany; (L.N.); (U.K.); (C.G.)
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5
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Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, Bataille V, Brochez L, Del Marmol V, Dummer R, Forsea AM, Gaudy-Marqueste C, Harwood CA, Hauschild A, Höller C, Kandolf L, Kellerners-Smeets NWJ, Lallas A, Leiter U, Malvehy J, Marinović B, Mijuskovic Z, Moreno-Ramirez D, Nagore E, Nathan P, Stratigos AJ, Stockfleth E, Tagliaferri L, Trakatelli M, Vieira R, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023; 192:113254. [PMID: 37604067 DOI: 10.1016/j.ejca.2023.113254] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
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Affiliation(s)
- Ketty Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | | | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London SE1 7EH, UK
| | - Lieve Brochez
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich and University Zurich, Switzerland
| | - Ana-Marie Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | | | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - Christoph Höller
- Department of Dermatology, Medical University of Vienna, Austria
| | - Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Nicole W J Kellerners-Smeets
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands; Department of Dermatology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, Croatia
| | - Zeljko Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - David Moreno-Ramirez
- Dermatology. Medicine School, University of Seville, University Hospital Virgen Macarena, Seville-Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Eggert Stockfleth
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | - Myrto Trakatelli
- Second Department of Dermatology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ricardo Vieira
- Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
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6
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Pihl C, Bendtsen KMS, Jensen HE, Andersen F, Bjerring P, Haedersdal M, Lerche CM. Oral phytochemicals as photoprotectants in UVR exposed hairless mice: A study of hesperidin methyl chalcone, phloroglucinol, and syringic acid. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 246:112760. [PMID: 37535996 DOI: 10.1016/j.jphotobiol.2023.112760] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
Ultraviolet radiation is the primary risk factor for keratinocyte carcinoma. Because of increasing incidence rates, new methods of photoprotection must be explored. Oral supplementation with photoprotective compounds presents a promising alternative. Phytochemical compounds like hesperidin methyl chalcone, phloroglucinol, and syringic acid are particularly of interest because of their antioxidant properties. Our primary outcome was to evaluate the effects of oral phytochemicals on photocarcinogenesis with time until tumour onset as the primary endpoint. A total of 125 hairless C3.Cg-Hrhr/TifBom Tac mice were randomised to receive tap water supplemented with either 100 mg/kg hesperidin methyl chalcone, phloroglucinol, or syringic acid, 600 mg/kg nicotinamide as a positive control, or no supplementation. The mice were irradiated with 3.5 standard erythema doses thrice weekly to induce photocarcinogenesis. Supplementation with the phytochemicals phloroglucinol and syringic acid and nicotinamide delayed tumour onset from a median of 140 days to 151 (p = 0.036), 157 days (p = 0.02), and 178 (p = 2.7·10-5), respectively. Phloroglucinol and nicotinamide supplementation reduced tumour number. Nicotinamide increased UV-induced pigmentation and reduced oedema formation, while phloroglucinol supplementation reduced epidermal thickness. These results indicate that oral supplementation with phloroglucinol and syringic acid protects against photocarcinogenesis in hairless mice, but not to the same extent as nicotinamide.
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Affiliation(s)
- Celina Pihl
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Pharmacy, University of Copenhagen, 2400 Copenhagen, Denmark.
| | - Katja M S Bendtsen
- Dept of Veterinary and Animal Sciences, Copenhagen University, 1870 Frederiksberg, Denmark.
| | - Henrik E Jensen
- Dept of Veterinary and Animal Sciences, Copenhagen University, 1870 Frederiksberg, Denmark.
| | - Flemming Andersen
- Dept of Dermatology, Private Hospital Molholm, 7100 Vejle, Denmark; Dept of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark.
| | - Peter Bjerring
- Dept of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark.
| | - Merete Haedersdal
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Clinical Medicine, University of Copenhagen, 2400 Copenhagen, Denmark.
| | - Catharina M Lerche
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Pharmacy, University of Copenhagen, 2400 Copenhagen, Denmark.
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7
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Ascott A, van Bodegraven B, Vernon S, Orteu CH, Venables ZC. The geographical variation of melanoma, basal and squamous cell carcinoma in England. Br J Dermatol 2023; 189:142-144. [PMID: 36992527 DOI: 10.1093/bjd/ljad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/26/2023] [Accepted: 04/02/2023] [Indexed: 03/31/2023]
Abstract
Skin cancer rates are increasing worldwide due to ageing populations, sun-seeking behaviours and increasing rates of immunosuppression. Understanding the regional variation in skin cancer is vital to planning healthcare services, prevention and screening strategies. Our objective was to report the regional incidence of the three most common types of skin cancer in England: basal cell carcinoma, cutaneous squamous cell carcinoma and melanoma.
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Affiliation(s)
- Anna Ascott
- Department of Dermatology, University Hospitals Sussex, Worthing
| | - Birgitta van Bodegraven
- British Association of Dermatologists, London
- National Disease Registration Service, Data and Analytics, NHS England
| | - Sally Vernon
- National Disease Registration Service, Data and Analytics, NHS England
| | - Cate H Orteu
- Department of Dermatology, Royal Free London NHS Foundation Trust, London
| | - Zoe C Venables
- National Disease Registration Service, Data and Analytics, NHS England
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich
- Norwich Medical School, University of East Anglia, Norwich, UK
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8
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Keim U, Katalinic A, Holleczek B, Wakkee M, Garbe C, Leiter U. Incidence, mortality and trends of cutaneous squamous cell carcinoma in Germany, the Netherlands, and Scotland. Eur J Cancer 2023; 183:60-68. [PMID: 36801607 DOI: 10.1016/j.ejca.2023.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/30/2023]
Abstract
AIM OF THE STUDY Cutaneous squamous cell carcinoma (cSCC) incidences are increasing but scarcely available separated. We analysed incidence rates of cSCC over three decades with an extrapolation to 2040. METHODS Cancer registries from the Netherlands, Scotland and two federal states of Germany (Saarland/Schleswig-Holstein) were sourced for separate cSCC incidence data. Incidence and mortality trends between 1989/90 and 2020 were assessed using Joinpoint regression models. Modified age-period-cohort models were applied to predict incidence rates up to 2044. Rates were age-standardised using the new European standard population (2013). RESULTS Age-standardised incidence rates (ASIR, per 100,000 persons per year) increased in all populations. The annual percent increase ranged between 2.4% and 5.7%. The highest increase occurred in the age groups ≥60 years, especially in men aged ≥80 years, with a three to 5-fold increase. Extrapolations up to 2044 showed an unrestrained increase in incidence rates in all countries investigated. Age-standardised mortality rates (ASMR) showed slight increases between 1.4 and 3.2% per year in Saarland and Schleswig-Holstein for both sexes and for men in Scotland. For the Netherlands, ASMRs remained stable for women but declined for men. CONCLUSION There was a continuous increase of cSCC incidence over three decades with no tendency for levelling-off, especially in the older populations as males ≥80 years. Extrapolations point to a further increasing number of cSCC up to 2044, especially among ≥60 years. This will have a significant impact on the current and future burden on dermatologic health care which will be faced with major challenges.
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Affiliation(s)
- Ulrike Keim
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Alexander Katalinic
- Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
| | | | - Marlies Wakkee
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.
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9
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Soutou B, Massih C, Sleilaty G, Trak-Smayra V, Nasr M, Helou J, Hokayem N, Ferran F, Sleilati FH, Stéphan F, Halabi-Tawil M, Tomb R. Clinical and pathological features associated with high-risk, multiple, and recurrent basal cell carcinomas: a retrospective cohort analysis from the Levantine coast of the Mediterranean Sea. Arch Dermatol Res 2023; 315:51-59. [PMID: 35059802 DOI: 10.1007/s00403-021-02316-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 01/07/2023]
Abstract
Basal cell carcinoma (BCC) data coming from the Levantine coast of the Mediterranean Sea are limited. The study aimed to primarily analyze the demographic, clinical, pathological, and prognostic characteristics of BCC in this region of the world and secondarily identify features associated with high-risk, recurrent, or multiple BCCs. Patients with at least one diagnosis of BCC registered in the pathology department between January 2015 and December 2019 were included in this analytical retrospective single-center cohort study. Patients with basal cell nevus syndrome were excluded. Patients' characteristics and pathological features were collected through file check for a first analysis. Risk factors and evolution were sought through a phone call interview for the second analysis. The first analysis included 506 BCCs corresponding to 365 patients with a mean age of 65 ± 15 years, twenty-two (6%) were less than 40 years old, 180 (49.3%) were women, and 85 (23.3%) had two or more BCCs. The second analysis included 279 BCCs corresponding to 205 patients. Periorificial and infiltrative BCCs were more frequent in men. Periorificial tumors were more frequently nodular or infiltrative and were associated with recurrence. Tumors with perineural involvement were histologically never nodular nor superficial. Recurrence was more frequent in BCCs having periorificial location, a size larger than 2 cm, or an infiltrative subtype. Multiple BCCs were more frequent in patients with light skin type or familial history of skin cancer. High-risk BCCs were more common in patients with low sun exposure.
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Affiliation(s)
- Boutros Soutou
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon.
| | - Carine Massih
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon.
| | - Ghassan Sleilaty
- Statistics department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Viviane Trak-Smayra
- Pathology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Marwan Nasr
- Plastic and Reconstructive Surgery Department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Josiane Helou
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon
| | - Nabil Hokayem
- Plastic and Reconstructive Surgery Department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Fady Ferran
- Plastic and Reconstructive Surgery Department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Fadi H Sleilati
- Plastic and Reconstructive Surgery Department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Farid Stéphan
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon
| | - Maya Halabi-Tawil
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon
| | - Roland Tomb
- Dermatology department, School of Medicine, Université Saint-Joseph, and Hôtel-Dieu de France University Hospital, Hôtel-Dieu de France, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon
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10
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KURU H, JOKELAINEN J, TASANEN K, HUILAJA L. Risk of Non-cutaneous Cancers in Individuals with Basal Cell Carcinoma: A Population-based Cohort Study. Acta Derm Venereol 2022; 102:adv00826. [PMID: 36448850 PMCID: PMC9811299 DOI: 10.2340/actadv.v102.4451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Evidence of the association between a personal history of basal cell carcinoma and the risk of non-cutaneous malignancies is conflicting. The aim of this study was to retrospectively clarify the risk of non-cutaneous cancers in individuals with basal cell carcinoma using nationwide Finnish registry data for 96,304 patients and 394,503 randomly selected population controls. In this study, individuals with basal cell carcinoma have an increased risk of other cancers (odds ratio (OR) 1.38; 95% confidence interval (95% CI) 1.36-1.40). The risk was most prominent for lip cancer (OR 5.29; 95% CI 4.50-6.21), mycosis fungoides (OR 3.13; 95% CI 2.31-4.23) and soft tissue cancers (OR 2.77; 95% CI 2.43-3.16). In age-adjusted model, men had higher risk of cancers overall compared with women (p < 0.05). In conclusion, the study found increased overall cancer risk among patients with basal cell carcinoma compared with randomly selected population controls.
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Affiliation(s)
- Hanna KURU
- Department of Dermatology, University Hospital of Oulu,Medical Research Center, PEDEGO Research Group, University of Oulu
| | - Jari JOKELAINEN
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu,Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Kaisa TASANEN
- Department of Dermatology, University Hospital of Oulu,Medical Research Center, PEDEGO Research Group, University of Oulu
| | - Laura HUILAJA
- Department of Dermatology, University Hospital of Oulu,Medical Research Center, PEDEGO Research Group, University of Oulu
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11
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Moisejenko-Goluboviča J, Groma V, Svirskis Š, Ivanova A. Serum Vitamin D Levels Explored in the Latvian Cohort of Patients with Basal Cell Carcinoma Linked to the Sonic Hedgehog and Vitamin D Binding Protein Cutaneous Tissue Indices. Nutrients 2022; 14:nu14163359. [PMID: 36014865 PMCID: PMC9413259 DOI: 10.3390/nu14163359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Ultraviolet radiation is known as one of the major contributors to skin malignancies, including basal cell carcinoma (BCC), which is the most common type of skin cancer. It is a heterogeneous tumor, which presents with various types that are stratified into low- and high-risk tumors. Sunlight is important for overall health and vitamin D synthesis in the skin, whereas deviations from the optimal level of vitamin D are shown to be associated with the risk of the development of BCC. The accumulating evidence suggests the ability of vitamin D to antagonize the Sonic Hedgehog (SHH) signaling, the key tumor pathway, and play a protective role in the development of BCC. Additionally, a vitamin D binding protein (DBP) is shown to be implicated in the complex regulation of vitamin D. Here, we aimed to explore serum vitamin D in patients with different primary and recurrent BCC of the head and neck and investigate cutaneous DBP and SHH indices, confirmed immunohistochemically in these subjects. According to the results, 94.9% of the Latvian cohort of BCC patients were found to be deficient in vitamin D. No significant differences in serum vitamin D levels were found between genders, primary and recurrent tumors, and different types of BCC. Serum vitamin D was inversely associated with tumor size. Susceptible male individuals with low blood vitamin D levels were recognized at risk of developing aggressive and recurrent BCC confirmed by the use of hierarchical clustering analysis. In smaller tumors with a favorable course, such as superficial and nodular BCC, the association between high DBP and low SHH tissue expression was found, providing supportive evidence of the existence of a link between vitamin D, proteins involved in its metabolism, as exemplified by the DBP and SHH signaling pathway. The assumption of a deficiency in the protective effect of vitamin D in patients with high-risk BCCs was proposed in low DBP and high SHH tissue indices. New extensions to existing knowledge and characterization of the BCC signaling pathways and their cross-talk with vitamin D are warranted when searching for a preferential effect of vitamin D on skin cancer.
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Affiliation(s)
- Jeļena Moisejenko-Goluboviča
- Department of Doctoral Studies, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia
- Correspondence: ; Tel.: +371-26048005
| | - Valērija Groma
- Institute of Anatomy and Anthropology, Riga Stradins University, 9 Kronvalda Blvd., LV-1010 Riga, Latvia
| | - Šimons Svirskis
- Institute of Microbiology and Virology, Riga Stradins University, Rātsupītes Str. 5, LV-1067 Riga, Latvia
| | - Anna Ivanova
- Department of Maxillofacial Surgery, Institute of Stomatology, Riga Stradins University, Dzirciema Street 20, LV-1007 Riga, Latvia
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12
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Bi Y, Shi X, Chen D, Zhao Y. CD133, but Not CD44, May Serve as a Novel Biomarker for Differential Diagnosis Between Basal Cell Carcinoma and Trichoblastomas. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1517-1526. [PMID: 35941854 PMCID: PMC9356750 DOI: 10.2147/ccid.s373331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022]
Abstract
Purpose To investigate the clinical value of CD133 and CD44 as putative cancer stem cell markers in distinguishing between basal cell carcinoma (BCC) and trichoblastomas (TB). Patients and Methods Tumor samples from 24 BCC and 23 TB patients were retrospectively retrieved for immunohistochemical staining of CD133 and CD44. The results were interpreted using a semiquantitative scoring system (H score). A receiver operating characteristic (ROC) curve was developed to identify an optimal cutoff value for differentiating between BCC and TB. Results Expression of CD133 was significantly higher in BCC patients than in TB patients (median H score: 30 [IQR: 12.5–56.3] vs 0 [IQR: 0–2], P < 0.001). However, there was no significant difference in CD44 expression between the two groups (median H score: 105 [IQR: 63.8–155.0] vs 60 [IQR: 30–120], P = 0.095). The ROC analysis of CD133 immunostaining yielded an area under the curve (AUC) of 0.881 (95% CI: 0.756–1.000) for differentiating between BCC and TB by using a H score of 7 as the cut-off value (98.5% sensitivity and 87.0% specificity). By contrast, immunostaining of CD44 showed a lower diagnostic value, with an AUC of 0.642 (95% CI: 0.476–0.808) at the optimal cut-off value of 85 (62.5% sensitivity and 73.9% specificity). The positive and negative predictive values were 88.5% and 95.2% for CD133 and 71.4% and 65.4% for CD44, respectively. Additionally, CD133 expression was significantly associated with mitotic activity in BCC patients (r = 0.549, P = 0.005). Conclusion Our study expanded upon previous studies of CD133 and CD44 expressions in skin tumors, suggesting that CD133, but not CD44, may serve as a novel biomarker for differential diagnosis of BCC, although future studies using a larger number of patients are needed to justify it further.
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Affiliation(s)
- Yalan Bi
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
| | - Xiaohua Shi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Dian Chen
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
| | - Yi Zhao
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
- Correspondence: Yi Zhao, Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, People’s Republic of China, Tel/Fax +86 010 56119127, Email
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13
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Karlsdóttir SB, Johannessen S, Bjerrum NC, Frydkjær-Olsen U, Blindbæk SL, Møller F, Wellejus C. Periocular basal cell carcinoma results and surgical outcome during a 5-year period in a larger Danish population. BMC Ophthalmol 2022; 22:282. [PMID: 35761210 PMCID: PMC9237979 DOI: 10.1186/s12886-022-02494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background To report tumour pathology, surgical procedure, complication rates and overall outcome of periocular basal cell carcinoma (BCC) in the Department of Ophthalmology at Sygehus Lillebaelt, Southern Denmark Region over a 5-year period. Methods Medical records for all patients who underwent surgery for periocular BCC between January 2016 and December 2020 were reviewed. All tumours were excised with a 3 mm margin beyond the clinically apparent delimitation of the tumour and analysed by frozen section histological examination. Paraffin sections were subsequently examined for a final histopathological diagnosis. Patient age, gender, date of resection, former cancer history, referring unit and follow-up time were recorded. Furthermore, histological subtypes identified from biopsy and resection, lesion location, lesion diameter, free margin after the first operation, lacrimal punctum involvement, reconstructive techniques and complications were also recorded. Results A total of 242 surgical excisions from 237 patients were recorded. The mean age was 69.7 ± 12.6 with women significantly predominant compared to men (1.8:1, p < 0.0001, binomial test). The mean tumour diameter was 4.29 mm (range 0.5–20 mm). The most common location and histological subtype was the lower eyelid and nodular BCC respectively (64.9% and 74.0% of cases). In 17.4% of the patients, the initial resection margin on the frozen section histology was not free of tumour cells and the risk was significantly greater for BCC subtypes considered aggressive in terms of growth pattern (morphea form, infiltrative and micronodular features) as compared to non-aggressive BCC subtypes (nodular and superficial) (p = 0.002, X2). In 239 (98.8%) of the patients, the BCC was found to be radically removed after final histopathological examination. The sensitivity of identification of aggressive subtypes of periocular BCC in biopsies was 47.7%. No recurrences were found during the 5-year period. Conclusion This study demonstrated a tendency towards more women than men being diagnosed with periocular BCC. The initial biopsy performed for all patients underestimated the aggressiveness of BCC in almost half of the cases while aggressive BCC subtypes were more likely to need further resection after frozen section compared to non-aggressive subtypes.
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14
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Ferro M, Deodato F, Ferro M, Panza G, Buwenge M, Pezzulla D, Cilla S, Boccardi M, Romano C, Arcelli A, Cammelli S, Zamagni A, Morganti AG, Macchia G. A SHort course Accelerated RadiatiON therapy (SHARON) dose-escalation trial in older adults head and neck non-melanoma skin cancer. Br J Radiol 2022; 95:20211347. [PMID: 35451856 PMCID: PMC10996410 DOI: 10.1259/bjr.20211347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/01/2022] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess feasibility and safety of a SHort-course Accelerated RadiatiON therapy (SHARON) regimen, in the treatment of non-melanoma skin cancers (NMSC) in older patients. METHODS Old patients (age ≥ 80 years) with histological confirmed non-melanoma skin cancers were enrolled. The primary endpoint was to determine the maximum tolerated dose (MTD). Radiotherapy regimen was based on the delivery of four radiotherapy fractions (5 Gy per fraction) with a twice daily fractionation in two consecutive days. Three different level of dose were administered: 20 Gy (one cycle), 40 Gy (two cycles) and 60 Gy (three cycles). RESULTS Thirty patients (median age: 91 years; range: 80-96) were included in this analysis. Among fourteen patients who completed the one cycle, only one (7%) experimented acute G4 skin toxicity. Twelve patients reported an improvement or resolution of baseline symptoms (overall palliative response rate: 85.8%). Nine and seven patients underwent to two and three RT cycles, respectively: of these, no G3 toxicities were recorded. The overall response rate was 100% when three cycles were delivered. The overall six-month symptom-free survival was 78.7% and 77.8% in patients treated with one course and more courses, respectively. CONCLUSIONS Short-course accelerated radiotherapy in older patients with non-melanoma skin cancers is well tolerated. High doses seem to be more effective in terms of response rate. ADVANCES IN KNOWLEDGE This approach could represent an option for older adults with NMSC, being both palliative (one course) or potentially curative (more courses) in the aim, accordingly to the patient's condition.
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Affiliation(s)
- Milena Ferro
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Francesco Deodato
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
- Istituto di Radiologia, Università Cattolica del Sacro
Cuore, Rome,
Italy
| | - Marica Ferro
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Giulia Panza
- Università Cattolica del Sacro Cuore,
Rome, Italy
| | - Milly Buwenge
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Bologna,
Italy
- Department of Experimental, Diagnostic, and Specialty Medicine
- DIMES, Alma Mater Studiorum Bologna University,
Bologna, Italy
| | - Donato Pezzulla
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Savino Cilla
- Medical Physics Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Mariangela Boccardi
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Carmela Romano
- Medical Physics Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
| | - Alessandra Arcelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Bologna,
Italy
- Department of Experimental, Diagnostic, and Specialty Medicine
- DIMES, Alma Mater Studiorum Bologna University,
Bologna, Italy
| | - Silvia Cammelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Bologna,
Italy
- Department of Experimental, Diagnostic, and Specialty Medicine
- DIMES, Alma Mater Studiorum Bologna University,
Bologna, Italy
| | - Alice Zamagni
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Bologna,
Italy
- Department of Experimental, Diagnostic, and Specialty Medicine
- DIMES, Alma Mater Studiorum Bologna University,
Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di
Bologna, Bologna,
Italy
- Department of Experimental, Diagnostic, and Specialty Medicine
- DIMES, Alma Mater Studiorum Bologna University,
Bologna, Italy
| | - Gabriella Macchia
- Radiation Oncology Unit, Gemelli Molise Hospital,
Università Cattolica del Sacro Cuore,
Campobasso, Italy
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15
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Thomsen SB, Ungaro RC, Allin KH, Elmahdi R, Poulsen G, Andersson M, Colombel JF, Jess T. Impact of thiopurine discontinuation at anti-tumour necrosis factor initiation in inflammatory bowel disease treatment: a nationwide Danish cohort study. Aliment Pharmacol Ther 2022; 55:1128-1138. [PMID: 35080036 DOI: 10.1111/apt.16777] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/27/2021] [Accepted: 01/08/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Escalation to anti-tumour necrosis factor (anti-TNF) in inflammatory bowel disease (IBD) patients on thiopurine is a common clinical scenario. However, the impact of discontinuing thiopurine at escalation is unclear. AIM To assess the impact of discontinuing versus continuing thiopurine therapy at anti-TNF initiation. METHODS We used the Danish registries to establish a national cohort of patients with IBD on thiopurine therapy prior to initiating anti-TNF from 2003 to 2018. We compared patients discontinuing thiopurine therapy within 90 days of anti-TNF initiation to those continuing. Our primary outcome was a composite of any new oral corticosteroid use, IBD-related hospitalization, surgery or death. We used Cox regression models to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI). RESULTS Of the 10,352 anti-TNF exposed patients, 2,630 (1590 Crohn's disease (CD) and 1040 ulcerative colitis (UC)) received thiopurines prior to anti-TNF. After anti-TNF initiation, 979 patients discontinued thiopurines. Discontinuing thiopurines within 90 days of anti-TNF initiation, increased the risk of the primary outcome (aHR: 1.22; 95% CI: 1.10-1.36), particularly for IBD-related hospitalization (aHR: 1.14; 95% CI: 1.00-1.31) and oral corticosteroid use (aHR: 1.27; 95% CI: 1.13-1.44). This increased risk of the primary outcome was seen in both CD (aHR: 1.17; 95% CI 1.02-1.34) and UC (aHR: 1.32; 95% CI: 1.12-1.55). CONCLUSIONS In a nationwide cohort study of IBD patients, we observed that discontinuing thiopurines after anti-TNF initiation was associated with an increased risk of adverse outcomes, in particular an increase in hospitalizations. Further interventional studies exploring this common clinical scenario are required.
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Affiliation(s)
- Sandra Bohn Thomsen
- Department of Clinical Medicine, Center for Molecular Prediction of Inflammatory Bowel Disease, Aalborg University, Copenhagen, Denmark
| | - Ryan C Ungaro
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Kristine H Allin
- Department of Clinical Medicine, Center for Molecular Prediction of Inflammatory Bowel Disease, Aalborg University, Copenhagen, Denmark
| | - Rahma Elmahdi
- Department of Clinical Medicine, Center for Molecular Prediction of Inflammatory Bowel Disease, Aalborg University, Copenhagen, Denmark
| | - Gry Poulsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Jean-Frederic Colombel
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Tine Jess
- Department of Clinical Medicine, Center for Molecular Prediction of Inflammatory Bowel Disease, Aalborg University, Copenhagen, Denmark.,Department of Gastroenterology and Hepatology, Aalborg University Hospital, Denmark
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16
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Eyelid malignancies in young individuals: clinical peculiarities. Int Ophthalmol 2022; 42:1867-1874. [PMID: 35088362 DOI: 10.1007/s10792-021-02184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The incidence of malignant eyelid tumors is considerably increasing, even in young patients. The purpose of this study was to identify particularities in individuals under 40 years of age affected by eyelid malignancies. METHODS Clinical charts of patients under 40 years of age who underwent eyelid tumor excision from 2014 to 2020 in two reference centers, one in Brazil and one in the USA, were reviewed. Demographic and outcome measures included: age, gender, skin phototype, comorbidities, diagnosis, time until diagnosis, lesion location, recurrence and metastasis. In addition, associated characteristics, including chronic sun exposure, intentional tanning (outdoor or artificial), history of smoking, use of sunscreen, family history of skin cancer and exposure to pesticides or herbicides, were reviewed. RESULTS A total of 24 malignant eyelid tumors from 17 patients were identified. Twelve (70.6%) patients were female, and the most prevalent tumor was basal cell carcinoma (62.5%). Three (17.6%) patients had xeroderma pigmentosum and presented with multiple lesions. Family history of skin cancer was reported by 47% of patients. Prolonged sun exposure was reported by 41.2%; history of smoking and intentional tanning were reported by 23.5 and 17.6%, respectively, and might have played a role in carcinogenesis. CONCLUSIONS Although uncommon in young subjects, eyelid malignancies present some peculiarities in individuals under 40 years of age. Our results suggest that women with family history of skin cancer and history of chronic exposure to ultraviolet radiation are at risk. Association with genetic syndromes is also relevant among younger age groups.
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17
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Kappelin J, Green AC, Ingvar Å, Ahnlide I, Nielsen K. Incidence and trends of basal cell carcinoma in Sweden: A population-based registry study. Br J Dermatol 2021; 186:963-969. [PMID: 34939666 DOI: 10.1111/bjd.20964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer. Incidence is largely unknown because of incomplete, or lack of, registration in most countries. OBJECTIVES To assess current incidence rates and recent trends for BCC in the Swedish population. METHODS Patient- and tumour-related features of all histologically confirmed BCC tumours diagnosed in Sweden from 2004 to 2017 were extracted from the population-based Swedish BCC Registry. Incidence rates were standardized to the 2013 European Standard Population and trends were analysed using Poisson regression models. RESULTS Age-standardized person-based incidence rate of BCC in Sweden in 2017 was 405/100 000, rising from 308/100 000 in 2004, corresponding to an annual relative increase of 1.8% (women, 2.1%; men, 1.4%). Incidence was highest in the elderly and the most common tumour site was the head and neck. In 2017, the most common BCC subtypes were nodular and micronodular/infiltrative BCC (each 31%). Incidence of aggressive BCC subtypes increased faster than other subtypes. CONCLUSIONS BCC incidence rates in Sweden are relatively high and increasing. The increasing trends were more pronounced in women and for aggressive BCC subtypes.
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Affiliation(s)
- Johan Kappelin
- Department of Clinical Sciences Helsingborg, Dermatology, Lund University.,Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Helsingborg Hospital, Sweden
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane.,CRUK Manchester Institute, University of Manchester, Manchester, UK
| | - Åsa Ingvar
- Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Skåne University Hospital, Lund, Sweden
| | - Ingela Ahnlide
- Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Landskrona Hospital, Sweden
| | - Kari Nielsen
- Department of Clinical Sciences Helsingborg, Dermatology, Lund University.,Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Helsingborg Hospital, Sweden.,Skåne University Hospital, Lund, Sweden
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18
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Schreuder K, Hollestein L, Nijsten TEC, Wakkee M, Louwman MWJ. A nationwide study of the incidence and trends of first and multiple basal cell carcinoma in the Netherlands and prediction of future incidence. Br J Dermatol 2021; 186:476-484. [PMID: 34726263 DOI: 10.1111/bjd.20871] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most frequently diagnosed malignancy worldwide and an ever increasing annual incidence is observed. However, nationwide registries of BCCs are very rare and often extrapolation of the data was necessary to estimate the absolute number of diagnoses. Since September 2016, all histopathologically confirmed BCCs are registered in the Netherlands, due to developments in automatic notification and import in the Netherlands cancer registry. This offers the unique possibility to assess the nationwide population-based incidence of first and multiple BCC. OBJECTIVES The current study aims to assess nationwide incidence and trends of first and multiple BCC in the Netherlands and to predict incidence rates up to 2029. METHODS All patients with histopathologically confirmed BCC between 2001 and 2019 were selected from the population-based Netherlands Cancer Registry. Age-standardized incidence rates were calculated and trends were analyzed with use of the estimated annual percentage change. Prediction of BCC incidence rates up to 2029 was based on a regression model. RESULTS In total, 601,806 patients were diagnosed with a first BCC over the period 2001-2019. The age-standardized incidence rates for both men and women with a first BCC increased over these years from 158 to 304 and 124 to 274 per 100,000 person-years, respectively. For male and female patients aged between 30-39 years, decreases in annual incidences of -3.6% and -3.0% were found in recent years, respectively. For patients aged 50 years or older an ever increasing trend was found. A quarter of the patients with a first primary BCC developed one or more subsequent BCCs within three years. Increases in incidence of 30.4% (male) and 25.3% (female) is expected in the next 10 years. CONCLUSIONS BCC incidence doubled over the past decades. Trends seemed to stabilize in recent years for patients aged below 50 years. This might be a first sign of a decreasing trend. The incidence keeps rising in patients aged 50 years and older. In the next decade a further increase in BCC incidence is expected.
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Affiliation(s)
- K Schreuder
- Department of Research and Development, Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - L Hollestein
- Department of Research and Development, Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.,Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - T E C Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M W J Louwman
- Department of Research and Development, Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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19
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Ragaini BS, Blizzard L, Newman L, Stokes B, Albion T, Venn A. Temporal trends in the incidence rates of keratinocyte carcinomas from 1978 to 2018 in Tasmania, Australia: a population-based study. Discov Oncol 2021; 12:30. [PMID: 35201459 PMCID: PMC8777529 DOI: 10.1007/s12672-021-00426-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/11/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES We described incidence trends of keratinocyte carcinomas (KCs)-namely basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-in the Australian state of Tasmania. METHODS We identified histologically confirmed KCs within the Tasmanian Cancer Registry (TCR) and conducted assessments to ensure data quality. Age-standardised incidence rates were calculated for first (1985-2018) and annual KCs (1978-2018). Average annual percentage changes were computed using Joinpoint regression models. RESULTS The TCR is a reliable source of KC data. A total of 83,536 people were registered with a KC between 1978 and 2018. Age-standardised incidence rates of first KCs increased on average by 3% per annum for BCCs and 4% per annum for SCCs, reaching 363/100,000 and 249/100,000 in 2018, respectively. Age-standardised incidence rates of annual KCs increased on average by 5% per annum for BCCs and 6% per annum for SCCs, up to 891/100,000 and 514/100,000 in 2018, respectively. This increase was steeper for females than males and highest during the late 1980s and early 1990s. A change in trend around 2014 suggested that incidence rates have started to decline. CONCLUSION While the incidence of KCs in Tasmania increased substantially over 41 years, rates have recently plateaued and started to decline. The findings may reflect changes in sun exposure behaviours due to awareness campaigns, but high incidence rates in 2018 indicate that KCs still pose a substantial burden to this population.
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Affiliation(s)
- Bruna S Ragaini
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Leah Newman
- Australian Institute of Health and Welfare, Canberra, Australia
| | - Brian Stokes
- Tasmanian Cancer Registry, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Tim Albion
- Tasmanian Cancer Registry, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
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20
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Meyer T, Sand M, Schmitz L, Stockfleth E. The Role of Circular RNAs in Keratinocyte Carcinomas. Cancers (Basel) 2021; 13:cancers13164240. [PMID: 34439394 PMCID: PMC8392367 DOI: 10.3390/cancers13164240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
Keratinocyte carcinomas (KC) include basal cell carcinomas (BCC) and cutaneous squamous cell carcinomas (cSCC) and represents the most common cancer in Europe and North America. Both entities are characterized by a very high mutational burden, mainly UV signature mutations. Predominately mutated genes in BCC belong to the sonic hedgehog pathway, whereas, in cSCC, TP53, CDKN2A, NOTCH1/2 and others are most frequently mutated. In addition, the dysregulation of factors associated with epithelial to mesenchymal transition (EMT) was shown in invasive cSCC. The expression of factors associated with tumorigenesis can be controlled in several ways and include non-coding RNA molecules, such as micro RNAs (miRNA) long noncoding RNAs (lncRNA) and circular RNAs (circRNA). To update findings on circRNA in KC, we reviewed 13 papers published since 2016, identified in a PubMed search. In both BCC and cSCC, numerous circRNAs were identified that were differently expressed compared to healthy skin. Some of them were shown to target miRNAs that are also dysregulated in KC. Moreover, some studies confirmed the biological functions of individual circRNAs involved in cancer development. Thus, circRNAs may be used as biomarkers of disease and disease progression and represent potential targets of new therapeutic approaches for KC.
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Affiliation(s)
- Thomas Meyer
- Department of Dermatology St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
- Correspondence: ; Tel.: +49-234-5096014
| | - Michael Sand
- Department of Plastic and Reconstructive Surgery, St. Josef-Hospital, Heidbergweg 22–24, 45257 Essen, Germany;
| | - Lutz Schmitz
- Institute of Dermatopathology, MVZ Corius DermPath Bonn, GmbH, Trierer Strasse 70–72, 53115 Bonn, Germany;
| | - Eggert Stockfleth
- Department of Dermatology St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
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21
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Teng Y, Yu Y, Li S, Huang Y, Xu D, Tao X, Fan Y. Ultraviolet Radiation and Basal Cell Carcinoma: An Environmental Perspective. Front Public Health 2021; 9:666528. [PMID: 34368047 PMCID: PMC8339433 DOI: 10.3389/fpubh.2021.666528] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/19/2021] [Indexed: 01/03/2023] Open
Abstract
Ultraviolet radiation (UVR) is a known carcinogen participated for the development of skin cancers. Solar UVR exposure, particularly ultraviolet B (UVB), is the mostly significant environmental risk factor for the occurrence and progress of basal cell carcinoma(BCC). Both cumulative and intermittent high-grade UVR exposure could promote the uncontrolled replication of skin cells. There are also exsiting other contributing environmental factors that combine with the UVR exposure to promote the development of BCC. DNA damage in formation of skin cancers is considered to be a result of UVR toxicity. It is UVR that could activate a series of oncogenes simultaneously inactivating tumor suppressor genes and aberrant proliferation and survival of keratinocytes that repair these damages. Furthermore, mounting evidence demonstrates that inflammatory responses of immune cells in the tumor microenvironment plays crucial role in the skin tumorigenesis as well. In this chapter, we will follow the function of UVR in the onset and development of BCC. We describe the factors that influence BCC induced by UVR, and also review the recent advances of pathogenesis of BCC induced by UVR from the genetic and inflammatory aspects.
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Affiliation(s)
- Yan Teng
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yong Yu
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Sujing Li
- Bengbu Medical College, Bengbu, China
| | - Youming Huang
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Danfeng Xu
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xiaohua Tao
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yibin Fan
- Department of Dermatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
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22
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Collier V, Musicante M, Patel T, Liu-Smith F. Sex disparity in skin carcinogenesis and potential influence of sex hormones. SKIN HEALTH AND DISEASE 2021; 1:e27. [PMID: 35664979 PMCID: PMC9060035 DOI: 10.1002/ski2.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 02/05/2023]
Abstract
Background Sex or gender disparity in skin cancer has been documented for a long time at the population level. UV radiation (UVR) is a common environmental risk for all three major types of skin cancer: cutaneous melanoma (CM), basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). The underlying mechanism for sex disparity has been largely attributed to sex‐differentiated behaviour patterns related to UVR. Non‐UVR factors such as intrinsic physiological differences have been suggested but remain understudied. Aims, Materials and Methods This review summarizes and compares the known sex differences in three skin cancer types with regard to body site distribution and age influence. Results We found a similar age‐dependent sex difference pattern in CM and BCC. Specifically, CM and BCC tend to show higher incidence in young women and old men, with a switching age around menopause. The switching age suggests involvement of sex hormones, which has shown controversial influence on skin cancers at epidemiological level. Literatures regarding sex hormone receptors for oestrogen, androgen and progesterone are summarized for potential explanations at molecular level. Discussion Overall, more and more evidence suggests non‐UVR factors such as sex hormones play critical roles in skin cancer (especially CM and BCC), yet solid population and molecular evidence are required. Incidences of skin cancer are increasing which suggests limited effect for the current UVR‐avoidance prevention methods. Conclusion Fully understanding the causes of sex disparities in incidence is necessary for developing a comprehensive prevention strategy.
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Affiliation(s)
- V Collier
- Kaplan-Amonette Department of Dermatology The University of Tennessee Health Science Center Memphis Tennessee USA
| | - M Musicante
- College of Medicine University of Tennessee Health Science Center Memphis Tennessee USA
| | - T Patel
- Kaplan-Amonette Department of Dermatology The University of Tennessee Health Science Center Memphis Tennessee USA
| | - F Liu-Smith
- Kaplan-Amonette Department of Dermatology The University of Tennessee Health Science Center Memphis Tennessee USA.,Department of Preventative Medicine University of Tennessee Health Science Center Memphis Tennessee USA
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23
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Caini S, De Angelis SP, Corso F, Fantini C, Raimondi S, Pala L, Stanganelli I, de Giorgi V, Gandini S. Exogenous sex hormones, menstrual and reproductive history, and risk of non-melanoma skin cancer among women: a systematic literature review and meta-analysis. Sci Rep 2021; 11:8524. [PMID: 33875740 PMCID: PMC8056000 DOI: 10.1038/s41598-021-88077-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
Non-melanoma skin cancers (NMSC) are more frequent among men, but women (especially those aged < 40 years) have experienced steeper growth in their incidence rates in recent years. Hormonal factors were hypothesized to be playing a role in modulating NMSC risk, but the studies published to date provided conflicting results. We systematically reviewed and meta-analysed the studies focusing on the association between hormone-related characteristics (use of exogenous sex hormones, and aspects of menstrual and reproductive history) and the risk of NMSC among women. We included observational and experimental studies published in PubMed and EMBASE until February 2020. We calculated summary relative risk (SRR) and 95% confidence intervals (CI) by applying random effects models with maximum likelihood estimation, and used the I2 statistics to quantify the degree of heterogeneity of risk estimates across studies. Eleven independent studies encompassing a total of over 30,000 NMSC cases were included in quantitative analyses. No evidence of an increased NMSC risk emerged among ever vs. never users of oral contraceptives (SRR 1.13, 95% CI 0.88-1.45) or hormones for menopause (SRR 1.09, 95% CI 0.87-1.37). Likewise, age at menarche or at menopause and parity were not associated with NMSC risk. Heterogeneity across studies was low, and pooled results were comparable between NMSC subtypes. We found no evidence that hormonal factors play a role in the pathogenesis of NMSC among women.
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Affiliation(s)
- Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50141, Florence, Italy.
| | | | - Federica Corso
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Carolina Fantini
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Laura Pala
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ignazio Stanganelli
- Dermatology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST), IRCSS, Meldola, Italy
| | | | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
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24
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Tokez S, Hollestein L, Louwman M, Nijsten T, Wakkee M. Incidence of Multiple vs First Cutaneous Squamous Cell Carcinoma on a Nationwide Scale and Estimation of Future Incidences of Cutaneous Squamous Cell Carcinoma. JAMA Dermatol 2021; 156:1300-1306. [PMID: 33112377 DOI: 10.1001/jamadermatol.2020.3677] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Until now, most studies on cutaneous squamous cell carcinoma (cSCC) incidence rates concerned only the first cSCC per patient. Given the increase in incidence rates and the frequent occurrence of subsequent cSCCs per patient, population-based data on the incidence rates of both first and multiple cSCCs are needed. Objectives To calculate annual age-standardized incidence rates for histopathologically confirmed first and multiple cSCCs per patient and to estimate future cSCC incidence rates up to 2027. Design, Setting, and Participants A nationwide population-based epidemiologic cohort study used cancer registry data on 145 618 patients with a first histopathologically confirmed cSCC diagnosed between January 1, 1989, and December 31, 2017, from the Netherlands Cancer Registry and all patients with multiple cSCCs diagnosed in 2017. Main Outcomes and Measures Age-standardized incidence rates for cSCC-standardized to the European Standard Population 2013 and United States Standard Population 2000-were calculated per sex, age group, body site, and disease stage. A regression model with positive slope was fitted to estimate cSCC incidence rates up to 2027. Results A total of 145 618 patients in the Dutch population (84 572 male patients [58.1%]; mean [SD] age, 74.5 [11.5] years) received a diagnosis of a first cSCC between 1989 and 2017. Based on incident data, European Standardized Rates (ESRs) increased substantially, with the highest increase found among female patients from 2002 to 2017, at 8.2% (95% CI, 7.6%-8.8%) per year. The ESRs for first cSCC per patient in 2017 were 107.6 per 100 000 person-years (PY) for male patients, an increase from 40.0 per 100 000 PY in 1989, and 68.7 per 100 000 PY for female patients, an increase from 13.9 per 100 000 PY in 1989, which corresponds with a US Standardized Rate of 71.4 per 100 000 PY in 2017 for men and 46.4 per 100 000 PY in 2017 for women. Considering multiple cSCCs per patient, ESRs increased by 58.4% for men (from 107.6 per 100 000 PY to 170.4 per 100 000 PY) and 34.8% for women (from 68.7 per 100 000 PY to 92.6 per 100 000 PY). Estimation of ESRs for the next decade show a further increase of 23.0% for male patients (ESR up to 132.4 per 100 000 PY [95% prediction interval, 125.8-139.0 per 100 000 PY]) and 29.4% for female patients (ESR up to 88.9 per 100 000 PY [95% prediction interval, 84.3-93.5 per 100 000 PY]). Conclusions and Relevance This nationwide epidemiologic cohort study suggests that incidence rates of cSCC keep increasing, especially among female patients, and that the occurrence of multiple cSCCs per patient significantly adds to the current and future burden on dermatologic health care. Revision of skin cancer policies are needed to halt this increasing trend.
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Affiliation(s)
- Selin Tokez
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Loes Hollestein
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - Marieke Louwman
- Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
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25
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Matas-Nadal C, Sagristà M, Gómez-Arbonés X, Sobrino Bermejo C, Fernández-Armenteros JM, Àngel Baldó J, Casanova Seuma JM, Aguayo Ortiz R. Risikofaktoren für Basalzellkarzinome in jungem Alter und Trend zur Prädominanz bei Frauen. J Dtsch Dermatol Ges 2021; 19:364-372. [PMID: 33709601 DOI: 10.1111/ddg.14390_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Clara Matas-Nadal
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Corporació de Salut de la Selva i el Maresme, Girona, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Marc Sagristà
- Dermatology Department, Corporació de Salut de la Selva i el Maresme, Girona, Spain
| | | | - Carmen Sobrino Bermejo
- Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | | | - Joan Àngel Baldó
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Josep Manel Casanova Seuma
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain.,Departament de Medicina, Universitat de Lleida, Lleida, Spain
| | - Rafael Aguayo Ortiz
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
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26
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Matas-Nadal C, Sagristà M, Gómez-Arbonés X, Sobrino Bermejo C, Fernández-Armenteros JM, Àngel Baldó J, Casanova Seuma JM, Aguayo Ortiz R. Risk factors for early-onset basal cell carcinomas and the trend towards their female predominance. J Dtsch Dermatol Ges 2021; 19:364-371. [PMID: 33576181 DOI: 10.1111/ddg.14390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND A dramatic rise in the incidence rates of basal cell carcinoma (BCC) in young women has been reported. OBJECTIVES We investigate potential risk factors (RF) for sporadic BCC in young patients and the current distribution of such RF in the general population of Catalonia, comparing the differences among men and women. PATIENTS AND METHODS A case-control study was performed, 69 BCCs diagnosed in patients ≤ 45 years of age vs. 69 healthy controls. Afterward, 1,078 participants from the general population completed an RF questionnaire. RESULTS Repeated sunburns were more frequent in instances of early-onset BCC in covered skin than in sun-exposed skin (P = 0.029). In the general population, 39.1 % of participants reported sunbed use (50.1 % in women, 10.9 % in men). Sunbed use was the only relevant RF more predominant in women than men, favoring the trend to female predominance of BCCs above other RF. Additionally, we found a significant trend in young participants for reduced sunbed use (P < 0.001), although they had the same percentage of repeated sunburns. Repeated sunburns are the most relevant RF for early-onset BCCs that can be targeted in prevention campaigns. CONCLUSIONS We should be aware of the more relevant RF for early-onset BCCs and their distribution among the general population to address preventive campaigns.
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Affiliation(s)
- Clara Matas-Nadal
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Corporació de Salut de la Selva i el Maresme, Girona, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Marc Sagristà
- Dermatology Department, Corporació de Salut de la Selva i el Maresme, Girona, Spain
| | | | - Carmen Sobrino Bermejo
- Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | | | - Joan Àngel Baldó
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
| | - Josep Manel Casanova Seuma
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain.,Departament de Medicina, Universitat de Lleida, Lleida, Spain
| | - Rafael Aguayo Ortiz
- IRB Lleida, Lleida, Catalunya, Spain.,Dermatology Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
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27
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Gordon LG, Rodriguez-Acevedo AJ, Køster B, Guy GP, Sinclair C, Van Deventer E, Green AC. Association of Indoor Tanning Regulations With Health and Economic Outcomes in North America and Europe. JAMA Dermatol 2020; 156:401-410. [PMID: 32074257 DOI: 10.1001/jamadermatol.2020.0001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Importance UV radiation emissions from indoor tanning devices are carcinogenic. Regulatory actions may be associated with reduced exposure of UV radiation at a population level. Objective To estimate the long-term health and economic consequences of banning indoor tanning devices or prohibiting their use by minors only in North America and Europe compared with ongoing current levels of use. Design, Setting, and Participants This economic analysis modeled data for individuals 12 to 35 years old in North America and Europe, who commonly engage in indoor tanning. A Markov cohort model was used with outcomes projected during the cohort's remaining life-years. Models were populated by extracting data from high-quality systematic reviews and meta-analyses, epidemiologic reports, and cancer registrations. Main Outcomes and Measures Main outcomes were numbers of melanomas and deaths from melanoma, numbers of keratinocyte carcinomas, life-years, and health care and productivity costs. Extensive sensitivity analyses were performed to assess the stability of results. Results In an estimated population of 110 932 523 in the United States and Canada and 141 970 492 in Europe, for the next generation of youths and young adults during their remaining lifespans, regulatory actions that ban indoor tanning devices could be expected to gain 423 000 life-years, avert 240 000 melanomas (-8.2%), and avert 7.3 million keratinocyte carcinomas (-7.8%) in North America and gain 460 000 life-years, avert 204 000 melanomas (-4.9%), and avert 2.4 million keratinocyte carcinomas (-4.4%) in Europe compared with ongoing current levels of use. Economic cost savings of US $31.1 billion in North America and €21.1 billion (US $15.9 billion) in Europe could occur. Skin cancers averted and cost savings after prohibiting indoor tanning by minors may be associated with one-third of the corresponding benefits of a total ban. Conclusions and Relevance Banning indoor tanning may be associated with reduced skin cancer burden and health care costs. Corresponding gains from prohibiting indoor tanning by minors only may be smaller.
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Affiliation(s)
- Louisa G Gordon
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology School of Nursing, Brisbane, Queensland, Australia.,The University of Queensland School of Medicine, Brisbane, Queensland, Australia
| | - Astrid J Rodriguez-Acevedo
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Gery P Guy
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Adèle C Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,Manchester Academic Health Science Centre, CRUK Manchester Institute and Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
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28
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Caparrotti F, Troussier I, Ali A, Zilli T. Localized Non-melanoma Skin Cancer: Risk Factors of Post-surgical Relapse and Role of Postoperative Radiotherapy. Curr Treat Options Oncol 2020; 21:97. [PMID: 33034759 PMCID: PMC7546974 DOI: 10.1007/s11864-020-00792-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 11/23/2022]
Abstract
The mainstay treatment of localized non-melanoma skin cancer (NMSC) is surgical excision or Mohs surgery. However, approximately 5% of patients with NMSC harbor high-risk clinicopathologic features for loco-regional recurrence, and distant metastasis. Prognostic factors such as close or positive margins, tumor size ≥ 2 cm, poor tumor differentiation, perineural invasion, depth of invasion, and immunosuppression have all been associated with increased loco-regional recurrence and impaired survival rates. In these patients more aggressive treatments are needed and radiotherapy (RT) is often discussed as adjuvant therapy after surgical resection. Due to the retrospective setting and the heterogeneity of the available studies, indications for adjuvant RT in patients with localized resected NMSC harboring high-risk features remain debated. Studies highlighting the limitations of our current understanding of the independent prognosis of each risk factor are needed to better define the role of adjuvant RT on outcome of localized NMSC and standardize its indications in the clinical setting.
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Affiliation(s)
- Francesca Caparrotti
- Department of Radiation Oncology, Geneva University Hospital, CH-1211, Geneva 14, Switzerland
| | - Idriss Troussier
- Department of Radiation Oncology, Geneva University Hospital, CH-1211, Geneva 14, Switzerland
| | - Abdirahman Ali
- Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Thomas Zilli
- Department of Radiation Oncology, Geneva University Hospital, CH-1211, Geneva 14, Switzerland. .,Faculty of Medicine, Geneva University, Geneva, Switzerland.
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29
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Ye T, Chen T, Jiang B, Yang L, Liu X, Chen B, Zou Y, Yu B. 5-aminolevulinic acid photodynamic therapy inhibits invasion and metastasis of SCL-1 cells probably via MTSS1 and p63 gene related pathways. Photodiagnosis Photodyn Ther 2020; 32:102039. [PMID: 33017656 DOI: 10.1016/j.pdpdt.2020.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the effect of 5-aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) on the invasion and metastasis in cutaneous squamous cell carcinoma (cSCC) cell line(SCL-1) and to study whether the effect was via the MTSS1 gene and p63 gene related pathways. METHODS SCL-1 cells were cultured and submitted to ALA-PDT treatment (ALA-PDT group), ALA treatment alone (ALA group), LED illumination alone (LED group) and remains untreated (control group). Scratch test, Transwell migration chamber assay and Matrigel cell invasion assay were used to detect the ability of migration and invasion of SCL-1 cells after treatment. The mRNA levels and protein expressions of tumor metastasis suppressor gene (MTSS1) and p63 gene were further detected by using quantitative real-time PCR and flow cytometry assay respectively after treatment. RESULTS The migration and invasion abilities of SCL-1 cells after treatment were significantly reduced in the ALA-PDT groups than that in ALA group, LED group and control group (P<0.05). Both the mRNA and protein expression levels of MTSS1 gene were up-regulated, while the mRNA and protein expression levels of p63 gene were down-regulated after ALA-PDT treatment. CONCLUSION ALA-PDT suppressed the migration and invasion of human cSCC cell line, probably via the MTSS1 gene and p63 gene related pathways. This study put forward a possible mechanism of invasion in SCL-1 cell, also providing a potential target for the therapy of cSCC.
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Affiliation(s)
- TingLu Ye
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - TingTing Chen
- Department of Dermatology, Longhua People's Hospital of Shenzhen, Shenzhen, 518109, China
| | - Bin Jiang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - LiLi Yang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - XiaoMing Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - BanCheng Chen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - YanFen Zou
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
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30
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Borup H, Mortensen OS, Grandahl K. Sex as a Risk Factor for Solar Ultraviolet Radiation Exposure?-Dosimetry in Danish Outdoor Workers. Photochem Photobiol 2020; 96:1350-1354. [PMID: 32737886 PMCID: PMC7754363 DOI: 10.1111/php.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/24/2020] [Indexed: 12/01/2022]
Abstract
Solar ultraviolet radiation (UVR) exposure is a known risk factor for the development of skin cancer. Heterogeneity in solar UVR exposure may explain the diversity in skin cancer incidence between men and women. This, however, has not previously been investigated in Danish outdoor workers using UVR dosimetry. The aim of this study was to evaluate sex differences in solar UVR dosimetry in Danish outdoor workers on working and leisure days. A cross‐sectional design was used to collect dosimetry data during the Danish summer season (May to September). Analysis was based on an electronic questionnaire and dosimetry data from 450 outdoor workers (88 women, 362 men). Dosimetry data were reported as standard erythema dose (SED). The daily median SED (Interquartile range) on working days was 1.6 (2.5) in men and 1.5 (2.1) in women while on leisure days it was 0.5 (1.4) in men and 0.6 (1.3) in women. Analysis by multiple linear regression did not show any association between daily median SED and sex on either working or leisure days. In conclusion, solar UVR exposure in Danish outdoor workers did not vary according to sex.
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Affiliation(s)
- Helene Borup
- Department of Occupational and Social Medicine, Holbaek Hospital, Part of Copenhagen University Hospital, Holbaek, Denmark
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbaek Hospital, Part of Copenhagen University Hospital, Holbaek, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Grandahl
- Department of Occupational and Social Medicine, Holbaek Hospital, Part of Copenhagen University Hospital, Holbaek, Denmark
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Ye T, Jiang B, Chen B, Liu X, Yang L, Xiong W, Yu B. 5-aminolevulinic acid photodynamic therapy enhance the effect of acitretin on squamous cell carcinoma cells: An in vitro study. Photodiagnosis Photodyn Ther 2020; 31:101887. [PMID: 32565180 DOI: 10.1016/j.pdpdt.2020.101887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022]
Abstract
Squamous cell carcinoma (SCC) remains the second most common nonmelanoma skin cancer (NMSC) worldwide. Both acitretin and 5-Aminolevulinic acid mediated photodynamic therapy (ALA-PDT) have validated effect on SCC. However, the effects of both treatmens remain limited, and there has been no report concerning the potential synergistic effect of both treatments for SCC. OBJECTIVE To investigate the cytotoxic effect of acitretin on SCL-1 cells, and whether ALA-PDT enhances this effect. METHODS CCK-8 and trypan blue exclusion array were used to detect the cell cytotoxicity after acitretin treatment with different concentrations (1.6 × 10-4mg/mL, 1.6 × 10-3 mg/mL, 1.6 × 10-2mg/mL and 1.6 × 10-1mg/mL) for 24 h, 48 h and 72 h. Flow cytometry and trypan blue exclusion assay were used to detect the apoptosis and viability of SCL-1 cells after treated with acitretin, ALA-PDT and ALA-PDT immediately followed by acitretin. Independent sample t test was used to analyze the different incubation time of acitretin and acitretin combined with ALA-PDT on SCL-1 cells. Bonferroni Test One-way Anova method was used to analyze the effect of different treatment on the SCL-1 cells. RESULTS A significant cytotoxic effect was observed after acitretin treatment, in an acitretin concentration-dependent manner within the range of 1.6 × 10-4mg/mL to 1.6 × 10-1mg/mL and an acitretin incubation time-dependent manner within 24 h-72 h. The total apoptosis rate and dead cells rate in group of ALA-PDT combined with acitretin were both significantly higher than that of acitretin, ALA-PDT group. A stronger apoptotic and cytotoxic effect detected 24 h after treated with acitretin than that of 12 h was observed in this study. CONCLUSION Acitretin has a cytotoxic effect on SCL-1 cells, and ALA-PDT treatment enhances the the cytotoxic effect of acitretin.
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Affiliation(s)
- TingLu Ye
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bin Jiang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - BanCheng Chen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - XiaoMing Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - LiLi Yang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Wei Xiong
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
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Galindo-Ferreiro A, Sanchez-Tocino H, Diez-Montero C, Belani-Raju M, García-Sanz R, Diego-Alonso M, Llorente-Gonzalez I, Perez PC, Khandekar R, Schellini S. Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain. J Curr Ophthalmol 2020; 32:183-188. [PMID: 32671303 PMCID: PMC7337017 DOI: 10.4103/joco.joco_28_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/01/2020] [Accepted: 02/02/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose: To define the incidence, characteristics, and management of eyelid basal cell carcinoma (BCC) in Central Spain. Methods: This retrospective study investigates the characteristics and the outcome of eyelid BCC from 2000 to 2016 in a central region of Spain. Data were collected on demographics, skin phenotype, location of the eyelid lesion, clinical and histological diagnosis, surgery, commitment of surgical margins, and recurrence rate. Results: Primary eyelid BCC occurred in a mean of 20.6 lesions a year or 9.4/100,000 inhabitants/year. The mean age of BCC carriers was 69.4 ± 16.2 years, with no gender difference (P = 0.479), predominantly affecting Fitzpatrick II–III skin (81.3%) (P < 0.001). The most common location was the inner canthus (154/45.7%) (P < 0.001) and type nodular (215 cases/63.8%) (P < 0.001). The surgical margins were affected in 69 (20.5%) individuals, and the recurrence rate was 5.6 (95% confidence interval, 3.2–8.3) significantly higher in affected margins (P < 0.001). The most common location for recurrence was the inner canthus (P = 0.003), and the most common histological type for recurrence was sclerosing (16.7%), then multinodular (12.5%), and infiltrating (10.4%) with no significant difference (P = 0.27). Conclusions: The frequency of occurrence of eyelid BCC is much less than the estimated crude incidence for skin tumors involving all areas of the body in the Spanish population. Eyelid BCC is more common in the seventh decade of life, with no predilection for gender. Nodular histological type is the most common. The recurrence rate is 5.6%, depending on site and affected margins, even though clear free margins also can present with recurrence.
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Affiliation(s)
| | | | | | - Minal Belani-Raju
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Raquel García-Sanz
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Miguel Diego-Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | | | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Silvana Schellini
- Department of Ophthalmology, Botucatu Medical University - UNESP, São Paulo, Brazil
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33
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Park YJ, Kwon GH, Kim JO, Kim NK, Ryu WS, Lee KS. A retrospective study of changes in skin cancer characteristics over 11 years. Arch Craniofac Surg 2020; 21:87-91. [PMID: 32380807 PMCID: PMC7206466 DOI: 10.7181/acfs.2020.00024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/20/2020] [Indexed: 02/01/2023] Open
Abstract
Background The incidence of skin cancer, which is primarily caused by exposure to ultraviolet radiation, has steadily increased in recent years. The authors of the present study sought to investigate changes in the epidemiology of skin cancer by conducting a retrospective review of patients diagnosed with skin cancer who received related care at a single medical institution. Methods The present study included patients who were diagnosed with skin cancer and received treatment at Gyeongsang National University Hospital from 2008 to 2018. The site and type of skin cancer, the number of patients with skin cancer each year, the sex and sex ratio of the patients, and changes in patients’ age at first diagnosis were examined through retrospective chart reviews. Results The number of patients with skin cancer significantly increased, but statistically significant changes were not found in patients’ sex, skin cancer sites, or the types of skin cancer. However, patients’ age at the first diagnosis of skin cancer showed a statistically significant decrease starting in 2015. Conclusion In this study, the number of patients with skin cancer increased over time. However, patients’ age at first diagnosis has decreased since 2015. Therefore, younger patients should take care to prevent skin cancer, and further research on the causes of skin cancer in younger patients is needed.
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Affiliation(s)
- Young Ji Park
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Gyu Hyeon Kwon
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Jun Oh Kim
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Nam Kyun Kim
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Woo Sang Ryu
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Kyung Suk Lee
- Department of Plastic and Reconstructive Surgery, Gyeongsang National University Hospital, Jinju, Korea
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Kappelin J, Nielsen K, Nilsson F, Bjellerup M, Ahnlide I. Surgical treatment of basal cell carcinoma: a case series on factors influencing the risk of an incomplete primary excision. J Eur Acad Dermatol Venereol 2020; 34:2518-2525. [PMID: 32124503 DOI: 10.1111/jdv.16327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/11/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer form, and one first-line treatment is surgical excision. Complete excision is vital to minimize risk of recurrence. Studies on occurrence of incomplete excisions have given diverse results and seldom include large populations from a dermatological setting. OBJECTIVES The rate of positive surgical margins in primary surgery of BCC at a tertiary dermatology clinic is studied. Factors associated with an incomplete primary excision are analysed. METHODS Patients scheduled for standard excision, without perioperative margin control, of BCC during the years 2008-2015 were prospectively enrolled in the study. Tumour-specific factors, including histopathologic subtype, as well as postoperative outcome were registered. Incomplete excisions were analysed in relation to patient- and tumour-related factors. RESULTS In total, 4.6% of 3911 BCC tumours were incompletely excised. The rate of incomplete excisions was higher for facial tumours and among tumours with an aggressive histological subtype. Morpheiform BCC on the nose or ear had the highest rate of an incomplete excision, 61.5% and 50%, respectively. CONCLUSIONS Most BCCs, irrespective of subtype, were completely excised during the primary excision. Tumour sites nose and ears were associated with the highest rate of positive primary surgical margins, especially for infiltrative or morpheiform BCCs. Surgery with perioperative examination of margins is strongly recommended for these tumours.
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Affiliation(s)
- J Kappelin
- Department of Clinical Sciences Helsingborg and Department of Clinical Sciences Lund, Dermatology, Lund University, Lund, Sweden.,Helsingborg Hospital, Helsingborg, Sweden
| | - K Nielsen
- Department of Clinical Sciences Helsingborg and Department of Clinical Sciences Lund, Dermatology, Lund University, Lund, Sweden.,Helsingborg Hospital, Helsingborg, Sweden.,Skåne University Hospital, Lund, Sweden
| | - F Nilsson
- Clinical Pharmacology, Lund University, Lund, Sweden
| | - M Bjellerup
- Department of Clinical Sciences Helsingborg and Department of Clinical Sciences Lund, Dermatology, Lund University, Lund, Sweden
| | - I Ahnlide
- Department of Clinical Sciences Helsingborg and Department of Clinical Sciences Lund, Dermatology, Lund University, Lund, Sweden.,Helsingborg Hospital, Helsingborg, Sweden
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35
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Cárcamo-Martínez Á, Domínguez-Robles J, Mallon B, Raman MT, Cordeiro AS, Bell SEJ, Larrañeta E, Donnelly RF. Potential of Polymeric Films Loaded with Gold Nanorods for Local Hyperthermia Applications. NANOMATERIALS 2020; 10:nano10030582. [PMID: 32210094 PMCID: PMC7153715 DOI: 10.3390/nano10030582] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 12/15/2022]
Abstract
Current strategies for the treatment of superficial non-melanoma skin cancer (NMSC) lesions include topical imoquimod, 5-fluorouracil, and photodynamic therapy. Although these treatments are effective, burning pain, blistering, and dermatitis have been reported as frequent side effects, making these therapies far from ideal. Plasmonic materials have been investigated for the induction of hyperthermia and use in cancer treatment. In this sense, the effectiveness of intratumorally and systemically injected gold nanorods (GnRs) in inducing cancer cell death upon near-infrared light irradiation has been confirmed. However, the in vivo long-term toxicity of these particles has not yet been fully documented. In the present manuscript, GnRs were included in a crosslinked polymeric film, evaluating their mechanical, swelling, and adhesion properties; moreover, their ability to heat up neonatal porcine skin (such as a skin model) upon irradiation was tested. Inclusion of GnRs into the films did not affect mechanical or swelling properties. GnRs were not released after film swelling, as they remained entrapped in the polymeric network; moreover, films did not adhere to porcine skin, altogether showing the enhanced biocompatibility of the material. GnR-loaded films were able to heat up the skin model over 40 °C, confirming the potential of this system for non-invasive local hyperthermia applications.
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Affiliation(s)
- Álvaro Cárcamo-Martínez
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
| | - Juan Domínguez-Robles
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
| | - Brónach Mallon
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
| | - Md. Taifur Raman
- School of Chemistry and Chemical Engineering, Queen’s University Belfast, Belfast BT9 5AG, UK; (M.T.R.); (S.E.J.B.)
| | - Ana Sara Cordeiro
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
| | - Steven E. J. Bell
- School of Chemistry and Chemical Engineering, Queen’s University Belfast, Belfast BT9 5AG, UK; (M.T.R.); (S.E.J.B.)
| | - Eneko Larrañeta
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
| | - Ryan F. Donnelly
- School of Pharmacy, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK (J.D.-R.); (B.M.); (A.S.C.); (E.L.)
- Correspondence:
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36
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Adalsteinsson JA, Ratner D, Olafsdóttir E, Grant-Kels J, Ungar J, Silverberg JI, Kristjansson AK, Jonasson JG, Tryggvadottir L. Basal cell carcinoma: an emerging epidemic in women in Iceland. Br J Dermatol 2020; 183:847-856. [PMID: 32030719 DOI: 10.1111/bjd.18937] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND An epidemic of basal cell carcinoma (BCC) has led to a significant healthcare burden in white populations. OBJECTIVES To provide an update on incidence rates and tumour burden in an unselected, geographically isolated population that is exposed to a low level of ultraviolet radiation. METHODS This was a whole-population study using a cancer registry containing records of all cases of BCC in 1981-2017. We assessed BCC incidence according to age, residence and multiplicity and assessed trends using join-point analysis. Age-standardized and age-specific incidence rates were calculated along with cumulative and lifetime risks. RESULTS During the study period, the age-standardized incidence rates increased from 25·7 to 59·9 for men, and from 22·2 to 83·1 for women (per 100 000). Compared with the single-tumour burden, the total tumour burden in the population was 1·72 times higher when accounting for multiplicity. At the beginning of the study period, the world-standardized rates in men and women were similar, but by the end of the study period the rates were 39% higher in women (83·1 per 100 000, 95% confidence interval 77·9-88·3) than in men (59·9 per 100 000, 95% confidence interval 55·6-64·2). This increase was most prominent in women on sites that are normally not exposed to ultraviolet radiation in Iceland: the trunk and legs. CONCLUSIONS This is the only reported population in which the incidence of BCC is significantly higher in women than in men. The period of notable increase in BCC lesions correlates with the period of an increase in tanning beds and travel popularity. The high multiplicity rates suggest that the total tumour burden worldwide might be higher than previously thought. What is already known about this topic? Basal cell carcinoma (BCC) is becoming an increasing healthcare burden worldwide, especially in white populations. Recent population studies have reported a rapid increase in incidence among younger individuals, especially women. What does this study add? Iceland is the only reported population in which the incidence of BCC is significantly higher in women than in men, and there does not seem to be a clear relationship between latitude and BCC incidence in Europe. Men might be comparatively protected in the northern low-ultraviolet environment, with tanning beds and travel abroad likely playing important roles in the observed incidence increase, especially in women. The high multiplicity rates suggest that the total tumour burden worldwide might be higher than previously thought. Linked Comment: Pandeya. Br J Dermatol 2020; 183:799-800.
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Affiliation(s)
- J A Adalsteinsson
- University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland.,University of Connecticut Department of Dermatology, 263 Farmington Ave, Farmington, CT, 06003, USA
| | - D Ratner
- NYU Langone Health, Department of Dermatology, New York, NY, 10016, USA
| | - E Olafsdóttir
- University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland.,Icelandic Cancer Registry, Skogarhlid 8, 105 Reykjavik, Iceland
| | - J Grant-Kels
- University of Connecticut Department of Dermatology, 263 Farmington Ave, Farmington, CT, 06003, USA
| | - J Ungar
- Mount Sinai Department of Dermatology, One Gustave L. Levy Place, NY, 10029, USA
| | - J I Silverberg
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - A K Kristjansson
- University of Connecticut Department of Dermatology, 263 Farmington Ave, Farmington, CT, 06003, USA
| | - J G Jonasson
- Faculty of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland.,Department of Pathology, Landspitali National-University Hospital, Hringbraut 101, 101 Reykjavik, Iceland
| | - L Tryggvadottir
- Icelandic Cancer Registry, Skogarhlid 8, 105 Reykjavik, Iceland
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Abstract
Melanoma and keratinocyte skin cancer (KSC) are the most common types of cancer in White-skinned populations. Both tumor entities showed increasing incidence rates worldwide but stable or decreasing mortality rates. Rising incidence rates of cutaneous melanoma (CM) and KSC are largely attributed to increasing exposure to ultraviolet (UV) radiation, the main causal risk factor for skin cancer.Incidence rates of KSC, comprising of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are much higher than that of melanoma. BCC development is mainly the cause of an intensive UV exposure in childhood and adolescence, while SCC development is related to chronic, cumulative UV exposure over decades. Although mortality is relatively low, KSC is an increasing problem for health care services causing significant morbidity.Cutaneous melanoma is rapidly increasing in White populations, with an estimated annual increase of around 3-7% over the past decades. In contrast to SCC, melanoma risk is associated with intermittent and chronic exposure to sunlight. The frequency of its occurrence is closely associated with the constitutive color of the skin and the geographical zone. Changes in outdoor activities and exposure to sunlight during the past 70 years are an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in the USA, Australia, and in European countries. In the USA even dropping numbers of death cases were recently reported, probably reflecting efficacy of the new systemic treatments.Among younger cohorts in some populations (e.g., Australia and New Zealand,), stabilizing or declining incidence rates of CM are observed, potentially caused by primary prevention campaigns aimed at reducing UV exposure. In contrast, incidence rates of CM are still rising in most European countries and in the USA. Ongoing trends towards thinner melanoma are largely ascribed to earlier detection.
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A Systematic Review and Meta-Analysis of the Accuracy of in VivoReflectance Confocal Microscopy for the Diagnosis of Primary Basal Cell Carcinoma. J Clin Med 2019; 8:jcm8091462. [PMID: 31540342 PMCID: PMC6780971 DOI: 10.3390/jcm8091462] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 12/18/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies’ methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87–0.95; I2 = 85.27%) and 0.93 (95% CI, 0.85–0.97; I2 = 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8–31.37; I2 = 91.01%) and 0.08 (95% CI, 0.05–0.14; I2 = 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73–397.02; I2 = 71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC.
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39
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Youn JC, Stehlik J, Wilk AR, Cherikh W, Kim IC, Park GH, Lund LH, Eisen HJ, Kim DY, Lee SK, Choi SW, Han S, Ryu KH, Kang SM, Kobashigawa JA. Temporal Trends of De Novo Malignancy Development After Heart Transplantation. J Am Coll Cardiol 2019; 71:40-49. [PMID: 29301626 DOI: 10.1016/j.jacc.2017.10.077] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Malignancy is a concern in cardiac transplant recipients, but the temporal trends of de novo malignancy development are unknown. OBJECTIVES The goal of this study was to describe the temporal trends of the incidence, types, and predictors of de novo malignancy in cardiac transplant recipients. METHODS The authors analyzed the temporal trends of post-transplant incidence, types, and predictors of malignancy using 17,587 primary adult heart-only transplant recipients from the International Society for Heart and Lung Transplantation registry. The main study outcomes included the incidence of, types of, and time to de novo malignancy. RESULTS The risk of any de novo solid malignancy between years 1 and 5 after transplantation was 10.7%. The cumulative incidence by malignancy type was: skin cancer (7.0%), non-skin solid cancer (4.0%), and lymphoproliferative disorders (0.9%). There was no temporal difference in the time to development according to malignancy type. However, the cumulative incidence of de novo solid malignancy increased from 2000 to 2005 vs. 2006 to 2011 (10.0% vs. 12.4%; p < 0.0001). Survival in patients after de novo malignancy was markedly lower than in patients without malignancy (p < 0.0001). Older recipients and patients who underwent transplantation in the recent era had a higher risk of de novo malignancy. CONCLUSIONS More than 10% of adult heart transplant recipients developed de novo malignancy between years 1 and 5 after transplantation, and this outcome was associated with increased mortality. The incidence of post-transplant de novo solid malignancy increased temporally, with the largest increase in skin cancer. Individualized immunosuppression strategies and enhanced cancer screening should be studied to determine whether they can reduce the adverse outcomes of post-transplantation malignancy.
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Affiliation(s)
- Jong-Chan Youn
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
| | - Josef Stehlik
- Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Amber R Wilk
- United Network for Organ Sharing, Richmond, Virginia; ISHLT Transplant Registry, Dallas, Texas
| | - Wida Cherikh
- United Network for Organ Sharing, Richmond, Virginia; ISHLT Transplant Registry, Dallas, Texas
| | - In-Cheol Kim
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Gyeong-Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Lars H Lund
- Department of Medicine, Unit of Cardiology, Karolinska Institutet, Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Howard J Eisen
- Division of Cardiology, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania
| | - Do Young Kim
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Sun Ki Lee
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Suk-Won Choi
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Seongwoo Han
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Kyu-Hyung Ryu
- Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jon A Kobashigawa
- Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
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National incidence of eyelid cancer in Ireland (2005-2015). Eye (Lond) 2019; 33:1534-1539. [PMID: 30976073 DOI: 10.1038/s41433-019-0437-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/23/2019] [Accepted: 03/13/2019] [Indexed: 12/27/2022] Open
Abstract
AIMS We report on the incidence of cutaneous eyelid tumours in Ireland over the 11-year-period from 2005 to 2015, we identify associations between demographic factors and cutaneous eyelid tumour risk. METHODS Skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma, and other cancers, located on the eyelid or canthus according to ICD-10 coding, as registered by the National Cancer Registry of Ireland (NCRI), were captured from the period 2005 to 2015. Age standardised rates (ASR) were calculated according to the European Standard Population (2013). Longitudinal data analysis using linear regression, and associations with age and sex were evaluated with the statistics program R. RESULTS There were 4824 patients diagnosed with eyelid BCC during the study period, the ASR in men and women was mean 15.87 and 13.49 per 100,00, respectively. The relative risk for eyelid BCC in men compared with women was 1.18, age was associated with incidence. There were 528 patients diagnosed with SCC; the ASR of eyelid SCC in men and women was 2.10 and 1.39 per 100,000, respectively, and increased in women annually (β = 0.07, p = 0.0005). The relative risk for eyelid SCC in men compared with women was 1.51, and age was exponentially associated with SCC. Melanoma and other eyelid tumours were uncommon-50 and 55 cases, respectively. CONCLUSION Incidence of both BCC and SCC increases with age and male sex. The incidence of eyelid SCC is increasing in women, and under age 50, eyelid BCC is more common in women than men. SYNOPSIS We describe the recent incidence of eyelid cancers in Ireland, from National Cancer Registry Data. We find eyelid BCC, and also SCC, are associated with increased age. Rate of eyelid SCC is increasing in women.
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Dermoscopy Patterns and Histopathological Findings in Nodular Basal Cell Carcinoma-Study on 68 Cases. CURRENT HEALTH SCIENCES JOURNAL 2019; 45:116-122. [PMID: 31297272 PMCID: PMC6592668 DOI: 10.12865/chsj.45.01.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/17/2019] [Indexed: 11/18/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, with an increasing incidence in Europe particularly in young individuals. Nodular basal cell carcinoma is the most common subtype and accounts for approximately 57.6-78.7% of all BCCs. We performed an observational, morphological study which involved 68 patients with the diagnosis of nodular BCC. The localization and diameter of the lesion, histological subtype of the lesion, dermoscopic patterns, Fitzpatrick skin type and sex of each patient were recorded. The most common dermoscopic pattern seen in nodular BCCs was irregular vascularity and, arborizing vessels (>0.2mm in diameter) being the most frequent irregular vascular pattern. The second most common dermoscopic feature in patients with nodular BCCs was translucency. The most common dermoscopic features of the 12 pigmented BCCs were: pigmented islands (blue-gray globules and blue-gray ovoid nests); the pigmented distribution pattern (with (maple leaf-like structures and spoke wheel-like areas); arborizing vessels and white streaks/white areas. The histopathological analysis of the 68 BCCs revealed that the nodular type was the most frequently identified for 71.7% of cases The differential diagnosis between basal cell carcinoma and other skin lesions and inflammatory skin diseases is very important, since serious morbidity may result from an undiagnosed tumor.
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Grandahl K, Olsen J, Friis KBE, Mortensen OS, Ibler KS. Photoaging and actinic keratosis in Danish outdoor and indoor workers. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:201-207. [PMID: 30687943 PMCID: PMC6850006 DOI: 10.1111/phpp.12451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/23/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The risk of photoaging and actinic keratosis caused by work related solar ultraviolet radiation exposure has not previously been investigated in Nordic countries. The objectives of this study were to describe the occurrence of photoaging, actinic keratosis, and keratinocyte cancer in a population of Danish outdoor and indoor workers, and investigate the association between these clinical findings and semi-objective measures of work related solar ultraviolet radiation exposure in the same population. METHODS A clinical cross-sectional study of the occurrence of facial wrinkles, actinic keratosis, keratinocyte cancer, and melanocytic nevi in a population of Danish outdoor and indoor workers and associations with semi-objective measures of work related solar ultraviolet radiation exposure based on a combination of dosimetry and self-report. RESULTS Work related solar ultraviolet radiation exposure was significantly positively associated with occurrence of facial wrinkles (α = 0.05). Actinic keratosis was associated to status as outdoor worker (OR = 4.272, CI [1.045-17.471]) and age (P < 0.001, CI [1.077-1.262]) and twice as common in outdoor workers (10.3% CI [0.05, 0.15]) compared to indoor workers (5.1% CI [0.00, 0.10]). Only two cases of keratinocyte cancer were diagnosed (<1%). Older age was negatively associated with occurrence of melanocytic nevi. CONCLUSION Outdoor work in Denmark is associated with increased occurrence of facial wrinkles and actinic keratosis from solar ultraviolet radiation exposure, thus justifying sun safety at Danish workplaces from a clinical perspective.
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Affiliation(s)
- Kasper Grandahl
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark
| | - Jonas Olsen
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
| | | | - Ole Steen Mortensen
- The Department of Occupational Medicine, Copenhagen University Holbaek, Holbaek, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Sophie Ibler
- The Department of Dermatology, Zealand University Hospital Roskilde, Roskilde, Denmark
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Cameron MC, Lee E, Hibler BP, Barker CA, Mori S, Cordova M, Nehal KS, Rossi AM. Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol 2019; 80:303-317. [PMID: 29782900 DOI: 10.1016/j.jaad.2018.03.060] [Citation(s) in RCA: 237] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 12/17/2022]
Abstract
As the most common human cancer worldwide and continuing to increase in incidence, basal cell carcinoma is associated with significant morbidity and cost. Continued advances in research have refined both our insight and approach to this seemingly ubiquitous disease. This 2-part continuing medical education article will provide a comprehensive and contemporary review of basal cell carcinoma. The first article in this series describes our current understanding of this disease regarding epidemiology, cost, clinical and histopathologic presentations, carcinogenesis, natural history, and disease associations.
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Affiliation(s)
- Michael C Cameron
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erica Lee
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brian P Hibler
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christopher A Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shoko Mori
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kishwer S Nehal
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony M Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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Umezono Y, Sato Y, Noto M, Yamada K, Noguchi N, Hasunuma N, Osada SI, Manabe M. Incidence rate of cutaneous squamous cell carcinoma is rapidly increasing in Akita Prefecture: Urgent alert for super-aged society. J Dermatol 2019; 46:259-262. [DOI: 10.1111/1346-8138.14759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Yuko Umezono
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Yuriko Sato
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Mai Noto
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Katsuhiro Yamada
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Natsuko Noguchi
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Naoko Hasunuma
- Department of Community Medicine and Primary Care Development; Akita University School of Medicine; Akita Japan
| | - Shin-Ichi Osada
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
| | - Motomu Manabe
- Department of Dermatology and Plastic Surgery; Akita University Graduate School of Medicine; Akita Japan
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45
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García-Díez I, Hernández-Muñoz I, Hernández-Ruiz E, Nonell L, Puigdecanet E, Bódalo-Torruella M, Andrades E, Pujol RM, Toll A. Transcriptome and cytogenetic profiling analysis of matched in situ/invasive cutaneous squamous cell carcinomas from immunocompetent patients. Genes Chromosomes Cancer 2019; 58:164-174. [DOI: 10.1002/gcc.22712] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 11/01/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Irene García-Díez
- Department of Dermatology; Hospital del Mar, Universitat Autònoma de Barcelona (UAB); Barcelona Spain
- Group of Inflammatory and Neoplastic Dermatological Diseases, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Inmaculada Hernández-Muñoz
- Group of Inflammatory and Neoplastic Dermatological Diseases, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Eugenia Hernández-Ruiz
- Department of Dermatology; Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB); Barcelona Spain
| | - Lara Nonell
- Microarray Analysis Service, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Eulàlia Puigdecanet
- Microarray Analysis Service, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Marta Bódalo-Torruella
- Microarray Analysis Service, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Evelyn Andrades
- Group of Inflammatory and Neoplastic Dermatological Diseases, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Ramon M. Pujol
- Department of Dermatology; Hospital del Mar, Universitat Autònoma de Barcelona (UAB); Barcelona Spain
- Group of Inflammatory and Neoplastic Dermatological Diseases, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
| | - Agustí Toll
- Department of Dermatology; Hospital del Mar, Universitat Autònoma de Barcelona (UAB); Barcelona Spain
- Group of Inflammatory and Neoplastic Dermatological Diseases, IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
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Cook S, Leist T, Comi G, Montalban X, Giovannoni G, Nolting A, Hicking C, Galazka A, Sylvester E. Safety of cladribine tablets in the treatment of patients with multiple sclerosis: An integrated analysis. Mult Scler Relat Disord 2018; 29:157-167. [PMID: 30885374 DOI: 10.1016/j.msard.2018.11.021] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/09/2018] [Accepted: 11/19/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Treating patients with relapsing multiple sclerosis (MS) with cladribine tablets (two times 4 or 5 days of treatment each year for 2 years) results in long-lasting efficacy, with continued stability in many patients for 4 or more years. Safety and tolerability outcomes from individual clinical studies with cladribine tablets have been reported previously. OBJECTIVE Report safety data from an integrated analysis of clinical trials and follow-up in patients with MS to further characterize the safety profile of cladribine tablets. METHODS Data for patients treated with cladribine tablets 10 mg (MAVENCLAD®; 3.5 mg/kg cumulative dose over 2 years, referred to as cladribine tablets 3.5 mg/kg) as monotherapy (n = 923) or placebo (n = 641) in Phase III clinical trials (CLARITY, CLARITY Extension and ORACLE-MS) and followed up in the PREMIERE registry were aggregated (Monotherapy Oral cohort). To better characterize rare events, additional data from earlier studies which involved the use of parenteral cladribine in patients with MS, and the ONWARD study, in which patients were given cladribine tablets in addition to interferon (IFN)-β or placebo plus IFN-β were included in an All Exposed cohort (cladribine, n = 1926; placebo, n = 802). Adjusted adverse events incidences per 100 patient-years (Adj-AE per 100 PY) were calculated for the integrated analyses. RESULTS The incidence rate of treatment-emergent adverse events (TEAEs) in the Monotherapy Oral cohort was 103.29 vs. 94.26 Adj-AEs per 100 PY for placebo. TEAEs that occurred more frequently with cladribine tablets were mainly driven by the TEAEs of lymphopenia (Adj-AE per 100 PY 7.94 vs. 1.06 for placebo) and lymphocyte count decreased (Adj-AE per 100 PY 0.78 vs. 0.10 for placebo) as anticipated due to the mode of action of cladribine. An increase in TEAE incidence rate was also observed in the cladribine tablets 3.5 mg/kg group vs. placebo for herpes zoster (Adj-AE per 100 PY 0.83 vs. 0.20, respectively). There were no cases of systemic, serious disseminated herpes zoster attributed to treatment with cladribine tablets. In general there was no increase in the risk of infections including opportunistic infections with cladribine tablets versus placebo, except for herpes zoster. Periods of severe lymphopenia (< 0.5 × 109 cells/L) were associated with an increased frequency of infections, but the nature of these was not different to that observed in the overall patient group treated with cladribine tablets 3.5 mg/kg. Within the constraints of a limited sample size, malignancy rates in the overall clinical program for cladribine in MS did not show evidence of an increase compared to placebo-treated patients and there was no increase in the incidence of malignancies over time in cladribine-treated patients. CONCLUSION The AE profile for cladribine tablets 3.5 mg/kg as a monotherapy has been well-characterized in a pooled population of patients from early to more advanced relapsing MS. There was no increased risk for infections in general except for a higher incidence of herpes zoster. Lymphopenia was amongst the most frequently observed TEAEs that occurred at a higher incidence with cladribine relative to placebo. There was also no increase in malignancy rates for cladribine relative to placebo.
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Affiliation(s)
- Stuart Cook
- Rutgers, The State University of New Jersey, New Jersey Medical School, Department of Neurology & Neurosciences, 185 South Orange Avenue, Newark, NJ 07101-1709, United States.
| | - Thomas Leist
- Division of Clinical Neuroimmunology, Jefferson University, Comprehensive MS Center, 900 Walnut Street, Philadelphia, PA 19107, United States
| | - Giancarlo Comi
- Department of Neurology and Institute of Experimental Neurology, Università Vita-Salute San Raffaele, Ospedale San Raffaele, Via Olgettina 48, Milan 20132, Italy
| | - Xavier Montalban
- Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada; Department of Neurology-Neuroimmunology, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Passeif de la Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Gavin Giovannoni
- Queen Mary University of London, Blizard Institute, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London, E1 2AT, UK
| | - Axel Nolting
- Merck KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany
| | | | - Andrew Galazka
- Merck, Zone Industrielle de L'Ouriettaz, Aubonne, 1170, Switzerland, a division of Merck KGaA, Darmstadt, Germany
| | - Elke Sylvester
- Merck KGaA, Frankfurter Str. 250, 64293 Darmstadt, Germany
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Aluma-Tenorio MS, Ávila-Álvarez A, Jaimes N, Caballero-Uribe N, González A, Terzian LR, Ocampo-Candiani J, Zuluaga MA, Garza-Rodríguez V, Tamayo-Betancur MC, Cuesta-Castro DP, Garcés JR, Ruiz-Salas V, Goldberg L, Kimyai-Asadi A. Basal cell carcinoma treated with Mohs micrographic surgery in young Ibero-American patients. Int J Dermatol 2018; 57:1447-1453. [PMID: 30168850 DOI: 10.1111/ijd.14195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/15/2018] [Accepted: 08/01/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The incidence of basal cell carcinoma (BCC) in younger individuals has increased in recent decades. However, the characteristics of BCCs in this population, especially in Ibero-Latin American countries, have not been completely defined. OBJECTIVE To describe the demographic, clinical, and histopathological characteristics of BCCs in patients younger than 40 treated with Mohs Micrographic Surgery (MMS). MATERIALS AND METHODS A multicenter, retrospective study conducted between January 2009 and December 2014, in five Ibero-American countries, included biopsy-proven BCCs in patients younger than 40 that were treated with MMS. Demographic, clinical, histopathological, and surgical characteristics were described. RESULTS The study included 301 tumors in 241 patients, of whom 61% were female. The most common Fitzpatrick phototype was III. The most common histological subtypes were nodular (37.5%) and infiltrative (18.9%). Perineural invasion was encountered in 1.7%, and tumor clearance was achieved in 87.4% within two stages of MMS. CONCLUSIONS This is the first Ibero-Latin American transnational study describing the characteristics of BCCs in young patients treated with MMS. Despite darker skin phototypes in this population, BCCs can occur in early ages and may present with aggressive features. Therefore, MMS may be considered an appropriate first-line treatment option in this population.
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Affiliation(s)
| | | | - Natalia Jaimes
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Natalia Caballero-Uribe
- Aurora, Centro Especializado en Cáncer de Piel, Medellín, Colombia.,Universidade do federal do ABC, Santo André, SP, Brazil
| | - Abel González
- Instituto Médico Especializado Alexander Fleming, Buenos Aires, Argentina.,Instituto de Oncologia, Ángel H. Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Jorge Ocampo-Candiani
- Facultad de Medicina. Servicio de Dermatología, Universidad Autónoma de Nuevo León. Hospital Universitario, Monterrey, México
| | - María Alejandra Zuluaga
- Facultad de Medicina. Servicio de Dermatología, Universidad Autónoma de Nuevo León. Hospital Universitario, Monterrey, México
| | - Verónica Garza-Rodríguez
- Facultad de Medicina. Servicio de Dermatología, Universidad Autónoma de Nuevo León. Hospital Universitario, Monterrey, México
| | | | | | - Joan Ramón Garcés
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro Médico Teknon, Barcelona, Catalunya, Spain
| | - Verónica Ruiz-Salas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Centro Médico Teknon, Barcelona, Catalunya, Spain
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Oh CM, Cho H, Won YJ, Kong HJ, Roh YH, Jeong KH, Jung KW. Nationwide Trends in the Incidence of Melanoma and Non-melanoma Skin Cancers from 1999 to 2014 in South Korea. Cancer Res Treat 2018; 50:729-737. [PMID: 28707459 PMCID: PMC6056982 DOI: 10.4143/crt.2017.166] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/10/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This descriptive study was aimed to examine trends in the incidence of melanoma and nonmelanoma in South Korea. MATERIALS AND METHODS The nationwide incidence data for melanoma and non-melanoma skin cancer was obtained from the Korea Central Cancer Registry. Age-standardized rates were calculated and analyzed, using a Joinpoint regression model. RESULTS The incidence of basal cell carcinoma has increased dramatically both in men (average annual percentage change [AAPC], 8.0 [95% confidence interval (CI), 6.0 to 10.1]) and women (AAPC, 9.0 [95% CI, 7.5 to 10.4]). Squamous cell carcinoma has also steadily increased both in men (AAPC, 3.3 [95% CI, 2.6 to 4.0]) and women (AAPC, 6.8 [95% CI, 5.3 to 8.4]). Cutaneous melanoma increased continuously from 1999 to 2014 inwomen (AAPC, 3.5 [95% CI, 2.4 to 4.6]), whilst rapidly increasing in men until 2005 (APC, 7.9 [95% CI, 2.4 to 13.7]) after which no increase has been observed (APC, ‒0.2 [95% CI, ‒2.3 to 2.0]). CONCLUSION The incidence rates of melanoma and non-melanoma skin cancer have increased over the past years, with the exception of melanoma in men. Further studies are required to investigate the reasons for the increased incidence of these skin cancers in South Korea.
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Affiliation(s)
- Chang-Mo Oh
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyunsoon Cho
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Cancer Surveillance Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Yun Ho Roh
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Ki-Heon Jeong
- Department of Dermatology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyu-Won Jung
- Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
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Jimenez-Rosales A, Flores-Merino MV. A Brief Review of the Pathophysiology of Non-melanoma Skin Cancer and Applications of Interpenetrating and Semi-interpenetrating Polymer Networks in Its Treatment. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2018. [DOI: 10.1007/s40883-018-0061-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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50
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Risk Factors for Basal Cell Carcinoma in Men Younger Than 40 Years: A Case-Control Study. Dermatol Surg 2018; 44:1373-1378. [PMID: 29746427 DOI: 10.1097/dss.0000000000001541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common malignancy in the United States and is more prevalent in older populations. OBJECTIVE The aim of this study was to investigate BCC risk factors in male patients younger than 40 years. MATERIALS AND METHODS A consecutive series of male patients with pathology-proven BCC and younger than 40 years at time of diagnosis were retrospectively identified along with matched controls. Phone interviews were conducted using a structured questionnaire, and differences between patients with and without BCC were investigated. RESULTS A total of 50 patients with BCC and 27 controls were included in this study. Compared with controls, patients with BCC worked outdoor jobs for longer lengths of time (43.2 vs 15.6 months; p = .04), were more likely to have a family history of skin cancer (66% vs 44%; p = .02), and were more likely to use sunscreen heavily after biopsy (p = .02). Patients with multiple BCCs (n = 20) were more likely to have a history of substantial recreational sun exposure (p = .01) than patients with solitary lesions (n = 30). CONCLUSION The authors conclude that outdoor sun exposure in patients with underlying genetic susceptibility is the most likely mechanism of BCC formation in young male patients.
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