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Rosenthal A, Juhasz MLW, Chang C, Gharavi NM. Lasers for the Treatment of Nonmelanoma Skin Cancer: A Systematic Review of the Literature. Dermatol Surg 2024; 50:714-719. [PMID: 38651741 DOI: 10.1097/dss.0000000000004198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Lasers may present an alternative treatment modality for the management of nonmelanoma skin cancer (NMSC). OBJECTIVE To investigate lasers as a definitive treatment of NMSC. METHODS A comprehensive search was performed on MEDLINE, the Cochrane Library, and the National Institutes of Health ( www.clinicaltrials.gov ). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to finalize a list of relevant literature studies evaluating the role of laser therapy for NMSC. Articles published through May 1, 2023, were included. RESULTS The authors identified 37 studies investigating nonablative and ablative lasers alone and in combination with other lasers, noninvasive imaging, and additional modalities for the treatment of basal cell carcinomas, 10 focusing on squamous cell carcinoma in situ and 3 focusing on the treatment of both basal and squamous cell carcinomas. CONCLUSION Although surgical management continues to be superior to laser therapy for the management of high-risk and cosmetically sensitive tumors, laser therapy may be an acceptable alternative for low-risk lesions on the trunk and extremities. However, further studies are needed to optimize parameters, determine maximal efficacy, and provide long-term follow-up before the adoption of laser therapy for NMSC into daily clinical practice.
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Affiliation(s)
- Amanda Rosenthal
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Margit L W Juhasz
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Crystal Chang
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Nima M Gharavi
- Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, California
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2
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Chen M, Zhou A, Khachemoune A. Photodynamic Therapy in Treating a Subset of Basal Cell Carcinoma: Strengths, Shortcomings, Comparisons with Surgical Modalities, and Potential Role as Adjunctive Therapy. Am J Clin Dermatol 2024; 25:99-118. [PMID: 38042767 DOI: 10.1007/s40257-023-00829-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 12/04/2023]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, for which there are multiple treatment options, including the gold standard Mohs micrographic surgery (MMS), surgical excision, electrodesiccation and curettage, radiation therapy, cryosurgery, and photodynamic therapy (PDT). While PDT is currently approved for treating actinic keratosis, it has been used off-label to treat BCC patients who may not tolerate surgery or other treatment modalities. We present a review of the efficacy of these modalities and describe important considerations that affect the usage of PDT and MMS. ALA-PDT and MAL-PDT are both efficacious treatment options for lower-risk BCC that can serve as non-invasive alternatives to surgical excision with favorable cosmetic outcomes in patients unsuitable to undergo surgery. In particular, PDT may be considered an adjuvant for the prevention and treatment of BCC lesions in patients with some genetic syndromes such as Gorlin syndrome, and in combination with surgical excision in lesions presenting in certain locations. Limitations to PDT include lack of margin control to prevent recurrence, pain, and cost of certain photosensitizers. Future studies should investigate the role of PDT as adjunctive therapy, standardization of protocols, and causes and ways to address recurrence following PDT treatment.
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Affiliation(s)
- Maggie Chen
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Albert Zhou
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Amor Khachemoune
- Department of Dermatology, State University of New York Downstate and Veterans Affairs Medical Center, 800 Poly Pl, Brooklyn, NY, 11209, USA.
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3
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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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Kranz S, Brunnmeier G, Yilmaz P, Thamm J, Schiele S, Müller G, Key C, Welzel J, Schuh S. Optical coherence tomography-guided Nd:YAG laser treatment and follow-up of basal cell carcinoma. Lasers Surg Med 2023; 55:257-267. [PMID: 36740365 DOI: 10.1002/lsm.23638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Basal cell carcinoma (BCC) is the most common skin tumor with an annually increasing incidence. Standard care requires several visits for diagnosis and treatment. Optical coherence tomography (OCT) as a diagnostic tool increases the sensitivity (95%) and specificity (77%) of the diagnosis of BCC. Although laser therapy is not the standard of care, the long-pulsed 1064 nm Nd:YAG laser seems to be a promising option. However, data are scarce. The published papers had a short follow-up (FU) time and used to some extent inferior methods to detect complete tumor clearance. To address this research gap, this study evaluates the efficiency of laser treatment by FU OCT. We pursue a patient-focused approach and combine OCT with Nd:YAG laser treatment in one procedure. MATERIALS AND METHODS The study was conducted as a prospective, single-center trial that recruited biopsy-confirmed or OCT-proven BCC with a tumor thickness of less than 1.2 mm. Patients underwent two or three repeated sessions with the Nd:YAG laser (5-6 mm spot, fluence of 120-140 J/cm2 , pulse duration of 8-10 milliseconds). Each BCC was assessed at baseline, and 3 and 12 months after laser treatment by clinical image, dermoscopy, and OCT. Incomplete tumor clearance (ITC) was defined as a clearly detectable BCC on the OCT image or a biopsy-confirmed BCC in the treated area. RESULTS Forty-five patients completed the 12-month FU (46.7% women; median age of 74.0 [52-88] years) with a total number of 78 BCC lesions. At baseline, all patients had their BCC diagnosed by OCT (tumor thickness of 0.6 [0.4; 0.8] mm), 15.4% lesions were additionally diagnosed by histopathology. The most common subtype of BCC was superficial (48.7%), followed by nodular (47.4%) and infiltrative (3.8%). ITC rate after the treatment using Nd:YAG laser was 30.8% (95% CI: 20.8%-42.2%) (24/78) after 3 months and 7.4% (95% CI: 2.1%-17.9%) (4/54) after 12 months. ITC was not associated with histological subtype, tumor thickness, or location. If ITC was detected, the lesion was treated again. Out of 19 lesions with at least one additional laser treatment, 7 lesions (36.8%) suffered from incomplete tumor removal. In 46.7% of the treated lesions, the cosmetic outcome was rated as moderate or severe scarring after 12 months. CONCLUSION Our results demonstrate that the ITC rate of BCC treated with the Nd:YAG laser is much higher (up to one-third) than reported, although the laser settings were identical to prior studies. This is especially evident at the 3-month FU. In addition, we witnessed a larger number of side effects and a worse cosmetic outcome compared to previous studies.
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Affiliation(s)
- Stefanie Kranz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Gisela Brunnmeier
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Pelinsu Yilmaz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Janis Thamm
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Stefan Schiele
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Clara Key
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
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5
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Holm KBE, Nielsen LJ, Lock-Andersen J, Behrendt N, Svensson MS, Themstrup L, Jemec GBE. Optical coherence tomography for presurgical delineation of basal cell carcinomas on the face-A comparison with histopathology. J Cutan Pathol 2023; 50:441-449. [PMID: 36794511 DOI: 10.1111/cup.14412] [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: 01/26/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND To minimize the risk of incomplete excision of basal cell carcinomas (BCC) the macroscopic tumor margins should be adequately defined. Optical coherence tomography (OCT) is a non-invasive imaging tool that can provide structural and vascular information about skin cancer lesions. The study objective was to compare the presurgical delineation of facial BCC by clinical examination, histopathology, and OCT imaging in tumors undergoing full excision. METHODS Ten patients with BCC lesions on the face were examined clinically, with OCT and histopathology at 3-mm intervals, from the clinical lesion border and beyond the resection line. The OCT scans were evaluated blinded and a delineation estimate of each BCC lesion was made. The results were compared to the clinical and histopathologic results. RESULTS OCT evaluations and histopathology were in agreement in 86.6% of the collected data points. In three cases the OCT scans estimated a reduction of the tumor size compared to the clinical tumor border set by the surgeon. CONCLUSION The results of this study support the notion that OCT can have a role in the clinical daily practice by aiding clinicians in delineating BCC lesions before surgery.
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Affiliation(s)
- K B E Holm
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - L J Nielsen
- Department of Plastic and Breast Surgery, Zealand University Hospital, Roskilde, Denmark
| | - J Lock-Andersen
- Department of Plastic and Breast Surgery, Zealand University Hospital, Roskilde, Denmark
| | - N Behrendt
- Department of Pathology, Zealand University Hospital, Roskilde, Denmark
| | - M S Svensson
- Department of Pathology, Zealand University Hospital, Roskilde, Denmark
| | - L Themstrup
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
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6
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Saitburkhanov R, Kubanov A, Plakhova X, Kondrakhina I. Use of 585 and 1064 nm laser for the treatment of basal cell skin cancer. VESTNIK DERMATOLOGII I VENEROLOGII 2023. [DOI: 10.25208/vdv1390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Basal cell skin cancer is the most common malignant epithelial skin neoplasm in fair-skinned people and accounts for two-thirds of all skin cancers in this population. Tumor lesions have a supporting vascular network that serves as a target for vascular selective lasers.
Aim. To assess the effects of laser radiation at a wavelength of 585 and 1064 nm on the vasculature of various forms of basal cell skin cancer using dermatoscopy and in vivo confocal microscopy.
Materials and methods. The study included 20 patients with 20 lesions of histologically confirmed basal cell skin cancer treated with a pulsed dye laser (wavelength 585 nm) and a long-pulse neodymium laser (wavelength 1064 nm) in the conditions of the consultative and diagnostic center of the Federal State Budgetary Institution "GNTSDK" of the Ministry of Health RF in the period from 2021 to 2022. The effectiveness of therapy was assessed using non-invasive methods for examining the skin.
According to the results of the two-year follow-up period, 100% effectiveness of therapy in both groups is noted, in 2 patients treated with a neodymium laser, the formation of hypertrophic scars in the treatment area is noted.
Treatment of patients with basal cell skin cancer with selective vascular lasers may be an effective treatment option. Additional studies with a larger sample of observations and a long monitoring period are needed to confirm the effectiveness of this treatment method.
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7
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Welzel J. [Will medical decisions be made by artificial intelligence in the future? : The tricorder from Star Trek takes charge of the bridge]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2022; 73:656-658. [PMID: 35267043 DOI: 10.1007/s00105-022-04975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg Medizincampus Süd, Sauerbruchstr. 6, 86179, Augsburg, Deutschland.
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8
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Advances in Management and Therapeutics of Cutaneous Basal Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14153720. [PMID: 35954384 PMCID: PMC9367462 DOI: 10.3390/cancers14153720] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Basal cell carcinoma (BCC) is the most common malignancy in humans with a range of treatment options available. Tumor and patient characteristics aid in risk-stratification, which influences treatment considerations. Here, we review the advancements in surgical, topical, field, immunotherapeutic, molecular-targeted, and experimental treatment modalities that can be employed in the correct clinical setting for the treatment of BCC. Abstract Basal cell carcinoma (BCC), the most common cancer in humans, is a malignant neoplasm of cells derived from the basal layer of the epidermis. Tumor characteristics such as histologic subtype, primary versus recurrent tumor, anatomic location, size, and patient attributes determine the risk level and acceptable treatment options. Surgical options offer histologic confirmation of tumor clearance. Standard excision provides post-treatment histologic assessment, while Mohs micrographic surgery (MMS) provides complete margin assessment intraoperatively. Additional treatment options may be employed in the correct clinical context. Small and low-risk BCCs, broad field cancerization, locally-advanced disease, metastatic disease, cosmetic concerns, or morbidity with surgical approaches raise consideration of other treatment modalities. We review herein a range of treatment approaches and advances in treatments for BCC, including standard excision, MMS, electrodesiccation and curettage, ablative laser treatment, radiation therapy, targeted molecular therapies, topical therapies, field therapies, immunotherapy, and experimental therapies.
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9
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Felice S, Bressler MY, Karim R, Markowitz O. Transforming the treatment of psoriasis to the 21st century: Detecting subclinical therapeutic response to secukinumab using optical coherence tomography as a prognostic indicator. Lasers Surg Med 2022; 54:825-834. [PMID: 35598099 DOI: 10.1002/lsm.23551] [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: 12/23/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is a noninvasive imaging device that scans the skin up to 2 mm in depth. OCT can capture real-time epidermal thickness (ET) measurements and detect subclinical changes in inflammatory skin diseases like eczema and psoriasis. © 2022 Wiley Periodicals LLC. OBJECTIVE To determine if measuring ET with OCT can detect a subclinical therapeutic response in psoriasis treated with the biological therapy, secukinumab (an IL-17A antagonist). DESIGN Phase IV, single-center, open-label, and single-arm study. PARTICIPANTS Twenty-six consecutive patients with moderate to severe plaque psoriasis. MEASUREMENTS Clinical, dermoscopic, and OCT images were obtained at each visit. The clinician measured disease severity with the Investigator's Global Assessment (IGA) and Psoriasis Area And Severity Index (PASI). OCT was used to scan the ET at the center of lesional skin (ET-L), along the border, and normal skin (ET-N) on the same body plane; their difference was noted as ΔET. RESULTS Initially, ET-L was greater than ET-N (p < 0.0001), their differences decreased throughout the study, and there were no significant differences at Week 16 (p = 0.48). Twenty-four (92%) patients achieved a 50% reduction in PASI score (PASI50); they had lower ΔET at Weeks 0, 1, 3, 4, and 8 compared to those who did not clear (p < 0.04). Having a lower ΔET at Week 4 was associated with a shorter time to reach PASI50 (p = 0.02). CONCLUSION ET measurements using OCT can detect an early subclinical response to secukinumab compared to clinical scoring and identify nonresponders as early as 4 weeks.
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Affiliation(s)
- Skye Felice
- OptiSkin, New York, New York, USA.,Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York, USA
| | - Moshe Y Bressler
- OptiSkin, New York, New York, USA.,Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | | | - Orit Markowitz
- OptiSkin, New York, New York, USA.,Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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10
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Zhang Y, Jing Y, Pan R, Ding K, Chen R, Meng Q. Mechanisms of Cancer Inhibition by Local Anesthetics. Front Pharmacol 2021; 12:770694. [PMID: 34950031 PMCID: PMC8688799 DOI: 10.3389/fphar.2021.770694] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/15/2021] [Indexed: 01/17/2023] Open
Abstract
The use of local anesthetics during surgical treatment of cancer patients is an important part of perioperative analgesia. In recent years, it has been showed that local anesthetics can directly or indirectly affect the progression of tumors. In vitro and in vivo studies have demonstrated that local anesthetics reduced cancer recurrence. The etiology of this effect is likely multifactorial. Numerous mechanisms were proposed based on the local anesthetic used and the type of cancer. Mechanisms center on NaV1.5 channels, Ras homolog gene family member A, cell cycle, endothelial growth factor receptor, calcium Influx, microRNA and mitochondrial, in combination with hyperthermia and transient receptor potential melastatin 7 channels. Local anesthetics significantly decrease the proliferation of cancers, including ovarian, breast, prostate, thyroid, colon, glioma, and histiocytic lymphoma cell cancers, by activating cell death signaling and decreasing survival pathways. We also summarized clinical evidence and randomized trial data to confirm that local anesthetics inhibited tumor progression.
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Affiliation(s)
- Yiguo Zhang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yixin Jing
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rui Pan
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ke Ding
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rong Chen
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China.,Department of Anesthesiology, East Hospital, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qingtao Meng
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China.,Department of Anesthesiology, East Hospital, Renmin Hospital of Wuhan University, Wuhan, China
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