Recent advances in phototherapy and photochemotherapy of skin disease

Different Anatomical Distribution of Basal Cell Carcinoma Subtypes in Iranian Population: Association between Site and Subtype

Background

Basal cell carcinoma (BCC) is the most common type of human cancer. Despite the high prevalence of these tumors, there is a lack of reliable epidemiological data in some regions including Iran.

Objective

To assess the relationship between BCC subtypes and anatomical distribution in the Iranian population.

Methods

There were 876 patients with a single BCC enrolled in this study (March 2007 to March 2010; Razi Dermatology Center, Tehran, Iran).

Results

Among 876 patients, 544 were males and 332 females. Of the lesions, 43% were nodular, 32.4% mixed type, 3% superficial and rest of other subtypes. In the lesion location, 58.2% were on the face, 29.2% on scalp, 6.2% on ears, 2.3% on neck, 1.7% on trunk and 1.3% on the extremities. There was no significant difference between male and female in the BCC subtypes, but anatomical distribution of the tumor was different (p=0.002). Most of the trunk-arising BCCs were superficial, and most of the facial BCCs were nodular subtype. Also, most of the BCC subtypes occurred in patients between 40 to 80 years old and mostly on the face and scalp (p=0.04). However, superficial BCCs mostly occurred in younger patients over others (p=0.001).

Conclusion

Subtype is associated with a site, independent of gender or age. Also BCCs occurring on the trunk are mostly of the superficial subtype.

Calcitonin gene-related peptide decreases expression of HLA-DR and CD86 by human dendritic cells and dampens dendritic cell-driven T cell-proliferative responses via the type I calcitonin gene-related peptide receptor

These studies were performed to establish whether functional receptors for calcitonin gene-related peptide (CGRP) are present on human dendritic cells (DCs) and to investigate potential immunomodulatory effects of CGRP on DCs other than Langerhans cells. Reverse transcriptase-PCR revealed expression of mRNA for a type 1 CGRP receptor by mature and immature blood-derived DCs. Sequence analysis confirmed the identity of the type 1 CGRP receptor (CGRP-R1). Addition of CGRP (10-7 M) to mature and immature DCs resulted in mobilization of intracellular calcium. Treatment of immature DCs with CGRP (10-7 M), before and after maturation in monocyte-conditioned medium, resulted in decreased cell surface expression of HLA-DR MHC class II and the costimulatory molecule, CD86. Treatment of immature DCs with CGRP (10-7 M) also resulted in decreased expression of CD86, but expression of HLA-DR was unchanged. When CGRP-treated mature DCs were used to stimulate allogeneic T cells, proliferative responses were dampened (approximately 50%), especially at low DC:T cell ratios (1:360). This effect was not observed with CGRP-treated, immature DCs. In contrast, CGRP-treated mature or immature DCs were no less efficient than untreated DCs in driving syngeneic T cell-proliferative responses to staphylococcal enterotoxin B. We conclude that mature and immature DCs express type 1 CGRP receptors and that signaling through these receptors may dampen mature DC-driven T cell proliferation most likely via down-regulation of CD86 and HLA-DR.

Ultraviolet-A radiation induces adhesion molecule expression on human dermal microvascular endothelial cells

Ultraviolet radiation is capable of inducing numerous skin reactions. Considerable amounts of UVA radiation penetrate the epidermis and reach the microvascular endothelium of the papillary dermis. In order to investigate putative direct effects of UV radiation on endothelial cells, we studied adhesion molecule expression by immunostaining procedures and FACS analysis, following irradiation of normal human skin and cultured human dermal endothelial cells. Enhanced immunostaining for ICAM-1 and E-selectin was detected in biopsies taken after in vivo UVA and UVB irradiation, compared with non-irradiated control skin. On cultured human dermal endothelial cells, however, ICAM-1 and E-selectin were inducible by UVA but not UVB. The induction was dose-dependent, peaking at 20 J/cm2 for both adhesion molecules, and time-dependent, peaking after 6 and 24 h for E-selectin and ICAM-1, respectively. Expression of VCAM-1 and PECAM/EndoCAM/CD31 was unaffected by any UV-radiation modality. The functional integrity of irradiated cells was monitored by an exclusion assay of the fluorescent dye 7-AAD, and by staining for the cytoskeletal proteins actin and vimentin. Our results demonstrate that dermal microvascular endothelial cells are a critical and direct target of UVA, and suggest they may play a pivotal role in UV-induced inflammatory skin conditions.