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Dong Z, Chen Z, Tan Q. Body fat percentage vs body mass index in estimating basal cell carcinoma. Heliyon 2024; 10:e35297. [PMID: 39170446 PMCID: PMC11336599 DOI: 10.1016/j.heliyon.2024.e35297] [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] [Received: 06/18/2024] [Revised: 07/25/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024] Open
Abstract
Background The role of body mass index (BMI) in basal cell carcinoma (BCC) risk remains controversial, and limited information is available regarding the relationship between other physical measurements and BCC. Several recent studies have found a positive effect of adiposity on improved survival when obesity was determined solely by BMI (the "obesity paradox"). We hypothesize that body fat percentage (BFP) may serve as a more sensitive risk factor for BCC than BMI. Methods The study conducted a retrospective analysis of clinical data from two distinct centers in China. Individual patient-level data were obtained from medical record reviews spanning January 1, 2015, to December 31, 2022. Associations with outcomes were analyzed using univariate and stratified analyses and assessed using multiple logistic regression with adjustment for confounding factors. Additionally, we performed a meta-analysis to further test the observations in our study. Results A total of 337 patients, ranging in age from 50 to 91 years, with a mean age of 66.88 (standard deviation 10.16), were included. We observed no significant association between BMI and BCC after adjusting for confounders (OR: 0.71, 95 % CI: 0.36-1.40, P = 0.3186). There was also no convincing effect in a meta-analysis (n = 158,741) (OR: 0.99, 95 % CI: 0.93-1.06, P = 0.8). Furthermore, BFP was found to be associated with BCC (OR: 2.64, 95 % CI: 1.17-5.97, P = 0.0196), supported by strong clinical evidence. Conclusions Our study supports the hypothesis that BFP is superior to BMI in assessing BCC risk. Multiple logistic regression analyses, coupled with meta-analysis, provided robust evidence that BFP is a sensitive risk factor for BCC, while BMI appears unrelated to risk. According to these findings, routine healthcare practices could benefit from utilizing BFP measurements. The reduction of body fat percentage in low-fat diets may be beneficial for adjuvant treatment of BCC.
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Affiliation(s)
- Zheng Dong
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Department of Burn and Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Zhenyu Chen
- Department of Plastic Surgery, Affiliated Hospital of Medical Collage Qingdao University, Qingdao, Shandong, 266000, China
| | - Qian Tan
- Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Department of Burn and Plastic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
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Sol S, Boncimino F, Todorova K, Waszyn SE, Mandinova A. Therapeutic Approaches for Non-Melanoma Skin Cancer: Standard of Care and Emerging Modalities. Int J Mol Sci 2024; 25:7056. [PMID: 39000164 PMCID: PMC11241167 DOI: 10.3390/ijms25137056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024] Open
Abstract
Skin cancer encompasses a range of cutaneous malignancies, with non-melanoma skin cancers (NMSCs) being the most common neoplasm worldwide. Skin exposure is the leading risk factor for initiating NMSC. Ultraviolet (UV) light induces various genomic aberrations in both tumor-promoting and tumor-suppressing genes in epidermal cells. In conjunction with interactions with a changed stromal microenvironment and local immune suppression, these aberrations contribute to the occurrence and expansion of cancerous lesions. Surgical excision is still the most common treatment for these lesions; however, locally advanced or metastatic disease significantly increases the chances of morbidity or death. In recent years, numerous pharmacological targets were found through extensive research on the pathogenic mechanisms of NMSCs, leading to the development of novel treatments including Hedgehog pathway inhibitors for advanced and metastatic basal cell carcinoma (BCC) and PD-1/PD-L1 inhibitors for locally advanced cutaneous squamous cell carcinoma (cSCC) and Merkel cell carcinoma (MCC). Despite the efficacy of these new drugs, drug resistance and tolerability issues often arise with long-term treatment. Ongoing studies aim to identify alternative strategies with reduced adverse effects and increased tolerability. This review summarizes the current and emerging therapies used to treat NMSC.
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Affiliation(s)
- Stefano Sol
- Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Fabiana Boncimino
- Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Kristina Todorova
- Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | | | - Anna Mandinova
- Cutaneous Biology Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
- Broad Institute of Harvard and MIT, 7 Cambridge Center, Cambridge, MA 02142, USA
- Harvard Stem Cell Institute, 7 Divinity Avenue, Cambridge, MA 02138, USA
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3
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Lee T, Oka T, Demehri S. High-Risk Non-Melanoma Skin Cancers: Biological and Therapeutic Advances. Hematol Oncol Clin North Am 2024:S0889-8588(24)00053-4. [PMID: 38908957 DOI: 10.1016/j.hoc.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Nonmelanoma skin cancers (NMSCs) are the most common cancers, with high-risk NMSCs sharing features such as poor histologic differentiation, invasion into deeper layers, and anatomic location. NMSC includes basal cell carcinoma, cutaneous squamous cell carcinoma, and Merkel cell carcinoma. Herein, the authors describe advances in understanding the genetic mechanisms of malignant transformation and the composition of tumor microenvironment for these cancers. They summarize recent therapeutic advances, including targeted therapy and immunotherapy for NMSCs. Effective skin protection against ultraviolet radiation-induced carcinogenesis remains an urgent unmet need for NMSC prevention. The authors highlight immune-based interventions as novel strategies to address this need.
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Affiliation(s)
| | - Tomonori Oka
- Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Cutaneous Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Shadmehr Demehri
- Harvard Medical School, Boston, MA 02115, USA; Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Cutaneous Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA.
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Barbarossa L, D’Onghia M, Cartocci A, Suppa M, Tognetti L, Cappilli S, Peris K, Perez-Anker J, Malvehy J, Baldino G, Militello C, Perrot JL, Rubegni P, Cinotti E. Understanding the Dermoscopic Patterns of Basal Cell Carcinoma Using Line-Field Confocal Tomography. Tomography 2024; 10:826-838. [PMID: 38921940 PMCID: PMC11209319 DOI: 10.3390/tomography10060063] [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: 04/14/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Basal cell carcinoma (BCC) is the most frequent malignancy in the general population. To date, dermoscopy is considered a key tool for the diagnosis of BCC; nevertheless, line-field confocal optical coherence tomography (LC-OCT), a new non-invasive optical technique, has become increasingly important in clinical practice, allowing for in vivo imaging at cellular resolution. The present study aimed to investigate the possible correlation between the dermoscopic features of BCC and their LC-OCT counterparts. In total, 100 histopathologically confirmed BCC cases were collected at the Dermatologic Clinic of the University of Siena, Italy. Predefined dermoscopic and LC-OCT criteria were retrospectively evaluated, and their frequencies were calculated. The mean (SD) age of our cohort was 65.46 (13.36) years. Overall, BCC lesions were mainly located on the head (49%), and they were predominantly dermoscopically pigmented (59%). Interestingly, all dermoscopic features considered had a statistically significant agreement with the LC-OCT criteria (all p < 0.05). In conclusion, our results showed that dermoscopic patterns may be associated with LC-OCT findings, potentially increasing accuracy in BCC diagnosis. However, further studies are needed in this field.
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Affiliation(s)
- Lorenzo Barbarossa
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Martina D’Onghia
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Alessandra Cartocci
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Simone Cappilli
- Department of Dermatology, Sacred Heart Catholic University, 00168 Rome, Italy; (S.C.)
| | - Ketty Peris
- Department of Dermatology, Sacred Heart Catholic University, 00168 Rome, Italy; (S.C.)
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Gennaro Baldino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Caterina Militello
- Department of Pathological Anatomy, University of Siena, 53100 Siena, Italy
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy (L.T.); (P.R.); (E.C.)
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Mørk E, Mjønes P, Foss OA, Mørk C, Bachmann IM, Kroon S, Dotterud LK, Helsing P, Vatne Ø, Christensen E. Clinical versus Histological Assessment of Basal Cell Carcinoma Subtype and Thickness of Tumours Selected for Photodynamic Therapy. Acta Derm Venereol 2024; 104:adv18308. [PMID: 38751175 PMCID: PMC11110808 DOI: 10.2340/actadv.v104.18308] [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: 08/04/2023] [Accepted: 04/11/2024] [Indexed: 05/24/2024] Open
Abstract
Photodynamic therapy is an approved treatment for primary, superficial, and small nodular basal cell carcinomas with a thickness of < 2 mm located on low-risk sites. Histologically verified basal cell carcinomas clinically assessed as suited for photodynamic therapy were included. The study aimed to investigate the agreement between clinical and histological assessments of basal cell carcinoma subtypes and thickness of tumours selected for photodynamic therapy with histopathological evaluation as a reference. A total of 343 tumours were included. The agreement between clinical and histological diagnosis of basal cell carcinoma subtype was 72% (p < 0.001). Clinical assessment of subtype had a sensitivity of 93% and specificity of 55% for superficial tumours and a sensitivity of 55% and specificity of 85% for nodular tumours. The mean ± SD thickness values by clinical and histological assessments were 0.95 ± 0.53 and 0.86 ± 0.75. The difference of 0.09 mm was statistically significant (p = 0.017), but not considered to be clinically relevant, although the differences between specific subgroups could be relevant. Among basal cell carcinomas clinically diagnosed as superficial, 91% were histologically consistent with the current photodynamic therapy criteria. The main results suggest that histopathological evaluation should precede photodynamic therapy to ensure selection of suitable basal cell carcinomas. In selected cases, the clinical diagnosis alone may be adequate before proceeding with photodynamic therapy.
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Affiliation(s)
- Erik Mørk
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Patricia Mjønes
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Olav A Foss
- Department of Orthopaedic Surgery, Clinic of Orthopaedics, Rheumatology and Dermatology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cato Mørk
- Akershus Dermatology Centre, Lørenskog, Norway
| | - Ingeborg M Bachmann
- Institute of Medical Science, University of Bergen, Bergen, Norway; Department of Dermatology, Haukeland University Hospital, Bergen, Norway
| | - Susanne Kroon
- Department of Dermatology and Venerology, Stavanger University Hospital, Stavanger, Norway
| | | | - Per Helsing
- Department of Dermatology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Øystein Vatne
- Department of Dermatology, Førde Central Hospital, Førde, Norway
| | - Eidi Christensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Dermatology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
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Idriss MH, Stull CM, Migden MR. Treatments on the horizon for locally advanced basal cell carcinoma. Cancer Lett 2024; 589:216821. [PMID: 38521198 DOI: 10.1016/j.canlet.2024.216821] [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: 11/19/2023] [Revised: 02/16/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
Basal cell carcinoma (BCC) is one of the most common human cancers. Most cases of BCC are amenable to surgical and topical treatments with excellent prognosis if diagnosed timely and managed appropriately. However, in a small percentage of cases, it could be locally advanced BBC (laBCC) and not amenable to surgery or radiation, including recurrent, large tumors or tumors that invade deeper tissue. Hedgehog inhibitors (vismodegib and sonidegib) are approved as the first-line treatment of laBCC. PD-1 inhibitor immunotherapy (cemiplimab) is indicated for cases that progressed on or could not tolerate hedgehog inhibitors or when hedgehog inhibitors are contraindicated. Given the modest response and bothersome side effects of some of the agents above, there are reports of novel treatments, and clinical trials are currently evaluating multiple agents.
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Affiliation(s)
- Munir H Idriss
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Carolyn M Stull
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael R Migden
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Akella SS, Lee J, May JR, Puyana C, Kravets S, Dimitropolous V, Tsoukas M, Manwar R, Avanaki K. Using optical coherence tomography to optimize Mohs micrographic surgery. Sci Rep 2024; 14:8900. [PMID: 38632358 PMCID: PMC11024158 DOI: 10.1038/s41598-024-53457-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/31/2024] [Indexed: 04/19/2024] Open
Abstract
Mohs micrographic surgery (MMS) is considered the gold standard for treating high-risk cutaneous basal cell carcinoma (BCC), but is expensive, time-consuming, and can be unpredictable as to how many stages will be required or how large the final lesion and corresponding surgical defect will be. This study is meant to investigate whether optical coherence tomography (OCT), a highly researched modality in dermatology, can be used preoperatively to map out the borders of BCC, resulting in fewer stages of MMS or a smaller final defect. In this prospective study, 22 patients with BCC undergoing surgical excision were enrolled at a single institution. All patients had previously received a diagnostic biopsy providing confirmation of BCC and had been referred to our center for excision with MMS. Immediately prior to performing MMS, OCT was used to map the borders of the lesion. MMS then proceeded according to standard protocol. OCT images were compared to histopathology for agreement. Histopathologic analysis of 7 of 22 MMS specimens (32%) revealed a total absence of BCC, indicating resolution of BCC after previous diagnostic biopsy. This outcome was correctly predicted by OCT imaging in 6 of 7 cases (86%). Nine tumors (9/22, 41%) had true BCC and required a single MMS stage, which was successfully predicted by pre-operative OCT analysis in 7 of 9 cases (78%). The final six tumors (27%) had true BCC and required two MMS stages for complete excision; preoperative OCT successfully predicted the need for a second stage in five cases (5/6, 83.3%). Overall, OCT diagnosed BCC with 95.5% accuracy (Cohen's kappa, κ = 0.89 (p-value = < 0.01) in the center of the lesion. Following a diagnostic biopsy, OCT can be used to verify the existence or absence of residual basal cell carcinoma. When residual tumor is present that requires excision with MMS, OCT can be used to predict tumor borders, optimize surgery and minimize the need for additional surgical stages.
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Affiliation(s)
- Sruti S Akella
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jenna Lee
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Julia Roma May
- School of Medicine, University of Illinois-Chicago, Chicago, IL, USA
| | - Carolina Puyana
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Sasha Kravets
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois-Chicago, Chicago, IL, USA
| | | | - Maria Tsoukas
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Rayyan Manwar
- Department of Biomedical Engineering, University of Illinois-Chicago, Chicago, IL, USA
| | - Kamran Avanaki
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA.
- Department of Biomedical Engineering, University of Illinois-Chicago, Chicago, IL, USA.
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Lin J, Luo M, Zhuo Q, Zhang H, Chen N, Han Y. The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review. Medicine (Baltimore) 2024; 103:e37629. [PMID: 38608090 PMCID: PMC11018215 DOI: 10.1097/md.0000000000037629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/26/2024] [Indexed: 04/14/2024] Open
Abstract
Basal cell carcinoma (BCC) represents the most prevalent cancer globally. The past decade has witnessed significant advancements in BCC treatment, primarily through bibliometric studies. Aiming to perform a comprehensive bibliometric analysis of BCC treatments to comprehend the research landscape and identify trends within this domain, a dataset comprising 100 scientific publications from the Web of Science Core Collection was analyzed. Country co-operation, journal co-citation, theme bursts, keyword co-occurrence, author co-operation, literature co-citation, and field-specific references were examined using VOSviewer and CiteSpace visualization tools. These articles, published between 2013 and 2020, originated predominantly from 30 countries/regions and 159 institutions, with the USA and Germany at the forefront, involving a total of 1118 authors. The keyword analysis revealed significant emphasis on the hedgehog pathway, Mohs micrographic surgery, and photodynamic therapy. The research shows developed nations are at the forefront in advancing BCC therapies, with significant focus on drugs targeting the hedgehog pathway. This treatment avenue has emerged as a crucial area, meriting considerable attention in BCC therapeutic strategies.
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Affiliation(s)
- Jinger Lin
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Min Luo
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Qianwei Zhuo
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Haosong Zhang
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Nuo Chen
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Yue Han
- Department of Dermatology, The Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
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Negrutiu M, Danescu S, Popa T, Focșan M, Vesa ȘC, Baican A. Advancements in Basal Cell Carcinoma Diagnosis: Non-Invasive Imaging and Multimodal Approach. J Clin Med 2023; 13:39. [PMID: 38202046 PMCID: PMC10779576 DOI: 10.3390/jcm13010039] [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: 11/11/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The aim of this study was to correlate the diagnostic criteria described in dermatoscopy, ultrasonography (US), ex vivo confocal microscopy, and histology to the most common subtypes of basal cell carcinoma (BCC). (2) Methods: We conducted a prospective study including 46 BCC cases, which were analyzed with dermatoscopy using the Delta 30 dermatoscope and Vidix 4.0 videodermoscope, with US using a high-resolution 20 MHz linear probe, with confocal microscopy, along with histopathological analysis. (3) Results: This study categorized BCC by histological subtype, with nodular being the most common (84.8%) and various other subtypes represented. US measurements of tumor thickness correlated strongly with the histopathological depth of invasion index (DI). Dermatoscopy analysis revealed significant associations between specific features and BCC subtypes. The DI was directly related to arborized vessels but inversely related to short, fine telangiectasias, maple-leaf-like areas, and spoke-wheel areas. The presence of ulceration was directly related to the DI. Confocal microscopy images exhibited several characteristics, including fluorescence, nuclear crowding, peripheral palisading, clefting, increased nuclear-cytoplasmic (N/C) ratio, and a "cauliflower-like" appearance. (4) Conclusion: The advanced detection of BCC through imagistic techniques like dermatoscopy, confocal microscopy, and ultrasound improves the diagnosis and may offer valuable insights for treatment in the future by evaluating lesion characteristics.
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Affiliation(s)
- Mircea Negrutiu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Sorina Danescu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Theodor Popa
- Department of Rehabilitation, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Monica Focșan
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271 Cluj-Napoca, Romania;
| | - Ștefan Cristian Vesa
- Department of Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Adrian Baican
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
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Pedersen SJV, Paoli J, Gniadecki R, Glud M. Repair of Defects of the Nasal Tip After Mohs Surgery. Dermatol Pract Concept 2023; 13:dpc.1304a228. [PMID: 37992361 PMCID: PMC10656174 DOI: 10.5826/dpc.1304a228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Mohs Micrographic Surgery (MMS) is a treatment option for high-risk facial nonmelanoma skin cancer with high cure rates. Especially on the nasal tip, the tissue sparing properties of MMS are appealing. The nasal tip is a common location of nonmelanoma skin cancer and can be a challenging anatomical structure for reconstructive surgery due to its prominent location in the face, the shortage of spare tissue, as well as the stiffness and composition of different skin types, cartilage and bone. OBJECTIVES The aim of the present paper is to review and demonstrate how reconstruction of the nasal tip can be done successfully to improve the care for patients undergoing MMS in this area. METHODS Using selected literature on the area and the surgeons experience, each method of repair are described including their individual advantages and challenges. Pictures and consent were selected from one patient who underwent each repair method and three photos are presented in this paper: one after tumor resection, one immediately after repair, and one minimum 6 months post-surgery. RESULTS We present eight surgical methods as well as pictures from previous surgeries. CONCLUSIONS The results demonstrate obtainable results using very different surgical methods and the importance of an individualized approach to repairing cutaneous defects of the nasal tip.
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Affiliation(s)
- Sasia JV Pedersen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Robert Gniadecki
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital
| | - Martin Glud
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital
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Kosche C, Rossi AM. Perianal Malignancies: A Review for the Dermatologic Surgeon. Dermatol Surg 2023; 49:914-920. [PMID: 37643240 DOI: 10.1097/dss.0000000000003906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Perianal malignancies are rare tumors with unique presentations and treatment options. OBJECTIVE To review published literature about primary malignancies that present on perianal skin and published guidelines and treatment options. MATERIALS AND METHODS A PubMed search was conducted for original articles about perianal malignancies. RESULTS Squamous cell carcinoma, basal cell carcinoma, melanoma, and extramammary Paget disease are the most common tumors to present on perianal skin. Anal squamous cell carcinoma incidence is increasing and certain populations may benefit from screening. Surgical management is often recommended for localized perianal tumors. CONCLUSION Dermatologic surgeons should be familiar with the presentation and treatment options available for perianal malignancies.
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Affiliation(s)
- Cory Kosche
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
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Tan IJ, Pathak GN, Silver FH. Topical Treatments for Basal Cell Carcinoma and Actinic Keratosis in the United States. Cancers (Basel) 2023; 15:3927. [PMID: 37568743 PMCID: PMC10416997 DOI: 10.3390/cancers15153927] [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: 06/05/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Skin cancer is an overarching label used to classify a variety of cutaneous malignancies. Surgical excision procedures are the commonly used treatments for these lesions; however, the choice to perform operative intervention may be influenced by other factors. Established research and literature suggest that topical treatments limit the need for surgical intervention and its commonly associated adverse effects, including infection and scarring. In addition, the growing indications for the usage of topical therapies in BCC treatment, as well as their increased availability and therapeutic options, allow for their greater applicability in the dermatology clinic. Certain topical therapies have been highlighted in research, especially those targeting basal cell carcinoma (BCC) and actinic keratosis (AK). There is also a clear correlation between cost and treatment outcomes, considering BCC's ever-growing prevalence and the proportion of excised lesions being reported as malignant. This review will discuss BCC and AK lesion criteria that result in the most successful outcomes using topical treatments, then highlight the various topical treatment options, and finally address their clinical significance moving forward.
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Affiliation(s)
| | | | - Frederick H. Silver
- Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08854, USA
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13
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Sooksamran A, Pichai P, Suphannaphong M, Singthong S. Previous therapy and the recurrence rate of basal cell carcinoma after Mohs surgery: a meta-analysis. Arch Dermatol Res 2023; 315:1747-1754. [PMID: 36847828 DOI: 10.1007/s00403-023-02558-w] [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: 03/08/2022] [Revised: 12/15/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC) is indicated for patients at high risk of recurrence; other therapies, including standard surgical excision, cryotherapy, electrodesiccation and curettage, and radiotherapy, are used in low-risk BCC and in patients who cannot undergo surgery. However, in the case of recurrence following treatment with any of these methods, MMS is indicated. This study aimed to examine how preoperative treatment before MMS affects the recurrence rate after surgery. We conducted a meta-analysis to compare the recurrence rates of primary BCC and previously treated BCC in patients undergoing MMS, with a 5-year follow-up. The secondary outcomes were the recurrence rate after MMS based on previous radiation therapy status, mean time to recurrence, and number of cases undergoing more than one stage of MMS. The recurrence rate in the previously treated group was 2.44 times greater than that of the primary BCC group. In the previous treatment group, the patients who underwent previous radiation showed a 2.52-fold higher recurrence rate than those with no previous radiation therapy. However, there was no significant difference in the mean time to recurrence and the number of cases requiring MMS > 1 stage between the previously treated and non-treated groups. Patients with previously treated BCC, especially those treated using radiation, had a higher likelihood of recurrence.
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Affiliation(s)
- Apasee Sooksamran
- Department of Medical Services, Institute of Dermatology, Phayathai, Bangkok, 10400, Thailand.
| | - Pitchayasak Pichai
- Department of Medical Services, Institute of Dermatology, Phayathai, Bangkok, 10400, Thailand
| | - Mingkwan Suphannaphong
- Department of Medical Services, Institute of Dermatology, Phayathai, Bangkok, 10400, Thailand
| | - Sasathorn Singthong
- Department of Medical Services, Institute of Dermatology, Phayathai, Bangkok, 10400, Thailand
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14
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Lin A, Schmalbach CE. Surgery in the Era of Immunotherapy for Advanced Head and Neck Non-melanoma Skin Cancer. Curr Oncol Rep 2023; 25:735-742. [PMID: 37010785 DOI: 10.1007/s11912-023-01391-8] [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] [Accepted: 01/17/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE OF REVIEW Surgery remains the mainstay of treatment for non-melanoma skin cancer (NMSC). Immunotherapy (IO) has emerged as an alternative option. This review provides a contemporary summary of how to incorporate IO into the management of advanced NMSC. Evidence-based outcomes and recent clinical trials are provided with emphasis on the three most common NMSC diagnoses: cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma (BCC), and merkel cell carcinoma (MCC). RECENT FINDINGS Surgical resection while preserving form and function remains the standard of care for the majority of NMSCs. In recalcitrant cases failing traditional surgery and/or primary radiation, patient ineligible for such treatments, or unresectable disease, IO has emerged as a promising alternative. In the majority of cases, it is a supplanting primary chemotherapy. Surgery remains the standard of care for NMSC. Immunotherapy has emerged as an alternative option for non-surgical candidates and as a neoadjuvant means to minimize morbidity.
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Affiliation(s)
- Alice Lin
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente School of Medicine, Pasadena, CA, USA
| | - Cecelia E Schmalbach
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
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15
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Wu MJ, Chen YC, Cui XL, Yang Q, Xue QL. Tislelizumab for squamous lung cancer combined with basal cell carcinoma of the skin: A case report. Medicine (Baltimore) 2023; 102:e33788. [PMID: 37171300 PMCID: PMC10174383 DOI: 10.1097/md.0000000000033788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Surgery is the preferred treatment for basal cell carcinoma (BCC), locally advanced or metastatic BCC, radiation therapy or systemic therapy can be considered. Programmed death receptor 1 (PD-1) inhibitors are rarely used to treat cutaneous BCC. In the present case, we found that tislelizumab, a PD-1 immunosuppressant, had a positive effect on BCC. PATIENT CONCERNS A 74-year-old male patient presented with a mass in the left back in October 2021, which was surgically removed and diagnosed as BCC. The patient was diagnosed with squamous lung cancer after presenting with a cough and coughing up a small amount of white, sticky sputum in December 2021. DIAGNOSIS BCC and squamous lung cancer. INTERVENTIONS Docetaxel + nedaplatin systemic chemotherapy combined with tislelizumab immunotherapy. OUTCOMES Both BCC and squamous lung cancer were significantly reduced in size. CONCLUSION After 2 cycles of immunotherapy with tislelizumab, the lung tumor shrank, the back mass disappeared, and the wound healed.
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Affiliation(s)
- Ming-Jun Wu
- Respiratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
- Respiratory, The Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Yu-Chun Chen
- Respiratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
- Respiratory, The Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Xiao-Li Cui
- Respiratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
- Respiratory, The Clinical Medical College of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Qian Yang
- Respiratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
| | - Qing-Liang Xue
- Respiratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
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16
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Yacob F, Siarov J, Villiamsson K, Suvilehto JT, Sjöblom L, Kjellberg M, Neittaanmäki N. Weakly supervised detection and classification of basal cell carcinoma using graph-transformer on whole slide images. Sci Rep 2023; 13:7555. [PMID: 37160953 PMCID: PMC10169852 DOI: 10.1038/s41598-023-33863-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
The high incidence rates of basal cell carcinoma (BCC) cause a significant burden at pathology laboratories. The standard diagnostic process is time-consuming and prone to inter-pathologist variability. Despite the application of deep learning approaches in grading of other cancer types, there is limited literature on the application of vision transformers to BCC on whole slide images (WSIs). A total of 1832 WSIs from 479 BCCs, divided into training and validation (1435 WSIs from 369 BCCs) and testing (397 WSIs from 110 BCCs) sets, were weakly annotated into four aggressivity subtypes. We used a combination of a graph neural network and vision transformer to (1) detect the presence of tumor (two classes), (2) classify the tumor into low and high-risk subtypes (three classes), and (3) classify four aggressivity subtypes (five classes). Using an ensemble model comprised of the models from cross-validation, accuracies of 93.5%, 86.4%, and 72% were achieved on two, three, and five class classifications, respectively. These results show high accuracy in both tumor detection and grading of BCCs. The use of automated WSI analysis could increase workflow efficiency.
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Affiliation(s)
- Filmon Yacob
- AI Sweden, Gothenburg, Sweden
- AI Competence Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Siarov
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Villiamsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Juulia T Suvilehto
- AI Competence Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lisa Sjöblom
- AI Competence Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Kjellberg
- AI Competence Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Noora Neittaanmäki
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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17
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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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18
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Comment on "Basal cell carcinoma: Contemporary approaches to diagnosis, treatment, and prevention". J Am Acad Dermatol 2023; 88:e29-e30. [PMID: 31394136 DOI: 10.1016/j.jaad.2019.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 11/22/2022]
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19
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Antibiotic Use and Surgical Site Infections in Immunocompromised Patients After Mohs Micrographic Surgery: A Single-Center Retrospective Study. Dermatol Surg 2022; 48:1283-1288. [DOI: 10.1097/dss.0000000000003620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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20
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Moro F, Ciccone D, Fania L, Mariotti F, Salemme A, Rahimi S, Pallotta S, Di Zenzo G. Case report: A rare case of imiquimod-induced atypical pemphigus vulgaris. Front Med (Lausanne) 2022; 9:1054544. [PMID: 36507544 PMCID: PMC9729728 DOI: 10.3389/fmed.2022.1054544] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Pemphigus vulgaris is an autoimmune intraepithelial bullous disease involving the skin and the mucous membranes. Imiquimod, a topical therapy for skin basal cell carcinoma, is an amine that induces the production of tumor necrosis factor alfa, interleukin-1 and other cytokines. Pemphigus induced by drugs has been frequently reported, mostly after systemic therapy. Case presentation We present the case of a 50-year-old man who developed skin, intraoral, and genital mucosae lesions 3 days after a treatment with Imiquimod for multiple superficial basal cell carcinoma of the trunk. Direct and indirect immunofluorescence results were compatible with the diagnosis of pemphigus vulgaris. Enzyme-linked immunosorbent assay was negative for desmoglein 1 and 3, but interestingly, by immunoblotting on keratinocyte extracts a band of 170 kDa was obtained by IgG. The patient, after interrupting Imiquimod application, started a treatment with prednisolone and in 4 weeks showed a complete remission. Conclusion Topical Imiquimod therapy might induce atypical pemphigus vulgaris in some patients.
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Affiliation(s)
- Francesco Moro
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy,*Correspondence: Francesco Moro,
| | - Davide Ciccone
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Luca Fania
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Feliciana Mariotti
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Adele Salemme
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Siavash Rahimi
- Department of Anatomic Pathology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Sabatino Pallotta
- Dermatology Clinic, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
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Litaiem N, Hayder F, Benlagha I, Karray M, Dziri C, Zeglaoui F. The Use of Dermoscopy in the Delineation of Basal Cell Carcinoma for Mohs Micrographic Surgery: a Systematic Review With Meta-Analysis. Dermatol Pract Concept 2022; 12:e2022176. [PMID: 36534540 PMCID: PMC9681184 DOI: 10.5826/dpc.1204a176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Several studies investigated the use of dermoscopy in the delineation of basal cell carcinoma (BCC) for Mohs micrographic surgery (MMS) with conflicting results. OBJECTIVES The purpose of this systematic review with meta-analysis was to evaluate the effectiveness of the use of dermoscopy-guided MMS in the treatment of BCC. METHODS We included all comparative studies. Cases of BCC treated using dermoscopy-guided MMS (or slow MMS) were compared to those treated with curettage-guided MMS or "standard" MMS. RESULTS A total of 6 studies including 508 BCCs were reviewed. There was no statistically significant difference in the proportion of total margin clearance on the first MMS stage between BCCs removed using dermoscopy-guided MMS and those that had curettage or visual inspection. However, lateral margin involvement was significantly lower in BCCs that had dermoscopy-guided MMS. CONCLUSIONS Dermoscopy allows visualization of structures up to 1mm into the dermis. Therefore, it is rational to use it for lateral margin evaluation. Currently, there are two comparative studies showing the efficacy of dermoscopy for lateral margin evaluation during MMS. Future studies are required to develop an evidence-based recommendation regarding the utility of dermoscopy in MMS.
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Affiliation(s)
- Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
| | - Faten Hayder
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
| | - Imene Benlagha
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
| | - Manel Karray
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
| | - Chadli Dziri
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
- Director of Honoris Medical Simulation Center, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculté de Médecine de Tunis, Tunis, Tunisia
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22
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Patil NK, Bubna AK, Hussain S, Singh N. Giant Solitary Trichoepithelioma: A Diagnosis of Exclusion. Int J Trichology 2022; 14:221-223. [PMID: 37034549 PMCID: PMC10075344 DOI: 10.4103/ijt.ijt_9_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 03/15/2023] Open
Affiliation(s)
| | - Aditya Kumar Bubna
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
| | - Seeba Hussain
- Department of Dermatology, Katihar Medical College, Katihar, Bihar, India
| | - Neha Singh
- Department of Pathology, Katihar Medical College, Katihar, Bihar, India
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23
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Cohen PR. Cutaneous Basal Cell Carcinoma In Situ: A Case Series. Cureus 2022; 14:e29479. [DOI: 10.7759/cureus.29479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
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24
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Venturi F, Pellacani G, Farnetani F, Maibach H, Tassone D, Dika E. Non – Invasive diagnostic techniques in the preoperative setting of Mohs micrographic surgery: a review of the literature. Dermatol Ther 2022; 35:e15832. [DOI: 10.1111/dth.15832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/28/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Federico Venturi
- Section of Dermatology, Department of Health Sciences University of Florence Florence Italy
| | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I Sapienza University of Rome Rome Italy
| | | | - Howard Maibach
- Dermatology University of California San Francisco, San Francisco California
| | - Daniela Tassone
- IRCCS di Policlinico Sant'Orsola, via Massarenti 9 Bologna Italia
| | - Emi Dika
- IRCCS di Policlinico Sant'Orsola, via Massarenti 9 Bologna Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna Bologna Italy
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25
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Niculet E, Bobeica C, Craescu M, Nicolescu AC, Tocu G, Onisor C, Arbune M, Tatu AL. Multimodal Considerations Concerning Basal Cell Carcinoma Clefting – Profile of Structural and Aggressive Traits – Perspectives. Clin Cosmet Investig Dermatol 2022; 15:2087-2095. [PMID: 36199384 PMCID: PMC9529228 DOI: 10.2147/ccid.s385213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/11/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Correspondence: Mihaela Craescu, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40751869864, Email
| | | | - George Tocu
- Department of Pharmaceutical Sciences, “Dunărea de Jos” University, Galati, Romania
- George Tocu, Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 35 Alexandru Ioan Cuza Street, Galați, 800008, Romania, Tel +40773819438, Email
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Manuela Arbune
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galați, Romania
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26
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Sławińska M, Płaszczyńska A, Lakomy J, Pastuszak K, Biernat W, Sikorska M, Nowicki RJ, Sobjanek M. Significance of Dermoscopy in Association with Clinical Features in Differentiation of Basal Cell Carcinoma and Benign Trichoblastic Tumours. Cancers (Basel) 2022; 14:cancers14163964. [PMID: 36010957 PMCID: PMC9406107 DOI: 10.3390/cancers14163964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Although basal cell carcinoma (BCC) can, in the majority of cases, be diagnosed based on clinical and dermoscopic assessment, a potential overlap with benign adnexal skin tumours seems to exist, including trichoblastic tumours (TT). Methods: Retrospective analysis of clinical and dermoscopic features of benign TT and BCC cases was performed to develop a diagnostic algorithm with a potential utility in clinical practice. Results: In the study, 502 histopathologically confirmed BCC cases were compared with 61 TT (including 44 TB (72.13%), 10 TE (16.39%) and 7 DTE (11.48%]). Patients in the BCC group were statistically older (mean age was 71.4 vs. 64.4 years, respectively; p = 0.009). BCC presented generally as larger tumours (mean tumour size 11.0 vs. 8.2 mm for the TT group; p = 0.001) and was more frequently associated with clinically visible ulceration (59.4% vs. 19.7%, respectively; p < 0.001). Comparison of lesion morphology, clinically visible pigmentation, and anatomical location did not show significant differences between the analysed groups. Dermoscopically visible ulceration was significantly more common in the BCC group compared to the TT group (52.2% vs. 14.8%; p < 0.0001). Pigmented structures, specifically brown dots and brown globules, were significantly more prevalent in the TT group (32.8% vs. 11.4%; p = 0.0001 and 29.5% vs. 8.2%; p <0.0001). Similarly, TT more commonly than BCC showed the presence of cloudy/starry milia-like cysts (26.2% vs. 11.6%; p = 0.0031) and yellow globules (16.4% vs. 7.2%; p = 0.033). Conclusions: Despite differences in frequency of clinical and dermoscopic features between BCC and TT in the studied group, differential diagnosis based on these variables is not reliable. Histopathological examination remains a diagnostic gold standard in differentiation of BCC and TT.
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Affiliation(s)
- Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Correspondence:
| | - Anna Płaszczyńska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Joanna Lakomy
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Krzysztof Pastuszak
- Department of Algorithms and System Modeling, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, 80-233 Gdańsk, Poland
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Monika Sikorska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Roman J. Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Souto EB, da Ana R, Vieira V, Fangueiro JF, Dias-Ferreira J, Cano A, Zielińska A, Silva AM, Staszewski R, Karczewski J. Non-melanoma skin cancers: physio-pathology and role of lipid delivery systems in new chemotherapeutic treatments. Neoplasia 2022; 30:100810. [PMID: 35649306 PMCID: PMC9160356 DOI: 10.1016/j.neo.2022.100810] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022]
Abstract
Non-melanoma carcinoma has high incidence rates and has two most common subtypes: basal cell carcinoma and squamous cell carcinoma. This type of carcinoma is usually not fatal; however, it can destroy sensory organs such as the nose, ears, and lips. The treatment of these injuries using non-invasive methods is thus strongly recommended. Some treatments for non-melanoma carcinoma are already well defined, such as surgery, cryosurgery, curettage and electrode section, and radiotherapy; however, these conventional treatments cause inflammation and scarring. In the non-surgical treatment of non-melanoma carcinoma, the topical administration of chemotherapeutic drugs contributes for an effective treatment with reduced side effects. However, the penetration of anticancer drugs in the deeper layers of the skin is required. Lipid delivery systems (liposomes, solid lipid nanoparticles, nanostructured lipid carriers) have been developed to overcome epidermal barrier of the skin and to allow the drugs to reach tumor cells. These lipid nanoparticles contribute to control the release profile of the loaded chemotherapeutic drugs, maintaining their stability and increasing death of tumor cells. In this review, the characteristics of non-melanoma carcinoma will be discussed, describing the main existing treatments, together with the contribution of lipid delivery systems as an innovative approach to increase the effectiveness of topical therapies for non-melanoma carcinomas.
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Affiliation(s)
- Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; REQUIMTE/UCIBIO, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Raquel da Ana
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Vânia Vieira
- Faculty of Health Sciences, University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Porto, Portugal
| | - Joana F Fangueiro
- Faculty of Health Sciences, University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Porto, Portugal
| | - João Dias-Ferreira
- Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Amanda Cano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08007 Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN2UB), 08007 Barcelona, Spain
| | - Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Amélia M Silva
- Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal; Centre for Research and Technology of Agro-Environmental and Biological Sciences, CITAB, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal
| | - Rafał Staszewski
- Department of Hypertension Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jacek Karczewski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland; Department of Gastroenterology, Dietetics and Internal Diseases, H. Swiecicki University Hospital, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
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Rosenberg A, Cho S. We Can Do Better at Protecting Our Service Members From Skin Cancer. Mil Med 2022; 187:311-313. [PMID: 35789273 DOI: 10.1093/milmed/usac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/26/2022] [Accepted: 06/21/2022] [Indexed: 11/14/2022] Open
Abstract
Skin cancer rates have been steadily increasing among the American public for decades, but multiple studies have demonstrated that the U.S. military suffers from higher rates of skin cancer than the general public. As with so many aspects of health, simple preventive measures made early on can dramatically improve long-term health outcomes. Ample research has demonstrated that ultraviolet protection reduces skin damage and cancer rates. Although further research is needed to fully understand current barriers to soldiers' use of sun protection, we recommend a variety of simple measures the U.S. military can implement to reduce skin cancer risk for our soldiers. Early education and intervention to reduce skin cancer risk and promote sun-protective strategies is critical. These include improving sun protection offered by uniform items, such as increasing the availability of the sun hat, using eye protection with tinted inserts, and testing and publicizing the ultraviolet protection level of uniform items. We also recommend increasing sunscreen access for soldiers. Options to do so include issuing soldiers small portable packets or bottles of sunscreen to carry on their person, incorporating small packets of sunscreen in MREs, and issuing sunscreen to commands to distribute before field exercises. Unit and medical leadership should encourage the use of sunscreen and sun-protective strategies when possible; leadership engagement is critical to overcoming current behavioral barriers to change. Finally, we recommend that units attempt to reduce sun exposure during training by encouraging soldiers to seek shade and avoiding outdoor training in the middle of the day.
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Affiliation(s)
- Alexandra Rosenberg
- Department of Dermatology, Walter Reed National Military Medicine Center, Bethesda, MD 20889-5611, USA
| | - Sunghun Cho
- Department of Dermatology, Uniformed Services University, Bethesda, MD 20814, USA
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Natural Killer Cell Recognition and Control of Epithelial Cancers. Cancer J 2022; 28:263-269. [PMID: 35880935 PMCID: PMC9336556 DOI: 10.1097/ppo.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Natural killer (NK) cells possess an innate ability to recognize cancer and are key mediators of cytotoxic efficacy for anticancer antibodies. Recent advances in the ability to generate, qualify, and safely infuse NK cells have led to a wide variety of clinical trials in oncology. Although their efficacy is best established for liquid cancers, their potential application in solid cancers has received increased attention. Here, we provide general background across a disparate group of exemplary solid tumors for which there is evidence for an NK cell role, discuss NK cell recognition motifs specific to each and murine and human studies of each that are supportive of NK cell adoptive immunotherapy, and end with special considerations relevant to the solid tumor microenvironment.
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Kim M, Kim JW, Shin JW, Na JI, Huh CH. Basal cell carcinoma of the scalp shows distinct features from the face in Asians. Sci Rep 2022; 12:10183. [PMID: 35715697 PMCID: PMC9205873 DOI: 10.1038/s41598-022-14533-y] [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: 10/29/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Basal cell carcinoma (BCC) affecting different sites has been reported to have different clinicopathological features. In previous studies, the scalp was commonly classified to the head and neck region. However, the scalp has distinct characteristics from those of other parts of the skin. We retrospectively reviewed the medical records of patients who underwent surgical treatment for BCC. A total of 734 lesions were examined, and 13.2% originated from the scalp. The nodular type was the most common histologic subtype; however, the proportion of the superficial type was significantly higher than that of facial BCC (p < 0.001). Compared with facial BCC, younger age (p = 0.046) and larger tumor size (p < 0.001) were observed in scalp BCC. These characteristics were similar to those of truncal BCC in that they demonstrated a higher proportion of the superficial type (p < 0.001), younger age (p = 0.001), and larger tumor diameter (p < 0.001) compared with BCC in the head and neck region. Scalp BCC and truncal BCC were not significantly different in terms of age (p = 0.052) and tumor size (p = 0.230). In conclusion, despite the anatomical proximity, features of scalp BCC were similar to those of truncal lesions compared with facial lesions. Scalp BCC might be a separate entity from facial BCC.
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Affiliation(s)
- Minsu Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jee-Woo Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jung-Won Shin
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Jung-Im Na
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea
| | - Chang-Hun Huh
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-Ro 173 Beon-Gil, Seongnam, 13620, Gyeonggi, Korea.
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Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14122836. [PMID: 35740502 PMCID: PMC9221328 DOI: 10.3390/cancers14122836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Non-melanoma skin cancers (NMSC) represent about one-third of all malignancies. While surgery is the current gold standard treatment, many nonsurgical approaches are available for selected cases. Currently, there are no studies concerning the overall impact of dermoscopy, optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) for NMSC treatment monitoring. Therefore, we aim to review the current literature and provide an updated summary of noninvasive skin imaging in NMSC medical treatment management and the diagnostic accuracy of the most advanced technologies. Abstract Background/Objectives: Non-melanoma skin cancer (NMSC) treated with nonsurgical therapies can be monitored with noninvasive skin imaging. The precision of dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in detecting clearance is unclear. We aim to report the proportion of persisting tumors identified with noninvasive technologies available in the literature. Methods: A systematic literature search was conducted on the PubMed and Cochrane Public Library Databases for articles published prior to November 2021. Statistical analyses were conducted with MedCalc 14.8.1 software. Results: A total of eight studies (352 lesions) reporting noninvasive imaging for NMSC clearance following nonsurgical treatment were included. Most (n = 7) reported basal cell carcinoma (BCC), and one study reported squamous cell carcinoma (SCC) clearance. A meta-analysis of the BCC clearance revealed that the summary effect for RCM was higher, as compared to the other techniques. Interestingly, the sensitivity and specificity for OCT were 86.4% (95% CI: 65.1–97.1) and 100% (95% CI: 94.8–100.0), respectively, whilst, for RCM, they reached 100% (95%CI: 86.8–100) and 72.5% (95% CI: 64.4–79.7), respectively. Conclusions: Routine clinical examination and dermoscopy underperform when employed for NMSC clearance monitoring, although they represent the first approach to the patient. OCT and RCM seem to improve the detection of persistent BCC after medical treatment.
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A Profile and Three-Year Follow-Up of Patients with Basal Cell Carcinoma in the Western Cape, South Africa. J Skin Cancer 2022; 2022:8443867. [PMID: 35573164 PMCID: PMC9098340 DOI: 10.1155/2022/8443867] [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: 03/07/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Basal cell carcinoma (BCC) is an important malignancy in sub-Saharan Africa. There is a paucity of data regarding BCC in South Africa. Aims To describe the clinicopathological features of patients presenting with BCC in a cohort of South African patients. Methods This retrospective descriptive study reviewed the medical records of 149 patients with BCC who attended the dermatology clinic at Tygerberg Academic Hospital from September 2015 to August 2016. Demographic and clinical data of those patients with histologically proven BCC were retrieved from clinical records. The data included the assessment for BCC recurrence after three years (September 2016–August 2019). Results Of 390 patients, 155 (39.7%) had histologically confirmed BCCs. Complete medical records were available for 149 of these patients, and most were male (55.7%) and white (85.9%) with a median age of 70 years. Most patients had their BCC lesions for 12 months (43.1%) before diagnosis. BCCs were mostly located on the head and neck area (58.1%). In most patients (72.0%), a diagnostic punch biopsy confirmed BCC. Plastic surgeons subsequently excised the BCC lesions in 74.0% of these patients. The most common histological subtype was nodular BCC (74.0%). The National Comprehensive Cancer Network (NCCN) risk of recurrence was approximately evenly distributed between high- (54.1%) and low-risk groups (45.9%). The major high-risk feature was the location (36.6%). Histologically confirmed BCC recurrence occurred in 9 of the 149 patients (3.7%) over three years. Conclusions BCC represents a high burden of disease in our setting. Compared to existing studies, the BCCs in this study are clinically and histologically similar to international reports.
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Mainville L, Smilga AS, Fortin PR. Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis. J Cutan Med Surg 2022; 26:297-308. [PMID: 35134311 PMCID: PMC9125143 DOI: 10.1177/12034754221078201] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral nicotinamide is recommended in individuals with a field of cancerization or with ≥1 previous cutaneous squamous cell carcinoma (cSCC). OBJECTIVE To evaluate the effect of nicotinamide in prevention of skin cancers. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the effect of nicotinamide. We used Medline, EMBASE, CENTRAL, and Web of Science databases from their inception to October 2020 to search the following concepts: "nicotinamide"; "randomized controlled trial" (validated filters). Two independent reviewers screened titles and abstracts for intervention and study design before searching full texts for eligibility criteria. To be eligible, ≥1 outcome had to be covered. We used a standardized collection grid to complete data extraction in duplicate. The primary outcome was skin cancers (all types). Secondary outcomes were basal cell carcinomas (BCCs); cSCCs; actinic keratoses; melanomas; digestive, cutaneous, and biochemical adverse effects (AEs). Subgroup analyses were planned a priori. RESULTS We screened 4730 citations and found 29 trials (3039 patients) meeting inclusion criteria. Nicotinamide was associated with a significant reduction in skin cancers compared to control (rate ratio 0.50 (95% CI, 0.29-0.85; I 2 = 64%; 552 patients; 5 trials); moderate strength of the evidence). Heterogeneity was explained by risk of bias. Nicotinamide was associated with a significant reduction in BCCs and cSCCs, and increased risk of digestive AEs. CONCLUSION Oral nicotinamide should be considered in healthy patients or organ transplant recipients with history of skin cancer (GRADE: weak recommendation; moderate-quality evidence), in particular of BCC and cSCC.
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Affiliation(s)
| | | | - Paul R. Fortin
- Infectious and Immune Diseases, Centre de recherche du CHU de Québec – Université Laval, Quebec, Canada
- Division of Rheumatology, Department of Medicine, CHU de Québec – Université Laval, Quebec, Canada
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Kimura T, Sakata KI, Sato J, Ouchi C, Ohga N, Yanagawa-Matsuda A, Hida K, Kitagawa Y. Metastatic basal cell carcinoma of buccal mucosa: a report of a rare case. World J Surg Oncol 2022; 20:127. [PMID: 35449063 PMCID: PMC9022234 DOI: 10.1186/s12957-022-02592-4] [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] [Received: 12/26/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background Basal cell carcinoma (BCC) is the most common cancer worldwide. Most of BCCs can be detected in the early stages and are generally well controlled with local resection. Despite the high incidence of BCC, metastasis is rarely observed. Metastatic BCCs generally have an aggressive phenotype and are refractory to conventional treatment. Case presentation We describe a rare case of BCC in which a series of local relapses culminated in metastasis into the oral cavity 10 years after the first diagnosis of cutaneous BCC. We performed surgical resection and postoperative radiotherapy in this patient; 11 months after the final course of radiotherapy, the BCC remains stable, and the patient continues to be monitored regularly. Conclusions Because metastatic BCC is refractory to current treatment and difficult to control, his treatment history and the pathohistological features of BCC had to be considered in posttreatment planning.
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Affiliation(s)
- Taku Kimura
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Ken-Ichiro Sakata
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan.
| | - Jun Sato
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Chisato Ouchi
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Noritaka Ohga
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Aya Yanagawa-Matsuda
- Vascular Biology and Molecular Pathology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Kyoko Hida
- Vascular Biology and Molecular Pathology, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
| | - Yoshimasa Kitagawa
- Department of Oral Diagnosis and Medicine, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
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Real-time high-resolution millimeter-wave imaging for in-vivo skin cancer diagnosis. Sci Rep 2022; 12:4971. [PMID: 35322133 PMCID: PMC8943071 DOI: 10.1038/s41598-022-09047-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/16/2022] [Indexed: 12/26/2022] Open
Abstract
High-resolution millimeter-wave imaging (HR-MMWI), with its high discrimination contrast and sufficient penetration depth, can potentially provide affordable tissue diagnostic information noninvasively. In this study, we evaluate the application of a real-time system of HR-MMWI for in-vivo skin cancer diagnosis. 136 benign and malignant skin lesions from 71 patients, including melanoma, basal cell carcinoma, squamous cell carcinoma, actinic keratosis, melanocytic nevi, angiokeratoma, dermatofibroma, solar lentigo, and seborrheic keratosis were measured. Lesions were classified using a 3-D principal component analysis followed by five classifiers including linear discriminant analysis (LDA), K-nearest neighbor (KNN) with different K-values, linear and Gaussian support vector machine (LSVM and GSVM) with different margin factors, and multilayer perception (MLP). Our results suggested that the best classification was achieved by using five PCA components followed by MLP with 97% sensitivity and 98% specificity. Our findings establish that real-time millimeter-wave imaging can be used to distinguish malignant tissues from benign skin lesions with high diagnostic accuracy comparable with clinical examination and other methods.
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Damsin T, Lebas E, Marchal N, Rorive A, Nikkels AF. Cemiplimab for locally advanced and metastatic basal cell carcinoma. Expert Rev Anticancer Ther 2022; 22:243-248. [PMID: 35175882 DOI: 10.1080/14737140.2022.2043748] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Locally advanced basal cell carcinoma (laBCC) represents approximatively 1% of all BCCs. Metastatic BCC (mBCC) is even more rare. Most cases are observed in immunocompromised patients, particularly solid organ transplant recipients (OTRs). When surgery and/or radiation therapy for laBCC or mBCC is not reasonable, oral hedgehog inhibitor (HHI) therapy may be initiated. LaBCC or mBCC patients with primary or secondary resistance, progression or intolerance to HHIs could benefit from programmed cell death protein-1 (PD-1) inhibitors as this has recently been published for cemiplimab, a recombinant IgG4 human monoclonal antibody anti-PD-1 for the intravenous treatment of laBCC and mBCC. AREAS COVERED Principal studies evaluating the efficacy and safety of cemiplimab for laBCC and mBCC are presented and discussed. EXPERT OPINION Cemiplimab is the first FDA (2021) approved anti-PD-1 antagonist for the systemic treatment of laBCC and mBCC which had previously shown disease progression on or intolerance to HHIs. Experts currently recommend cemiplimab as a first-line systemic alternative. As cemiplimab therapy is associated with a risk of organ graft rejection, advantages and disadvantages should be evaluated for every individual OTR patient with laBCC or mBCC, eligible for cemiplimab therapy.
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Affiliation(s)
- Thomas Damsin
- Department of Dermatology, Skin Cancer Center, University Hospital Centre, CHU du Sart Tilman, Liège, BELGIUM
| | - Eve Lebas
- Department of Dermatology, Skin Cancer Center, University Hospital Centre, CHU du Sart Tilman, Liège, BELGIUM
| | - Nathalie Marchal
- Department of Medical Oncology, Skin Cancer Center, University Hospital Centre, CHU du Sart Tilman, Liège, BELGIUM
| | - Andrée Rorive
- Department of Medical Oncology, Skin Cancer Center, University Hospital Centre, CHU du Sart Tilman, Liège, BELGIUM
| | - Arjen F Nikkels
- Department of Dermatology, Skin Cancer Center, University Hospital Centre, CHU du Sart Tilman, Liège, BELGIUM
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Kubanov AA, Saytburkhanov RR, Plakhova XI, Kondrakhina IN. Non-surgical treatments for basal cell skin cancer. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Basal cell carcinoma is the most common nonmelanoma skin cancer. It originates from undifferentiated cells in the basal cell layer of the epidermis or from the outer root sheath of the hair follicle. The most important factor in development of basalioma is ultraviolet radiation. Surgery is considered the gold standard of treatment for basal cell cancer. However, nonsurgical options are available for individuals who are unsuitable for surgery. The purpose of this review is to summarize the efficacy and indications of alternative, nonsurgical treatments that can be used in the management of basal cell cancer
Effective nonsurgical treatments include destructive methods (eg, curettage and electrodessication, cryosurgery, laser), photodynamic therapy, topical medications, hedgehog pathway inhibitors. Nonsurgical therapeutic alternatives are safe and effective for the treatment of BCC. Factors such as tumor location, size, and histopathological subtype should be taken into consideration when selecting optimal treatment, cosmetic results and patient preference should be considered too.
To search for the necessary literature, the PubMed, MedLine, Web of Science and RSCI databases were used.
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Niculet E, Craescu M, Rebegea L, Bobeica C, Nastase F, Lupasteanu G, Stan DJ, Chioncel V, Anghel L, Lungu M, Tatu AL. Basal cell carcinoma: Comprehensive clinical and histopathological aspects, novel imaging tools and therapeutic approaches (Review). Exp Ther Med 2021; 23:60. [PMID: 34917186 PMCID: PMC8630439 DOI: 10.3892/etm.2021.10982] [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: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is one of the most common malignant tumors worldwide, involving the skin. It is also part of keratinocyte carcinomas, alongside its squamous counterpart. It has low mortality and extremely low metastatic rates (although when present, it indicates a poor patient prognosis); it also has a high morbidity rate through local destruction and recurrence, particularly when perineural invasion is observed, clinically or histopathologically. BCC development is the result of environmental and patient factors, with genetics and ultraviolet radiation playing major roles. The clinical and histopathological aspects vary according to tumor subtype, being classified as high-risk tumors (nodular, superficial, pigmented and infundibulocystic BCC with adnexal differentiation) and fibroepithelial subtypes, or as high-risk tumors (micronodular, infiltrating, sclerosing/morphoeic and basosquamous subtype or the type with sarcomatoid differentiation). Dermoscopy is now complimented by novel in vivo diagnostic tools (optical coherence tomography, reflectance confocal microscopy, high-resolution ultrasonography, Raman spectroscopy or terahertz pulse imaging), improving the diagnostic accuracy and providing tumor depth and lateral margins without the use of invasive techniques. Novel treatment approaches for the treatment of BCC have recently been investigated with the use of hedgehog pathway inhibitors, such as Vismodegib. These approaches aim for complete resolution, minimal side-effects, high patient satisfaction with the optimal cosmetic results, particularly in key areas, such as the face. The present review article summarizes and discusses the comprehensive clinical and histopathological aspects of BCC, and presents novel imaging tools and therapeutic approaches that have been identified.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Pathology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania
| | - Laura Rebegea
- Department of Clinical Radiotherapy, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Carmen Bobeica
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Florentina Nastase
- Department of Neuropsychomotor Rehabilitation, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galați, Romania
| | - Gabriela Lupasteanu
- Department of Infectious Diseases, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Medical Doctoral School, 'Ovidius' University, 900573 Constanta, Romania
| | - Daniela Jicman Stan
- Department of Otorhinolaryngology, 'Sfantul Apostol Andrei' Emergency Clinical Hospital, 800578 Galați, Romania.,Biomedical Doctoral School, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galați, 800010 Galați, Romania
| | - Valentin Chioncel
- Department of Cardio-Thoracic Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Department of Clinical Cardiology, 'Bagdasar Arseni' Emergency Hospital, 041915 Bucharest, Romania
| | - Lucretia Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Mihaela Lungu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania
| | - Alin Laurentiu Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800010 Galați, Romania.,Department of Dermatology, 'Sfanta Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galați, Romania.,Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galați, Romania.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), 'Dunărea de Jos' University, 800010 Galați, Romania
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Awosika O, Eleryan MG, Soleymani T. Reply to "Local recurrence of clinically observed basal cell carcinomas following complete saucerization or punch removal with negative margins: Retrospective case series from 2010 to 2020". J Am Acad Dermatol 2021; 85:e293-e294. [PMID: 34274411 DOI: 10.1016/j.jaad.2021.05.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Olabola Awosika
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan
| | - Misty G Eleryan
- Division of Dermatologic Surgery, David Geffen School of Medicine at University of California, Los Angeles, California
| | - Teo Soleymani
- Division of Dermatologic Surgery, David Geffen School of Medicine at University of California, Los Angeles, California.
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Gompertz-Mattar M, Perales J, Sahu A, Mondaca S, Gonzalez S, Uribe P, Navarrete-Dechent C. Differential expression of programmed cell death ligand 1 (PD-L1) and inflammatory cells in basal cell carcinoma subtypes. Arch Dermatol Res 2021; 314:777-786. [PMID: 34647186 DOI: 10.1007/s00403-021-02289-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 01/14/2023]
Abstract
Few studies have evaluated programmed cell death ligand (PD-L1) expression and lymphocytic infiltrates in Basal Cell Carcinoma (BCC). The objectives of this study are to assess PD-L1 expression and markers of local immune response in nodular, superficial, and morpheaform BCC, and compare it to normal, sun-exposed skin from the periphery of intradermal nevi. This was a retrospective study that included three histological subtypes of BCCs, and sun-exposed skin from the periphery of dermal nevi as quality controls. Tissue microarrays (TMA) were constructed with subsequent staining of H&E and immunohistochemistry (IHC) for CD4, CD8, FOXP3 and PD-L1. Non-automated quantification of the infiltrate in the intratumoral and stromal compartments on TMAs was performed. A total of 115 BCC (39 nodular, 39 morpheaform, and 37 superficial) and 41 sun-exposed skin samples were included (mean age 65.4 years; 52.6% females). BCC showed higher expression of PD-L1 (5.4 vs 0.7%, p < 0.001), CD8 (29.8 vs 19.7%, p = 0.002), and FOXP3 (0.3 vs 0.06%, p = 0.022) compared to sun-exposed skin. There was a higher PD-L1 expression in nodular BCC compared with other subtypes. Low-risk BCC subtypes (superficial and nodular) exhibited more PD-L1 expression in intratumoral and stromal immune infiltrates as compared to high-risk BCC subtypes. As a limitation, no immune cells function was evaluated in this study, only the presence/absence of T-lymphocyte sub-populations was recorded. Substantial differences in both PD-L1 expression and lymphocytic infiltrates were found amongst the histological subtypes of BCC and sun-exposed skin. Highest PD-L1 expression was found in nodular BCCs which suggests a potentially targetable strategy in the treatment of this most common BCC subtype.
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Affiliation(s)
- Matias Gompertz-Mattar
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, 6th Floor, 8330077, Santiago, Chile
| | - Juan Perales
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, 6th Floor, 8330077, Santiago, Chile
| | - Aditi Sahu
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sebastián Mondaca
- Department of Medical Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Sergio Gonzalez
- Department of Pathology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Pablo Uribe
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, 6th Floor, 8330077, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, 6th Floor, 8330077, Santiago, Chile. .,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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41
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Baek YS, Kim A, Seo JY, Jeon J, Oh CH, Kim J. Dynamic thermal imaging for pigmented basal cell carcinoma and seborrheic keratosis. Int J Hyperthermia 2021; 38:1462-1468. [PMID: 34620028 DOI: 10.1080/02656736.2021.1986142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Clinical differentiation between pigmented basal cell carcinoma (BCC) and seborrheic keratosis (SK) can sometimes be difficult. Noninvasive diagnostic technologies, such as thermal imaging, can be helpful in these situations. This study explored the use of dynamic thermal imaging (DTI), which records thermal images after the application of external thermal stimuli (heat or cold) for the differential diagnosis of pigmented BCC and SK. MATERIALS AND METHODS Twenty-two patients with pigmented BCC and 15 patients with SK participated in this study. Dynamic thermal images of lesions (pigmented BCC or SK) and control sites (contralateral normal skin) were recorded after the heat and cold stimuli. Temperature changes in the region of interest (ROI) are plotted as a thermal response graph. After fitting an exponential equation to each thermal response graph, the rate constants were compared between groups (pigmented BCC versus control, SK versus control). RESULTS The thermal response graphs revealed that the average temperature of pigmented BCC showed faster thermal recovery to baseline than the control site. There was a significant difference in the rate constants of the fitted exponential equations between the pigmented BCCs and the control sites (p<.001). However, we did not find a significantly different thermal recovery pattern between SK lesions and control sites. CONCLUSIONS DTI can be used as a diagnostic tool for distinguishing pigmented BCC from SK by comparing thermal recovery patterns between target lesions (pigmented BCC or SK) and the control site.
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Affiliation(s)
- Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Anna Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Yun Seo
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chil Hwan Oh
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.,Department of Dermatology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea.,Research Institute for Skin Image, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jaeyoung Kim
- Research Institute for Skin Image, Korea University College of Medicine, Seoul, Republic of Korea
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Wenzel AN, Apel PJ, Gosnell HL, Grider DJ. Fortuitous Eradication of an Aggressive Basal Cell Carcinoma Via Foreign Body Reaction to a Polyurethane Vacuum-Assisted Closure Sponge. Am J Dermatopathol 2021; 43:740-745. [PMID: 33534210 DOI: 10.1097/dad.0000000000001912] [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: 11/26/2022]
Abstract
ABSTRACT The foreign body reaction (FBR) is a well-documented immune reaction. Much of the literature on FBRs has focused on minimizing this immune response to mitigate the impact on medical implants. Here, we present a case that illustrates a serendipitous oncologic outcome from an FBR. A 54-year-old man presented with an aggressive basal cell carcinoma (BCC). At the first resection, he had broadly positive surgical margins. The surgical wound was temporized with a polyurethane wound vacuum assisted closure (VAC) device. He was lost to follow-up having retained a VAC sponge for a total of 12 weeks. A wide re-resection was performed 7 months after the initial resection. Exhaustive examination of the resected specimen was performed. There was an absence of any BCC, replaced by a widespread chronic FBR to polyurethane VAC sponge particles. This suggests that the foreign body immune response was sufficiently intense to eradicate any remaining BCC. This case illustrates the concept of an FBR as a novel method of local immunotherapy.
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Affiliation(s)
| | - Peter J Apel
- Virginia Tech Carilion School of Medicine, Roanoke, VA
- Department of Orthopaedic Surgery, Carilion Clinic, Roanoke, VA; and
| | | | - Douglas J Grider
- Virginia Tech Carilion School of Medicine, Roanoke, VA
- Dominion Pathology Associates, Roanoke VA
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43
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van Winden MEC, Hetterschijt CRM, Bronkhorst EM, van de Kerkhof PCM, de Jong EMGJ, Lubeek SFK. Evaluation of Watchful Waiting and Tumor Behavior in Patients With Basal Cell Carcinoma: An Observational Cohort Study of 280 Basal Cell Carcinomas in 89 Patients. JAMA Dermatol 2021; 157:1174-1181. [PMID: 34495284 DOI: 10.1001/jamadermatol.2021.3020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Importance Few studies have examined watchful waiting (WW) in patients with basal cell carcinoma (BCC), although this approach might be suitable in patients who might not live long enough to benefit from treatment. Objective To evaluate reasons for WW and to document the natural course of BCC in patients who chose WW and reasons to initiate later treatment. Design, Setting, and Participants An observational cohort study was performed at a single institution between January 2018 and November 2020 studying patients with 1 or more untreated BCC for 3 months or longer. Exposures Watchful waiting was chosen by patients and proxies regardless of this study. Main Outcome and Measures The reasons for WW and treatment were extracted from patient files and were categorized for analyses. Linear mixed models were used to estimate tumor growth and identify covariates associated with tumor growth. Results Watchful waiting was chosen for 280 BCCs in 89 patients (47 men [53%] and 42 women [47%]), with a median (interquartile range [IQR]) follow-up of 9 (4-15) months. The median (IQR) age of the included patients was 83 (73-88) years. Patient-related factors or preferences (ie, prioritizations of comorbidities, severe frailty, or limited life expectancy) were reasons to initiate WW in 74 (83%) patients, followed by tumor-related factors (n = 49; 55%). Treatment-related and circumstantial reasons were important for 35% and 46% of the patients, respectively. The minority of tumors increased in size (47%). Tumor growth was associated with BCC subtype (odds ratio, 3.35; 95% CI, 1.47-7.96; P = .005), but not with initial tumor size and location. The estimated tumor diameter increase was 4.46 mm (80% prediction interval, 1.42 to 7.46 mm) in 1 year for BCCs containing at least an infiltrative/micronodular component and 1.06 mm (80% prediction interval, -1.79 to 4.28 mm) for the remaining BCCs (only nodular/superficial component/clinical diagnosis). Most common reasons to initiate treatment were tumor burden or potential tumor burden, resolved reason(s) for WW, and reevaluation of patient-related factors. Conclusions and Relevance In this cohort study of patients with BCC, WW was an appropriate approach in several patients, especially those with asymptomatic nodular or superficial BCCs and a limited life expectancy. Patients should be followed up regularly to determine whether a WW approach is still suitable and whether patients still prefer WW and to reconsider consequences of treatment and refraining from treatment.
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Affiliation(s)
- Marieke E C van Winden
- Radboud Institute for Health Sciences, Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Charlotte R M Hetterschijt
- Radboud Institute for Health Sciences, Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ewald M Bronkhorst
- Department of Biostatistics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter C M van de Kerkhof
- Radboud Institute for Health Sciences, Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Elke M G J de Jong
- Radboud Institute for Health Sciences, Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Satish F K Lubeek
- Radboud Institute for Health Sciences, Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
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Line-Field Confocal Optical Coherence Tomography May Enhance Monitoring of Superficial Basal Cell Carcinoma Treated with Imiquimod 5% Cream: A Pilot Study. Cancers (Basel) 2021; 13:cancers13194913. [PMID: 34638396 PMCID: PMC8507996 DOI: 10.3390/cancers13194913] [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: 07/26/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/12/2022] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a novel, non-invasive technique for real-time skin imaging. Imiquimod (IQ) 5% cream is an immune response modifier currently approved for the treatment of small, superficial basal cell carcinoma (BCC). The aim of this study was to investigate if LC-OCT may be useful to enhance the treatment monitoring of BCC. Twenty superficial BCCs from 12 patients were treated with IQ 5% cream once daily, five days a week, for six weeks. Clinical and LC-OCT evaluations were performed at baseline and 4 weeks after the end of treatment. At the end of the study, 13 lesions showed a complete clinical and LC-OCT response, 4 lesions a partial clinical and LC-OCT response, and 3 lesions a complete clinical response but residual tumoral signs at LC-OCT. Our pilot study suggests that LC-OCT may represent a promising tool able to enhance the evaluation of the treatment response of BCCs to non-invasive treatments. In our case series, its use highlighted, through a detailed, fast, and complete examination of the treated area, three cases of residual BCC that otherwise would have gone undetected at clinical examination. Future studies on larger series of patients treated with different modalities and with a longer follow-up are advisable.
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45
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Weissman JP, Samlowski W, Meoz R. Hedgehog Inhibitor Induction with Addition of Concurrent Superficial Radiotherapy in Patients with Locally Advanced Basal Cell Carcinoma: A Case Series. Oncologist 2021; 26:e2247-e2253. [PMID: 34472658 DOI: 10.1002/onco.13959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 08/19/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Locally advanced basal cell cancer is a rare and challenging clinical problem. Historically, these patients were treated with aggressive surgery or radiotherapy. Most sporadic basal cell carcinomas have somatic mutations in the hedgehog pathway. Oral hedgehog inhibitors induce rapid and often complete clinical responses in locally advanced basal cell tumors. Unfortunately, these responses are usually transient. We hypothesized that treatment failure represents persistence of drug resistant cells that could be eradicated by addition of localized radiotherapy. MATERIALS AND METHODS We performed a retrospective review of our patients with locally advanced basal cell cancer treated with sonidegib or vismodegib induction therapy who were treated with added superficial radiotherapy at the time of maximal response. RESULTS Twelve patients met inclusion criteria. All patients achieved a complete response following hedgehog inhibitor therapy with addition of radiotherapy. Progression-free survival at 40 months was 89%, with a median follow-up of 40 months. Relapses occurred in only 2 of 12 patients (16.6%). Nine patients experienced grade I-II toxicity from hedgehog inhibitor induction therapy (taste changes [3], weight loss [3], muscle cramps [3]). Eight patients experienced mild radiotherapy-induced skin toxicity during concurrent therapy. No patients had to discontinue treatment. CONCLUSION Induction therapy with hedgehog inhibitors followed by addition of concurrent radiation therapy resulted in an extremely high clinical response rate with relatively minor and reversible toxicity. This gave a high rate of progression-free survival and a low disease-specific progression rate. Further prospective evaluation of this treatment approach is needed to confirm the apparent clinical activity. IMPLICATIONS FOR PRACTICE Locally advanced basal cell cancers are challenging to treat. Previously, aggressive surgical resection or radiotherapy represented the best treatment options. Most basal cell cancers have somatic mutations in the hedgehog pathway. Oral inhibitors of this pathway produce rapid but transient clinical responses. This study reports 12 patients treated with hedgehog inhibitor induction therapy to near-maximal response. Addition of concurrent involved field radiotherapy resulted in a very high complete response rate with minimal toxicity. There was prolonged progression-free survival in 90% of patients. This study identified a novel treatment approach for patients with advanced basal cell carcinoma.
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Affiliation(s)
- Joshua P Weissman
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA.,Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA
| | - Wolfram Samlowski
- Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA.,School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.,University of Nevada School of Medicine, Reno, Nevada, USA
| | - Raul Meoz
- Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA.,School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.,University of Nevada School of Medicine, Reno, Nevada, USA
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46
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Jerjes W, Hamdoon Z, Rashed D, Sattar AA, Hopper C. In vivo optical coherence tomography in assessment of suspicious facial lesions: A prospective study. Photodiagnosis Photodyn Ther 2021; 36:102493. [PMID: 34419675 DOI: 10.1016/j.pdpdt.2021.102493] [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: 06/07/2021] [Revised: 07/31/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Skin cancer continues to be the most common cancer in the Caucasian population. Over the past two decades, researchers around the world started assessing the possibility of diagnosing tissue pathologies by using optical systems. In this study, we aimed to use in vivo optical coherence tomography (OCT) technology to describe the morphologic features of normal and pathologic skin conditions. MATERIALS AND METHODS In this study, 72 patients with suspected skin pre-cancer/cancer were recruited. The lesions were subjected to in vivo OCT scanning using compact size probe. The main scanned areas were the centre of the lesion, periphery of the lesion and control reading at least 2cm from the lesion periphery but within the same dermatomal distribution. Following assessment, each lesion was surgically excised. All acquired OCT images were correlated with the corresponding histopathology images to ensure an accurate diagnosis and appropriate co-localisation of abnormal lesion on both OCT image and pathology slide. This was achieved in every resected lesion. RESULTS Histopathological analysis revealed that of the 96 macroscopically suspicious scanned lesions 26 were actinic keratosis (AK), 51 were basal cell carcinoma (BCC) and 19 were cutaneous squamous cell carcinoma (SCC). Different layers of healthy skin can be distinguished with clear demarcation between the epidermis and papillary dermis. An increase in epidermal thickness was observed in OCT images in AK that appeared relatively hyperintense. Cutaneous SCC was characterized by hypoechoic signal free spaces within the dermis and damaged of dermal-epidermal junction. BCCs were visualized as hypoechoic structures but showed a mixed echogenicity. Solid nodular BCC appeared as single or multiple areas with no clear arrangement surrounding low-reflectivity lobular structures surrounded. Cystic structures were identifiable by signal-free areas adjacent to healthy skin. Sensitivity and specificity for in vivo OCT in diagnosing these lesions were impressive, based on this small sample size. CONCLUSIONS OCT have shown that there are qualitative differences in OCT image features of skin with varying degrees of pathology, and between normal and pathological skin. This study indicates that in vivo OCT shows a good promise as a useful optical diagnostic technique in diagnosing skin pathologies.
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Affiliation(s)
- Waseem Jerjes
- North End Medical Centre, London, UK; UCL Medical School, London, UK.
| | - Zaid Hamdoon
- College of Dental Medicine, University of Sharjah, UAE; Unit of OMFS, UCL Eastman Dental Institute, London, UK.
| | - Dara Rashed
- Unit of OMFS, UCL Eastman Dental Institute, London, UK
| | | | - Colin Hopper
- UCL Medical School, London, UK; Unit of OMFS, UCL Eastman Dental Institute, London, UK
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47
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Known and new facts on basal cell carcinoma. J Dtsch Dermatol Ges 2021; 19:1021-1041. [PMID: 34288482 PMCID: PMC8361778 DOI: 10.1111/ddg.14580] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumor in light‐skinned people and amounts to about 75 % of all cases of skin cancer. Increasing incidence rates have been reported for decades all over the world. The main risk factors include UV radiation, male sex, light skin type, advanced age, long‐term immunosuppression, a positive individual or family history, and certain genodermatoses. BCC metastasizes only rarely, and its mortality is low, but it is associated with significant morbidity. Genetic mutations especially in the hedgehog pathway play an important role in BCC pathogenesis. Non‐invasive procedures such as optical coherence tomography or confocal laser scan microscopy are increasingly utilized for diagnostics in addition to visual inspection and dermatoscopy, but only in exceptional cases can histological confirmation of the diagnosis be dispensed with. Various clinical and histological subtypes have been defined. Differentiating between BCC with high and low risk of recurrence has a significant influence on the choice of treatment. Most BCC can be treated effectively and safely with standard surgery, or in selected cases with topical treatment. Locally advanced and metastasized BCC must be treated with radiation or systemic therapy. Radiation is also an option for older patients with contraindications for surgery. The hedgehog inhibitors vismodegib and sonidegib are currently approved for systemic therapy of BCC in Europe. Approval for the PD1 inhibitor cemiplimab as second‐line therapy is expected in the near future.
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Affiliation(s)
- Magdalena Seidl-Philipp
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nina Frischhut
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nicole Höllweger
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Matthias Schmuth
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
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Fania L, Massone C, Cusano F, Fantini F, Dellambra E, Samela T, Passarelli F, Morese R, Tartaglione T, Maggiore M, Gentile P, Falchetto Osti M, Sampogna F, Pallotta S, Abeni D, Marchetti P, Naldi L. Integrated care pathways and the hub-and-spoke model for the management of non-melanoma skin cancer: A proposal of the Italian Association of Hospital Dermatologists (ADOI). Dermatol Reports 2021; 13:9278. [PMID: 34497705 PMCID: PMC8404423 DOI: 10.4081/dr.2021.9278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022] Open
Abstract
The term non-melanoma skin cancer (NMSC) refers to skin cancer different from melanoma, and it is usually restricted to basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and their pre-cancerous lesions, e.g., actinic keratosis. These conditions represent the most frequent tumors in Caucasians and are characterized by an increasing incidence worldwide and a high socio-economic impact. The term Integrated Care Pathway (ICP) refers to "a complex intervention for the mutual decision making and organization of care processes for a well-defined group of patients during a well-defined period". The purpose of this paper is to present a proposal from the Italian Association of Hospital Dermatologists (ADOI) for an ICP organization of care of NMSC, considering the hub-and-spoke model in the different geographical areas. This proposal is based on the most recent literature and on documents from the Italian Association of Medical Oncology (AIOM), the European consensus-based interdisciplinary guidelines from the European Association of Dermato- Oncology (EADO), and the National Comprehensive Cancer Network (NCCN). We initially discuss the NMSC outpatient clinic, the role of the multidisciplinary working groups, and the hub-and-spoke model regarding this topic. Then, we define the ICP processes specific for BCC and SCC. The ICP for NMSC is an innovative strategy to guarantee the highest possible quality of health care while the hub-andspoke model is crucial for the organization of different health care structures. Considering the importance on this topic, it is essential to create a valid ICP together with an efficient organization within the different geographical areas.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | - Tonia Samela
- IDI-IRCCS, Dermatological Research Hospital, Rome
| | | | | | | | | | - Piercarlo Gentile
- University of Pittsburgh Medical Center, San Pietro Fatebenefratelli, Rome
| | | | | | | | | | | | - Luigi Naldi
- Centro Studi GISED, Bergamo and San Bortolo Hospital, Vicenza, Italy
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Yadav PR, Munni MN, Campbell L, Mostofa G, Dobson L, Shittu M, Pattanayek SK, Uddin MJ, Das DB. Translation of Polymeric Microneedles for Treatment of Human Diseases: Recent Trends, Progress, and Challenges. Pharmaceutics 2021; 13:1132. [PMID: 34452093 PMCID: PMC8401662 DOI: 10.3390/pharmaceutics13081132] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022] Open
Abstract
The ongoing search for biodegradable and biocompatible microneedles (MNs) that are strong enough to penetrate skin barriers, easy to prepare, and can be translated for clinical use continues. As such, this review paper is focused upon discussing the key points (e.g., choice polymeric MNs) for the translation of MNs from laboratory to clinical practice. The review reveals that polymers are most appropriately used for dissolvable and swellable MNs due to their wide range of tunable properties and that natural polymers are an ideal material choice as they structurally mimic native cellular environments. It has also been concluded that natural and synthetic polymer combinations are useful as polymers usually lack mechanical strength, stability, or other desired properties for the fabrication and insertion of MNs. This review evaluates fabrication methods and materials choice, disease and health conditions, clinical challenges, and the future of MNs in public healthcare services, focusing on literature from the last decade.
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Affiliation(s)
- Prateek Ranjan Yadav
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
- Chemical Engineering Department, Indian Institute of Technology, Delhi 110016, India;
| | | | - Lauryn Campbell
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | - Golam Mostofa
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (M.N.M.); (G.M.)
| | - Lewis Dobson
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | - Morayo Shittu
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
| | | | - Md. Jasim Uddin
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (M.N.M.); (G.M.)
- Department of Pharmacy, Brac University, 66 Mohakhali, Dhaka 1212, Bangladesh
| | - Diganta Bhusan Das
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK; (P.R.Y.); (L.C.); (L.D.); (M.S.)
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50
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Bekanntes und Neues zum Basalzellkarzinom. J Dtsch Dermatol Ges 2021; 19:1021-1043. [PMID: 34288462 DOI: 10.1111/ddg.14580_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Magdalena Seidl-Philipp
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nina Frischhut
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nicole Höllweger
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Matthias Schmuth
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Van Anh Nguyen
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
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