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Cebolla-Verdugo M, Llamas-Segura C, Velasco-Amador JP, Almazán-Fernández FM, Ruiz-Villaverde R. Understanding and managing locally advanced basal cell carcinoma: insights into pathogenesis, therapeutic strategies, and the role of hedgehog pathway inhibitors. Ital J Dermatol Venerol 2024; 159:530-542. [PMID: 39422527 DOI: 10.23736/s2784-8671.24.07993-3] [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: 10/19/2024]
Abstract
Understanding and managing locally advanced basal cell carcinoma (BCC) is crucial given its substantial prevalence and potential for local tissue destruction. While BCC typically exhibits low metastatic potential, its high incidence underscores the need for enhanced therapeutic strategies. Locally advanced BCC presents unique challenges, often necessitating aggressive interventions to prevent disfigurement and functional impairment. The emergence of hedgehog pathway inhibitors (HHIs) offers promising therapeutic avenues by targeting aberrant hedgehog signaling, a key driver in BCC pathogenesis. Thus, elucidating the pathogenesis of locally advanced BCC and exploring the role of HHIs are critical endeavors in effectively managing this prevalent carcinoma. Epidemiologically, BCC primarily affects individuals with fair skin and chronic sun exposure, with an increasing incidence noted among younger age groups. Risk factors include UV radiation exposure, familial history of skin cancer, immunosuppression, and genetic syndromes such as basal cell nevus syndrome and xeroderma pigmentosum. Pathogenetically, BCC arises from cells in the skin's epidermis, with hedgehog pathway activation being a primary genetic driver, involving mutations in PTCH1 and SMO. Resistance to hedgehog inhibitors may occur due to genetic changes, complicating treatment strategies. BCC is characterized by low immunogenicity, which hinders immune response and contributes to treatment challenges. Enhanced understanding of the epidemiology, risk factors, and pathogenesis of locally advanced BCC, along with the development of targeted therapeutic approaches such as hedgehog pathway inhibitors, is essential for effectively managing this prevalent carcinoma and improving patient outcomes.
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Affiliation(s)
- Marta Cebolla-Verdugo
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain
- Instituto Biosanitario de Granada, Ibs, Granada, Spain
| | - Carlos Llamas-Segura
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain
- Instituto Biosanitario de Granada, Ibs, Granada, Spain
| | - Juan P Velasco-Amador
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain
- Instituto Biosanitario de Granada, Ibs, Granada, Spain
| | - Francisco M Almazán-Fernández
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain
- Instituto Biosanitario de Granada, Ibs, Granada, Spain
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, San Cecilio University Hospital, Granada, Spain -
- Instituto Biosanitario de Granada, Ibs, Granada, Spain
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Saeidi A, Gülses A, Jamil M, Alolayan A, Elsayed S, Wiltfang J, Flörke C. Retrospective Analysis of Clinicopathological Characteristics of Surgically Treated Basal Cell Carcinomas of the Face: A Single-Centre Maxillofacial Surgery Experience. J Clin Med 2024; 13:5470. [PMID: 39336956 PMCID: PMC11432292 DOI: 10.3390/jcm13185470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/09/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Basal cell carcinoma is the most common nonmelanoma skin cancer, followed by cutaneous squamous cell carcinoma. The objective of the current study was to retrospectively evaluate the epidemiology, characteristic variations, histological aspects, and prognosis of basal cell carcinoma of the facial region based on a single-centre experience. Methods: Data from 125 patients admitted to the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein (UKSH), Kiel, for surgical treatment of basal cell carcinomas of the face between January 2015 and April 2021 were evaluated. Results: The mean patient age was 79.58 years, 60.5% were male and 39.5% were female. Six patients (4.8%) had tumour recurrence with no regional metastasis. Seventy-nine patients (63%) were classified as T1. The nose and the temporal region were the most common areas. The mean tumour thickness was 3.20 mm. Conclusions: Micronodular, sclerosing/morphoeic, nodular, and superficial growth patterns of basal cell carcinoma are highly correlated to recurrence, so an excision safety margin is recommended. There is a strong correlation between tumour thickness and recurrence among basal cell carcinoma cases. When completely excised, the recurrence rate for basal cell carcinoma is relatively low.
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Affiliation(s)
- Abdullah Saeidi
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Madinah 42353, Saudi Arabia (S.E.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany
| | - Aydin Gülses
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany
| | - Maryam Jamil
- King Fahd General Hospital, Jeddah MOH, Jeddah 21589, Saudi Arabia;
| | - Albraa Alolayan
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Madinah 42353, Saudi Arabia (S.E.)
| | - Shadia Elsayed
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Madinah 42353, Saudi Arabia (S.E.)
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany
| | - Christian Flörke
- Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany
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Bozsányi S, Boostani M, Farkas K, Hamilton-Meikle P, Varga NN, Szabó B, Vasanits F, Kuroli E, Meznerics FA, Lőrincz K, Holló P, Bánvölgyi A, Wikonkál NM, Paragh G, Kiss N. Optically Guided High-Frequency Ultrasound to Differentiate High-Risk Basal Cell Carcinoma Subtypes: A Single-Centre Prospective Study. J Clin Med 2023; 12:6910. [PMID: 37959375 PMCID: PMC10648659 DOI: 10.3390/jcm12216910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common type of skin cancer in the Caucasian population. Currently, invasive biopsy is the only way of establishing the histological subtype (HST) that determines the treatment options. Our study aimed to evaluate whether optically guided high-frequency ultrasound (OG-HFUS) imaging could differentiate aggressive HST BCCs from low-risk tumors. METHODS We conducted prospective clinical and dermoscopic examinations of BCCs, followed by 33 MHz OG-HFUS imaging, surgical excision, and a histological analysis. We enrolled 75 patients with 78 BCCs. In total, 63 BCCs were utilized to establish a novel OG-HFUS risk classification algorithm, while 15 were employed for the validation of this algorithm. The mean age of the patients was 72.9 ± 11.2 years. Histology identified 16 lesions as aggressive HST (infiltrative or micronodular subtypes) and 47 as low-risk HST (superficial or nodular subtypes). To assess the data, we used a one-sided Fisher's exact test for a categorical analysis and a Receiver Operating Characteristic (ROC) curve analysis to evaluate the diagnostic accuracy. RESULTS OG-HFUS distinguished aggressive BCC HSTs by their irregular shape (p < 0.0001), ill-defined margins (p < 0.0001), and non-homogeneous internal echoes (p = 0.004). We developed a risk-categorizing algorithm that differentiated aggressive HSTs from low-risk HSTs with a higher sensitivity (82.4%) and specificity (91.3%) than a combined macroscopic and dermoscopic evaluation (sensitivity: 40.1% and specificity: 73.1%). The positive and negative predictive values (PPV and NPV, respectively) for dermoscopy were 30.2% and 76.8%, respectively. In comparison, the OG-HFUS-based algorithm demonstrated a PPV of 94.7% and an NPV of 78.6%. We verified the algorithm using an independent image set, n = 15, including 12 low-risk and 3 high-risk (high-risk) with two blinded evaluators, where we found a sensitivity of 83.33% and specificity of 91.66%. CONCLUSIONS Our study shows that OG-HFUS can identify aggressive BCC HSTs based on easily identifiable morphological parameters, supporting early therapeutic decision making.
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Affiliation(s)
- Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Phyllida Hamilton-Meikle
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Boglárka Szabó
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Flóra Vasanits
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Enikő Kuroli
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
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Mannino M, Piccerillo A, Fabbrocini G, Quaglino P, Argenziano G, Dika E, Ascierto PA, Pellacani G, Longo C, Fargnoli MC, Bianchi L, Calzavara-Pinton P, Zalaudek I, Fava P, Scalvenzi M, Bocchino E, Di Stefani A, Peris K. Clinical Characteristics of an Italian Patient Population with Advanced BCC and Real-Life Evaluation of Hedgehog Pathway Inhibitor Safety and Effectiveness. Dermatology 2023; 239:868-876. [PMID: 37311439 DOI: 10.1159/000531280] [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: 03/01/2023] [Accepted: 05/22/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Advanced basal cell carcinoma (aBCC) represents a complex and clinically heterogeneous group of lesions for which curative surgery and/or radiotherapy is unlikely. Systemic therapy with hedgehog pathway inhibitors (HHIs) changed the treatment landscape for this complex patient population. OBJECTIVES The aims of the present study are to describe the clinical characteristics of a real-life Italian cohort diagnosed with aBCC and to investigate effectiveness and safety of HHI. METHODS A multicenter observational study was performed by twelve Italian centers in the period January 1, 2016 - October 15, 2022. Patients aged ≥18 years and diagnosed with aBCC (locally advanced [laBCC] and metastatic BCC [mBCC]) were eligible for the study. Methods for investigating tumor response to HHI included clinical and dermatoscopic evaluation, radiological imaging, and histopathology. For HHI safety assessment, therapy-related adverse events (AEs) were reported and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. RESULTS We enrolled 178 patients under treatment with HHI: 126 (70.8%) and 52 patients (29.2%) received sonidegib and vismodegib, respectively. Comprehensive data on HHI effectiveness and disease outcome were available for 132 (74.1%) of 178 patients: 129 patients had a diagnosis of laBCC (n = 84, sonidegib; n = 45, vismodegib) and 3 patients of mBCC (n = 2, vismodegib; n = 1, sonidegib, off-label). Objective response rate was 76.7% (95% confidence interval [CI]: 82.3-68.7) and 33.3% (95% CI: 88.2-1.7) for laBCC (complete response [CR]: 43/129; PR: 56/129) and mBCC (CR: 0/3; PR: 1/3), respectively. High-risk aBCC histopathological subtypes and occurrence of >2 therapy-related AEs were significantly associated with nonresponse to HHI therapy ([OR: 2.61; 95% CI: 1.09-6.05; p: 0.03] and [OR: 2.74; 95% CI: 1.03-7.9; p: 0.04]), respectively. Majority of our cohort (54.5%) developed at least 1 therapy-related AE, most of which were mild-moderate in severity. CONCLUSIONS Our results demonstrate the effectiveness and safety profile of HHI and confirm the reproducibility of pivotal trial results in real-life clinical setting.
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Affiliation(s)
- Maria Mannino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy,
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy,
| | | | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Emi Dika
- Dermatology - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Paolo Antonio Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy
| | | | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luca Bianchi
- Dermatology Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Iris Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - Paolo Fava
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Enrico Bocchino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Müller CSL, Hauer N, Kofler K, Kofler L. [Micrographic controlled surgery in everyday dermatosurgery]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05158-x. [PMID: 37249657 DOI: 10.1007/s00105-023-05158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/31/2023]
Abstract
Micrographic controlled surgery (MCS) has become established in dermatosurgery in recent years and includes various methods to enable the histologically proven complete resection of malignant cutaneous tumors, while at the same time sparing tumor-free tissue in the immediate vicinity as much as possible. MCS is of great importance in the surgical treatment of cutaneous malignancies in so-called problem locations and aggressive tumor subtypes. Indications for MCS include basal cell carcinoma, cutaneous squamous cell carcinoma, Bowen's disease and Bowen's carcinoma, melanoma in chronic light-damaged skin with acral lentiginous melanoma, dermatofibrosarcoma protuberans (DFSP), and Merkel cell carcinoma. However, other tumor entities are also treated using MCS, such as extramammary Paget's disease and various cutaneous sarcomas. All procedures subsumed under MCS have in common the marking of the surgical specimen for topographical orientation, which provides assignment of remaining tumor remnants. Various methods of MCS (3D histology, the horizontal method or Mohs surgery) are presented in this article. Furthermore, this article aims to raise awareness of the possibilities and limitations of micrographically controlled surgery.
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Affiliation(s)
- Cornelia Sigrid Lissi Müller
- MVZ für Histologie, Zytologie und molekulare Diagnostik Trier GmbH, Wissenschaftspark Trier, Max-Planck-Str. 5 und 17, 54296, Trier, Deutschland.
- Medizinische Fakultät, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg/Saar, Deutschland.
| | - Nina Hauer
- MVZ für Histologie, Zytologie und molekulare Diagnostik Trier GmbH, Wissenschaftspark Trier, Max-Planck-Str. 5 und 17, 54296, Trier, Deutschland
| | - Katrin Kofler
- Universitätshautklinik, Studienzentrum Operative Dermatologie, Eberhard-Karls-Universität Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
- skin + more MVZ GmbH, Holzmarkt 6, 88400, Biberach, Deutschland
| | - Lukas Kofler
- Universitätshautklinik, Studienzentrum Operative Dermatologie, Eberhard-Karls-Universität Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
- skin + more MVZ GmbH, Holzmarkt 6, 88400, Biberach, Deutschland
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Deng LJ, Jia M, Luo SY, Li FZ, Fang S. Expression of Hedgehog Signaling Pathway Proteins in Basal Cell Carcinoma: Clinicopathologic Study. Clin Cosmet Investig Dermatol 2022; 15:2353-2361. [PMCID: PMC9637365 DOI: 10.2147/ccid.s389551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Li-Jia Deng
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Meng Jia
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Si-Yu Luo
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Feng-Zeng Li
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Sheng Fang
- Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Sheng Fang, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Email
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Assessment of Basal Cell Carcinoma Using Dermoscopy and High Frequency Ultrasound Examination. Diagnostics (Basel) 2022; 12:diagnostics12030735. [PMID: 35328289 PMCID: PMC8947530 DOI: 10.3390/diagnostics12030735] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 01/27/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common form of cutaneous neoplasia in humans, and dermoscopy may provide valuable information for histopathological classification of BCC, which allows for the choice of non-invasive topical or surgical therapy. Similarly, dermoscopy may allow for the identification of incipient forms of BCC that cannot be detected in clinical examination. The importance of early diagnosis using the dermoscopy of superficial BCC forms is proven by the fact that despite their indolent clinical appearance, they can be included in high-risk BCC forms due to the rate of postoperative recurrence. Nodular pigmentary forms of BCCs present ovoid gray-blue nests or multiple gray-blue dots/globules associated with arborized vessels, sometimes undetectable on clinical examination. The management of BCC depends on this, as pigmentary forms have been shown to have a poor response to photodynamic therapy. High frequency ultrasound examination (HFUS) aids in the diagnosis of BCC with hypoechoic tumour masses, as well as in estimating tumour size (thickness and diameter), presurgical margin delineation, and surgical planning. The examination is also useful for determining the invasion of adjacent structures and for studying local recurrences. The use of dermoscopy in combination with HFUS allows for optimisation of the management of the oncological patient.
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Kappelin J, Green AC, Ingvar Å, Ahnlide I, Nielsen K. Incidence and trends of basal cell carcinoma in Sweden: A population-based registry study. Br J Dermatol 2021; 186:963-969. [PMID: 34939666 DOI: 10.1111/bjd.20964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer. Incidence is largely unknown because of incomplete, or lack of, registration in most countries. OBJECTIVES To assess current incidence rates and recent trends for BCC in the Swedish population. METHODS Patient- and tumour-related features of all histologically confirmed BCC tumours diagnosed in Sweden from 2004 to 2017 were extracted from the population-based Swedish BCC Registry. Incidence rates were standardized to the 2013 European Standard Population and trends were analysed using Poisson regression models. RESULTS Age-standardized person-based incidence rate of BCC in Sweden in 2017 was 405/100 000, rising from 308/100 000 in 2004, corresponding to an annual relative increase of 1.8% (women, 2.1%; men, 1.4%). Incidence was highest in the elderly and the most common tumour site was the head and neck. In 2017, the most common BCC subtypes were nodular and micronodular/infiltrative BCC (each 31%). Incidence of aggressive BCC subtypes increased faster than other subtypes. CONCLUSIONS BCC incidence rates in Sweden are relatively high and increasing. The increasing trends were more pronounced in women and for aggressive BCC subtypes.
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Affiliation(s)
- Johan Kappelin
- Department of Clinical Sciences Helsingborg, Dermatology, Lund University.,Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Helsingborg Hospital, Sweden
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane.,CRUK Manchester Institute, University of Manchester, Manchester, UK
| | - Åsa Ingvar
- Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Skåne University Hospital, Lund, Sweden
| | - Ingela Ahnlide
- Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Landskrona Hospital, Sweden
| | - Kari Nielsen
- Department of Clinical Sciences Helsingborg, Dermatology, Lund University.,Department of Clinical Sciences Lund, Dermatology, Lund University Skin Cancer Research group, Lund University.,Helsingborg Hospital, Sweden.,Skåne University Hospital, Lund, Sweden
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9
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Villani R, Murigneux V, Alexis J, Sim SL, Wagels M, Saunders N, Soyer HP, Parmentier L, Nikolaev S, Fink JL, Roy E, Khosrotehrani K. Subtype-Specific Analyses Reveal Infiltrative Basal Cell Carcinomas Are Highly Interactive with their Environment. J Invest Dermatol 2021; 141:2380-2390. [PMID: 33865912 DOI: 10.1016/j.jid.2021.02.760] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
Little is known regarding the molecular differences between basal cell carcinoma (BCC) subtypes, despite clearly distinct phenotypes and clinical outcomes. In particular, infiltrative BCCs have poorer clinical outcomes in terms of response to therapy and propensity for dissemination. In this project, we aimed to use exome sequencing and RNA sequencing to identify somatic mutations and molecular pathways leading to infiltrative BCCs. Using whole-exome sequencing of 36 BCC samples (eight infiltrative) combined with previously reported exome data (58 samples), we determine that infiltrative BCCs do not contain a distinct somatic variant profile and carry classical UV-induced mutational signatures. RNA sequencing on both datasets revealed key differentially expressed genes, such as POSTN and WISP1, suggesting increased integrin and Wnt signaling. Immunostaining for periostin and WISP1 clearly distinguished infiltrative BCCs, and nuclear β-catenin staining patterns further validated the resulting increase in Wnt signaling in infiltrative BCCs. Of significant interest, in BCCs with mixed morphology, infiltrative areas expressed WISP1, whereas nodular areas did not, supporting a continuum between subtypes. In conclusion, infiltrative BCCs do not differ in their genomic alteration in terms of initiating mutations. They display a specific type of interaction with the extracellular matrix environment regulating Wnt signaling.
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Affiliation(s)
- Rehan Villani
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Valentine Murigneux
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia; QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Josue Alexis
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia; Department of Plastic Surgery, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | - Seen-Ling Sim
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Michael Wagels
- Department of Plastic Surgery, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | - Nicholas Saunders
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - H Peter Soyer
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia; Department of Dermatology, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
| | | | - Sergey Nikolaev
- INSERM U981, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - J Lynn Fink
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Edwige Roy
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Kiarash Khosrotehrani
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia; Department of Dermatology, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia.
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10
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Nadir U, Nijhawan RI. Cells to Surgery Quiz: October 2021. J Invest Dermatol 2021. [PMID: 34560918 DOI: 10.1016/j.jid.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Umer Nadir
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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11
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Interpretable deep learning systems for multi-class segmentation and classification of non-melanoma skin cancer. Med Image Anal 2021; 68:101915. [DOI: 10.1016/j.media.2020.101915] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 01/29/2023]
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12
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Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study. Sci Rep 2020; 10:18475. [PMID: 33116191 PMCID: PMC7595159 DOI: 10.1038/s41598-020-72732-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/28/2020] [Indexed: 11/09/2022] Open
Abstract
Basosquamous carcinoma (BSC) is a rare non-melanoma skin cancer that shares the characteristic features of both basal and squamous cell carcinomas (BCC, SCC). Our research enables better characterization of BSC in comparison to high-risk subtypes of BCC and SCC. Paper includes a retrospective analysis of BSC cases regarding sex, age, number of tumors and anatomical distribution in comparison to BCC and SCC evaluating the differences and defining the implications. Histologically confirmed carcinomas recorded between 1999 and 2019 were studied. 181 diagnosed BSC cases were identified, making this study the largest cohorts of BSC patients reported worldwide. Most cases were reported on head and neck. Analysis of facial anatomic distribution shows that most commonly affected sites were the nose (43%) and the cheek (25%). The age at excision of metatypical BCC was higher than those of low-risk BCC (P < 0.05), however similar to high-risk BCC (P = 0.20). We revisited that the concept of BSC is the most similar to high-risk subtypes of BCC. Patients with diagnosed BSC have higher risk of second nonmelanoma skin cancer. Therefore, the frequency of follow-up examination should be adjusted to the individual risk of another skin cancer.
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13
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Campione E, Di Prete M, Lozzi F, Lanna C, Spallone G, Mazzeo M, Cosio T, Rapanotti C, Dika E, Gaziano R, Orlandi A, Bianchi L. High-Risk Recurrence Basal Cell Carcinoma: Focus on Hedgehog Pathway Inhibitors and Review of the Literature. Chemotherapy 2020; 65:2-10. [PMID: 32777789 DOI: 10.1159/000509156] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/04/2020] [Indexed: 11/19/2022]
Abstract
Basal cell carcinoma is the most common skin tumour, with the majority of the cases occurring on the head and neck district, where cosmetic and functional results are crucial. It can be locally destructive if not diagnosed early and treated appropriately. Surgery is the treatment of choice for most lesions, but aggressive, recurrent, or unresectable tumours can be challenging to manage. Advanced basal cell carcinoma includes high recurrence risk subtypes, in which standard therapies demonstrate lack of efficacy. This led to a need for investigating more deeply the pathogenesis of the disease and to the discovery of the implication of the hedgehog pathway. The development of systemic inhibitors of this pathway provides new treatment options for patients with advanced disease, resulting in survival improvement. Food and Drug Administration, before, and European Medicines Agency later approved 2 Hedgehog pathway inhibitors for the treatment of advanced basal cell carcinomas, vismodegib and sonidegib. Here, we present a review of the current English language literature trying to analyze differences in the 2 drugs as a head-to-head comparison between them has not already been documented in a randomized controlled clinical trial. Although vismodegib and sonidegib showed similar efficacy and safety profiles, in an indirect comparison scenario, sonidegib has shown slightly better outcomes in locally advanced basal cell carcinoma than vismodegib. They present different molecular structures, as they bind different residues on their targets and develop resistance for different mutations. In a future scenario, clinical trials comparing the 2 drugs are needed, as well as expanding data on discontinuation of therapy and/or consequential administration of them, with the aim to improve our clinical practise.
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Affiliation(s)
- Elena Campione
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy,
| | - Monia Di Prete
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Flavia Lozzi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Caterina Lanna
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Spallone
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mauro Mazzeo
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Terenzio Cosio
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Rapanotti
- Department of Laboratory Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emi Dika
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Roberta Gaziano
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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14
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Abstract
Basal cell carcinoma (BCC) is the most common malignancy and the incidence is rising. BCCs have low mortality but can cause significant morbidity primarily through local destruction. The pathogenesis is linked to the interplay between environmental and patient-derived characteristics. There are multiple therapeutic modalities, and appropriate selection requires knowledge of complications, cosmetic outcomes, and recurrence rates. This article reviews the epidemiology, staging, treatment, and prevention of BCC.
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Affiliation(s)
- Dennis P Kim
- Mohs Micrographic Surgery, Brigham and Women's Faulkner Hospital, 1153 Centre Street, Suite 4J, Jamaica Plain, MA 02130-3446, USA
| | - Kylee J B Kus
- Oakland University William Beaumont School of Medicine, 586 Pioneer Drive, Rochester, MI 48309-4482, USA
| | - Emily Ruiz
- High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women's Cancer Center, Mohs and Dermatologic Surgery Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, 1153 Centre Street, Suite 4J, Jamaica Plain, MA 02130-3446, USA.
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15
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16
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Papageorgiou C, Apalla Z, Vakirlis E, Sotiriou E, Ioannides D, Lallas A. Use of Dermoscopy to Diagnose and Select BCCs that can be Treated Empirically. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0215-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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17
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Akay BN, Kirmizi A, Demirdag HG, Erdem C, Okcu Heper A. Heavily pigmented fibroepithelioma of Pinkus mimicking melanoma. Int J Dermatol 2018; 57:753-754. [PMID: 29637996 DOI: 10.1111/ijd.13993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/17/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Bengu N Akay
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ayca Kirmizi
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hatice G Demirdag
- Department of Dermatology, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Cengizhan Erdem
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aylin Okcu Heper
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey
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18
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Bladen JC, Moosajee M, Tracey-White D, Beaconsfield M, O'Toole EA, Philpott MP. Analysis of hedgehog signaling in periocular sebaceous carcinoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:853-860. [PMID: 29423837 PMCID: PMC5856882 DOI: 10.1007/s00417-018-3900-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/14/2017] [Accepted: 01/05/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Sebaceous carcinoma (SC) is a clinical masquerader of benign conditions resulting in significant eye morbidity, sometimes leading to extensive surgical treatment including exenteration, and even mortality. Little is known about the genetic or molecular basis of SC. This study identifies the involvement of Hedgehog (Hh) signaling in periocular SC. METHODS Fifteen patients with periocular SC patients were compared to 15 patients with eyelid nodular basal cell carcinoma (nBCC; a known Hh tumor), alongside four normal individuals as a control for physiological Hh expression. Expression of Patched 1 (PTCH1), Smoothened (SMO), and glioma-associated zinc transcription factors (Gli1 and Gli2) were assessed in histological sections using immunohistochemistry and immunofluorescence (IF) techniques. Antibody specificity was verified using Western-blot analysis of a Gli1 over-expressed cancer cell line, LNCaP-Gli1. Semi-quantification compared tumors and control tissue using IF analysis by ImageJ software. RESULTS Expression of the Hh pathway was observed in SC for all four major components of the pathway. PTCH1, SMO, and Gli2 were more significantly upregulated in SC (P < 0.01) compared to nBCC. Stromal expression of PTCH1 and Gli2 was observed in SC (P < 0.01). In contrast, stromal expression of these proteins in nBCC was similar or down-regulated compared to physiological Hh controls. CONCLUSIONS The Hh signaling pathway is significantly more upregulated in periocular SC compared to nBCC, a known aberrant Hh pathway tumor. Furthermore, the stroma of the SC demonstrated Hh upregulation, in particular Gli2, compared to nBCC. Targeting of this pathway may be a potential treatment strategy for SC.
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Affiliation(s)
- John C Bladen
- Eyelid Oncology, Moorfields Eye Hospital, London, UK.
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK.
| | - Mariya Moosajee
- Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, UK
| | - Dhani Tracey-White
- Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, London, UK
| | | | - Edel A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK
| | - Michael P Philpott
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts & London School of Medicine, 4 Newark St, London, E1 2AT, UK
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19
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Non Melanoma Skin Cancer Pathogenesis Overview. Biomedicines 2018; 6:biomedicines6010006. [PMID: 29301290 PMCID: PMC5874663 DOI: 10.3390/biomedicines6010006] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/07/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Non-melanoma skin cancer is the most frequently diagnosed cancer in humans. The process of skin carcinogenesis is still not fully understood. However, several studies have been conducted to better explain the mechanisms that lead to malignancy; (2) Methods: We reviewed the more recent literature about the pathogenesis of non-melanoma skin cancer focusing on basal cell carcinomas, squamous cell carcinoma and actinic keratosis; (3) Results: Several papers reported genetic and molecular alterations leading to non-melanoma skin cancer. Plenty of risk factors are involved in non-melanoma skin cancer pathogenesis, including genetic and molecular alterations, immunosuppression, and ultraviolet radiation; (4) Conclusion: Although skin carcinogenesis is still not fully understood, several papers demonstrated that genetic and molecular alterations are involved in this process. In addition, plenty of non-melanoma skin cancer risk factors are now known, allowing for an effective prevention of non-melanoma skin cancer development. Compared to other papers on the same topic, our review focused on molecular and genetic factors and analyzed in detail several factors involved in non-melanoma skin cancer.
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20
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Sun MT, Rajak S, Selva D, Smith H. Periocular basal cell carcinoma: a comprehensive review. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1318066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Ting PT, Kasper R, Arlette JP. Metastatic Basal Cell Carcinoma: Report of Two Cases and Literature Review. J Cutan Med Surg 2016. [DOI: 10.1177/120347540500900104] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Metastatic basal cell carcinoma (MBCC) is defined as primary cutaneous basal cell carcinoma (BCC) that spreads to distant sites as histologically similar metastatic deposits of BCC. There are less than 300 reported cases of MBCC in the literature. Methods: This article examines two cases of MBCC and provides a literature review of risk factors inherent in epidemiology, patient demographics, and the clinicohistopathological characteristics of primary and metastatic BCC lesions. Results: MBCC is a rare complication of BCC with high morbidity and mortality rates. Patients with MBCC often begin with long-standing primary BCC lesions that are either large or recurrent after treatment. Cases of MBCC have a higher incidence of the more aggressive histologic patterns (morpheic, infiltrating, metatypical, and basosquamous). Perineural space invasion may be an indicator of aggressive disease. Metastases often involve regional lymph nodes, lungs, bone, and skin. Conclusion: These case reports and review provide important diagnostic and management considerations for primary BCC and MBCC. Early intervention with aggressive treatment measures may improve the prognosis and survival of MBCC patients.
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Affiliation(s)
- Patricia T. Ting
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard Kasper
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John P. Arlette
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
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22
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Goździalska A, Wojas-Pelc A, Drąg J, Brzewski P, Jaśkiewicz J, Pastuszczak M. Expression of metalloproteinases (MMP-2 and MMP-9) in basal-cell carcinoma. Mol Biol Rep 2016; 43:1027-33. [PMID: 27406386 PMCID: PMC5025502 DOI: 10.1007/s11033-016-4040-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/06/2016] [Indexed: 11/30/2022]
Abstract
The aim of this study was to compare the expressions of mRNA for metalloproteinases (MMP-2 and MMP-9) and type IV collagen in two different histological types of basal-cell carcinoma (BCCs; nodular and infiltrative) and in normal tissues from the tumor interface. The study included biopsy specimens of the skin involved with BCC and normal skin adjacent the lesion. The expressions of mRNA for MMP-2, MMP-9 and type IV collagen were determined by means of RT-PCR (Reverse transcription polymerase chain reaction). The level of type IV collagen mRNA in nodular and infiltrative BCCs turned out to be significantly lower, and the expressions of MMP-2 and MMP-9 mRNA significantly higher than in normal tissues adjacent to these tumors. The expression of mRNA for MMP-9 but not for MMP-2 was significantly higher in infiltrative BCCs than in the nodular BCCs. In turn, normal tissues adjacent to nodular BCCs showed significantly higher levels of mRNA for MMP-2 and significantly lower levels of type IV collagen mRNA than the normal tissues from the interface of infiltrative BCCs. The findings suggest that MMP-2 and MMP-9 could be used as prognostic factors of BCCs.
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Affiliation(s)
- Anna Goździalska
- Department of Health and Medical Sciences, Andrzej Frycz Modrzewski Krakow University, 1 G. Herlinga-Grudzińskiego St, 30-705, Krakow, Poland.
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland
| | - Jagoda Drąg
- Department of Health and Medical Sciences, Andrzej Frycz Modrzewski Krakow University, 1 G. Herlinga-Grudzińskiego St, 30-705, Krakow, Poland
| | - Paweł Brzewski
- Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy Jaśkiewicz
- Department of Health and Medical Sciences, Andrzej Frycz Modrzewski Krakow University, 1 G. Herlinga-Grudzińskiego St, 30-705, Krakow, Poland
| | - Maciej Pastuszczak
- Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland
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23
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Longo C, Pellacani G, Tomasi A, Mandel VD, Ponti G. Fibroepithelioma of Pinkus: Solitary tumor or sign of a complex gastrointestinal syndrome. Mol Clin Oncol 2016; 4:797-800. [PMID: 27123282 DOI: 10.3892/mco.2016.794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/23/2015] [Indexed: 01/15/2023] Open
Abstract
Fibroepithelioma of Pinkus (FEP), which is considered to be an uncommon variant of basal cell carcinoma, has been described in association with other systemic diseases. However, no specific studies are currently available on this subject. The aim of our study was to evaluate the clinical and morphological characteristics of FEP and investigate whether this rare tumor is a single entity or seen in the context of a more complex syndrome. We retrospectively analyzed 49 cases of FEP diagnosed and excised in a single academic institution from 1995 to 2011. The tumors were mainly located on the trunk (77.55%), followed by the lower extremities (12.20%) and the head and neck (10.20%). In 9 of the 49 cases (18%), FEP was associated with gastrointestinal tumors. The abovementioned cases are presented in an attempt to make clinicians more aware of a possible association between FEP and gastrointestinal cancer. Although a possible underlying common genetic background between FEP and gastrointestinal tumors was not provided, our study suggests that patients with FEP should be screened for the occurrence of gastrointestinal tumors.
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Affiliation(s)
- Caterina Longo
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, I-42123 Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, I-41100 Modena, Italy
| | - Aldo Tomasi
- Department of Clinical and Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, I-41100 Modena, Italy
| | - Victor Desmond Mandel
- Department of Dermatology, University of Modena and Reggio Emilia, I-41100 Modena, Italy
| | - Giovanni Ponti
- Department of Clinical and Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia, I-41100 Modena, Italy
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24
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A rare presentation of fibroepithelioma of Pinkus on the face. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2015.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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25
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Kim HS, Park JM, Mun JH, Song M, Ko HC, Kim BS, Kim MB. Usefulness of Dermatoscopy for the Preoperative Assessment of the Histopathologic Aggressiveness of Basal Cell Carcinoma. Ann Dermatol 2015; 27:682-7. [PMID: 26719636 PMCID: PMC4695419 DOI: 10.5021/ad.2015.27.6.682] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 09/30/2014] [Accepted: 10/12/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Limited information is available regarding dermatoscopic differences between non-aggressive and aggressive types of basal cell carcinoma (BCC). OBJECTIVE To investigate dermatoscopic differences between non-aggressive and aggressive types. METHODS We evaluated 145 histopathologically confirmed BCCs from 141 patients. Histopathologic types and aggressiveness from 4 mm punch biopsy and their dermatoscopic findings were evaluated. We assessed the statistical significance of dermatoscopic differences between non-aggressive and aggressive types. To objectively predict aggressiveness, we created a "dermatoscopic index of BCC aggressiveness" in which 1 point was added and subtracted for each dermatoscopic finding significantly higher in aggressive and non-aggressive types, respectively. RESULTS Large blue-gray ovoid nests were found more frequently in non-aggressive type than aggressive one (85/105 [80.9%] vs. 21/40 [52.5%], p=0.001). Compared to non-aggressive type, aggressive type had more multiple blue-gray globules (29/40 [72.5%] vs. 57/105 [54.3%], p=0.046), arborizing telangiectasia (29/40 [72.5%] vs. 48/105 [45.7%], p=0.004), and concentric structure (11/40 [27.5%] vs. 12/105 [11.4%], p=0.018). Regarding dermatoscopic index, cases of aggressive type with a score of 1 were most common (n=18, 45.0%), followed by a score of 2 (n=14, 35.0%). Limited number of aggressive type of BCCs and the effect of width on the determination of histopathologic aggressiveness. CONCLUSION Aggressive type BCCs more often exhibited multiple blue-gray globules, arborizing telangiectasia, and concentric structure, while the non-aggressive type exhibited large blue-gray ovoid nests more frequently. Score exceeding 2 on the dermoscopic index can be screening criteria for aggressiveness. These dermatoscopic features and dermoscopic index could be useful for assessing aggressiveness of BCCs before surgery.
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Affiliation(s)
- Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Jung-Min Park
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Je-Ho Mun
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Margaret Song
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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26
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Rivers JK, Mistry BD, Hung T, Vostretsova K, Mistry N. A 13-Year Retrospective Study of Basal Cell Carcinoma in a Canadian Dermatology Practice: A Comparison Between Anatomical Location and Histopathologic Subtypes. J Cutan Med Surg 2015; 20:233-40. [PMID: 26631769 DOI: 10.1177/1203475415620396] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND It is unknown whether the histologic subtypes of basal cell carcinoma (BCC) arise from a common progenitor cell or whether other factors play a role in their development. OBJECTIVE To investigate the relationship between the different BCC histopathologic subtypes and anatomical distribution of BCCs in a Canadian dermatology practice. METHODS The charts of all patients diagnosed with BCC between 1993 and 2005 from a single private dermatology practice in Vancouver, Canada, were reviewed. Descriptive data analysis was undertaken to look at the distribution of histologic subtypes based on age, gender, and anatomical location. RESULTS Nodular BCCs accounted for 58% of all tumors. Sixty-six percent of these were situated on the head/neck (odds ratio [OR] = 3.0, 95% confidence interval [CI] = 2.1-4.3, P < .0001). Infiltrative (OR = 2.4, 95% CI = 1.5-4.1, P = .0003) and superficial BCCs were more common in women (OR = 3.7, 95% CI = 2.5-5.7, P < .0001), affected the trunk (OR = 3.2, 95% CI = 2.1-4.9, P < .0001), and appeared in younger individuals (OR = 1.8, 95% CI = 1.2-2.7, P = .004). CONCLUSION Our results show a preference of distinct BCC subtypes for certain anatomical locations.
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Affiliation(s)
- Jason K Rivers
- Department of Dermatology and Skin Science, University of British Columbia and Pacific Dermaesthetics, Vancouver, BC, Canada
| | - Bhavik D Mistry
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tawny Hung
- DynalifeDx, University of Alberta, Departments of Pathology and Dermatology, University of Alberta, Edmonton, AB, Canada
| | | | - Nisha Mistry
- Department of Medicine (Dermatology), University of Toronto, Toronto, ON, Canada
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Lallas A, Apalla Z, Ioannides D, Argenziano G, Castagnetti F, Moscarella E, Longo C, Palmieri T, Ramundo D, Zalaudek I. Dermoscopy in the diagnosis and management of basal cell carcinoma. Future Oncol 2015; 11:2975-84. [PMID: 26450622 DOI: 10.2217/fon.15.193] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The dermoscopic findings of basal cell carcinoma (BCC) were first described more than a decade ago and the list of BCC-related criteria has been several times updated and enriched. Today, the dermatoscope is considered the key tool for the diagnosis of BCC, since it allows its early detection and enables its discrimination from other pigmented and nonpigmented skin tumors. The dermoscopic pattern of BCC results from several combinations of well-known BCC criteria, depending on several factors, including histopathologic subtype, location, gender, age and pigmentary trait. In addition, recent evidence highlighted that dermoscopy is also useful in the management of BCC, since it provides information on the tumor subtype, the presence of pigmentation or ulceration and the response to nonablative treatments.
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Affiliation(s)
- Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Zoe Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | | | - Fabio Castagnetti
- Surgery Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Tamara Palmieri
- Radiotherapy Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Dafne Ramundo
- Radiotherapy Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Abstract
Skin cancer accounts for most hand cancers. Prompt recognition of lesions with malignant potential can lead to early treatment and decreased disease burden. Understanding the appropriate diagnostic algorithm for a given lesion facilitates accurate staging, which guides therapy. A multidisciplinary approach that includes hand surgeons, dermatologists, oncologists, and radiation oncologists is often necessary to manage advanced disease. For most invasive tumors, the primary treatment modality remains surgical excision; however, several effective nonsurgical treatments exist for management of unresectable or low-grade cancers.
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Tan E, Lin F, Sheck L, Salmon P, Ng S. Growth of periocular basal cell carcinomas. Br J Dermatol 2015; 172:1002-7. [DOI: 10.1111/bjd.13470] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2014] [Indexed: 01/07/2023]
Affiliation(s)
- E. Tan
- Dermatologic Surgery Unit; Skin Cancer Institute; Tauranga Bay of Plenty New Zealand
| | - F.P.Y. Lin
- Department of Medicine; Waikato Hospital; Hamilton New Zealand
- Centre for Health Informatics; University of New South Wales; Sydney NSW Australia
| | - L.H.N. Sheck
- Department of Ophthalmology; Waikato Hospital; Hamilton New Zealand
| | - P.J. Salmon
- Dermatologic Surgery Unit; Skin Cancer Institute; Tauranga Bay of Plenty New Zealand
| | - S.G.J. Ng
- Department of Ophthalmology; Waikato Hospital; Hamilton New Zealand
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30
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Kukar M, Oxenberg J, Cho EE, Zeitouni NC, Skitzki J. Nonmelanoma Skin Cancers. Surg Oncol 2015. [DOI: 10.1007/978-1-4939-1423-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Liu H, Jian Q, Xue K, Ma C, Xie F, Wang R, Liao W, Liu Y, Chi S, Li C. The MEK/ERK signalling cascade is required for sonic hedgehog signalling pathway-mediated enhancement of proliferation and inhibition of apoptosis in normal keratinocytes. Exp Dermatol 2014; 23:896-901. [PMID: 25256290 DOI: 10.1111/exd.12556] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Haiyan Liu
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
- Department of Dermatology; Lanzhou General Hospital, Lanzhou Military District; Lanzhou China
| | - Qiang Jian
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
| | - Ke Xue
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
| | - Cuiling Ma
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
| | - Fang Xie
- Department of Dermatology; Chinese People's Liberation Army General Hospital; Beijing China
| | - Rui Wang
- Department of Dermatology; Chinese People's Liberation Army General Hospital; Beijing China
| | - Wenjun Liao
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
| | - Yufeng Liu
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
| | - Sumin Chi
- Department of Physiology; the Fourth Military Medical University; Xi'an China
| | - Chengxin Li
- Department of Dermatology; Xijing Hospital; the Fourth Military Medical University; Xi'an China
- Department of Dermatology; Chinese People's Liberation Army General Hospital; Beijing China
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32
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Moscarella E, Kyrgidis A, Sperduti I, Abramavicus A, Argenziano G, Cota C, Eibenschutz L, De Simone P, Longo C, Hofmann-Wellenhof R, Zalaudek I. Age-related prevalence and morphological appearance of facial skin tumours: a prospective, cross-sectional, observational, multicentre study with special emphasis on melanocytic tumours. J Eur Acad Dermatol Venereol 2014; 29:1331-8. [DOI: 10.1111/jdv.12844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- E. Moscarella
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - A. Kyrgidis
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - I. Sperduti
- Biostatistical Unit; Regina Elena National Cancer Institute; Rome Italy
| | - A. Abramavicus
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - C. Cota
- Dermatopathology Unit; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - L. Eibenschutz
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - P. De Simone
- Oncologic Dermatology; San Gallicano Dermatological Institute; IRCCS; Rome Italy
| | - C. Longo
- Dermatology and Skin Cancer Unit; 1st Medical Department; Arcispedale Santa Maria Nuova; IRCCS; Reggio Emilia Italy
| | - R. Hofmann-Wellenhof
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
| | - I. Zalaudek
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
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33
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Dreier J, Cheng P, Bogdan Alleman I, Gugger A, Hafner J, Tschopp A, Goldinger S, Levesque M, Dummer R. Basal cell carcinomas in a tertiary referral centre: a systematic analysis. Br J Dermatol 2014; 171:1066-72. [DOI: 10.1111/bjd.13217] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 01/21/2023]
Affiliation(s)
- J. Dreier
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - P.F. Cheng
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - I. Bogdan Alleman
- Department of Plastic, Reconstructive and Aesthetic Surgery University Hospital Zurich Zurich Switzerland
| | - A. Gugger
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - J. Hafner
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - A. Tschopp
- Division of Biostatistics Institute of Social and Preventive Medicine University of Zurich Zurich Switzerland
| | - S.M. Goldinger
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - M.P. Levesque
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - R. Dummer
- Department of Dermatology University Hospital Zurich Zurich Switzerland
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34
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Lallas A, Apalla Z, Argenziano G, Longo C, Moscarella E, Specchio F, Raucci M, Zalaudek I. The dermatoscopic universe of basal cell carcinoma. Dermatol Pract Concept 2014; 4:11-24. [PMID: 25126452 PMCID: PMC4131992 DOI: 10.5826/dpc.0403a02] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 03/08/2014] [Indexed: 11/09/2022] Open
Abstract
Following the first descriptions of the dermatoscopic pattern of basal cell carcinoma (BCC) that go back to the very early years of dermatoscopy, the list of dermatoscopic criteria associated with BCC has been several times updated and renewed. Up to date, dermatoscopy has been shown to enhance BCC detection, by facilitating its discrimination from other skin tumors and inflammatory skin diseases. Furthermore, upcoming evidence suggests that the method is also useful for the management of the tumor, since it provides valuable information about the histopathologic subtype, the presence of clinically undetectable pigmentation, the expansion of the tumor beyond clinically visible margins and the response to non-ablative treatments. In the current article, we provide a summary of the traditional and latest knowledge on the value of dermatoscopy for the diagnosis and management of BCC.
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Affiliation(s)
- Aimilios Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Zoe Apalla
- Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Medical Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Caterina Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Elvira Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Francesca Specchio
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Margaritha Raucci
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Graz, Austria
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35
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de Oliveira Poswar F, de Carvalho Fraga CA, Gomes ESB, Farias LC, Souza LWF, Santos SHS, Gomez RS, de-Paula AMB, Guimarães ALS. Protein expression of MMP-2 and MT1-MMP in actinic keratosis, squamous cell carcinoma of the skin, and basal cell carcinoma. Int J Surg Pathol 2014; 23:20-5. [PMID: 24984957 DOI: 10.1177/1066896914540998] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are 2 skin neoplasms with distinct potentials to invasion and metastasis. Actinic keratosis (AK) is a precursor lesion of SCC. Immunohistochemistry was performed to evaluate the expression of MMP-2 and MT1-MMP in samples of BCC (n = 29), SCC (n = 12), and AK (n = 13). The ratio of positive cells to total cells was used to quantify the staining. Statistical significance was considered under the level P < .05. We found a higher expression of MMP-2 in tumor stroma and parenchyma of SCC as compared to BCC. The expression of this protein was also similar between SCC and its precursor actinic keratosis, and it was higher in the stroma of high-risk BCC when compared to low-risk BCC. MT1-MMP, which is an activator of MMP-2, was similarly expressed in all groups. Our results suggest that MMP-2 expression may contribute to the distinct invasive patterns seen in SCC and BCC.
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Affiliation(s)
| | | | | | | | | | - Sérgio Henrique Souza Santos
- Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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36
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Abstract
The purpose of this article is to review the common neoplasms, infections, and inflammatory dermatoses that may present around or near the mouth. Dental professionals are well positioned to evaluate perioral skin conditions, further contributing to patients' general health. This article includes a review of seborrheic keratosis, warts, actinic keratoses, actinic cheilitis, and squamous cell carcinoma, among several other perioral cutaneous lesions.
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Affiliation(s)
- Geoffrey F S Lim
- Department of Dermatology, Drexel University College of Medicine, The Arnold T. Berman, M.D. Building, 219 North Broad Street, Philadelphia, PA 19107, USA.
| | - Carrie Ann R Cusack
- Department of Dermatology, Drexel University College of Medicine, The Arnold T. Berman, M.D. Building, 219 North Broad Street, Philadelphia, PA 19107, USA
| | - Joseph M Kist
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, South Pavilion, 1st Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Metastatic basal cell carcinoma: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:e79-82. [DOI: 10.1016/j.oooo.2012.04.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 03/23/2012] [Accepted: 04/02/2012] [Indexed: 11/23/2022]
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38
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Lallas A, Argenziano G, Kyrgidis A, Apalla Z, Moscarella E, Longo C, Ferrara G, Piana S, Benati E, Zendri E, Sotiriou E, Zalaudek I. Dermoscopy uncovers clinically undetectable pigmentation in basal cell carcinoma. Br J Dermatol 2014; 170:192-5. [DOI: 10.1111/bjd.12634] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2013] [Indexed: 12/23/2022]
Affiliation(s)
- A. Lallas
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - G. Argenziano
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - A. Kyrgidis
- Pathology Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - Z. Apalla
- Department of Otolaryngology Head & Neck Surgery; Medical School; Aristotle University; Thessaloniki Greece
| | - E. Moscarella
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - C. Longo
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - G. Ferrara
- First Department of Dermatology; Medical School; Aristotle University; Thessaloniki Greece
| | - S. Piana
- State Clinic of Dermatology; Hospital of Venereal and Skin Diseases; Thessaloniki Greece
| | - E. Benati
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - E. Zendri
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
| | - E. Sotiriou
- Anatomic Pathology Unit; Department of Oncology; Gaetano Rummo General Hospital; Benevento Italy
| | - I. Zalaudek
- Skin Cancer Unit; Arcispedale Santa Maria Nuova IRCCS; Viale Risorgimento 80 42123 Reggio Emilia Italy
- Department of Dermatology; Medical University of Graz; Graz Austria
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Wollina U, Pabst F, Krönert C, Schorcht J, Haroske G, Klemm E, Kittner T. High-risk basal cell carcinoma: an update. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.27] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Barth GA. The cockade technique--a closed wound variant of 3D histology-guided surgery. J Dtsch Dermatol Ges 2013; 11:1177-83. [PMID: 24267015 DOI: 10.1111/ddg.12204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 07/16/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND 3D histology-guided surgery provides high cure rates and tissue-sparing for the treatment of basal cell carcinomas (BCCs). The cockade technique is a closed wound variant of 3D histology-guided surgery, which has previously been designed to provide low postoperative complication rates and good feasibility in the office-setting. OBJECTIVES We examined the postoperative complication rates and feasibility of the cockade technique with a new double-bladed scalpel in the routine office setting. PATIENTS AND METHODS 145 patients with 213 BCCs of the head and neck areas were treated between July 2010 and August 2012. All patients underwent 3D histology-guided surgery with the cockade technique. The rates of postoperative surgical site infection (SSI) and postoperative bleeding were recorded. Also the feasibility of the cockade technique was examined. RESULTS 0.9 % of BCCs sites developed SSI, while no postoperative bleeding problems or hematomas were recorded. 94 % of the BCCs were completely excised in two surgical stages. The cockade technique allowed flexible scheduling of operation room use. In addition, the small margin strips taken by the new double-bladed scalpel could be evaluated microscopically without gaps. CONCLUSIONS The cockade technique is a practical method with low complication rates for the treatment of BCCs and can be easily integrated into outpatient care.
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Affiliation(s)
- Georg A Barth
- Dermatologic office Schatz, Barth & Degitz, München, Germany
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41
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Kempf W, Mertz KD, Hofbauer GFL, Tinguely M. Skin cancer in organ transplant recipients. Pathobiology 2013; 80:302-9. [PMID: 24013135 DOI: 10.1159/000350757] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Organ transplant recipients (OTR) are at a significantly increased risk for developing a wide variety of skin cancers, particularly epithelial skin cancer, Merkel cell carcinoma and Kaposi's sarcoma. Melanoma, skin adnexal neoplasm and cutaneous lymphomas are also more common in OTR and may differ in their clinicopathologic presentation from tumors in immunocompetent patients. The accuracy of clinical diagnosis of suspected premalignant and malignant skin lesions in OTR is modest. Therefore, histopathological diagnosis is an essential element for the diagnostic workup of skin cancers and, in addition, provides important information on prognosis. Squamous cell carcinoma and intraepithelial neoplasias (actinic keratosis, squamous cell carcinoma in situ or Bowen's disease) are the most common forms of skin cancer in OTR. The risk of Merkel cell carcinoma and Kaposi's sarcoma is dramatically increased in OTR. Merkel cell carcinoma shows a highly aggressive course. Kaposi's sarcoma tends to spread to extracutaneous sites. Primary cutaneous lymphomas developing after organ transplantation are rare. The spectrum of cutaneous B cell lymphomas in OTR, in particular, differs significantly from that of the general population, with a predominance of Epstein-Barr virus-driven posttransplant lymphoproliferative disorder. This review discusses the clinical and histopathological aspects of skin cancers in OTR, the impact of dermatopathological analysis on prognosis and the understanding of the pathogenesis of these neoplasms.
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Affiliation(s)
- Werner Kempf
- Kempf and Pfaltz Histological Diagnostics, Zurich, Switzerland
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42
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Transforming growth factor-Beta and urokinase-type plasminogen activator: dangerous partners in tumorigenesis-implications in skin cancer. ISRN DERMATOLOGY 2013; 2013:597927. [PMID: 23984088 PMCID: PMC3732602 DOI: 10.1155/2013/597927] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/18/2013] [Indexed: 01/01/2023]
Abstract
Transforming growth factor-beta (TGF-β) is a pleiotropic factor, with several different roles in health and disease. TGF-β has been postulated as a dual factor in tumor progression, since it represses epithelial tumor development in early stages, whereas it stimulates tumor progression in advanced stages. During tumorigenesis, cancer cells acquire the capacity to migrate and invade surrounding tissues and to metastasize different organs. The urokinase-type plasminogen activator (uPA) system, comprising uPA, the uPA cell surface receptor, and plasminogen-plasmin, is involved in the proteolytic degradation of the extracellular matrix and regulates key cellular events by activating intracellular signal pathways, which together allow cancer cells to survive, thus, enhancing cell malignance during tumor progression. Due to their importance, uPA and its receptor are tightly transcriptionally regulated in normal development, but are deregulated in cancer, when their activity and expression are related to further development of cancer. TGF-β regulates uPA expression in cancer cells, while uPA, by plasminogen activation, may activate the secreted latent TGF-β, thus, producing a pernicious cycle which contributes to the enhancement of tumor progression. Here we review the specific roles and the interplay between TGF-β and uPA system in cancer cells and their implication in skin cancer.
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43
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Peppelman M, Wolberink EA, Blokx WA, van de Kerkhof PC, van Erp PE, Gerritsen MJP. In vivo Diagnosis of Basal Cell Carcinoma Subtype by Reflectance Confocal Microscopy. Dermatology 2013; 227:255-62. [DOI: 10.1159/000354762] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 08/03/2013] [Indexed: 11/19/2022] Open
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44
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45
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Gropper AB, Girouard SD, Hojman LP, Huang SJ, Qian X, Murphy GF, Vleugels RA. Metastatic basal cell carcinoma of the posterior neck: case report and review of the literature. J Cutan Pathol 2012; 39:526-34. [PMID: 22515224 DOI: 10.1111/j.1600-0560.2012.01871.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although primary basal cell carcinoma (BCC) represents an extremely common malignancy, metastases derived from BCC are exceedingly rare. The prognosis for metastatic BCC is poor, and little consensus exists regarding predictive factors or optimal treatment strategies. Here, we present the case of a 63-year-old man with BCC of the neck who subsequently developed multiple metastases to subcutaneous tissue, lymph nodes, and the parotid gland. Risk factors and clinical features of metastatic BCC are reviewed, as is the relationship of histopathologic subtype to metastatic behavior. Current chemotherapeutic and targeted therapies also are discussed in the context of recent advances in molecular biology.
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Affiliation(s)
- Adrienne B Gropper
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
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46
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Jackson JE, Kelly B, Petitt M, Uchida T, Wagner RF. Predictive value of margins in diagnostic biopsies of nonmelanoma skin cancers. J Am Acad Dermatol 2012; 67:122-7. [DOI: 10.1016/j.jaad.2011.09.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 09/16/2011] [Accepted: 09/22/2011] [Indexed: 11/26/2022]
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Welsch MJ, Troiani BM, Hale L, DelTondo J, Helm KF, Clarke LE. Basal cell carcinoma characteristics as predictors of depth of invasion. J Am Acad Dermatol 2012; 67:47-53. [DOI: 10.1016/j.jaad.2011.02.035] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 11/19/2010] [Accepted: 02/18/2011] [Indexed: 02/03/2023]
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Jebodhsingh KN, Calafati J, Farrokhyar F, Harvey JT. Recurrence rates of basal cell carcinoma of the periocular skin: what to do with patients who have positive margins after resection. Can J Ophthalmol 2012; 47:181-4. [PMID: 22560426 DOI: 10.1016/j.jcjo.2012.01.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 11/15/2010] [Accepted: 02/08/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the recurrence rates of basal cell carcinoma of the periocular skin in patients who were in the following 3 groups after pathologic analysis: Mohs frozen sections (negative margins); permanent sections with positive tumor margins; and permanent sections with negative tumor margins at the time of primary surgical removal. DESIGN The study is a retrospective chart review. PARTICIPANTS We identified 385 patients who underwent surgery for basal cell carcinoma. The surgery was performed by a single surgeon between January 1, 1995 and January 1, 2005. METHODS The patients were divided into 3 groups: (i) Mohs frozen sections with margins negative for tumor; (ii) permanent sections with margins negative for tumor; (iii) permanent sections with margins positive for tumor. The recurrence rates of basal cell carcinoma were compared. RESULTS The recurrence-free rate was 92% for the group that had had Mohs frozen-section, 87% for the group that had had permanent sections with negative margins, and 80% for the group that had had permanent sections with positive margins at 170 months follow-up time. We found that the only predictor of recurrence rate was younger age (hazards ratio (HR) = 0.97 95%; CI 0.94, 0.99; p = 0.021). CONCLUSIONS The results showed a statistically significant difference in the recurrence-free rate in the 3 groups. A minimum of a 3-year follow-up is recommended in patients who have had basal cell carcinomas removed; the average time to recurrence was approximately 3 years.
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Affiliation(s)
- Kim N Jebodhsingh
- Hamilton Regional Eye Institute, McMaster University, Hamilton, Ontario, Canada
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Mougel F, Kanitakis J, Faure M, Euvrard S. Basosquamous cell carcinoma in organ transplant patients: A clinicopathologic study. J Am Acad Dermatol 2012; 66:e151-7. [DOI: 10.1016/j.jaad.2010.11.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 10/31/2010] [Accepted: 11/06/2010] [Indexed: 11/25/2022]
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Oh ST, Kim HS, Yoo NJ, Lee WS, Cho BK, Reichrath J. Increased immunoreactivity of membrane type-1 matrix metalloproteinase (MT1-MMP) and β-catenin in high-risk basal cell carcinoma. Br J Dermatol 2012; 165:1197-204. [PMID: 21729023 DOI: 10.1111/j.1365-2133.2011.10506.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although various immunohistological markers have been investigated to assess the aggressive characteristics of basal cell carcinoma (BCC), the role of membrane type-1 matrix metalloproteinase (MT1-MMP) has not been well established. OBJECTIVES To clarify the precise role of MT1-MMP in BCC, MT1-MMP expression was studied in various histological subtypes of BCC. MATERIALS AND METHODS High-risk subtypes of BCC were compared by assessing the expression of β-catenin and MT1-MMP. The tissue microarray technique was used for immunohistochemical staining. Fifty-eight samples were divided into six subtypes (10 nodular, 12 mixed, nine infiltrative, eight morphoeiform, 10 micro-nodular and nine basosquamous). Overall, the 10 nodular BCC samples were classified as low-risk BCC and the remaining 48 samples were classified as high-risk BCCs. RESULTS β-Catenin immunoreactivity was increased in the high-risk BCCs compared with the low-risk (nodular) BCC (P < 0·001). Nuclear β-catenin immunoreactivity was increased at the invading front of mixed BCC tumour islands compared with the upper portion of the lesion (P < 0·01). For the mixed BCC (P < 0·01), infiltrative BCC (P < 0·001), morphoeiform BCC (P < 0·001), micronodular BCC (P < 0·001) and basosquamous (P < 0·001) carcinoma, β-catenin immunoreactivity was increased at the invading front compared with nodular BCC. MT1-MMP immunoreactivity was increased in the high-risk BCCs compared with the low-risk (nodular) BCC (P < 0·01). The membranous MT1-MMP immunoreactivity was increased at the invading front of mixed BCC tumour islands compared with the upper portion of the lesions (P < 0·01). For the mixed (P < 0·01), infiltrative (P < 0·05), morphoeiform (P < 0·05), micronodular (P > 0·05) and basosquamous (P < 0·05) BCC, MT1-MMP immunoreactivity was also increased at the invading front compared with nodular BCC. CONCLUSIONS The results of this study suggest that MT1-MMP might be a novel marker for high-risk BCC. In addition, expression of both β-catenin and MT1-MMP was increased in high-risk BCC tumour cells, indicating that these two proteins may play an important role in locally invasive and highly destructive growth behaviour of high-risk BCCs.
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Affiliation(s)
- S T Oh
- Department of Dermatology, The Catholic University of Korea, Seoul, South Korea.
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