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Chai K, Liu J, Xiao R, Zhang G, Zhan Y. A huge verrucous carcinoma of the lower lip reconstructed by double Abbe flap: A case report and literature review. Front Oncol 2023; 13:1086963. [PMID: 36816913 PMCID: PMC9931191 DOI: 10.3389/fonc.2023.1086963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Lip verrucous carcinoma is a rare low-grade neoplasm, with an unsightly appearance and locally aggressive nature. Treatment of verrucous carcinoma is as yet challenging, no well-defined guidelines for effective and safe management of this disease are available. A case of a patient with a huge verrucous carcinoma of the lower lip successfully treated by surgical excision and double Abbe flap reconstruction technique is presented, and striking features of lip locations of this tumor as well as their management are discussed.
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Affiliation(s)
- Ke Chai
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Medical Epigenetics, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jinbing Liu
- Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, China
| | - Rong Xiao
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Medical Epigenetics, Second Xiangya Hospital of Central South University, Changsha, China
| | - Guiying Zhang
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Medical Epigenetics, Second Xiangya Hospital of Central South University, Changsha, China
| | - Yi Zhan
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China,Hunan Key Laboratory of Medical Epigenetics, Second Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Yi Zhan,
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2
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Liu D, Zhao S, Li J, Chen M, Wu L. The application of physical pretreatment in photodynamic therapy for skin diseases. Lasers Med Sci 2021; 36:1369-1377. [PMID: 33404884 DOI: 10.1007/s10103-020-03233-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023]
Abstract
Photodynamic therapy (PDT) is widely used in skin diseases; the response rate of PDT treatment varies widely. The limited penetration in the tissue of photosensitizers influenced the penetration depth of PDT, which obviously impacts the therapeutic effect. The studies have improved the efficacy of PDT through various pretreatment applications; especially, the physical pretreatment had achieved significant outcomes. We will review the physical pretreatment to optimize the efficacy of PDT in skin diseases by searching the literature on this topic. The types of physical pretreatment commonly used in the clinical practice are discussed: curettage, superficial shaving, laser, surgical resection, plum-blossom needles, and microneedles. Compared with PDT alone, the physical pretreatment before PDT application was generally improved the efficacy and reduced the recurrence, especially in actinic keratoses (AK), Bowen disease (BD), basal cell carcinoma (BCC), and viral warts. The application of the physical pretreatments before PDT may improve the efficacy of PDT in various skin diseases. However, each kind of physical pretreatment has the benefit and shortcoming, and the applicable situation is different.
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Affiliation(s)
- Dihui Liu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.,Department of Dermatology, Guangzhou Integrated Traditional Chinese and Western Medicine Hospital, 87 Yingbin Avenue, Huadu District, Guangzhou, 510800, Guangdong, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Jinmao Li
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Lisha Wu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,Institute of Medical Sciences, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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3
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Lee CN, Hsu R, Chen H, Wong TW. Daylight Photodynamic Therapy: An Update. Molecules 2020; 25:E5195. [PMID: 33171665 PMCID: PMC7664668 DOI: 10.3390/molecules25215195] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 12/17/2022] Open
Abstract
Daylight photodynamic therapy (dPDT) uses sunlight as a light source to treat superficial skin cancer. Using sunlight as a therapeutic device has been present for centuries, forming the basis of photodynamic therapy in the 20th century. Compared to conventional PDT, dPDT can be a less painful, more convenient and an effective alternative. The first clinical uses of dPDT on skin cancers began in Copenhagen in 2008. Currently, aminolevulinic acid-mediated dPDT has been approved to treat actinic keratosis patients in Europe. In this review article, we introduce the history and mechanism of dPDT and focus on the pros and cons of dPDT in treating superficial skin cancers. The future applications of dPDT on other skin diseases are expected to expand as conventional PDT evolves.
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Affiliation(s)
- Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-N.L.); (R.H.); (H.C.)
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng-Kung University, Tainan 704, Taiwan
| | - Rosie Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-N.L.); (R.H.); (H.C.)
| | - Hsuan Chen
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-N.L.); (R.H.); (H.C.)
| | - Tak-Wah Wong
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan; (C.-N.L.); (R.H.); (H.C.)
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Center of Applied Nanomedicine, National Cheng Kung University, Tainan 701, Taiwan
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4
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Tanaka Y, Murayama Y, Matsumoto T, Kubo H, Harada K, Matsuo H, Kubota T, Okamoto K, Otsuji E. Efficacy of 5-aminolevulinic acid-mediated photodynamic therapy in a mouse model of esophageal cancer. Oncol Lett 2020; 20:82. [PMID: 32863915 PMCID: PMC7436933 DOI: 10.3892/ol.2020.11943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/02/2020] [Indexed: 12/29/2022] Open
Abstract
5-Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is a minimally invasive therapeutic modality used in the management of various cancers, but to a lesser extent for esophageal cancer (EC). The current study investigated the antitumor effects of ALA-PDT. Human EC cells were treated with ALA, after which ALA-induced fluorescence was examined under a fluorescence microscope. The cytotoxic effects of ALA-PDT were assessed using three types of LEDs (blue, green and red) in vitro and in vivo. Subcutaneous tumor model mice was constructed with KYSE150 cells. ALA-PDT was performed once a week for 4 weeks and tumor weights were measured. A popliteal lymph node (PLN) metastasis murine model was generated using KYSE150 cells. KYSE150 cells were inoculated into the left footpad of nude mice. ALA-PDT was performed on the footpad once a week for 4 weeks. PLNs were then removed 3 weeks after the last treatment. The lymph nodes were evaluated by hematoxylin and eosin staining. Red fluorescence of protoporphyrin IX (PpIX) was observed in all EC cell lines. ALA-PDT using LEDs exerted significant antitumor effects in vitro and in vivo. The antitumor effects of ALA-PDT with blue LED were the strongest, followed by green and red LEDs. The number of metastasized PLNs was significantly smaller in the ALA-PDT group (0%) than in the control group (37.5%). The present results indicated that ALA-PDT is effective for EC.
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Affiliation(s)
- Yoshihiro Tanaka
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Yasutoshi Murayama
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Tatsuya Matsumoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Hidemasa Kubo
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Kyoichi Harada
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Hisataka Matsuo
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Takeshi Kubota
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Kazuma Okamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
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5
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Kadhim A, McKenzie LK, Bryant HE, Twyman LJ. Synthesis and Aggregation of a Porphyrin-Cored Hyperbranched Polyglycidol and Its Application as a Macromolecular Photosensitizer for Photodynamic Therapy. Mol Pharm 2019; 16:1132-1139. [PMID: 30694688 DOI: 10.1021/acs.molpharmaceut.8b01119] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Macromolecules are potentially useful delivery systems for cancer drugs, as their size allows them to utilize the enhanced permeability and retention effect (EPR), which facilitates selective delivery to (and retention within) tumors. In addition, macromolecular delivery systems can prolong circulation times as well as protect and solubilize toxic and hydrophobic drug moieties. Overall, these properties and abilities can result in an enhanced therapeutic effect. Photodynamic therapy (PDT) combines the use of oxygen and a photosensitizer (PS), which become toxic upon light irradiation. We proposed that a PS encapsulated within a water-soluble macromolecule could exploit the EPR effect and safely and selectively deliver the PS to a tumor. In this paper, we describe the synthesis of a porphyrin-cored hyperbranched polymer that aggregated into larger micellar structures. DLS and TEM indicated that these aggregated structures had diameters of 45 and 20 nm for the solvated and nonsolvated species, respectively. The porphyrin-cored HBP (PC-HBP), along with the nonencapsulated porphyrin (THPP), were screened against EJ bladder carcinoma cells in the dark and light. Both THPP and PC-HBP displayed good toxicity in the light, with LD50 concentrations of 0.5 and 1.7 μM, respectively. However, in the dark, the nonincorporated porphyrin (THPP) displayed significant toxicity, generating an LD50 of 4 μM. On the other hand, no dark toxicity was observed for the polymer system (PC-HBP) at concentrations of 100 μM or less. As such, incorporation within the large polymer aggregate serves to eliminate dark toxicity while maintaining excellent toxicity when irradiated.
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Affiliation(s)
- Alaa Kadhim
- Department of Chemistry , University of Sheffield , Sheffield S3 7HF , U.K
| | - Luke K McKenzie
- Department of Chemistry , University of Sheffield , Sheffield S3 7HF , U.K
- Department of Oncology and Metabolism , University of Sheffield , Sheffield S10 2RX , U.K
| | - Helen E Bryant
- Department of Oncology and Metabolism , University of Sheffield , Sheffield S10 2RX , U.K
| | - Lance James Twyman
- Department of Chemistry , University of Sheffield , Sheffield S3 7HF , U.K
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6
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Lee CN, Huang CC, Lin IC, Lee JYY, Ou CY, Wong TW. Recalcitrant lip verrucous carcinoma successfully treated with acitretin after carbon dioxide laser ablation. JAAD Case Rep 2018; 4:576-578. [PMID: 29998178 PMCID: PMC6038266 DOI: 10.1016/j.jdcr.2018.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Cheng Huang
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - I-Chun Lin
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Julia Yu-Yun Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Yen Ou
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tak-Wah Wong
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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7
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Jung SE, Kim SK, Kim YC. Photodynamic therapy in Bowen disease of the first web space of the hand. Ann Dermatol 2015; 27:76-8. [PMID: 25673936 PMCID: PMC4323607 DOI: 10.5021/ad.2015.27.1.76] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/14/2014] [Accepted: 04/10/2014] [Indexed: 11/08/2022] Open
Abstract
Bowen disease (BD), or intraepithelial squamous cell carcinoma (SCC), may progress to an invasive SCC. Although surgery is preferred because of the low recurrence rate, it can result in hypertrophic scarringor contracture, particularly in lesions on the hands. We report a case of BD in the first web space of the hand, which was treated with ablative fractional laser-assisted photodynamic therapy (AFXL-assisted PDT). After multiple AFXL-assisted PDT sessions, the lesion showed no clinical or pathological abnormalities. Thus, we believe that PDT can be an alternative treatment for BD occurring in the web space of the hand.
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Affiliation(s)
- Soo-Eun Jung
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - Sue Kyung Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
| | - You Chan Kim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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8
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Morton CA, Birnie AJ, Eedy DJ. British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014. Br J Dermatol 2014; 170:245-60. [PMID: 24313974 DOI: 10.1111/bjd.12766] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 01/14/2023]
Affiliation(s)
- C A Morton
- Stirling Community Hospital, Stirling, FK8 2AU, U.K
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9
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Martin DE, English JC, Goitz RJ. Squamous cell carcinoma of the hand. J Hand Surg Am 2011; 36:1377-81; quiz 1382. [PMID: 21549525 DOI: 10.1016/j.jhsa.2011.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 03/14/2011] [Indexed: 02/02/2023]
Affiliation(s)
- Daniel E Martin
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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10
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Photosensitizers and light sources for photodynamic therapy of the Bowen’s disease. Arch Dermatol Res 2011; 303:145-51. [DOI: 10.1007/s00403-011-1122-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 12/27/2010] [Accepted: 01/11/2011] [Indexed: 11/27/2022]
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11
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Herman JM, Pierce LJ, Sandler HM, Griffith KA, Jabbari S, Hiniker SM, Johnson TM. Radiotherapy using a water bath in the treatment of Bowen’s disease of the digit. Radiother Oncol 2008; 88:398-402. [DOI: 10.1016/j.radonc.2008.05.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 05/16/2008] [Accepted: 05/17/2008] [Indexed: 10/22/2022]
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12
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Kendler M, Maschke J, Simon J, Wetzig T. Interdigital squamous cell carcinoma in situ (Bowen's disease): treatment with microscopically controlled surgery. J Eur Acad Dermatol Venereol 2008; 22:763-5. [DOI: 10.1111/j.1468-3083.2007.02466.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Hsu CK, Lee JYY, Yu CH, Hsu MML, Wong TW. Lip verrucous carcinoma in a pregnant woman successfully treated with carbon dioxide laser surgery. Br J Dermatol 2007; 157:813-5. [PMID: 17627786 DOI: 10.1111/j.1365-2133.2007.08078.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Soft tissue tumors of the hand arise from skin, subcutaneous tissue, tendons, nerve, and blood vessels. Many of these lesions occur on other parts of the body; however, the hand remains a unique site because these tumors have symptoms, appearances, treatments, and prognoses that may be quite different than when on other parts of the body. Their characteristics and the severity of symptoms vary markedly depending on the exact location, size, and type of tumor-and many of these tumors can have multiple forms of presentation. Two articles are intended to provide an overview of benign (previous article) and malignant tumors (this article) of the hand. The rarer and more deleterious tumors are discussed in detail while the common tumors and epidermal lesions with which practitioners are familiar are briefly overviewed. At the completion of these review articles, participants should be able to identify and diagnose various benign and malignant hand tumors as well as understand the accepted current treatment of these growths.
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Affiliation(s)
- Joseph F Sobanko
- Department of Dermatology, Georgetown University Hospital/Washington Hospital Center, Washington, DC, USA.
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15
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Abstract
Multiple therapeutic options are available for treatment of Bowen's disease. The choice of therapy depends on clinical circumstance and medical practitioner experience. Newer therapies have more extensive support from the literature, but more established therapies may be preferred because of accessibility, cost and efficacy. An overview of the current therapeutic options for Bowen's disease is presented.
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Affiliation(s)
- Gilberto Moreno
- St George Dermatology and Skin and Cancer Centre, Kogarah, New South Wales, Australia
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16
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Abstract
This article represents a planned regular updating of the previous British Association of Dermatologists (BAD) guidelines for management of Bowen's disease. They have been prepared for dermatologists on behalf of the BAD. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines.
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Affiliation(s)
- N H Cox
- Craigavon Area Hospital, Craigavon BT63 5QQ, U.K.
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17
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Abstract
Nail abnormalities are varied and numerous. They include warts, keratoacanthomas, onychomatricomas, fibrokeratomas, osteochondromas, tumors (ie, glomus, giant cell, Koenen's, and others), and Bowen's disease. Although the gravity of these conditions may vary, prompt diagnosis and treatment is of the utmost importance. This article discusses the most common defects associated with the nail unit and its surrounding tissue, as well as the differential diagnosis and treatment of these conditions.
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Affiliation(s)
- Robert Baran
- Nail Disease Center, 42 rue des Serbes 06400, Cannes, France.
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18
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Abstract
ALA-PDT is a safe, well-tolerated, and effective treatment for many dermatologic conditions. Current data most strongly support its use in the treatment of actinic damage, but further investigation into alternative uses continues. Current efficacy is limited primarily by the depth of penetration of the photosensitizing agent and the activating light source. Even with this limitation, the potential applications of PDT are numerous. As new technology is developed to overcome current restraints, the future of PDT is wide open.
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Usmani N, Stables GI, Telfer NR, Stringer MR. Subungual Bowen's disease treated by topical aminolevulinic acid—photodynamic therapy. J Am Acad Dermatol 2005; 53:S273-6. [PMID: 16227107 DOI: 10.1016/j.jaad.2005.03.056] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2004] [Revised: 12/15/2004] [Accepted: 03/25/2005] [Indexed: 10/25/2022]
Abstract
A 66-year-old man presented with an 18-month history of progressive nail dystrophy involving his left index finger. A diagnostic biopsy specimen confirmed the clinical suggestion of subungual Bowen's disease (carcinoma in situ). Various treatment options were considered, and the decision was made to treat with photodynamic therapy using topical 5-aminolevulunic acid administered as two treatments 4 weeks apart. The patient was reviewed 3 months after treatment and then regularly at 6-month intervals. Thirty months after treatment there remained no clinical evidence of recurrence of the condition with preservation of a normal nail unit. Although the successful treatment of cutaneous Bowen's disease with photodynamic therapy is well documented, this is the first report of the successful treatment of subungual Bowen's disease using topical aminolevulunic acid-photodynamic therapy.
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Affiliation(s)
- Naila Usmani
- Centre for Dermatology, Leeds General Infirmary, Leeds, United Kingdom.
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Affiliation(s)
- Nathaniel J Jellinek
- Assistant Professor, Department of Dermatology, Brown Medical School, Providence, Rhode Island, USA
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21
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Liu GT, Lovell MO, Steinberg JS. Digital syndactylization for the treatment of interdigital squamous cell carcinoma in situ (Bowen disease). J Foot Ankle Surg 2004; 43:419-22. [PMID: 15605056 DOI: 10.1053/j.jfas.2004.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Bowen disease, or squamous cell carcinoma in situ, has been described as a premalignant intraepidermal lesion of the skin. Although more frequently occurring on limbs, interdigital presentation of squamous cell carcinoma in situ in the foot has been rarely reported, likely because of undetected development. Excision has been recommended as the treatment of choice; however, removal of these lesions from intertriginous skin may present few options for skin closure. Interdigital syndactylization may be an acceptable option for the treatment of interdigital manifestations of Bowen disease. The authors present a case of interdigital squamous cell carcinoma in situ successfully treated with excision and digital syndactylization. At the 2-year follow-up, there was no recurrence and no digital deformities.
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Affiliation(s)
- George T Liu
- Division of Podiatry, Department of Orthopaedics, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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22
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Peterson SR, Layton EG, Joseph AK. Squamous Cell Carcinoma of the Nail Unit with Evidence of Bony Involvement: A Multidisciplinary Approach to Resection and Reconstruction. Dermatol Surg 2004; 30:218-21. [PMID: 14756655 DOI: 10.1111/j.1524-4725.2004.30068.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of the nail bed is a rare disorder that is often misdiagnosed for years before definitive diagnosis with biopsy. Proper evaluation of this carcinoma includes radiographic evaluation for bony involvement of the phalanges of the affected digit. If bony involvement is evident by x-ray, amputation of the distal phalanx or the affected digit is warranted. Mohs micrographic surgery of the affected nail unit is advantageous in preserving vital tissue for reconstruction after phalangeal amputation by a hand surgeon, thus maximizing preservation of the densely innervated tissue from the volar finger pulp. This approach may maximize functional capacity of the reconstructed digit. OBJECTIVE To describe a multidisciplinary approach to resection, amputation, and reconstruction of digits with SCC of the nail bed. METHODS This is a description of three cases and a review of the pertinent medical literature. RESULTS Three SCCs of the nail bed were excised with Mohs micrographic surgery, preserving the volar pulp and skin of the distal finger. The patients were then referred for distal phalanx amputation and reconstruction by a hand surgeon. All patients remained disease free with acceptable function of the reconstructed digits at 15, 17, and 38 months of follow-up. CONCLUSION Although uncommon, SCC of the nail bed must be considered in all nails with chronic disease. Preoperative evaluation should include hand radiographs in search of bony involvement. Tissue-sparing excision combined with distal amputation of the affected phalanx and reconstruction of the digit using spared tissue may maximize hand and digit function.
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Affiliation(s)
- S Ray Peterson
- The University of Texas Health Science Center at Houston and The MD Anderson Cancer Center, Houston, Texas, USA.
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23
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Yang CH, Lee JC, Chen CH, Hui CY, Hong HS, Kuo HW. Photodynamic therapy for bowenoid papulosis using a novel incoherent light-emitting diode device. Br J Dermatol 2003; 149:1297-9. [PMID: 14674917 DOI: 10.1111/j.1365-2133.2003.05661.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sheen YS, Sheen MC, Sheu HM, Yang SF, Wang YW. Squamous cell carcinoma of the big toe successfully treated by intra-arterial infusion with methotrexate. Dermatol Surg 2003; 29:982-3. [PMID: 12930347 DOI: 10.1046/j.1524-4725.2003.29267.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND For preservation of integrity of appearance and function in a 57-year-old male with a squamous cell carcinoma of his left big toe who had refused amputation, intra-arterial infusion with methotrexate was used. OBJECTIVE To evaluate the effectiveness of arterial infusion with methotrexate in this uncommon big toe cancer. METHODS Left external iliac arterial catheterization and infusion with methotrexate (50 mg) were used every 24 hours plus simultaneous intramuscular injection of 6 mg of leucovorin every 6 hours for 8 days. RESULTS At 7 years and 3 months after therapy, the patient was in sustained complete remission with a functionally normal left foot. CONCLUSION This case study suggests that intra-arterial infusion chemotherapy is a simple and effective method for big toe squamous cell carcinoma with the unique advantage of preservation of organ and function. It can be considered as an effective alternative treatment.
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Affiliation(s)
- Yi-Shuan Sheen
- Departments of Surgery, Division of Surgical Oncology, Kaohsiung Medical University Hospital, 100 Shih Chuan 1st Road, Kaohsiung, Taiwan
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Wong TW, Aizawa K, Sheyhedin I, Wushur C, Kato H. Pilot Study of Topical Delivery of Mono-L-aspartyl Chlorin e6 (NPe6): Implication of Topical NPe6-Photodynamic Therapy. J Pharmacol Sci 2003; 93:136-42. [PMID: 14578580 DOI: 10.1254/jphs.93.136] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Photodynamic therapy (PDT) is an evolving cancer treatment with promising results in treating malignant tumors by photoactivation of a photosensitizer with a specific wavelength. The second generation photosensitizer mono-L-aspartyl chlorin e6 (NPe6) was reported to have significant efficacy in killing cancer cells in vitro and in vivo. Though topical application might yield a higher local concentration and less systemic side effect, no data concerning topical absorption of NPe6 is available even though the drug has already been used in clinical trial for several years. To evaluate the possibility of topical delivery of NPe6 via an animal model, escalated concentrations of NPe6 were applied to BALB/c mouse skin for a different time periods after barrier disruption with tape stripping. Since NPe6 fluorescence intensity and drug concentration in tissue was well correlated, we evaluated drug penetration depth with frozen sections of treated and non-treated skin under a fluorescence microscope. An on-line fluorescence imaging system was used to monitor the NPe6 fluorescence kinetics in the skin. The fluorescence microscope confirmed successful topical delivery of NPe6 in mouse skin with or even without barrier disruption. Orange to red NPe6 fluorescence appeared at the epidermis, dermis, and even the muscular layer when using 10 mg/ml NPe6 application. The fluorescence intensity peaked at 1 h and revealed a dose-dependent response pattern. NPe6 treated versus non-treated skin showed a statistically significant difference by Student's t-test (P<0.05). The results described here suggest that topical delivery of NPe6 is possible. It showed fast and deep penetration into mouse skin. This implies that NPe6 might be useful as a topical photosensitizer for PDT in treating skin cancers.
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Affiliation(s)
- Tak-Wah Wong
- Department of Dermatology & Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
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Affiliation(s)
- Katrin A Salva
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106, USA.
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