A Clinicopathological and Immunohistochemical Comparison of Squamous Cell Carcinoma Arising in Scars Versus Nonscar SCC in Japanese Patients

CCL27 Signaling in the Tumor Microenvironment

Chemokines are a group of small proteins which play an important role in leukocyte migration and invasion. They are also involved in the cellular proliferation and migration of tumor cells.Chemokine CCL27 (cutaneous T cell-attracting chemokine, CTACK) is mainly expressed by keratinocytes of the normal epidermis. It is well known that this chemokine plays an important role in several inflammatory diseases of the skin, such as atopic dermatitis, contact dermatitis, and psoriasis. Moreover, several studies have shown an association between CCL27 expression and a variety of neoplasms including skin cancer.In this chapter, we address the role of chemokine CCL27 in the tumor microenvironment in the most relevant cancers of the skin and other anatomical locations. We also make a brief comment on future perspectives and the potential relation of CCL27 with different immunotherapeutic modalities.

Squamous cell carcinoma of the skin: epidemiology, classification, management, and novel trends

Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer. It originates from epidermal keratinocytes or adnexal structures (such as eccrine glands or pilosebaceous units). We describe the salient features of cutaneous SCC. We also review novel classification schemes proposed during the last decade which attempt to stratify SCC lesions based on prognosis. Biopsy leads to definitive diagnosis. Treatment includes surgical excision; Mohs micrographic surgery produces excellent cure rates and spares the maximal amount of tissue. Other modalities include electrodessication and curettage, cryosurgery, radiotherapy, topical medications, photodynamic therapy, and systemic therapy. Management and follow-up depend on the risk stratification of individual lesions.

Pattern of Nonmelanoma Skin Cancers in Sikkim, India: A 3-year Clinicopathological Review

Basal cell carcinoma (BCC) and Squamous cell carcinoma (SCC), in combination, are referred to as Nonmelanoma skin cancers (NMSCs). NMSC has not been extensively studied in the population of the North eastern India as it has been done in the rest of India. This study was performed to understand the pattern of NMSCs in head and neck region in Sikkimese population. The present study is a retrospective analysis of NMSC of head and neck region that presented to the Department of ENT, Sikkim Manipal Institute of Medical sciences (SMIMS), a tertiary care center in Gangtok, Sikkim from July 2009 to July 2012. They were reviewed according to age, gender, site of involvement and histological types. Of the thirty-seven cases of NMSC analyzed during the 3 year study period, 24 cases were SCC and 13 cases were BCC. The most common age group for SCC was 40-50 years and BCC was 61-70 years. The most common site for both SCC and BCC was the upper lip. For SCC, the most common histologically type was well-differentiated and for BCC, it was the solid type. NMSCs comprise a small but significant proportion of all skin cancer patients in the world. SCC is the commonest variety unlike in western countries. The importance of understanding the risk factors as well as studying the frequency of histopathological patterns can help in the overall prognostic outlook for patients and also in planning an effective management.

Clinicopathological evaluation of nonmelanoma skin cancer

BACKGROUND

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), in combination, are referred to as nonmelanoma skin cancers (NMSCs). NMSC is not as extensively studied in the Asian population as it is in the Caucasian population.

AIM

This study sought to evaluate the clinical and histopathologic aspects of NMSC from cases of cutaneous malignancies.

MATERIALS AND METHODS

The present study is a descriptive analysis of NMSC specimens seen at Department of Pathology, SSIMS and RC, Davangere. Histologically diagnosed NMSC, i.e. BCC and SCC specimens from January 2005 to December 2009 were analyzed according to site distribution, risk factors and histological variants.

RESULTS

Of the various specimens received during the 5year study period, 60 were histologically categorized as skin malignancies, of which 31(51.6%) cases were of NMSC. SCC was the most common NMSC constituting 26 (83.9%) cases and 5 NMSC cases (16.1%) were of BCC. The most common incidence was among the age group 60-80 years (80%) for BCC and 40-60 years (50%) for SCC. Head and neck was the most common site of presentation with predilection for face. Forty-six percent of SCC was histologically categorized as well differentiated, 42.3% as moderately differentiated and 11.5% as poorly differentiated. Most common histological variant of BCC was solid (nodular) type.

CONCLUSION

NMSC often associated with greater morbidity, necessitating increased efforts to assess risk factors in individuals, to encourage periodic self-examination and professional evaluation of skin and to optimize strategies for earlier diagnosis and treatment.

CCR10 and CCL27 are overexpressed in cutaneous squamous cell carcinoma

C-C chemokine receptor (CCR)10 is a specific receptor for chemokine ligand (CCL)27, a selective chemoattractant for skin-associated memory T cells to cutaneous sites. In melanoma, CCR10 increases the ability of neoplastic cells to grow, invade tissues, disseminate to lymph nodes, and escape the host immune responses. In this study, we investigated the expression of CCR10 and its ligand CCL27 in squamous cell carcinoma (SCC). CCR10 and CCL27 were expressed in SCC, actinic keratosis (AK), Bowen's disease, and seborrheic keratosis (predominantly prickle cell type), but not in seborrheic keratosis (predominantly basal cell type) and basal cell carcinoma. Furthermore, CCR10 and CCL27 were overexpressed in SCC relative to Bowen's disease, an early stage of SCC. Consistently, a human SCC cell line, A253 cells, and HaCaT cells exhibited CCL27 production that was strongly induced by tumor necrosis factor-α and interleukin-1β. Finally, A253 cells expressed stronger intracellular CCR10 compared to HaCaT cells by flow cytometry. These results suggest that CCR10 and CCL27 overexpression in SCC is related to the progression of SCC and is useful for the diagnosis of SCC.

Is UV radiation beneficial in postburn wound healing?

Currently strict ultraviolet (UV) light avoidance strategies and utilizing sunblock containing products are generally advocated during the reepithelialization process as well as after wound closure. These recommendations are guided by a common appreciation of UV radiation as a predominant cause of skin cancer development. It is possible however that the currently accepted practice of near continuous UV protection abrogates the normal cutaneous response to injury, with melanocyte redistribution and pigmentation creating hypopigmented scars. We hypothesize that judicious UV exposure might in fact be beneficial for wound healing and skin homeostasis. UV light should be investigated as a potential modulator of keratinocyte-melanocyte cross-talk in wound healing. In vitro studies will have to prove whether UV radiation induced melanocyte activation might have a stimulatory paracrine effect on keratinocyte proliferation which could beneficially affect wound healing. We further hypothesize that UV exposure to wounds might stimulate and restore normal melanocyte distribution and melanin content in reepithelialized wounds preventing hypopigmentation. Furthermore, exposure of reepithelialized wounds to UV light might exert a photo protective effect in the skin by the production of melanin. This in turn may protect the epidermis from UV-induced damage and carcinogenesis. It is therefore proposed that moderate UV exposure should be commenced early in the healing process of cutaneous wounds. At present, current practice and literature do not support the notion that UV-sun block is necessary in postburn scar management. Burn scars do not seem to exert an enhanced risk for melanomagenesis, the occurrence of which has only very rarely been reported in burn scars. Different mutations in susceptibility genes or in genes involved in the control of the cell cycle or maintenance of cellular integrity which are UV radiation independent are involved in the initiation and promotion steps of skin cancer.