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Zilberg C, Lyons JG, Gupta R, Damian DL. The Immune Microenvironment in Basal Cell Carcinoma. Ann Dermatol 2023; 35:243-255. [PMID: 37550225 PMCID: PMC10407341 DOI: 10.5021/ad.22.042] [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: 03/01/2022] [Revised: 05/07/2022] [Accepted: 08/01/2022] [Indexed: 08/09/2023] Open
Abstract
The immune system plays a key role in the suppression and progression of basal cell carcinoma (BCC). The primary aetiological factor for BCC development is exposure to ultraviolet radiation (UVR) which, particularly in lighter Fitzpatrick skin types, leads to the accumulation of DNA damage. UVR has roles in the generation of an immunosuppressive environment, facilitating cancer progression. Rates of BCC are elevated in immunosuppressed patients, and BCC may undergo spontaneous immune-mediated regression. Histologic and immunohistochemical profiling of BCCs consistently demonstrates the presence of an immune infiltrate and associated immune proteins. Early studies of immune checkpoint inhibitors reveal promising results in BCC. Therefore, the host immune system and tumor responses to it are important in BCC pathogenesis. Understanding these interactions will be beneficial for disease prognostication and therapeutic decisions.
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Affiliation(s)
- Catherine Zilberg
- Department of Dermatology, The University of Sydney at Royal Prince Alfred Hospital, Sydney, Australia.
| | - James Guy Lyons
- Department of Dermatology, The University of Sydney at Royal Prince Alfred Hospital, Sydney, Australia
- Centenary Institute, The University of Sydney, Sydney, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, Australia
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Diona Lee Damian
- Department of Dermatology, The University of Sydney at Royal Prince Alfred Hospital, Sydney, Australia
- Melanoma Institute Australia, Sydney, Australia
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2
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Yuki A, Takatsuka S, Abe R, Takenouchi T. Diagnostic accuracy of dermoscopy for 934 basal cell carcinomas: A single-center retrospective study. J Dermatol 2023; 50:64-71. [PMID: 36229917 DOI: 10.1111/1346-8138.16607] [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: 08/17/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 01/04/2023]
Abstract
Although the efficacy of dermoscopic diagnosis of basal cell carcinoma (BCC) has already been established, most studies have been conducted in Western countries. However, there are racial differences in the clinicopathological characteristics of BCC, highlighting the need for a survey among Asians. Herein, we aimed to investigate the diagnostic accuracy of dermoscopy in 934 Japanese patients with BCC and statistically analyze the clinicopathological factors affecting diagnostic accuracy. We analyzed 5093 skin lesions, including 934 BCCs that were diagnosed consecutively from 1998 to 2018. The sensitivity and specificity of dermoscopic diagnosis for BCC were calculated. The sensitivity and specificity of dermoscopic diagnosis were 92.2% and 96.0%, respectively. There were 73 false-negative cases of BCCs that were clinically diagnosed with other diseases. The most common incorrect clinical diagnosis was seborrheic keratosis (n = 18), followed by melanocytic nevus (n = 15). Multiple logistic regression analysis showed that sensitivity was significantly lower in BCCs located on the trunk and extremities, which showed low pigmentation (less than 10% of the lesion surface) and were diagnosed by a resident dermatologist. Experience of 3-6 months of 12 resident dermatologists revealed increased sensitivity. Dermoscopy is a reliable tool for the accurate diagnosis of BCC in Japanese individuals. Care should be taken when diagnosing BCCs of the trunk and extremities, and the less-pigmented subtype because of lower sensitivity. A certain amount of experience is required to improve the skills for dermoscopy.
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Affiliation(s)
- Akihiko Yuki
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Sumiko Takatsuka
- Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Riichiro Abe
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuya Takenouchi
- Department of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan
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3
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Kamimura A, Nakamura Y, Takenouchi T, Matsushita S, Omodaka T, Yamamura K, Uchi H, Yoshikawa S, Yanagisawa H, Ito T, Kiyohara Y, Nakamura Y, Aoki M, Ishizuki S, Oashi K, Miyagawa T, Maeda T, Ogata D, Hatta N, Ohe S, Isei T, Takahashi A, Umeda Y, Yamaguchi B, Ishikawa M, Horimoto K, Fujsawa Y, Uehara J, Shibayama Y, Kiniwa Y, Kawahara Y, Matsuya T, Uhara H, Kato J, Nakamura Y, Murakami T, Namikawa K, Yoshino K, Funakoshi T, Takatsuka S, Matsui Y, Sasaki J, Koga H, Yokota K, Komori T, Fukushima S, Yamazaki N. Concordance in judgment of clinical borders of basal cell carcinomas in Japanese patients: A preliminary study of JCOG2005 (J-BASE-MARGIN). J Dermatol 2022; 49:837-844. [PMID: 35510662 DOI: 10.1111/1346-8138.16422] [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: 02/24/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma is the most common type of skin cancer, and surgical excision with clear margins is the standard of care. Surgical margins are determined based on risk factors (high or low risk) for recurrence according to the National Comprehensive Cancer Network and Japanese basal cell carcinoma guidelines. The clarity of the clinical tumor border (well-defined or poorly defined) is considered a risk factor, and significant discrepancies in the judgment of clinical tumor borders among dermato-oncologists may occur. Therefore, we analyzed the dermato-oncologists' concordance in judging the clinical tumor border of basal cell carcinoma. Forty-seven dermato-oncologists (experts: 37; young trainees: 10) participated in this study. The datasets of clinical and dermoscopic photographs of 79 Japanese cases of head and neck basal cell carcinoma were used to determine the concordance in the judgment of clinical tumor border. The probability of the border that was selected more often was used to calculate the rater agreement rate for each dataset. Correct judgment was defined as a more frequently selected border, and the concordance rate of clarity of clinical tumor border for each dermato-oncologist was calculated based on the definition of the correct judgment. A median concordance rate of 85% or higher for all dermato-oncologists was predefined as an acceptable rate for clinical use. Of the 79 datasets, rater agreement rates were 80-100%, 60-79%, and 51-59% for 55, 19, and five datasets, respectively. The median concordance rate for all dermato-oncologists was 86% (interquartile range: 82-89%). There was no significant difference in the concordance rate between the experts and the trainees (median, 87% vs. 85.5%; p = 0.58). The concordance rates of dermato-oncologists for all datasets were relatively high and acceptable for clinical use.
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Affiliation(s)
- Anna Kamimura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | | | - Kentaro Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Hiroshi Uchi
- Department of Dermatologic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Hiroto Yanagisawa
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Takamichi Ito
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - Yoshio Kiyohara
- Dermatology Division, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Megumi Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shoichiro Ishizuki
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kohei Oashi
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Takuya Miyagawa
- Department of Dermatology, University of Tokyo, Tokyo, Japan
| | - Taku Maeda
- Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo, Japan
| | - Dai Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Shuichi Ohe
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Taiki Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiyasu Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Buntaro Yamaguchi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masashi Ishikawa
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yasuhiro Fujsawa
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jiro Uehara
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Yu Kawahara
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Taisuke Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Junji Kato
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yoshiyuki Nakamura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takuo Murakami
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Sumiko Takatsuka
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Yu Matsui
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Jin Sasaki
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Kenji Yokota
- Department of Dermatology, Nagoya University, Nagoya, Japan
| | - Takaya Komori
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Han X, Li J, Zeng F, Liu H, He Y. Differential diagnosis of basal cell carcinoma by high-resolution ultrasound elastography. Skin Res Technol 2022; 28:350-354. [PMID: 35034391 PMCID: PMC9907658 DOI: 10.1111/srt.13139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/18/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess the value of high-resolution ultrasonic quantitative parameters of shear wave elastography (SWE) in basal cell carcinoma (BCC). A total of 86 cases of BCC were enrolled as the case group, and 38 other similar skin pigmented lesions were randomly selected as the control group. Using pathological results as the gold standard, the diagnostic test method was used to evaluate the ability of high-frequency ultrasonic elastography to diagnose BCC, and the 2D ultrasonographic features, blood flow image characteristics, and SWE of BCC were summarized.
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Affiliation(s)
- Xiaohua Han
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Jiyou Li
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Fuqiang Zeng
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, China
| | - Hongmei Liu
- Department of Ultrasound, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yanni He
- Department of Ultrasound, Institute of Ultrasound in Musculoskeletal Sports Medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
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Prediction of the invasive level of basal cell carcinomas in the facial area: Analysis of 718 Japanese cases. J Dermatol Sci 2020; 99:152-157. [PMID: 32811698 DOI: 10.1016/j.jdermsci.2020.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer. While Mohs micrographic surgery is commonly accepted for BCC treatment, surgical excision with free margins is widely considered the best treatment modality for BCCs in Japan. However, little is known about the predictors of the invasion levels of BCCs. OBJECTIVE To investigate the optimization of deep surgical margins by identifying factors significantly influencing the invasion levels of facial BCCs. METHODS The tumor invasion level was defined as the deepest part of a tumor. Tumor thickness was measured from the top of the granular layer to the deepest extension of the tumor or from the ulcer base overlying the deepest point of invasion in ulcerated lesions. Factors independently associated with tumor thickness and invasion level were identified by multivariate analysis. Six variables were tested: age, sex, anatomical region (nose, orbit, others), histologic pattern (aggressive, non-aggressive), presence of pigmentation, and diameter. RESULTS We included 718 cases of facial BCCs involving 705 Japanese patients. The most frequent anatomical region and histologic pattern were the nose and nodular pattern, respectively. Only tumor diameter showed a correlation with tumor thickness (β = 0.377, P < 0.001). Tumor diameter (AOR = 71.189, 95 % CI: 11.420-430.931, P = 0.01) and the following anatomical regions showed correlations with the invasion level: nose/others: AOR=2.769, 95 % CI: 1.235-6.493, P = 0.01; orbit/others: AOR=6.369, 95 % CI: 2.728-15.429, P < 0.001; orbit/nose: AOR=2.300, 95 % CI: 1.056-4.984, P = 0.04. CONCLUSIONS This study serves as a guide for optimizing deep surgical margins and planning surgery for facial BCCs considering independently associated factors.
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Nakamura Y, Matsushita S, Tanaka R, Saito S, Araki R, Teramoto Y, Aoki M, Yamamura K, Nakamura Y, Fujisawa Y, Brinker TJ, Yamamoto A. 2-mm surgical margins are adequate for most basal cell carcinomas in Japanese: a retrospective multicentre study on 1000 basal cell carcinomas. J Eur Acad Dermatol Venereol 2020; 34:1991-1998. [PMID: 31954082 DOI: 10.1111/jdv.16200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surgery is the gold standard for basal cell carcinomas (BCC). Current recommended surgical margins for BCCs are determined from studies in Caucasian populations. However, the appropriate surgical margins for BCCs in non-white races are unclear. OBJECTIVES To investigate the accuracy of preoperative determination of clinical tumour borders and appropriate surgical margins in Japanese patients with BCC. METHODS The maximum calculated differences in distance between the preoperatively determined surgical margins and the actual histologic tumour side margins were considered as 'accuracy gaps' of clinical tumour borders. Estimated side margin positivity rates (ESMPRs) with narrower (2 and 3 mm) surgical margins were calculated on the basis of the accuracy gaps. RESULTS Overall, 1000 surgically excised BCCs from 980 Japanese patients were included. The most frequent histologic subtype was nodular BCC (67%). The median accuracy gap was 0.3 mm [interquartile range (IQR): -0.5 to +1 mm]. The ESMPRs with 2- and 3-mm surgical margins were 3.8% and 1.4%, respectively. Only the ESMPRs between the well-defined (n = 921) and poorly defined clinical tumour border groups (n = 79) showed statistical difference [2-mm margin: 3.1% vs. 11.7%, OR: 3.89, 95% confidential interval (CI): 1.41-10.71, P <0.01; 3-mm margin: 0.97% vs. 6.3%, OR: 6.58, 95% CI: 1.67-25.99, P <0.01]. No significant differences in ESMPRs were noted in other subgroups including risk classifications. CONCLUSIONS The determined clinical tumour border accuracy gaps in this Japanese cohort were negligible. Dermatologic surgeons may use narrower surgical margins with acceptable margin positivity rates. The clarity of clinical tumour borders could be an appropriate guide for selection of different surgical margins in the Japanese cohort.
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Affiliation(s)
- Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - R Tanaka
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - S Saito
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - R Araki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Y Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - M Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - K Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Y Nakamura
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Y Fujisawa
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - T J Brinker
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Yamamoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
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Queen D, Knackstedt T, Polacco MA, Collins LK, Lee K, Samie FH. Characteristics of non-melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery. J Eur Acad Dermatol Venereol 2018; 33:305-311. [PMID: 30284728 DOI: 10.1111/jdv.15263] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/27/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The lip and surrounding perioral region are susceptible to non-melanoma skin cancer, but the distribution of basal cell and squamous cell carcinoma on the cutaneous and vermilion lips has not been fully elucidated. OBJECTIVE To investigate the distribution of cutaneous and vermilion lip non-melanoma skin cancer and to better describe risk factors, anatomic location, treatment characteristics and oncologic outcomes. METHODS A retrospective comparative case series of patients undergoing Mohs micrographic surgery (MMS) at a single academic centre for lip and perioral basal cell and squamous cell carcinoma was performed over a 5-year period. Demographics, medical comorbidities, surgical characteristics and recurrence status were extracted. RESULTS Forty-five vermilion and 116 cutaneous lip cancers were identified. Basal cell carcinoma (BCC) was more common in the cutaneous perioral region, while squamous cell carcinoma (SCC) was more common on the vermilion lip (P < 0.001). BCCs were more common on the upper vermilion lip and SCCs were more common on the lower vermilion lip (P < 0.001). Within the cutaneous perioral region, both BCCs and SCCs were more common on the upper perioral surface (P = 0.002). Male gender was associated with lower lip SCC (P = 0.015). Smoking, immunosuppression, anticoagulant use and hydrochlorothiazide use were not associated with cancer type or location. Recurrences were rare, but more common in vermilion lip cancers (6.6%) compared to perioral cutaneous cancers (0.8%). Outcomes for all groups were similar; BCCs of the vermilion lip had significantly greater mean MMS stages (P < 0.001) as did SCCs (P = 0.05). CONCLUSION Basal cell carcinoma is more commonly encountered on the cutaneous lip, whereas SCC is more common on the vermilion lip. Within the vermilion lip, BCC favours the upper lip, while SCC favours the lower lip. Within the cutaneous perioral region, both BCC and SCC favour the upper cutaneous tissue. Early stage lip cancers are curable by Mohs micrographic surgery with rare recurrences.
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Affiliation(s)
- D Queen
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - T Knackstedt
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - M A Polacco
- Section of Otolaryngology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - L K Collins
- Section of Dermatology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - K Lee
- Department of Dermatology, The Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - F H Samie
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Section of Dermatology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
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8
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Nakamura Y, Tanese K, Hirai I, Kameyama K, Kawakami Y, Amagai M, Funakoshi T. Evaluation of the appropriate surgical margin for pigmented basal cell carcinoma according to the risk factors for recurrence: a single-institute retrospective study in Japan. J Eur Acad Dermatol Venereol 2018; 32:e453-e455. [DOI: 10.1111/jdv.15046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y. Nakamura
- Department of Dermatology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - K. Tanese
- Department of Dermatology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - I. Hirai
- Department of Dermatology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - K. Kameyama
- Department of Pathology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - Y. Kawakami
- Division of Cellular Signaling Institute for Advanced Medical Research; Keio University School of Medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - M. Amagai
- Department of Dermatology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
| | - T. Funakoshi
- Department of Dermatology; Keio University school of medicine; Shinanomachi 35 Shinjuku Tokyo 160-8582 Japan
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Trends in basal cell carcinoma incidence rates: a 16-year retrospective study of a population in central Poland. Postepy Dermatol Alergol 2018; 35:47-52. [PMID: 29599671 PMCID: PMC5872246 DOI: 10.5114/ada.2018.73164] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/25/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Basal cell carcinoma (BCC) is the most commonly occurring cancer worldwide, and the overall incidence is still rising. Unfortunately, the cancer registry in Poland does not record BCC individually. Thus, the incidence of BCC in a defined population is unknown. Aim Analysis of incidence rates of primary BCC in central Poland during 16 years considering sex, site distribution and age to determine trends. Material and methods We retrospectively included all cases of BCC which were diagnosed and treated in the Department of Dermatology and Venereology, Medical University of Lodz, during the 16-year period from 1999 to 2015. Results We recorded 945 BCCs occurring in 890 patients (504 females - 57%, 386 males - 43%). Patient's age was between 21 and 94. A distinct increase in BCC was observed after 1999, while after 2010 during the next 2-year period a slight decrease was noted. A statistically significant correlation was observed between histopathological types of BCC and the location of the lesions. The superficial type predominates on photoprotected areas, especially on the trunk, while the nodular type occurs mainly in facial areas. No statistically significant correlation was observed between histopathological types of BCC and sex. We found a significant increase in incidence for superficial BCC among middle-age patients, while the nodular type was observed more frequently among elderly subjects. Conclusions Basal cell carcinoma is quite common in Poland and predominantly develops in the facial area. In middle-age patients the most common is superficial BCC, while in elderly people the nodular type is most common. Based on our results we assume that there is a strong need to educate general physicians to enable them to diagnose BCC in the early stages.
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10
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Treatment of Pigmented Basal Cell Carcinoma with 3 mm Surgical Margin in Asians. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7682917. [PMID: 27652267 PMCID: PMC5019928 DOI: 10.1155/2016/7682917] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/11/2016] [Indexed: 12/05/2022]
Abstract
Background. In Asians, most basal cell carcinomas (BCCs) are pigmented with clear borders. The consensus of 4 mm surgical margin for BCC largely depends on studies in nonpigmented BCCs in Caucasians. However, little is known about recurrences of pigmented BCCs with a narrower surgical margin. We aimed to investigate 5-year recurrence of BCCs, either pigmented or nonpigmented, in Taiwanese with 3 mm surgical margin. Materials and Methods. 143 patients with BCC (M/F = 66/77, average 64 years) were confirmed pathologically from 2002 to 2013. Based on the pathological margin (>1 mm, ≤1 mm, and involved), patients were categorized into the complete excision group (n = 77), histology with close proximity group (n = 43), and unclear surgical margin group (n = 23). Results. Among 143 cases, 105 were pigmented. With standard 3 mm excision, there were 7 recurrences, with 6 of them from nonpigmented BCC group. Logistic regression showed that pigmentation was associated with lower recurrence. Interestingly, 5-year recurrence of completely excised and histology with close proximity BCC (0/77 versus 1/43) was not different statistically. Conclusions. A 3 mm surgical margin is adequate for pigmented BCC. A “wait and see” approach rather than further wide excision is appropriate for BCC with <1 mm free margin.
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11
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Tan ES, Ee M, Shen L, Chua H, Chan YH, Tan SH. Basal cell carcinoma in Singapore: a prospective study on epidemiology and clinicopathological characteristics with a secondary comparative analysis between Singaporean Chinese and Caucasian patients. Australas J Dermatol 2014; 56:175-9. [PMID: 25179179 DOI: 10.1111/ajd.12202] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/24/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Susceptibility to and clinical presentation of basal cell carcinoma (BCC) differ in Asian and Caucasian populations. This study aims to evaluate the epidemiological and clinicopathological characteristics of BCC in a multiracial Singaporean population, with a secondary comparative analysis between Chinese and Caucasian patients. METHODS We prospectively studied patients with newly diagnosed, histologically confirmed BCC at the National Skin Centre, Singapore from 2004 to 2008. RESULTS In total, 274 BCC from 260 patients were studied, with 19 patients having two or more tumours. Their mean age was 67.5 years and 54% were male. Chinese comprised 80% and Caucasians 14%. The Chinese were 1.8-fold as likely as Caucasians to be older than 60 years, and experienced itch thrice more frequently. Caucasians developed multiple BCC threefold and truncal or upper limb BCC 2.9-fold more frequently than the Chinese. In terms of tumour subtype, morphoeic BCC was 2.7-fold more common in Caucasians. Pigmented BCC occurred 2.7-fold more often in the Chinese, most frequently on the head and neck of elderly Chinese. CONCLUSIONS Compared to the Chinese, BCC occurred more often in younger Caucasians, with a predilection for the trunk and upper limb, suggesting a greater role for recreational sun exposure as a risk factor. Pigmented BCC more commonly occurred on the head and neck of elderly Chinese and may be reflective of cumulative sun exposure as a risk factor. Aggressive morphoeic BCC was more common in Caucasians than in Singaporean Chinese patients.
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Affiliation(s)
| | - Melvin Ee
- Dermatology & Surgery Clinic, National University Health System, Singapore
| | - Liang Shen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Hilary Chua
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Yiong-Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
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12
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Demirseren DD, Ceran C, Aksam B, Demirseren ME, Metin A. Basal cell carcinoma of the head and neck region: a retrospective analysis of completely excised 331 cases. J Skin Cancer 2014; 2014:858636. [PMID: 24864212 PMCID: PMC4016886 DOI: 10.1155/2014/858636] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 11/18/2022] Open
Abstract
The aim of the study is to analyze all completely excised BCCs in the head and neck region with regard to age, sex, personal and familial history, skin type, tumor localization and size, histopathological subtype of tumor, reconstruction method, and recurrence rates. Incompletely excised BCCs were not included in this study since incomplete excision is the most important preventable risk factor for recurrence. In 320 patients, 331 lesions were retrospectively evaluated by dividing into the following 8 subunits: scalp, frontotemporal, orbital, nose, cheek, auricula, perioral, and chin-neck area. Most of the patients were in 60-70 age group (34.7%). The nose (32.3%) was the most common site of presentation. Clinically, all lesions and, histopathologically, most of the lesions (42.2%) presented were of the nodular type. All cases of recurrence after complete excision (n = 9, 2.7%) were located in the median parts of the head and neck region and were mainly diagnosed histopathologically as sclerotic and micronodular. Even though completely excised, head and neck region BCCs, especially which are more prone to recurrence due to anatomical and histopathological properties, should be more closely monitored in order to decrease morbidity and health care costs.
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Affiliation(s)
- Duriye Deniz Demirseren
- Department of Dermatology, Ataturk Training and Research Hospital, Bilkent Way, 06800 Ankara, Turkey
| | - Candemir Ceran
- Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk Training and Research Hospital, 06800 Ankara, Turkey
| | - Berrak Aksam
- Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk Training and Research Hospital, 06800 Ankara, Turkey
| | - Mustafa Erol Demirseren
- Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk Training and Research Hospital, 06800 Ankara, Turkey
| | - Ahmet Metin
- Department of Dermatology, Ataturk Training and Research Hospital, Bilkent Way, 06800 Ankara, Turkey
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13
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Huang Y, Chen X, Yang S, Wu L, Zhao J, Li X, Tu P, Li H. Preliminary exploration of the clinical features of Chinese patients with skin malignancies and premalignancies: a retrospective study of 1420 cases from Peking University First Hospital. J Eur Acad Dermatol Venereol 2012; 27:1114-9. [DOI: 10.1111/j.1468-3083.2012.04673.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Berk DR, Ball Arefiev KL, Gladstone HB. Adamantinoid basal cell carcinoma: a predictor of more-aggressive clinical behavior. Dermatol Surg 2012; 38:1346-50. [PMID: 22551358 DOI: 10.1111/j.1524-4725.2012.02416.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Identifying histopathologic subtypes of basal cell carcinoma (BCC) associated with an aggressive clinical course helps the surgeon to anticipate the size of the postexcision defect and complexity of repair. During Mohs micrographic surgery (MMS), we have observed that BCC with adamantinoid histopathologic features tend to be clinically more aggressive. OBJECTIVE To characterize the subtype of BCC with adamantinoid histopathologic features and determine whether it is clinically more aggressive than other BCCs. METHODS AND MATERIALS A chart review was conducted of consecutive cases of MMS performed at Stanford University Medical Center for BCC from June 2002 through March 2004. Cases had been prospectively categorized as adamantinoid BCC if they met histopathologic criteria, including uniform clear areas around the individual tumor cells within tumor islands. We retrospectively compared adamantinoid and control cases in terms of patient age, sex, tumor location, number of Mohs stages required, area of post-Mohs defect, and type of repair. RESULTS Four hundred eighty-nine cases of MMS for BCC were reviewed. Forty-four (9%) were adamantinoid BCC. Patients with adamantinoid BCC did not differ statistically from the control group in terms of sex (23% vs 32% female, p = .20) but tended to be older (median age 73 vs 66, p = .04; mean age 70 vs 65 years, p = .05). The distribution of cases on the head and neck differed significantly between the adamantinoid and control groups (p = .02), with more adamantinoid cases located on the nose and ears. Adamantinoid BCC required more stages for clear histologic margins (median 3.00 vs 2.00, p < .001; mean 3.68 vs 2.34, p < .001) and had larger post-Mohs defects (median 3.00 vs 1.68 cm(2) , p < .001; mean 4.24 vs 2.78 cm(2) , p = .02). Only 4.5% of adamantinoid BCC cases were able to heal by second intention, with 20.4% requiring complex primary closure. Staged flaps were performed in 13.6% of individuals with adamantinoid BCC. CONCLUSION Adamantinoid BCC is an aggressive histopathologic subtype in terms of number of stages for clear margins and size of post-Mohs defect. It may also require more-complex repairs. Recognition of this aggressive variant may benefit future patients by facilitating prediction of the clinical extent of tumors.
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Affiliation(s)
- David R Berk
- Division of Dermatologic Surgery, Department of Dermatology, Stanford University Medical Center, Redwood City, California, USA
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15
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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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Jang MS, Baek JW, Park JB, Kang DY, Kang JS, Suh KS, Kim ST. Large superficial Basal cell carcinoma arising in the scalp. Ann Dermatol 2011; 23 Suppl 1:S96-9. [PMID: 22028585 PMCID: PMC3199435 DOI: 10.5021/ad.2011.23.s1.s96] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 10/11/2010] [Accepted: 10/11/2010] [Indexed: 12/05/2022] Open
Abstract
Superficial basal cell carcinoma (sBCC), a rare sub-type of basal cell carcinoma, can frequently occur in younger patients. This cancer type preferentially develops on the trunk. However, other subtypes of BCC can occur in the head and neck, probably secondary to sunlight exposure. Especially, sBCC on the scalp has been rarely-reported, accounting for 0.7~0.8% of all sBCC cases. We report a case of 71-year-old female with a large sBCC of the scalp, an unusual site of sBCC.
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Affiliation(s)
- Min Soo Jang
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
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Basal cell carcinoma of the head and neck region in ethnic chinese. Int J Surg Oncol 2011; 2011:890908. [PMID: 22611492 PMCID: PMC3265281 DOI: 10.1155/2011/890908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 06/04/2011] [Accepted: 06/08/2011] [Indexed: 11/17/2022] Open
Abstract
Objectives. This study aims to report our experience in the management of HNBCC in ethnic Chinese over a 10-year period. Methods. A retrospective review of all ethnic Chinese patients with HNBCC treated in a tertiary centre from 1999 to 2009. Results. From 1999 to 2009, 225 patients underwent surgical excision for HNBCC. Majority were elderly female patients. Commonest presentation was a pigmented (76.2%) ulcer (64.8%) over the nose (31.6%). Median skin margin taken on tumour excision was 2.0 mm; primary skin closure was achieved in 51.8%. Postresection skin margin was clear in 75.4%. Of those with inadequate skin margins, 56.7% opted for further treatment, 43.4% for observation. Recurrence rates were 2.6% and 13.8%, respectively (P = 0.106). Overall recurrence rate was 5.5%. Conclusions. HNBCC commonly presented as pigmented ulcers over the nose of elderly female patients in our locality. Adequate tumour excision ± reconstruction offered the best chance of cure. Reexcision of those with inadequate skin margins improved local tumour control.
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18
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Basal cell carcinoma of the head and neck. J Skin Cancer 2010; 2011:496910. [PMID: 21209728 PMCID: PMC3010650 DOI: 10.1155/2011/496910] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 08/17/2010] [Accepted: 10/19/2010] [Indexed: 11/18/2022] Open
Abstract
Basal cell carcinoma (BCC) is a malignant neoplasm derived from nonkeratinizing cells that originate from the basal layer of the epidermis and is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor. BCC occurs most frequently at sun-exposed sites, with the head and neck being common areas. Tumors can be classified as nodular, superficial, morpheaform, infiltrating, metatypic, and fibroepithelioma of Pinkus. Several treatment options such as surgical excision and nonsurgical procedures are available. The choice of treatment should be determined based on the histological subtype of a lesion, cost, its size and location, patient age, medical condition of the patient, treatment availability, and the patient's wishes. The aim of any therapy selected for BCC treatment involving the head and neck is to ensure complete removal, the preservation of function, and a good cosmetic outcome.
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19
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Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer among Orientals. Data on this malignancy is lacking in Malaysia, prompting a retrospective study to determine the clinical characteristics in the skin clinic, Sarawak General Hospital between 2000 and 2008. METHODS Demographic data and clinical features of 64 histopathologically proven BCC from 43 patients were retrieved. Statistical analysis was performed comparing the clinical characteristics based on the region of involvement and gender. RESULTS The mean age of presentation was 60.9 years. Male to female ratio was 1.05. Majority of the patients were Chinese (44.2%) followed by Malays (32.6%), Bidayuhs (14.0%) and Ibans (6.9%). Nodular BCC accounted for 95.3% of cases while 4.7% were superficial BCC. All the nodular BCC were pigmented. Ulceration was noted in 18%. There were 82.8% of BCC on the head and neck region and 17.2% on the trunk and limb region. BCC on the latter region were larger (mean 35.0 cf. 14.4 mm, p < 0.001) and ulcerated (45.5% cf. 11.3%, p = 0.01). Superficial BCC were also more frequently encountered in this region (18.2% cf. 1.9%, p = 0.02). Compared to women, men had larger BCC (mean 21.1 cf. 13.3 mm, p = 0.03) and kept them for a longer duration (mean 21.6 cf. 13.3 months, p = 0.04). CONCLUSION Clinical characteristics of BCC in Sarawak were similar to other Asian studies. Additionally, BCC on the trunk and limbs and in men were larger, ulcerative and long standing warranting better efforts for earlier detection.
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Affiliation(s)
- Felix Boon Bin Yap
- Department of Dermatology, Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia.
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20
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Clinical and histopathologic findings of basal cell carcinomas on completely covered anatomical sites of the body. EUROPEAN JOURNAL OF PLASTIC SURGERY 2010. [DOI: 10.1007/s00238-010-0446-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Lesiak A, Slowik-Rylska M, Rogowski-Tylman M, Sysa-Jedrzejowska A, Norval M, Narbutt J. Risk factors in Central Poland for the development of superficial and nodular basal cell carcinomas. Arch Med Sci 2010; 6:270-5. [PMID: 22371758 PMCID: PMC3281351 DOI: 10.5114/aoms.2010.13907] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 10/02/2008] [Accepted: 10/22/2008] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the last decades the number of skin carcinomas has dramatically increased, which is mainly connected with changes in lifestyle, especially with common use of artificial light sources such as sunbeds. Basal cell carcinoma (BCC) is the most common form of skin cancer in white populations. Basal cell carcinomas are divided into subtypes, depending on their clinical picture and histology. The main groups are nodular (nBCC) and superficial (sBCC) ones. The major recognized risk factors for basal cell carcinoma (BCC) are exposure to chronic and intermittent burning doses of sunlight. Other risk factors leading to the development of the nBCC and sBCC subtypes of BCC are not well established. MATERIAL AND METHODS An analysis of 123 patients with either nBCC or sBCC, living in Lodz, Poland, regarding various intrinsic and environmental parameters was undertaken following the histological diagnosis of BCC. RESULTS No statistical differences were observed between the BCC subtype and sex, age, hair colour, eye colour, smoking, family history of skin cancer, occupation, or past episodes of sunburn. While sBCCs tended to occur on unexposed body sites in phototype I/II subjects who mainly avoided direct sunlight, nBCCs tended to occur on sun-exposed body sites in phototype III subjects who were frequently in direct sunlight. CONCLUSIONS Thus the development of particular BCC subtypes is partially dependent on phototype and personal sun behaviour.
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Affiliation(s)
| | | | | | | | - Mary Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland
| | - Joanna Narbutt
- Department of Dermatology, Medical University of Lodz, Lodz, Poland
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Chen CC, Chen CL. Clinical and histopathologic findings of superficial basal cell carcinoma: A comparison with other basal cell carcinoma subtypes. J Chin Med Assoc 2006; 69:364-71. [PMID: 16970272 DOI: 10.1016/s1726-4901(09)70274-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in white populations. However, BCC is uncommon in Taiwan, and its subtype, superficial BCC (SBCC), is even less common. The characteristics of these 2 cancers in Taiwanese have never been analyzed before. Our purpose was to study the clinical and histopathologic features of SBCC in comparison with other BCC subtypes (OBCC). METHODS Thirty Taiwanese patients with SBCC from 1974 to 2003 were retrospectively examined at Taipei Veterans General Hospital. We analyzed the age, gender distribution, site of the lesions, clinical appearance, incidence of metastasis, and the proportion of secondary amyloid deposits. We then compared these features with those of 354 Taiwanese patients with OBCC. RESULTS Compared with the black pearly appearance of OBCC, erythematous plaques or patches with multiple tiny blackish papules were the most common clinical appearance of SBCC. Tumor size was significantly larger than OBCC (p < 0.05). The trunk was the most common area where SBCC arose. Conversely, OBCC occurred mainly on the head and neck (p < 0.001). Females were significantly younger than males in both SBCC and OBCC groups (p < 0.05). The frequency of secondary amyloid deposits was lower in SBCC than OBCC (p < 0.05). CONCLUSION The unique findings of SBCC would help to classify the subtypes of BCC. The mechanism of development of each subtype is worth further investigation in the future.
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Affiliation(s)
- Chih-Chiang Chen
- Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taiwan, ROC
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Abstract
Basal cell carcinoma (BCC) is the most common form of cancer in Caucasians. This study was undertaken to define clinical features of BCC treated by surgical excision in Turkish patients. One-hundred and ninety-eight patients with 216 BCC, all treated by surgical excision, were studied prospectively. Age and sex distribution, personal and family history, skin type, site and size of the lesions, clinical type of the lesions, status of surgical margins and incidence of recurrence were analyzed. The male to female ratio was 9:10, and the average age of the patients was 64.5 years. Of the tumors, 91.5% occurred on the head and neck. There was also personal and/or family history of cancer in 24.8% of our cases. Of all BCC treated, 83.8% had a noduloulcerative clinical appearance. The vast majority of our patients were Fitzpatrick type 3 (53.0%) and type 2 (41.5%). There were seven recurrences after follow-up periods varying between 3 months and 2 years. In conclusion, clinical characteristics of BCC in Turkish patients have both similarities and differences compared with other countries.
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Affiliation(s)
- Yiğit Ozer Tiftikcioğlu
- Plastic and Reconstructive Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
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Tiftikcioğlu YO, Karaaslan O, Aksoy HM, Aksoy B, Koçer U. Basal cell carcinoma in Turkey. J Dermatol 2006; 32:946-50. [PMID: 16471455 DOI: 10.1111/j.1346-8138.2005.tb00879.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Accepted: 07/14/2005] [Indexed: 11/28/2022]
Abstract
Basal cell carcinoma (BCC) is the most common form of cancer in Caucasians. This study was undertaken to define the clinical features of BCC treated by surgical excision in Turkish patients. A group of 198 patients with 216 BCCs, all treated by surgical excision, were studied prospectively. The age and sex distribution, personal and family histories of the patients, skin type, sites and sizes of the lesions, clinical types of the lesions, status of the surgical margins, and incidences of recurrence were analyzed. The male to female ratio was 0.9, and the average age of the patients was 64.5 years. Of the tumors, 91.5% occurred on the head and neck. There were also personal and/or family histories of cancer in 24.8% of our cases. Of all BCCs treated, 83.8% had a noduloulcerative clinical appearance. The vast majority of our patients were Fitzpatrick type 3 (53.0%) and type 2 (41.5%). There were seven recurrences after follow-up periods varying between three months and two years. In conclusion, the clinical characteristics of BCC in Turkish patients have both similarities and differences compared to those of other countries.
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Affiliation(s)
- Yiğit Ozer Tiftikcioğlu
- Plastic and Reconstructive Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
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Rawashdeh MA, Matalka I. Basal cell carcinoma of the maxillofacial region: site distribution and incidence rates in Arab/Jordanians, 1991 to 2000. J Oral Maxillofac Surg 2004; 62:145-9. [PMID: 14762745 DOI: 10.1016/j.joms.2003.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We sought to estimate the incidence rates and disease trends for basal cell carcinoma (BCC) of the maxillofacial region in the civilian population in the north of Jordan. METHODS A retrospective study was undertaken of all BCCs of the maxillofacial region diagnosed at the Regional Histopathology Department during the period 1991 to 2000. RESULTS The age-adjusted rate for BCC in 1992 was 6.3:100,000, and in 2000, it was 8.8:100,000. However, several disease trends were observed during the study period. Age- and gender-specific incidence rates apparently increased during the study period. Lesions were most commonly seen on the nose, facial skin, and periorbital skin. The proportions of BCC in the various anatomic sites that were reviewed remained fairly constant over the 10-year period. CONCLUSIONS In comparison with populations from other geographic areas, the incidence of BCC in the north of Jordan is low. Further studies are needed to identify behavioral and environmental factors that contribute to the development of BCC and to determine whether changes in diagnostic practices could account for the apparent rise in the incidence of this tumor in this population in recent years.
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Affiliation(s)
- Ma'amon A Rawashdeh
- Jordan University of Science and Technology and King Abdullah University Hospital, Irbid, Jordan.
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Smith DR, Sheu HM, Hsieh FS, Lee YL, Chang SJ, Guo YL. Prevalence of skin disease among nursing home patients in southern Taiwan. Int J Dermatol 2002; 41:754-9. [PMID: 12452997 DOI: 10.1046/j.1365-4362.2002.01425.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Continuing advances in medical care and nutrition have prolonged the lifespan and expanded the elderly demographic world-wide. Despite increasing elderly populations within Taiwanese nursing homes, there has been a lack of dermatologic surveys, and the prevalence of skin conditions within this group is unknown. METHODS To establish the prevalence of skin disease within nursing homes in southern Taiwan, we undertook a dermatologic and epidemiologic investigation of 398 patients in Tainan City, southern Taiwan, between November 1999 and February 2000. RESULTS This study revealed that more than half of all nursing home patients suffered from fungus (61.6%) and xerosis (58.3%), while other pruritic skin diseases, such as dermatitis and scabies, were less prevalent at 7.3% and 3.3%, respectively. Risk factors for fungal infection included bedridden status (risk ratio (RR), 1.2; 95% confidence interval (CI), 1.1-1.4) and male gender (RR, 1.2; 95% CI, 1.0-1.3). Xerosis was statistically correlated with an age range of 80-90 years (RR, 1.2; 95% CI, 1.0-1.4) when compared to other age ranges. Current scabies diagnosis was strongly associated with a previous history of scabies (RR, 8.9; 95% CI, 1.7-21.1). CONCLUSIONS Our study provides clinically relevant data regarding the prevalence of skin diseases in institutionalized Taiwanese patients for the first time. The results suggest that scabies persists within some nursing homes despite treatment, and that some patients remain undiagnosed. The dermatologic needs of these Taiwanese patients are not currently being satisfied.
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Affiliation(s)
- Derek Richard Smith
- Faculty of Sciences, The University of Southern Queensland, Toowoomba, Australia
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The effects of sunlight on the skin of Asians. ACTA ACUST UNITED AC 2001. [DOI: 10.1016/s1568-461x(01)80039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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