1
|
Riva HR, Yoon T, Mohammad K Shalabi M, Hussain A, Khachemoune A. Benefits and challenges of Mohs micrographic surgery for human papilloma virus-associated cutaneous malignancies: a systematic review. Arch Dermatol Res 2024; 316:617. [PMID: 39276166 DOI: 10.1007/s00403-024-03364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 08/16/2024] [Accepted: 08/26/2024] [Indexed: 09/16/2024]
Abstract
Mohs micrographic surgery is the gold standard for treating many types of skin cancer, particularly skin cancers of high-risk areas such as the face, genitalia, and digits, due to its tissue-sparing technique and low recurrence rates. The use of Mohs micrographic surgery for human papilloma virus-associated cutaneous malignancies has yet to be explored in a systematic review. The authors sought to assess outcomes including recurrence rates of Mohs micrographic surgery for human papilloma virus-associated cutaneous malignancies. PubMed was searched for the use of Mohs micrographic surgery in types of human papilloma virus-associated cutaneous malignancies. After application of exclusion and inclusion criteria, 33 articles were included. 700 cases from 33 studies were included. Overall recurrence rate following Mohs micrographic surgery was 39/478 (8.2%) at a mean follow-up time of 51.5 months. Recurrence rate for nail unit/digit squamous cell carcinoma was 10/103 (9.7%) at mean follow-up of 47.6 months. Recurrence rate for penile squamous cell carcinoma was 15/181 (8.3%) at mean follow-up of 45.9 months. Recurrence rate for Bowen's disease in extragenital areas was 11/189 (5.9%) at mean follow-up of 59.7 months. Patients overall reported satisfactory functional and cosmetic results. Mohs micrographic surgery demonstrates low recurrence rates and excellent functional and cosmetic outcomes in the treatment of human papilloma virus-associated cutaneous malignancies.
Collapse
Affiliation(s)
- Hannah R Riva
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Teresa Yoon
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | | | - Aamir Hussain
- Galaria Plastic Surgery & Dermatology, Chantilly, VA, USA
| | - Amor Khachemoune
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA.
| |
Collapse
|
2
|
Petzold A, Wessely A, Steeb T, Berking C, Heppt MV. Efficacy of interventions for cutaneous squamous cell carcinoma in situ (Bowen's disease): A systematic review and meta-analysis of proportions. J Eur Acad Dermatol Venereol 2024. [PMID: 39148440 DOI: 10.1111/jdv.20267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/11/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma in situ (Bowen's disease) is a precancerous condition confined to the epidermis of the skin. Despite the critical need for effective interventions to halt its progression, there remains a notable shortage of comprehensive data comparing the efficacy of various therapeutic approaches. OBJECTIVES This systematic review and meta-analysis endeavour to compare the different efficacies of interventions by investigating and synthesizing data from numerous trials. METHODS A pre-defined protocol was registered in PROSPERO (CRD42021242224, registration date: 16 April 2021). Systematic searches in Medline, Embase and Central, along with manual trial register searches, identified studies reporting lesion clearance rates (LCR), participant clearance rates (PCR) or recurrence rates (date of last search: 12 June 2024). Quality assessment followed guidelines from the National Heart, Lung, and Blood Institute (NHLBI). After the study arms were categorized into treatment groups and groups of study quality, the proportions were pooled using the generalized linear mixed model (GLMM) as meta-analytical method. RESULTS A comprehensive inclusion of 71 studies facilitated an evaluation of 3783 lesions for LCR, 1225 patients for PCR, 4073 lesions for lesion recurrence rates (LRR) and 740 patients for participant recurrence rates (PRR). Surgery demonstrated the highest LCR and PCR (0.97, 95% confidence interval (CI): 0.90-0.99) and the lowest LRR (0.04, 95% CI: 0.02-0.07). CONCLUSIONS This study provides a thorough overview of reported efficacy outcomes for practice-relevant interventions for Bowen's disease. Surgery outperformed other treatments for Bowen's disease. For the other intervention groups, it was not possible to show clear differences in effectiveness: LCR, PCR, LRR and PRR showed various treatment rankings, and the comparability was restricted by different numbers of studies between treatment groups and outcome measures, methodical and clinical heterogeneity. Further high-quality studies are needed to investigate practice-relevant interventions for Bowen's disease.
Collapse
Affiliation(s)
- Anne Petzold
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Anja Wessely
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Theresa Steeb
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Comprehensive Cancer Center Erlangen - European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
- Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| |
Collapse
|
3
|
Scurtu LG, Scurtu F, Dumitrescu SC, Simionescu O. Squamous Cell Carcinoma In Situ-The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat. Diagnostics (Basel) 2024; 14:1799. [PMID: 39202286 PMCID: PMC11353497 DOI: 10.3390/diagnostics14161799] [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: 07/24/2024] [Revised: 08/07/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen's disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. The classification of precancerous lesions of the vulva and penis has undergone multifarious transformations due to variations in clinical and histopathological characteristics. Presently, erythroplasia of Queyrat is categorized as a clinical variant of penile intraepithelial neoplasia (PeIN). The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. Aceto-white testing demonstrates a notably high negative predictive value for genital precancerous lesions. Histopathological examination represents the gold-standard diagnosis in VIN and PeIN, while p16 and p53 immunostainings alongside HPV testing provide crucial diagnostic clues. The histopathologic features, degree of differentiation, and associations with lichen planus, lichen sclerosus, and HPV guide the selection of conservative treatments or surgical excision.
Collapse
Affiliation(s)
- Lucian G. Scurtu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.G.S.); (S.C.D.)
- Department of Dermatology I, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Francesca Scurtu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.G.S.); (S.C.D.)
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | - Sebastian Catalin Dumitrescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.G.S.); (S.C.D.)
- Department of Dermatology I, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Olga Simionescu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.G.S.); (S.C.D.)
- Department of Dermatology I, Colentina Clinical Hospital, 020125 Bucharest, Romania
| |
Collapse
|
4
|
Stamer DK, Goldsmith J, Dodge LE, Tahan SR. Invasion risk of cutaneous squamous cell carcinoma in situ by histological subtype: a retrospective cohort study. J Clin Pathol 2024:jcp-2024-209608. [PMID: 38839089 DOI: 10.1136/jcp-2024-209608] [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: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
AIMS Cutaneous squamous cell carcinoma in situ (SCCis) can be classified histopathologically into four subtypes: full-thickness (FT), hypertrophic actinic keratosis (HAK), Bowenoid, and acantholytic types. 3%-5% of SCCis lesions progress to invasive squamous cell carcinoma (iSCC), however progression risk by subtype has not been assessed. Aim one of this study is to quantitatively assess the risk of iSCC associated with each histological subtype of SCCis. Aim two is to evaluate if the histological grade of iSCC differs among subtypes of the associated SCCis. METHODS The pathology information system at our institution was queried for cutaneous SCCis cases with and without associated iSCC from 2020 to 2022. The study group consisted of 65 cases of SCCis with associated iSCC and control group 65 randomly selected cases of SCCis without invasion. For each case SCCis subtype was classified as FT, HAK, Bowenoid or acantholytic type. iSCCs were classified as low grade if well to moderately differentiated (LG) and high grade (HG) if moderately to poorly differentiated. RESULTS iSCC was most often associated with HAK-type SCCis, followed by acantholytic and FT-type SCCis, with Bowenoid type rarely associated with iSCC. 41% (14/34) of iSCCs associated with HAK-type SCCis were HG compared with 84% (21/25) for FT-type SCCis. CONCLUSIONS iSCC is most often associated with HAK-type SCCis, followed by acantholytic and FT-types, and rarely with Bowenoid type. HG invasive SCC is most often associated with FT-type, and LG with HAK-type SCCis. Stratifying SCCis by subtype can inform clinical management.
Collapse
Affiliation(s)
| | - Joshua Goldsmith
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Laura E Dodge
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Steven R Tahan
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Cozma EC, Banciu LM, Celarel AM, Soare E, Srichawla BS, Kipkorir V, Găman MA. Molecular mechanisms of human papilloma virus related skin cancers: A review. Medicine (Baltimore) 2024; 103:e38202. [PMID: 38787972 PMCID: PMC11124606 DOI: 10.1097/md.0000000000038202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/19/2024] [Indexed: 05/26/2024] Open
Abstract
The human papillomavirus (HPV) belongs to the Papillomaviridae family of viruses which includes small, double-stranded DNA viral agents. Approximately 90% of HPV infections occur asymptomatically and resolve spontaneously. However, infection with high-risk viral strains can lead to the development of preneoplastic lesions, with an increased propensity to become cancerous. The location of these malignancies includes the oral cavity, cervix, vagina, anus, and vulva, among others. The role of HPV in carcinogenesis has already been demonstrated for the aforementioned neoplasia. However, regarding skin malignancies, the mechanisms that pinpoint the role played by HPV in their initiation and progression still elude our sight. Until now, the only fully understood mechanism of viral cutaneous oncogenesis is that of human herpes virus 8 infection in Kaposi sarcoma. In the case of HPV infection, however, most data focus on the role that beta strains exhibit in the oncogenesis of cutaneous squamous cell carcinoma (cSCC), along with ultraviolet radiation (UVR) and other environmental or genetic factors. However, recent epidemiological investigations have highlighted that HPV could also trigger the onset of other non-melanocytic, for example, basal cell carcinoma (BCC), and/or melanocytic skin cancers, for example, melanoma. Herein, we provide an overview of the role played by HPV in benign and malignant skin lesions with a particular focus on the main epidemiological, pathophysiological, and molecular aspects delineating the involvement of HPV in skin cancers.
Collapse
Affiliation(s)
- Elena-Codruta Cozma
- University of Medicine and Pharmacy of Craiova, Craiova, Romania
- Elias University Emergency Hospital, Bucharest, Romania
| | | | | | - Elena Soare
- Elias University Emergency Hospital, Bucharest, Romania
| | | | - Vincent Kipkorir
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| |
Collapse
|
6
|
Antonetti P, Pellegrini C, Caponio C, Bruni M, Dragone L, Mastrangelo M, Esposito M, Fargnoli MC. Photodynamic Therapy for the Treatment of Bowen's Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome. Biomedicines 2024; 12:795. [PMID: 38672152 PMCID: PMC11048221 DOI: 10.3390/biomedicines12040795] [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: 02/23/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3-5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.
Collapse
Affiliation(s)
- Paolo Antonetti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Cristina Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Chiara Caponio
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Manfredo Bruni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Lorenzo Dragone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Mirco Mastrangelo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
| | - Maria Esposito
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| |
Collapse
|
7
|
Zengin HB, Tan PH, Liu R, Smoller BR. 'Eczematous' dermatitis of the nipple: clinical and histopathological differential diagnosis of Paget disease. Pathology 2024; 56:300-312. [PMID: 38307774 DOI: 10.1016/j.pathol.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 02/04/2024]
Abstract
The nipple can be affected by many malignant and benign entities. A wide variety of diseases including Paget disease, atopic dermatitis and nipple candidiasis can cause eczema-like changes in the nipple. In cases of diagnostic uncertainty, tissue sampling may be indicated. A true eczematous lesion, such as atopic dermatitis, typically shows a spongiotic dermatitis pattern. Paget disease, on the other hand, presents with infiltration of the nipple epidermis by neoplastic cells. The presence of atypical cells scattered in the epidermis in a pagetoid pattern opens up a histopathological differential diagnosis encompassing squamous cell carcinoma in situ and malignant melanoma, among others. Immunohistochemistry is commonly used to render a diagnosis. The objective of this article is to discuss Paget disease and highlight relevant clinical and histopathological differential diagnoses.
Collapse
Affiliation(s)
- Hatice B Zengin
- University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, Rochester, NY, USA.
| | - Puay Hoon Tan
- Luma Medical Centre, Pathology, Royal Square Medical Centre, Singapore
| | - Regina Liu
- University of Rochester Medical Center, Department of Dermatology, Rochester, NY, USA
| | - Bruce R Smoller
- University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, Rochester, NY, USA; University of Rochester Medical Center, Department of Dermatology, Rochester, NY, USA
| |
Collapse
|
8
|
Ahmady S, Nelemans PJ, Kelleners-Smeets NWJ, Arits AHMM, de Rooij MJM, Kessels JPHM, Essers BAB, Mosterd K. Surgical excision versus topical 5% 5-fluorouracil and photodynamic therapy in treatment of Bowen's disease: A multicenter randomized controlled trial. J Am Acad Dermatol 2024; 90:58-65. [PMID: 37666424 DOI: 10.1016/j.jaad.2023.08.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/22/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Randomized controlled trials comparing the effectiveness of 5-fluorouracil cream, methylaminolevulinate photodynamic therapy (MAL-PDT) and surgical excision in patients with Bowen's disease are lacking. METHODS In this multicenter noninferiority trial, patients with a histologically proven Bowen's disease of 4-40 mm were randomly assigned to excision with 5 mm margin, 5% 5-fluorouracil cream twice daily for 4 weeks, or 2 sessions of MAL-PDT with 1 week interval. The primary outcome was the proportion of patients with sustained clearance at 12 months after treatment. A noninferiority margin of 22% was used. RESULTS Between May 2019 and January 2021, 250 patients were randomized. The proportion of patients with sustained clearance was 97.4% (75/77) after excision, 85.7% (66/77) after 5-fluorouracil, and 82.1% (64/78) after MAL-PDT. Absolute differences were -11.7% (95% CI -18.9 to -4.5; P = .0049) for 5-fluorouracil versus excision and -15.4% (95% CI -23.1 to -7.6; P = .00078) for MAL-PDT versus excision. Both noninvasive treatments significantly more often led to good or excellent cosmetic outcome. CONCLUSIONS Based on our predefined noninferiority margin of 22%, 5-fluorourcail is noninferior to excision and associated with better cosmetic outcome. For MAL-PDT noninferiority to excision cannot be concluded. Therefore, 5-fluorouracil should be preferred over excision and MAL-PDT in treatment of Bowen's disease.
Collapse
Affiliation(s)
- Shima Ahmady
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Patty J Nelemans
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Nicole W J Kelleners-Smeets
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Aimee H M M Arits
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Dermatology, Catharina Hospital, Eindhoven, the Netherlands
| | | | | | - Brigitte A B Essers
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| |
Collapse
|
9
|
Khachemoune A, Juan HY, Singh R. Shedding new light on actinic keratoses and squamous cell carcinoma in situ. JAAPA 2024; 37:1-6. [PMID: 38128142 DOI: 10.1097/01.jaa.0000995696.23729.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
ABSTRACT Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. This article describes the causes, epidemiology, and characteristics of suspicious premalignant squamous cell lesions so that clinicians can identify these lesions and refer patients for specialist treatment as appropriate.
Collapse
Affiliation(s)
- Amor Khachemoune
- Amor Khachemoune practices at the Brooklyn (N.Y.) Veterans Affairs Medical Center and SUNY Downstate's Department of Dermatology, also in Brooklyn, N.Y. Hui Yu Juan is a fourth-year medical student at the Virginia Commonwealth University School of Medicine in Richmond, Va. At the time this article was written, Rohan Singh was a third-year medical student at the University of Maryland School of Medicine in Baltimore, Md. Dr. Singh now is a first-year resident at the University of Maryland Medical Center's Department of Internal Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | |
Collapse
|
10
|
Kim Y, Khan AH, Papachristou C, Decker A, Lawrence N. Squamous Cell Carcinoma in Situ Achieves Tumor Clearance in More Mohs Stages Than Invasive Squamous Cell Carcinoma. Dermatol Surg 2023; 49:1104-1107. [PMID: 38019009 DOI: 10.1097/dss.0000000000004022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Squamous cell carcinoma in situ (SCCIS) has more subclinical lateral extension than invasive squamous cell carcinomas (SCC). OBJECTIVE To determine whether it takes a greater number of Mohs stages for clearance of SCCIS compared with SCC and whether the difference in final defect size and clinical size is larger in SCCIS than SCC. METHODS All Mohs micrographic surgery cases of SCCIS and SCC performed between January 2011 and December 2021 were identified. Number of Mohs stages were recorded and difference in final defect size and initial clinical size were calculated for SCCIS and SCC. RESULTS 4,363 cases were included, 1,066 SCCIS and 3,297 invasive SCC. The initial clinical size, final defect size, and the size difference were similar between SCCIS and SCC groups. However, SCCIS underwent more Mohs stages to achieve tumor clearance than invasive SCCs (1.5 ± 0.7 vs 1.4 ± 0.7 respectively, p < .001). In fact, 71% of SCCs were cleared after 1 Mohs stage compared with 61.1% of SCCIS. CONCLUSION These findings support that SCCIS has more subclinical lateral extension and therefore is appropriate for Mohs surgery.
Collapse
Affiliation(s)
- Yesul Kim
- Division of Dermatologic Surgery, Department of Medicine, Cooper University Health, Camden, NJ
- Division of Dermatologic Surgery, Department of Medicine, Rowan University, Camden, NJ
| | - Amaal H Khan
- Division of Dermatologic Surgery, Department of Medicine, Rowan University Medical School, Camden, NJ
| | | | - Ashley Decker
- Division of Dermatologic Surgery, Department of Medicine, Cooper University Health, Camden, NJ
- Division of Dermatologic Surgery, Department of Medicine, Rowan University, Camden, NJ
| | - Naomi Lawrence
- Division of Dermatologic Surgery, Department of Medicine, Cooper University Health, Camden, NJ
- Division of Dermatologic Surgery, Department of Medicine, Rowan University, Camden, NJ
| |
Collapse
|
11
|
Fougelberg J, Backman E, Hasselquist E, Sjöholm A, Claeson M, Paoli J. Cryosurgery versus curettage for intraepidermal carcinoma: A randomized controlled trial. J Eur Acad Dermatol Venereol 2023; 37:2370-2377. [PMID: 37437124 DOI: 10.1111/jdv.19322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/12/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Cryosurgery is a common destructive treatment method for intraepidermal carcinoma (IEC) above the knee. Curettage alone is a simple, non-aggressive and inexpensive treatment method commonly used on benign skin lesions. However, only one study has assessed curettage for treatment of IEC. OBJECTIVE We aimed to (1) compare the effectiveness of cryosurgery (standard method) to curettage (experimental method) for treatment of IEC in regard to overall clearance rates at 1-year follow-up, and (2) investigate whether wound healing times differed between the treatment groups. METHODS In this randomized and controlled, non-inferiority trial, adult patients with one or more IEC with a diameter of 5-20 mm, located above the knee and suitable for destructive treatment were recruited from Sahlgrenska University Hospital (Gothenburg, Sweden). Lesions were randomized to treatment with either cryosurgery or curettage. Wound healing was assessed by a nurse after 4-6 weeks and through self-report forms. Overall clearance was assessed by a dermatologist after 1 year. RESULTS In total, 183 lesions in 147 patients were included, with 93 lesions randomized to cryosurgery and 90 to curettage. Eighty-eight (94.6%) of the lesions in the cryosurgery group and 71 (78.9%) in the curettage group showed an overall clearance at the 1-year follow-up visit (p = 0.002). The non-inferiority analysis was inconclusive. Curettage resulted in both shorter self-reported wound healing times (mean time 3.1 vs. 4.8 weeks, p < 0.001) and a larger proportion of healed wounds after 4-6 weeks (p < 0.001). CONCLUSIONS Cryosurgery and curettage both result in high clearance rates for treatment of IEC, but cryosurgery is significantly more effective. On the other hand, curettage may result in shorter wound healing times.
Collapse
Affiliation(s)
- J Fougelberg
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Backman
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - E Hasselquist
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Sjöholm
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Claeson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
12
|
Kim YS, Park GS, Bang CH, Chung YJ. Genomic landscape of multiple Bowen's disease using whole-exome sequencing. J Dermatol 2023; 50:397-400. [PMID: 36117467 DOI: 10.1111/1346-8138.16584] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
The genomic landscape of Bowen's disease (BD), with multiple manifestations, has not yet been determined. This study aimed to investigate the genomic alterations in multiple BD. We performed whole-exome sequencing of BD lesions (n = 9) and matched germlines collected from three patients with multiple (≥3) BD to detect somatic and germline mutations. We found a median of 64 somatic mutations in each sample (range 20-267). UV-signature mutations accounted for 64.9% (median, range 26.0%-82.1%) of point mutations. Putative driver mutations were found in five BDs (RB1 p.R445*, ARID2 p.R274*, TP53 p.Y163D/p.Y205D/p.R342*, KMT2C p.R4549C) but not in the other four lesions. Somatic mutations were not shared between multiple BD lesions collected from the same patient, indicating a different clonal origin. We also found no known pathogenic germline mutations in cancer-related genes. The mutational signature analysis revealed that UV signatures (SBS7a/7b) and age-related signatures (SBS1/5) were the main active signatures. Copy number alterations (CNAs) were found in two BDs: one with extensive CNA regions (21.7% of the genome), including driver genes (PIK3CA/SOX2/TP63 and MYC gain, and CDKN2A loss), and the other with 1q gain. Our study revealed that multiple BD lesions harbor distinct genomic landscapes, suggesting that they have different risks of malignant progression.
Collapse
Affiliation(s)
- Yoon-Seob Kim
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,IRCGP, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Gyeong Sin Park
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yeun-Jun Chung
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,IRCGP, College of Medicine, The Catholic University of Korea, Seoul, South Korea.,Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
13
|
Sharma A, Birnie AJ, Bordea C, Cheung ST, Mann J, Morton CA, Salim A, Hasan ZU, Hashme M, Mansour Kiaee Z, Mohd Mustapa MF, Exton LS. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma in situ (Bowen disease) 2022. Br J Dermatol 2023; 188:186-194. [PMID: 36763868 DOI: 10.1093/bjd/ljac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/11/2022] [Accepted: 09/26/2022] [Indexed: 01/09/2023]
Abstract
The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of squamous cell carcinoma in situ (SCC in situ). The document aims to: offer an appraisal of all relevant literature up to 13th August 2021, focusing on any key developments; address important, practical clinical questions relating to the primary guideline objective; provide guideline recommendations and if appropriate research recommendations.
Collapse
Affiliation(s)
- Ashish Sharma
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
| | - Andrew J Birnie
- East Kent Hospitals University NHSFT, Canterbury CT1 3NG, UK
| | | | | | - Jasmine Mann
- University Hospitals of Derby and Burton NHSFT, Derby DE22 3NG, UK
| | - Colin A Morton
- NHS Forth Valley, Stirling Community Hospital, Stirling FK8 2AU, UK
| | - Asad Salim
- Tallaght Hospital, Dublin D24 NR0A, Ireland
| | | | - Maria Hashme
- Willan House, British Association of Dermatologists, London W1T 5HQ, UK
| | | | | | - Lesley S Exton
- Willan House, British Association of Dermatologists, London W1T 5HQ, UK
| |
Collapse
|
14
|
Chen T, Ma DL. Annular scaly erythematous plaque on the right chest. BMJ 2022; 379:e071572. [PMID: 36593548 DOI: 10.1136/bmj-2022-071572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tian Chen
- Department of Dermatology, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China
| | - Dong-Lai Ma
- Department of Dermatology, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100730, China
| |
Collapse
|
15
|
Palaniappan V, Karthikeyan K. Bowen's Disease. Indian Dermatol Online J 2022; 13:177-189. [PMID: 35287414 PMCID: PMC8917478 DOI: 10.4103/idoj.idoj_257_21] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022] Open
Abstract
Bowen's disease (BD) is an in-situ squamous cell carcinoma of epidermis. The etiology of BD is multifactorial with high incidence among Caucasians. BD is common in photo-exposed areas of skin, but other sites can also be involved. Lesions are usually solitary. The morphology of BD differs based on age of the lesion, site of origin, and the degree of keratinization. BD is considered as the "lull before the storm," which precedes an overt squamous cell carcinoma. Histopathology is the gold standard diagnostic modality to confirm the diagnosis. Immunohistochemistry, dermoscopy, and reflectance confocal microscopy are the adjuvant modalities used in the diagnosis of BD. The treatment depends on various factors like site, size, immune status, patient's age, esthetic outcome, etc. The available therapeutic modalities include topical chemotherapy, surgical modalities, light-based modalities, and destructive therapies. It requires a combined effort of dermatologist, oncosurgeon, and plastic surgeon to plan and execute the management in various presentations of BD.
Collapse
Affiliation(s)
- Vijayasankar Palaniappan
- Department of Dermatology, Venereology and Leprosy, Sri ManakulaVinayagar Medical College and Hospital, Puducherry, India
| | - Kaliaperumal Karthikeyan
- Department of Dermatology, Venereology and Leprosy, Sri ManakulaVinayagar Medical College and Hospital, Puducherry, India
| |
Collapse
|
16
|
Mokoala KM, Lawal IO, Vorster M, Sathekge MM. Radionuclide Therapy of Skin Cancers and Bowen's Disease Using A Specially Designed Rhenium Cream. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00067-3] [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] Open
|
17
|
Xue WL, Ruan JQ, Liu HY, He HX. Efficacy of Photodynamic Therapy for the Treatment of Bowen's Disease: A Meta-Analysis of Randomized Controlled Trials. Dermatology 2021; 238:542-550. [PMID: 34657035 DOI: 10.1159/000519319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 08/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Photodynamic therapy is an established treatment option for Bowen's disease. Our meta-analysis was aimed at evaluating the efficacy and recurrence of photodynamic therapy or other topical treatments (5-fluorouracil, cryotherapy) and of photodynamic therapy alone or in combination with other therapies (ablative fractional CO2 laser or plum-blossom needle) for the treatment of Bowen's disease. METHODS Trials that met our inclusion criteria were identified from PubMed, EMBASE, Web of Science, and Cochrane Library databases, and meta-analyses were conducted with RevMan V.5.4. The risk of bias was estimated with the Cochrane Collaboration's risk of bias tools. Complete response rate, recurrence, pain/visual analogue scale score, cosmetic outcome, and adverse events were considered as outcomes. RESULTS Of the 2,439 records initially retrieved, 8 randomized controlled trials were included in this meta-analysis. According to our analyses, photodynamic therapy exhibited a significantly higher complete response rate (RR = 1.36, 95% CI [1.01, 1.84], I2 = 86%, p = 0.04), less recurrence (RR = 0.53, 95% CI [0.30, 0.95], I2 = 0%, p = 0.03), and better cosmetic outcome (RR = 1.34, 95% CI [1.15, 1.56], I2 = 0%, p = 0.0002) compared with other treatments. Moreover, there was a significant difference between the complete response rate of photodynamic therapy combined with ablative fractional CO2 laser and that of photodynamic therapy (RR = 1.85, 95% CI [1.38, 2.49], I2 = 0%, p < 0.0001). Photodynamic therapy combined with ablative fractional CO2 laser or plum-blossom needle also showed significantly less recurrence (RR = 0.21, 95% CI [0.09, 0.51], I2 = 0%, p = 0.0005) and a lower visual analogue scale score (RR = 0.51, 95% CI [0.06, 0.96], I2 = 0%, p = 0.03) than photodynamic therapy alone. However, there was no significant difference in the complete response rate between photodynamic therapy combined with ablative continuous CO2 laser and photodynamic therapy combined with ablative fractional CO2 laser (RR = 1.00, 95% CI [0.54, 1.86], I2 not applicable, p = 1.00). CONCLUSIONS This meta-analysis shows that photodynamic therapy can be used in the treatment of Bowen's disease with better efficacy, less recurrence, and better cosmetic outcomes than cryotherapy and 5-FU. Some methods, including ablative fractional CO2 laser, can be applied in combination with photodynamic therapy to improve efficacy. However, which laser-assisted photodynamic therapy scheme has the most advantages in the treatment of Bowen's disease warrants further exploration.
Collapse
Affiliation(s)
- Wen-Li Xue
- Department of Dermatology, the First Hospital of Shanxi Medical University, Tai Yuan City, China
| | - Jia-Qi Ruan
- School of Medicine, Zhejiang University, Hangzhou, China
| | - Hong-Ye Liu
- Department of Dermatology, the First Hospital of Shanxi Medical University, Tai Yuan City, China
| | - Hong-Xia He
- Department of Dermatology, the First Hospital of Shanxi Medical University, Tai Yuan City, China
| |
Collapse
|
18
|
Tokez S, Wakkee M, Louwman M, Noels E, Nijsten T, Hollestein L. Assessment of Cutaneous Squamous Cell Carcinoma (cSCC) In situ Incidence and the Risk of Developing Invasive cSCC in Patients With Prior cSCC In situ vs the General Population in the Netherlands, 1989-2017. JAMA Dermatol 2021; 156:973-981. [PMID: 32609322 DOI: 10.1001/jamadermatol.2020.1988] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The incidence rates of keratinocyte cancer are increasing globally; however, the incidence rates of cutaneous squamous cell carcinoma (cSCC) in situ and the risk of developing subsequent invasive cSCC remain unknown. Objective To estimate annual population-based age-standardized incidence rates of histopathologically confirmed cSCC in situ stratified by sex, age, and body site and to assess the risk of developing invasive cSCC among patients with cSCC in situ compared with the general population. Design, Setting, and Participants This nationwide epidemiological population-based cohort study used cancer registry data to identify all patients with a first incident of histopathologically confirmed cSCC in situ between January 1, 1989, and December 31, 2017. In addition, all patients with cSCC in situ who subsequently had a first incident of invasive cSCC were identified up to June 11, 2019. Data were analyzed between March 18 and November 12, 2019. Main Outcomes and Measures Age-standardized incidence rates per year for cSCC in situ, standardized to the 2013 edition of the European Standard Population, were calculated by sex, age, and body site. Cumulative risks, standardized incidence ratios, and absolute excess risks were calculated to assess the risk of invasive cSCC in patients with cSCC in situ compared with the general population. Results In this population-based cohort study of 88 754 patients with a first incident of cSCC in situ between January 1, 1989, and December 31, 2017, 58.8% were women; the median age was 75 years (interquartile range [IQR], 67-82 years) for women and 73 years (IQR, 65-80 years) for men. Increasing incidence rates were observed, with the highest incidence rates in 2017 among women in general (71.7 cases per 100 000 person-years) and among men 80 years and older (540.9 cases per 100 000 person-years). The most common body site among women was the face (15.9 cases per 100 000 person-years) and among men was the scalp and/or neck (12.3 cases per 100 000 person-years). After 5 years of follow-up, among patients with cSCC in situ, the cumulative risk of developing an invasive cSCC at any anatomic location was 11.7% (95% CI, 11.6%-11.9%) in men and 6.9% (95% CI, 6.8%-7.0%) in women (P < .001). The standardized incidence ratio was highest in the first year of follow-up among both men (16.6; 95% CI, 15.7-17.5) and women (15.1; 95% CI, 14.2-16.1). Conclusions and Relevance This study reports the first nationwide incidence rates of cSCC in situ to date. The increasing incidence rates of cSCC in situ and the high risk of developing invasive cSCC among patients with cSCC in situ may increase the health care burden associated with precursors of keratinocyte cancer and highlight the need to include cutaneous skin cancer precursor lesions when exploring policies to address skin cancer care.
Collapse
Affiliation(s)
- Selin Tokez
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marieke Louwman
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Eline Noels
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Loes Hollestein
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| |
Collapse
|
19
|
Zhong S, Zhang R, Mei X, Wang L. Efficacy of photodynamic therapy for the treatment of Bowen’s disease: An updated systematic review and meta-analysis of randomized controlled trials. Photodiagnosis Photodyn Ther 2020; 32:102037. [DOI: 10.1016/j.pdpdt.2020.102037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/14/2020] [Accepted: 09/25/2020] [Indexed: 12/01/2022]
|
20
|
Shi L, Zhou C, Li C, Hu C, Wang P, Zhang G, Wang X. Ulceration occurring after ALA-PDT combined with plum-blossom needle percussion for the treatment of pretibial Bowen's disease: A case report. Photodiagnosis Photodyn Ther 2020; 32:101958. [PMID: 32818644 DOI: 10.1016/j.pdpdt.2020.101958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/18/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Abstract
We used 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) combined with plum-blossom needle (PBN) on a 3.5 cm × 3.0 cm pretibial region to treat an elderly woman suffering from Bowen's disease (BD). Before the application of ALA, the PBN was inserted 3-4 times vertically starting at 5 cm above the lesion. Then, 20 % 5-ALA cream was applied with an incubation time of 3.5 h. A semiconductor laser at a wavelength of 635 nm was used to illuminate the lesion at 100 J/cm2 using 60 mW/cm2. A total of three sessions of ALA-PDT were performed at 2-3-week intervals, thus removing the lesion of BD. However, a 1.5 cm × 1.0 cm ulceration occurred 2 weeks after the third session when the PBN was used. Therefore, PBN percussion or other methods for promoting ALA penetration should be carefully applied to avoid ulceration, especially on the sites with less subcutaneous tissue.
Collapse
Affiliation(s)
- Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chu Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chunxiao Li
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chan Hu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|
21
|
Liang DG, Soliman B, Cha J. A rare case of Bowen’s disease of the nipple: Literature review and management pathway. Breast J 2020; 26:1234-1238. [DOI: 10.1111/tbj.13824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Derek G. Liang
- Department of Plastic, Reconstructive and Burns Surgery Royal North Shore Hospital St Leonards NSW Australia
| | - Bishoy Soliman
- Department of Plastic, Reconstructive and Burns Surgery Royal North Shore Hospital St Leonards NSW Australia
| | - Jeon Cha
- Department of Plastic, Reconstructive and Burns Surgery Royal North Shore Hospital St Leonards NSW Australia
| |
Collapse
|
22
|
Trends in the Incidence of Bowen Disease Based on a Single-Center Study in the Netherlands. Dermatol Surg 2020; 45:1353-1358. [PMID: 31274528 DOI: 10.1097/dss.0000000000001980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Incidence trends of nonmelanoma skin cancer show an increase. Few data have been published about the incidence of Bowen disease (BD). Three previous studies, conducted more than 15 years ago in North America, found large variation in incidence rates in Caucasians, and trends over longer periods have never been studied. OBJECTIVE To estimate the incidence of BD in a Caucasian population in Northern Europe (Maastricht, the Netherlands) between 2003 and 2013. METHODS Primary and histologically confirmed BD, diagnosed in Maastricht, the Netherlands, in the years 2003, 2008, and 2013, was retrieved from a pathology database. Age-standardized and sex-specific incidence rates per 100,000 inhabitants were calculated by using the age distribution of the European standard population of 2013. RESULTS A statistically significant increase in the annual age-standardized incidence rates per 100,000 people was found from 8.1 (95% confidence interval [CI] 3.7-12.5) in 2003 to 68.9 (95% CI 57.2-80.7) in 2013 (p < .001). For women, there was an increase from 7.7/100,000 (95% CI 2.0-13.4) in 2003 to 76.8/100,000 (95% CI 60.2-93.5) in 2013, respectively (p < .001). An increase from 8.8/100,000 (95% CI 1.8-15.9) in 2003 to 59.2/100,000 men (95% CI 42.8-75.6) in 2013 (p < .001) was found. CONCLUSION These findings suggest an increase in the annual age-standardized incidence rates in BD.
Collapse
|
23
|
Mishra J, Pandia A, Padhy A, Mahapatra M, Mohapatra J, Nayak B, Parija J, Giri S. Bowen's disease of vulva: A rare case of vulvar premalignant disorder. CLINICAL CANCER INVESTIGATION JOURNAL 2020. [DOI: 10.4103/ccij.ccij_61_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
24
|
Mishra NK, Jain A, Patel G, Nurbhai SM. A Rare Disease of the Breast: Bowen’s Disease. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_223_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractBowen’s disease is also known as squamous cell carcinoma in situ and it occurs predominantly in older patients. Etiological factors for Bowen’s disease include ultraviolet light mainly, and in some cases, carcinogenic agents such as arsenic coal tar and petroleum products. It is frequently seen in sun-exposed area; however, other unexposed area can also be affected in few patients. Among the unexposed area, this disease affecting breast is a rare entity. These lesions are erythematous with raised, well-defined borders and a scaly appearance that may be confused with psoriasis. They present with an indolent history, having been present for years with slow growth. Histopathologically, there is atypia of the full thickness of the epidermis without dermal invasion. Progression to squamous carcinoma is slow, but 5% ultimately develop dermal invasion. Treatment generally requires complete excision for both definitive diagnosis and to rule out invasion and cure.
Collapse
Affiliation(s)
| | - Atul Jain
- Department of Surgery, ESI PGIMSR, New Delhi, India
| | - Gaurav Patel
- Department of Surgery, ESI PGIMSR, New Delhi, India
| | | |
Collapse
|
25
|
Enhancement of Photodynamic Therapy for Bowen's Disease Using Plum-Blossom Needling to Augment Drug Delivery. Dermatol Surg 2018; 44:1516-1524. [DOI: 10.1097/dss.0000000000001608] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
26
|
Zhao Z, Tay TKY, Agrawal R, Tan VKM, Tan YY, Tan PH. Intraepidermal malignancy in breast skin: A tale of two tumours. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
27
|
Kim HJ, Song KH. Ablative fractional laser–assisted photodynamic therapy provides superior long-term efficacy compared with standard methyl aminolevulinate photodynamic therapy for lower extremity Bowen disease. J Am Acad Dermatol 2018; 79:860-868. [DOI: 10.1016/j.jaad.2018.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/01/2018] [Accepted: 05/20/2018] [Indexed: 11/27/2022]
|
28
|
Towery LE, Merritt J, Konda S, Motaparthi K. Treatment of squamous cell carcinoma in situ of the lower extremity: a study of patient-reported outcomes. GIORN ITAL DERMAT V 2018; 154:114-119. [PMID: 30375210 DOI: 10.23736/s0392-0488.18.06107-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Squamous cell carcinoma in situ (SCCis) commonly presents on lower extremities (LE). Treatment may include local destruction, excision, or topical therapy, with efficacy supported by evidence. To date, evaluations of patient reported outcomes (PRO) following treatment of SCCis of the LE are lacking. Additionally, treatment of SCCis on the LE may be complicated by delayed wound healing and an increased risk of surgical site complications. METHODS This retrospective study evaluated PRO following treatment of SCCis of the LE. Healing time, satisfaction with aesthetic appearance of scar, interference with activities of daily living (ADLs), perceived tumor recurrence, and future preference for the same treatment were evaluated via patient survey. The recurrence rates associated with these therapies and anatomic site were also examined. RESULTS From February 2014 to February 2017, 152 patients met inclusion criteria; 62 of these patients completed the 5-question survey on PRO. Local destruction was the most commonly selected therapy. When comparing local destruction, excision, and topical therapy, there was no statistically significant difference in PRO regarding healing time, aesthetic appearance of scar, interference in ADLs, or likelihood of choosing the same treatment. There was also no significant difference in recurrence rates between therapies. Biopsy-proven and clinical recurrence rates in a sample of 152 patients were only 4.0% and 1.3%, respectively, and the overall rate of complications was 5.9%. CONCLUSIONS Taken together with the low recurrence rates of the three treatment categories, these PRO suggest that excisional, destructive, and topical therapies are all effective and appropriate for management of SCCis of the LE. Thus, therapeutic selection can be based on the relevant clinical context and patient preference.
Collapse
Affiliation(s)
- Laura E Towery
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jesalyn Merritt
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Sailesh Konda
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA -
| |
Collapse
|
29
|
Kitahara M, Hozumi Y, Watanabe A, Iijima T. Bowen's Disease of the Nipple. Case Rep Oncol 2018; 11:609-614. [PMID: 30323750 PMCID: PMC6180276 DOI: 10.1159/000492382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 07/23/2018] [Indexed: 11/28/2022] Open
Abstract
Bowen's disease is a type of intraepidermal squamous cell carcinoma that commonly develops in areas of the skin exposed to sunlight, such as the scalp, trunk, and limbs. Although development of Bowen's disease in other sites, such as the nipple, is extremely rare, we herein report our experience with one such case. A 76-year-old female presented to our hospital with complaints of right nipple pruritus. We diagnosed Bowen's disease via nipple skin biopsy, and the patient underwent right nipple resection. The deep tissue margin was positive for malignancy; therefore, the patient subsequently underwent right partial mastectomy. Histopathology revealed tumor cells inside the lactiferous ducts, but the resection margin was negative for malignancy. Bowen's disease of the nipple may progress from the skin to the lactiferous ducts. Clinical findings can be used to evaluate lesion progression and determine the necessary extent of skin and mammary gland resection.
Collapse
Affiliation(s)
- Miyuki Kitahara
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Yasuo Hozumi
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Akie Watanabe
- Department of Breast Surgery, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Tatsuo Iijima
- Department of Pathology, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| |
Collapse
|
30
|
Matsumoto AJ, Schmitt AR, Skelley LM, Baum CL. Factors Influencing Squamous Cell Carcinoma In Situ Recurrence and Implications for Treatment Choice. Dermatol Surg 2018; 44:613-620. [DOI: 10.1097/dss.0000000000001400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Albibas AA, Rose-Zerilli MJ, Lai C, Pengelly RJ, Lockett GA, Theaker J, Ennis S, Holloway JW, Healy E. Subclonal Evolution of Cancer-Related Gene Mutations in p53 Immunopositive Patches in Human Skin. J Invest Dermatol 2018; 138:189-198. [DOI: 10.1016/j.jid.2017.07.844] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/12/2017] [Accepted: 07/25/2017] [Indexed: 11/27/2022]
|
32
|
Minocha R, Damian DL, Halliday GM. Melanoma and nonmelanoma skin cancer chemoprevention: A role for nicotinamide? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:5-12. [DOI: 10.1111/phpp.12328] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Rashi Minocha
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
| | - Diona L. Damian
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
- Melanoma Institute Australia; North Sydney NSW Australia
| | - Gary M. Halliday
- Discipline of Dermatology; Bosch Institute; Central Clinical School; University of Sydney; Sydney NSW Australia
- Dermatology; Sydney Cancer Centre; Royal Prince Alfred Hospital; Sydney NSW Australia
| |
Collapse
|
33
|
Squamous Cell Carcinoma In Situ Upstaged to Invasive Squamous Cell Carcinoma: A 5-Year, Single Institution Retrospective Review. Dermatol Surg 2017; 43:698-703. [PMID: 28060173 DOI: 10.1097/dss.0000000000001028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Shave biopsy may not be able to accurately distinguish squamous cell carcinoma in situ (SCCIS) from invasive squamous cell carcinoma (SCC). Information on the incidence of biopsy-proven SCCIS upstaged to SCC after a more complete histologic examination is limited. OBJECTIVE To determine the incidence and clinical risk factors associated with upstaging the biopsy diagnosis of SCCIS into invasive SCC based on findings during Mohs micrographic surgery (MMS). METHODS All MMS cases of SCCIS performed between March 2007 and February 2012 were identified, MMS operative notes were examined, and invasive dermal components were confirmed by the MMS slide review. Upstaged SCCIS was defined as biopsy-diagnosed SCCIS subsequently found to be an invasive SCC during MMS. RESULTS From 566 cases with the preoperative diagnosis of SCCIS, 92 (16.3%) cases were SCCIS upstaged to SCC. Location of ears, nose, lips, and eyelids, preoperative diameter >10 mm, and biopsy report mentioning a transected base were significant predictors of upstaged SCCIS. CONCLUSION Considering the possibility that over 16% of SCCIS may be truly invasive SCC, biopsy-proven SCCIS should be treated adequately with margin-assessed treatment modalities such as surgical excision or Mohs surgery when indicated.
Collapse
|
34
|
Zaar O, Fougelberg J, Hermansson A, Gillstedt M, Wennberg-Larkö AM, Paoli J. Effectiveness of photodynamic therapy in Bowen's disease: a retrospective observational study in 423 lesions. J Eur Acad Dermatol Venereol 2017; 31:1289-1294. [PMID: 28190258 DOI: 10.1111/jdv.14164] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/30/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a well-known technique that is often used for treating superficial precancerous and cancerous skin lesions. However, only a handful of studies, with a relatively small number of treated lesions, have been carried out on the effectiveness of PDT for Bowen's disease (BD). OBJECTIVES This study aimed to assess the effectiveness and recurrence risk of PDT in the treatment of BD. The secondary objectives were to determine what factors affected the response rates and the cosmetic result of the treatment. METHOD In this retrospective observational study, the electronic patient charts at Sahlgrenska University Hospital (SUH) in Gothenburg, Sweden, were searched to find all patients diagnosed with BD who were treated with PDT between 1 January 2002 and 31 December 2014. Data were collected regarding clinical response at the first follow-up visit, recurrences during later follow-up visits and other relevant patient and tumour characteristics. RESULTS In total, 423 BD lesions in 335 patients were included in the study. The mean FU duration was 11.2 months (range 0.2-151 months). The complete response rate at the first FU visit was 77.5% for all BD lesions. During later FU visits, another 60 recurrences were observed, which resulted in a recurrence rate of 18.3%. Thus, the overall clearance rate after FU was 63.4% for all BD lesions. Significant risk factors for unsuccessful treatment in this study were large lesion size (>2 cm) and a single PDT session. CONCLUSION This study shows that PDT is a relatively effective treatment modality for BD.
Collapse
Affiliation(s)
- O Zaar
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Fougelberg
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Hermansson
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M Gillstedt
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A-M Wennberg-Larkö
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Paoli
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
35
|
Swindell WR, Sarkar MK, Liang Y, Xing X, Gudjonsson JE. Cross-Disease Transcriptomics: Unique IL-17A Signaling in Psoriasis Lesions and an Autoimmune PBMC Signature. J Invest Dermatol 2016; 136:1820-1830. [PMID: 27206706 DOI: 10.1016/j.jid.2016.04.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/29/2016] [Accepted: 04/12/2016] [Indexed: 11/30/2022]
Abstract
Transcriptome studies of psoriasis have identified robust changes in mRNA expression through large-scale analysis of patient cohorts. These studies, however, have analyzed all mRNA changes in aggregate, without distinguishing between disease-specific and nonspecific differentially expressed genes (DEGs). In this study, RNA-seq meta-analysis was used to identify (1) psoriasis-specific DEGs altered in few diseases besides psoriasis and (2) nonspecific DEGs similarly altered in many other skin conditions. We show that few cutaneous DEGs are psoriasis specific and that the two DEG classes differ in their cell type and cytokine associations. Psoriasis-specific DEGs are expressed by keratinocytes and induced by IL-17A, whereas nonspecific DEGs are expressed by inflammatory cells and induced by IFN-γ and tumor necrosis factor. Peripheral blood mononuclear cell-derived DEGs were more psoriasis specific than cutaneous DEGs. Nonetheless, peripheral blood mononuclear cell DEGs associated with major histocompatibility complex class I and natural killer cells were commonly downregulated in psoriasis and other autoimmune diseases (e.g., multiple sclerosis, sarcoidosis, and juvenile rheumatoid arthritis). These findings demonstrate "cross-disease" transcriptomics as an approach to gain insights into the cutaneous and noncutaneous psoriasis transcriptomes. This highlighted unique contributions of IL-17A to the cytokine network and uncovered a blood-based gene signature that links psoriasis to other diseases of autoimmunity.
Collapse
Affiliation(s)
- William R Swindell
- Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.
| | - Mrinal K Sarkar
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yun Liang
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Xianying Xing
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA
| | | |
Collapse
|
36
|
Histopathologic assessment of depth of follicular invasion of squamous cell carcinoma (SCC) in situ (SCCis): Implications for treatment approach. J Am Acad Dermatol 2016; 74:356-62. [DOI: 10.1016/j.jaad.2015.09.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 12/22/2022]
|
37
|
Knackstedt TJ, Brennick JB, Perry AE, Li Z, Quatrano NA, Samie FH. Frequency of squamous cell carcinoma (SCC) invasion in transected SCCin situreferred for Mohs surgery: the Dartmouth−Hitchcock experience. Int J Dermatol 2015; 54:830-3. [DOI: 10.1111/ijd.12867] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/28/2014] [Accepted: 09/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas J. Knackstedt
- Section of Dermatology; Department of Surgery; Dartmouth−Hitchcock Medical Center; Lebanon NH USA
| | | | - Ann E. Perry
- Department of Pathology; Dartmouth−Hitchcock Medical Center; Lebanon NH USA
| | - Zhongze Li
- Biostatistics Shared Resource; Norris Cotton Cancer Center; Dartmouth College; Lebanon NH USA
| | - Nicola A. Quatrano
- Section of Dermatology; Department of Surgery; Dartmouth−Hitchcock Medical Center; Lebanon NH USA
| | - Faramarz H. Samie
- Section of Dermatology; Department of Surgery; Dartmouth−Hitchcock Medical Center; Lebanon NH USA
| |
Collapse
|
38
|
|
39
|
Dhaou BB, Rachdi I, Mously RB, Aydi Z, Daoud F, Baili L, Mokhtar I, Boussema F. Bowen’s disease in a patient with Primary Sjögren’s syndrome: A case report and a review of the literature. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2015. [DOI: 10.1016/j.jdds.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
40
|
Westers-Attema A, Lohman BG, van den Heijkant F, Nelemans PJ, Winnepenninckx VJ, Kelleners-Smeets NW, Mosterd K. Photodynamic Therapy in Bowen's Disease: Influence of Histological Features and Clinical Characteristics on Its Success. Dermatology 2014; 230:55-61. [DOI: 10.1159/000366500] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022] Open
|
41
|
Micali G, Lacarrubba F, Nasca MR, Ferraro S, Schwartz RA. Topical pharmacotherapy for skin cancer: part II. Clinical applications. J Am Acad Dermatol 2014; 70:979.e1-12; quiz 9912. [PMID: 24831325 DOI: 10.1016/j.jaad.2013.12.037] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 12/15/2013] [Accepted: 12/20/2013] [Indexed: 01/11/2023]
Abstract
The purpose of the paper is to provide an in-depth, evidence-based analysis of the clinical use of topical treatments for skin cancer. A comprehensive review of topical drugs has been performed, including 5-fluorouracil, imiquimod, diclofenac, ingenol mebutate, retinoids, resiquimod, piroxicam, dobesilate, and betulinic acid. The evaluated studies were rated according to their level of evidence level (I-V), as indicated by recent guidelines for evidence-based medicine, The Oxford 2011 Levels of Evidence. Therapeutic response is generally related to tumor type, extent, and localization, and also to patient compliance. Careful patient selection is required in order to achieve the desired goal of complete tumor clearance.
Collapse
Affiliation(s)
| | | | | | | | - Robert A Schwartz
- Department of Dermatology, Rutgers University, New Jersey Medical School, Newark, New Jersey
| |
Collapse
|
42
|
Squamous-cell Carcinoma Arises in Red Parts of Multicolored Tattoo within Months. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2014; 2:e114. [PMID: 25289308 PMCID: PMC4174140 DOI: 10.1097/gox.0000000000000055] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 01/02/2014] [Indexed: 11/09/2022]
Abstract
Summary: Skin cancer formation is on the rise. Only a few case reports, which focus on skin cancer being caused by tattoos, have been published so far. Our aim is to determine whether skin cancer occurrence can be triggered by tattoos. In our presented case, a squamous-cell carcinoma developed inside of the red areas of a multicolored tattoo within months. Furthermore, surgical removal of the cancerously mutated skin area without mutilating the design of the tattoo was challenging. Due to widespread skin alterations in other red areas of the tattoo, those affected skin regions were surgically removed and split-skin grafting was performed. After 1-year follow-up period, the patient has been tumor free. Squamous-cell carcinoma is an unusual reaction that can occur in tattoos. Nevertheless, this skin cancer should be included in the list of cutaneous complications related to tattooing.
Collapse
|
43
|
Ko D, Kim K, Song K. A randomized trial comparing methyl aminolaevulinate photodynamic therapy with and without Er:YAG ablative fractional laser treatment in Asian patients with lower extremity Bowen disease: results from a 12-month follow-up. Br J Dermatol 2014; 170:165-72. [DOI: 10.1111/bjd.12627] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/26/2022]
Affiliation(s)
- D.Y. Ko
- Skin Cancer Center; Department of Dermatology; College of Medicine; Dong-A University; Dong dae sin-dong Seo-gu Busan 602-715 Korea
| | - K.H. Kim
- Skin Cancer Center; Department of Dermatology; College of Medicine; Dong-A University; Dong dae sin-dong Seo-gu Busan 602-715 Korea
| | - K.H. Song
- Skin Cancer Center; Department of Dermatology; College of Medicine; Dong-A University; Dong dae sin-dong Seo-gu Busan 602-715 Korea
| |
Collapse
|
44
|
Abstract
BACKGROUND Bowen's disease is the clinical term for in situ squamous cell carcinoma of the skin. Cutaneous lesions present as largely asymptomatic, well-defined, scaly erythematous patches on sun-exposed skin. In general, people with Bowen's disease have an excellent prognosis because the disease is typically slow-growing and responds favourably to treatment. Lesions are persistent and can be progressive, with a small potential (estimated to be 3%) to develop into invasive squamous cell carcinoma. The relative effectiveness of the available treatments is not known for Bowen's disease, and this review attempts to address which is the most effective intervention, with the least side-effects, for cutaneous Bowen's disease. OBJECTIVES To assess the effects of therapeutic interventions for cutaneous Bowen's disease. SEARCH METHODS We searched the following databases up to September 2012: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library (2012, Issue 9), MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1806), and LILACS (from 1982). We also searched online trials registers. We checked the bibliographies of included and excluded studies and reviews, for further references to relevant randomised controlled trials (RCTs). SELECTION CRITERIA We included all randomised controlled trials assessing interventions used in Bowen's disease, preferably histologically proven. DATA COLLECTION AND ANALYSIS Two authors independently carried out study selection and assessment of methodological quality. MAIN RESULTS The primary outcome measures were complete clearance of lesions after the first treatment cycle and recurrence rate at 12 months. Our secondary outcomes included the number of lesions that cleared after each treatment cycle, the number of treatment cycles needed to achieve clearance, the recurrence rates at > 12 months, cosmetic outcome, quality of life assessment, and adverse outcomes as reported by both participant and clinician.We included 9 studies, with a total of 363 participants. One study demonstrated statistically significantly greater clearance of lesions of Bowen's disease with MAL-PDT (methyl aminolevulinate with photodynamic therapy) when compared with placebo-PDT (RR (risk ratio) 1.68, 95% CI (confidence interval) 1.12 to 2.52; n = 148) or cryotherapy (RR 1.17, 95% CI 1.01 to 1.37; n = 215), but there was no significant difference when MAL-PDT was compared to 5-FU (5-fluorouracil). One study demonstrated statistically significantly greater clearance of lesions with ALA-PDT (5-aminolevulinic acid with photodynamic therapy) versus 5-FU (RR 1.83, 95% CI 1.10 to 3.06; n = 66), but no statistically significant difference in recurrence rates at 12 months (RR 0.33, 95% CI 0.07 to 1.53).Cryotherapy showed no statistically significant difference in clearance rates (RR 0.99, 95% CI 0.78 to 1.26) or recurrences at 1 year (RR 1.48, 95% CI 0.53 to 4.17) when compared to 5-FU in 1 study of 127 participants.One study compared imiquimod to placebo and demonstrated statistically significantly greater clearance rates in the imiquimod group (9/15 lesions) compared to placebo (0/16) (Fisher's Exact P value < 0.001). The imiquimod group did not report any recurrences at 12 months, but at 18 months, 2/16 participants in the placebo group had developed early invasive squamous cell carcinoma. AUTHORS' CONCLUSIONS Overall, there has been very little good-quality research on treatments for Bowen's disease. There is limited evidence from single studies to suggest MAL-PDT is an effective treatment. Although cosmetic outcomes appear favourable with PDT, five-year follow-up data are needed. Significantly more lesions cleared with MAL-PDT compared to cryotherapy. No significant difference in clearance was seen when MAL-PDT was compared with 5-FU, but one study found a significant difference in clearance in favour of ALA-PDT when compared to 5-FU. There was no significant difference in clearance when cryotherapy was compared to 5-FU.The lack of quality data for surgery and topical cream therapies has limited the scope of this review to one largely about PDT studies. The age group, number, and size of lesions and site(s) affected may all influence therapeutic choice; however, there was not enough evidence available to provide guidance on this. More studies are required in the immunosuppressed populations as different therapeutic options may be preferable. Specific recommendations cannot be made from the data in this review, so we cannot give firm conclusions about the comparative effectiveness of treatments.
Collapse
Affiliation(s)
- Fiona J Bath-Hextall
- School of Nursing, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, UK.
| | | | | | | |
Collapse
|
45
|
Corrêa LHL, Popoaski CP, Custódio G, Gonçalves CO, Trevisol FS. Epidemiology of squamous cell carcinomas among the population attended in the city of Tubarão, Brazil, between 1999 and 2009. An Bras Dermatol 2013; 87:572-7. [PMID: 22892771 DOI: 10.1590/s0365-05962012000400009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 10/15/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Skin cancer is the most common neoplasm in Brazil, with increasing incidence in recent decades. Data on the incidence of squamous cell carcinoma are scarce in southern Santa Catarina. OBJECTIVE To establish epidemiological data on squamous cell carcinoma in Tubarão, State of Santa Catarina. METHODS A cross-sectional review was conducted on anatomical pathology reports, positive for squamous cell carcinoma of the skin, found in the local laboratories. A convenience sampling method was used for data collection, since all the pathology reports from the local laboratories between 1999 and 2009 were included. The collected variables included year of diagnosis, age, gender, city of origin, tumor site, histological type and subtype, lesion size, margin involvement and relapse. RESULTS In total, 1,437 case reports were identified, most frequently in individuals between 70 and 79 years old. Patient morbidity was 69.5 per 100,000 population for the year 1999, and 136.7 per 100,000 population for the year 2009, which represents a 50 percent increase. The face was the most affected area and the most common histological subtype was the well-differentiated tumor. CONCLUSION There were 1,437 reports of squamous cell carcinoma of the skin between 1999 and 2009, with a significant increase in patient morbidity. There was an association between male gender and location on the lip and ear, and between females and the occurrence of squamous cell carcinoma of the skin on the nose, and upper and lower limbs. There was a prevalence of margin involvement after resection in 18% of lesions.
Collapse
|
46
|
Lee KC, Higgins HW, Lajevardi N, Cruz AP, Dufresne RG. Characteristics of squamous cell carcinoma in situ of the ear treated using Mohs micrographic surgery. Dermatol Surg 2012; 38:1951-5. [PMID: 22989104 DOI: 10.1111/j.1524-4725.2012.02581.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mohs micrographic surgery (MMS) is used to treat squamous cell carcinoma in situ (SCCIS) for tissue conservation. OBJECTIVE To examine characteristics of patients with SCCIS of the external ear treated using MMS. METHODS A retrospective review from 2005 to 2011. RESULTS We identified 173 cases of SCCIS of the ear. The population was 94% male (p < .01), with a mean age of 71. Eight percent (n = 13) of tumors were recurrent after prior treatment. Recurrent tumors occurred exclusively in men and were associated with larger initial size (p = .05), more layers for clearance p = .059), and larger final defect size (p = .01). Tumors with larger initial area were independently associated with older age (p < .01). Complexity of repair was independently associated with more layers (p < .01), larger initial area (p = .01), and larger final area (p = .02). Sex did not affect repair type. CONCLUSION SCCIS of the ear predominantly affects men in our referral base of 85% to 90% private patients and 10% to 15% veterans. Recurrent tumors were associated with larger initial size and subclinical spread of tumor. Primary tumors on average required 1.6 layers, validating the utility of MMS in this population in delineating the subclinical spread of SCCIS of the ear.
Collapse
Affiliation(s)
- Kachiu C Lee
- Department of Dermatology, Warren Alpert School of Medicine, Brown University, 593 Eddy Street, Providence, RI 02903, USA.
| | | | | | | | | |
Collapse
|
47
|
Perrotta RE, Giordano M, Malaguarnera M. Non-melanoma skin cancers in elderly patients. Crit Rev Oncol Hematol 2011; 80:474-80. [PMID: 21602051 DOI: 10.1016/j.critrevonc.2011.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 01/10/2011] [Accepted: 04/21/2011] [Indexed: 01/25/2023] Open
Abstract
Non-melanoma skin cancers are a common reality worldwide. The principal cause that determines the occurrence of these diseases is the exposition of the sun, which principally causes an alteration in the immune system. Therefore, it is possible that other forms of innate or acquired alterations of the immune system could favor the occurrence of non-melanoma skin cancers. For example, several studies have demonstrated that immunosenescence creates an immunosuppressive state that encourages the development of malignances, and new discoveries have noted the importance of T cells and in particular of T regulatory cells (Treg) and T receptor CD28 in this mechanism. Similar results are obtained analyzing the effect of immunosuppressive drugs. The importance of the immune system and its alteration in the genesis of non-melanoma skin cancers is fundamental for the creation of a new therapeutic and less invasive approach.
Collapse
|
48
|
Nakano A, Watanabe D, Akita Y, Kawamura T, Tamada Y, Matsumoto Y. Treatment efficiency of combining photodynamic therapy and ionizing radiation for Bowen’s disease. J Eur Acad Dermatol Venereol 2011; 25:475-8. [DOI: 10.1111/j.1468-3083.2010.03757.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
49
|
Nagarajan P, Chin SS, Wang D, Liu S, Sinha S, Garrett-Sinha LA. Ets1 blocks terminal differentiation of keratinocytes and induces expression of matrix metalloproteases and innate immune mediators. J Cell Sci 2011; 123:3566-75. [PMID: 20930145 DOI: 10.1242/jcs.062240] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The transcription factor Ets1 is normally expressed in the proliferative layer of stratified epithelium, but expression of Ets1 is significantly upregulated in squamous cell carcinomas. How elevated levels of Ets1 impact tumor initiation and progression is not well understood. To determine the biological consequences of overexpression of Ets1, we developed a transgenic mouse model that allows induction of Ets1 expression in keratinocytes of stratified epithelium in a regulatable fashion. Induction of Ets1 during embryonic development results in a dramatic alteration in epidermal structure and function by suppressing the expression of multiple stratum corneum constituents, while at the same time inducing expression of EGF ligands, AP1 transcription factors and matrix metalloproteases. Interestingly, expression of certain immune-related genes, including defensins, chemokines and cytokines was increased as well, suggesting a possible role for immune dysregulation in the promotion of squamous dysplasia. Experiments using cultured mouse keratinocytes indicate that Ets1 can induce expression of some of these mediators in a cell-intrinsic fashion. Collectively, our data reveal that elevated expression of Ets1 has a much broader array of pro-tumorigenic effects on epithelial cells than previously appreciated.
Collapse
Affiliation(s)
- Priyadharsini Nagarajan
- Department of Biochemistry, Developmental Genomics Focus Group, Center of Excellence in Bioinformatics and Life Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA
| | | | | | | | | | | |
Collapse
|
50
|
Gong HS, Cho JH, Roh YH, Chung MS, Baek GH. Bone invasion by squamous cell carcinoma in situ (Bowen's disease) of the finger during treatment with imiquimod 5% cream: case report. J Hand Surg Am 2010; 35:999-1002. [PMID: 20378275 DOI: 10.1016/j.jhsa.2010.02.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 02/22/2010] [Accepted: 02/22/2010] [Indexed: 02/02/2023]
Abstract
Imiquimod 5% cream is known as an alternative treatment option for squamous cell carcinoma in situ (SCCIS), frequently termed Bowen's disease. Although imiquimod cream has been reported by many authors to treat SCCIS successfully, its efficacy and safety have not been fully established. The authors experienced a case in which ray amputation was necessary because of bone invasion by SCCIS in a finger being treated with imiquimod cream.
Collapse
Affiliation(s)
- Hyun Sik Gong
- Department of Orthopaedics, Hand and Upper Extremity Service, Seoul National University Bundang Hospital, Seongnam, Korea.
| | | | | | | | | |
Collapse
|