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Knecht-Gurwin K, Stefaniak AA, Chlebicka I, Szepietowski JC. Basal Cell Carcinoma: Comprehensive Review with Emphasis on Scar Tissue Manifestation and Post-Vaccination Incidence. Biomedicines 2024; 12:1769. [PMID: 39200233 PMCID: PMC11351840 DOI: 10.3390/biomedicines12081769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/03/2024] [Accepted: 08/04/2024] [Indexed: 09/02/2024] Open
Abstract
Basal cell carcinoma (BCC) arising within scar tissue is a rare but clinically significant phenomenon. This comprehensive review aims to provide a succinct overview of the current state of knowledge regarding the etiological factors, pathogenesis, clinical presentation, and management of BCC. This study constitutes a literature review pertaining to BCC, with a particular emphasis on BCC developing within scar tissue. It also provides a clinical case presentation of a patient who had developed BCC in a BCG post-vaccination scar and a review of analogous findings available in the existing literature. Despite the fact that an array of mechanisms play a role in injury-related BCC growth, the main mechanism remains ambiguous and yet to be elucidated. The review also includes a detailed description of the various therapeutic options available for BCC, ranging from surgical interventions to novel pharmacological treatments. By examining these intersections, the review seeks to elucidate the potential mechanisms, identify risk factors, and suggest considerations for clinical practice. The findings underscore the importance of vigilant dermatological assessment in patients with scar tissue and those recently vaccinated, aiming to improve early detection and optimize management strategies for BCC.
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Affiliation(s)
| | | | | | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chałubińskiego 1, 50-368 Wrocław, Poland; (K.K.-G.); (A.A.S.); (I.C.)
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Vinay K, Mehta H, Chatterjee D, Reddy A, Jain S, Narang T, Dogra S. Clinico-epidemiological characteristics and long-term surgical outcome of basal cell carcinoma treated with standard excision in patients of skin of colour: A retrospective study from Northern India. Indian J Dermatol Venereol Leprol 2024; 0:1-7. [PMID: 39152878 DOI: 10.25259/ijdvl_717_2023] [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: 07/13/2023] [Accepted: 12/09/2023] [Indexed: 08/19/2024]
Abstract
Background There is scant data on basal cell carcinoma (BCC) in Indian patients. This retrospective study was conducted to explore epidemiology, risk factors, clinical and pathological aspects, and long-term treatment outcomes of BCC in a cohort of North Indian patients. Methods Data about patients registered in the dermatosurgery clinic between 01 January 2017 and 31 December 2022 with a confirmed diagnosis of BCC was collected. Results Among the 83 patients, 56.6% were females, and the median age was 62 years (6-85 years). Most patients (81.9%) had a single BCC lesion, resulting in a total of 126 assessed lesions. The median size of BCC at presentation was 1.90 cm, with nodular BCC being the most common histopathological subtype (39.7%). Head and neck region involvement was observed in 82.5% of patients, with the malar region, nose, and periorbital region being the most commonly affected sites. Pigmentation was clinically evident in 45.2% of cases. Surgical excision was the primary treatment modality (71.1% of patients). The median follow-up duration was 40 months (6-57 months). Recurrence occurred in five patients, with a longer disease-free survival period observed in the surgically treated group (55.58 ± 0.98 months) compared to patients treated with medical or destructive therapies (43.6 ± 3.482 months) (p = 0.003). Conclusion The data from this hospital-based study indicated a slight predilection for females among North Indian patients with BCC, with most cases occurring during their seventh decade of life. The condition commonly occurred on sun-exposed areas such as the malar region and nose, with a high percentage of pigmented lesions. Recurrence following surgical excision was rare, and overall treatment outcomes were favourable.
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Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Hitaishi Mehta
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashwini Reddy
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sejal Jain
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Bazzacco G, Zalaudek I, Errichetti E. Dermoscopy to differentiate clinically similar inflammatory and neoplastic skin lesions. Ital J Dermatol Venerol 2024; 159:135-145. [PMID: 38650495 DOI: 10.23736/s2784-8671.24.07825-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being employed for both tumors and inflammatory diseases. Whereas distinction between neoplastic and inflammatory lesions is often straightforward based on clinical data, there are some scenarios that may be troublesome, e.g., solitary inflammatory lesions or tumors superimposed to a widespread inflammatory condition that may share macroscopic morphological findings. EVIDENCE ACQUISITION We reviewed the literature to identify dermoscopic clues to support the differential diagnosis of clinically similar inflammatory and neoplastic skin lesions, also providing the histological background of such dermoscopic points of differentiation. EVIDENCE SYNTHESIS Dermoscopic differentiating features were identified for 12 relatively common challenging scenarios, including Bowen's disease and basal cell carcinoma vs. psoriasis and dermatitis, erythroplasia of Queyrat vs. inflammatory balanitis, mammary and extramammary Paget's disease vs. inflammatory mimickers, actinic keratoses vs. discoid lupus erythematosus, squamous cell carcinoma vs. hypertrophic lichen planus and lichen simplex chronicus, actinic cheilitis vs. inflammatory cheilitis, keratoacanthomas vs. prurigo nodularis, nodular lymphomas vs. pseudolymphomas and inflammatory mimickers, mycosis fungoides vs. parapsoriasis and inflammatory mimickers, angiosarcoma vs granuloma faciale, and Kaposi sarcoma vs pseudo-Kaposi. CONCLUSIONS Dermoscopy may be of aid in differentiating clinically similar inflammatory and neoplastic skin lesions.
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Affiliation(s)
- Giulia Bazzacco
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy -
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Negrutiu M, Danescu S, Popa T, Focșan M, Vesa ȘC, Baican A. Advancements in Basal Cell Carcinoma Diagnosis: Non-Invasive Imaging and Multimodal Approach. J Clin Med 2023; 13:39. [PMID: 38202046 PMCID: PMC10779576 DOI: 10.3390/jcm13010039] [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: 11/11/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The aim of this study was to correlate the diagnostic criteria described in dermatoscopy, ultrasonography (US), ex vivo confocal microscopy, and histology to the most common subtypes of basal cell carcinoma (BCC). (2) Methods: We conducted a prospective study including 46 BCC cases, which were analyzed with dermatoscopy using the Delta 30 dermatoscope and Vidix 4.0 videodermoscope, with US using a high-resolution 20 MHz linear probe, with confocal microscopy, along with histopathological analysis. (3) Results: This study categorized BCC by histological subtype, with nodular being the most common (84.8%) and various other subtypes represented. US measurements of tumor thickness correlated strongly with the histopathological depth of invasion index (DI). Dermatoscopy analysis revealed significant associations between specific features and BCC subtypes. The DI was directly related to arborized vessels but inversely related to short, fine telangiectasias, maple-leaf-like areas, and spoke-wheel areas. The presence of ulceration was directly related to the DI. Confocal microscopy images exhibited several characteristics, including fluorescence, nuclear crowding, peripheral palisading, clefting, increased nuclear-cytoplasmic (N/C) ratio, and a "cauliflower-like" appearance. (4) Conclusion: The advanced detection of BCC through imagistic techniques like dermatoscopy, confocal microscopy, and ultrasound improves the diagnosis and may offer valuable insights for treatment in the future by evaluating lesion characteristics.
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Affiliation(s)
- Mircea Negrutiu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Sorina Danescu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Theodor Popa
- Department of Rehabilitation, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Monica Focșan
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271 Cluj-Napoca, Romania;
| | - Ștefan Cristian Vesa
- Department of Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Adrian Baican
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
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Janczura K, Chlebicka I, Stefaniak AA, Bieniek A, Szepietowski JC. Use of Dermatoscopy in Lesions Suspicious for Melanoma: Two Case Reports. Acta Derm Venereol 2023; 103:adv18654. [PMID: 37974485 PMCID: PMC10666062 DOI: 10.2340/actadv.v103.18654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 11/19/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Kevin Janczura
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland
| | - Iwona Chlebicka
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland
| | - Aleksandra A Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland
| | - Andrzej Bieniek
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, PL-50-368 Wroclaw, Poland.
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Conte S, Ghezelbash S, Nallanathan B, Lefrançois P. Clinical and Molecular Features of Morpheaform Basal Cell Carcinoma: A Systematic Review. Curr Oncol 2023; 30:9906-9928. [PMID: 37999140 PMCID: PMC10670319 DOI: 10.3390/curroncol30110720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, with a lifetime risk currently approaching up to 40% in Caucasians. Among these, some clinical and pathological BCC variants pose a higher risk due to their more aggressive biological behavior. Morpheaform BCC (morBCC), also known as sclerosing, fibrosing, or morpheic BCC, represents up to 5-10% of all BCC. Overall, morBCC carries a poorer prognosis due to late presentation, local tissue destruction, tumor recurrence, and higher frequency of metastasis. In this systematic review, we review the epidemiological, clinical, morphological, dermatoscopical, and molecular features of morBCC. After the title and abstract screening of 222 studies and the full-text review of 84 studies, a total of 54 studies met the inclusion criteria and were thus included in this review.
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Affiliation(s)
- Santina Conte
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada;
| | - Sarah Ghezelbash
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Bonika Nallanathan
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Philippe Lefrançois
- Cancer Axis, Lady Davis Institute for Medical Research, Montreal, QC H3T 1E2, Canada; (S.G.); (B.N.)
- Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
- Division of Dermatology, Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
- Division of Dermatology, Department of Medicine, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Asodaria P, Hunt S, Kazmi D, Fleming A, Malhotra R. Perifolliculitis mimicking basal cell carcinoma. Orbit 2023:1-3. [PMID: 37428952 DOI: 10.1080/01676830.2023.2227706] [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: 03/27/2023] [Accepted: 06/15/2023] [Indexed: 07/12/2023]
Abstract
We present a case of a periocular painless perifolliculitis clinically mimicking basal cell carcinoma (BCC), excised by margin-controlled excision. This case reminds readers that perifolliculitis as a response to rosacea can mimic BCC. The value of diagnostic biopsy and dermoscopy to support management planning and avoid unnecessary surgery is discussed.
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Affiliation(s)
- Priyanka Asodaria
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Samantha Hunt
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex
| | - Danish Kazmi
- Kent Integrated Dermatology Service, Worthing, West Sussex
| | - Ann Fleming
- Histopathology Department, Maidstone Hospital, Maidstone, Kent
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, West Sussex
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Gürsel Ürün Y, Fiçicioğlu S, Ürün M, Can N. Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma. Dermatol Pract Concept 2023; 13:dpc.1301a4. [PMID: 36892362 PMCID: PMC9946123 DOI: 10.5826/dpc.1301a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC). OBJECTIVES To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns. METHODS Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis. RESULTS The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%). CONCLUSIONS In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.
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Affiliation(s)
- Yıldız Gürsel Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Sezin Fiçicioğlu
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Mustafa Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Nuray Can
- Departments of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Identification of Cancerous Skin Lesions Using Vibrational Optical Coherence Tomography (VOCT): Use of VOCT in Conjunction with Machine Learning to Diagnose Skin Cancer Remotely Using Telemedicine. Cancers (Basel) 2022; 15:cancers15010156. [PMID: 36612151 PMCID: PMC9818398 DOI: 10.3390/cancers15010156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022] Open
Abstract
In this pilot study, we used vibrational optical tomography (VOCT), along with machine learning, to evaluate the specificity and sensitivity of using light and audible sound to differentiate between normal skin and skin cancers. The results reported indicate that the use of machine learning, and the height and location of the VOCT mechanovibrational peaks, have potential for being used to noninvasively differentiate between normal skin and different cancerous lesions. VOCT data, along with machine learning, is shown to predict the differences between normal skin and different skin cancers with a sensitivity and specificity at rates between 78 and 90%. The sensitivity and specificity will be improved using a larger database and by using other AI techniques. Ultimately, VOCT data, visual inspection, and dermoscopy, in conjunction with machine learning, will be useful in telemedicine to noninvasively identify potentially malignant skin cancers in remote areas of the country where dermatologists are not readily available.
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