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Molecular Genetics & Genomic Medicine Oct 2023The risk of skin cancer is determined by environmental factors like ultraviolet radiation (UVR), personal habits like time spent outdoors and genetic factors. This... (Review)
Review
BACKGROUND
The risk of skin cancer is determined by environmental factors like ultraviolet radiation (UVR), personal habits like time spent outdoors and genetic factors. This review aimed to survey existing studies in gene-environment (GxE) interaction on skin cancer risk, and report on GxE effect estimates.
METHODS
We searched Embase, Medline (Ovid) and Web of Science (Core Collection) and included only primary research that reported on GxE on the risk of the three most common types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. Quality assessment followed the Newcastle-Ottawa Scale. Meta-analysis was not possible because no two studies examined the same interaction. This review was registered on PROSPERO (CRD42021238064).
RESULTS
In total 260 records were identified after exclusion of duplicates. Fifteen studies were included in the final synthesis-12 used candidate gene approach. We found some evidence of GxE interactions with sun exposure, notably, with MC1R, CAT and NOS1 genes in melanoma, HAL and IL23A in BCC and HAL and XRCC1 in SCC.
CONCLUSION
Sun exposure seems to interact with genes involved in pigmentation, oxidative stress and immunosuppression, indicating that excessive UV exposure might exhaust oxidative defence and repair systems differentially, dependent on genetic make-up. Further research is warranted to better understand skin cancer epidemiology and develop sun exposure recommendations. A genome-wide approach is recommended as it might uncover unknown disease pathways dependent on UV radiation.
PubMed: 37537768
DOI: 10.1002/mgg3.2259 -
The British Journal of Dermatology Jul 2015Several observational studies have assessed the correlation between Merkel cell carcinoma and Merkel cell polyomavirus with variable results. The objective of this... (Meta-Analysis)
Meta-Analysis Review
Several observational studies have assessed the correlation between Merkel cell carcinoma and Merkel cell polyomavirus with variable results. The objective of this systematic review was to determine whether there is a correlation between Merkel cell carcinoma and Merkel cell polyomavirus. Studies assessing the relationship between Merkel cell carcinoma and Merkel cell polyomavirus from January 2008 to August 2014 were pooled from Medline, Embase, PubMed, Cochrane Database of Systemic Reviews and Google Scholar. From each study we collected the first author's last name, publication year, country of origin, type of study design, characteristics of participants, possible variables incorporated into the multivariable analyses and the risk ratio (RR) for Merkel cell carcinoma associated with Merkel cell polyomavirus combined with the corresponding 95% confidence interval (CI). Methodological assessment of the study was evaluated using the Newcastle-Ottawa scale. Crude RR was calculated from the data provided in each article. Meta-analyses for the global RR and for the proportion of positives in both case and control samples were performed. In addition, in order to explore the sources of heterogeneity among the studies, meta-regression and sensitivity analyses are also provided. A total of 22 studies were identified for the analysis. The pooled RR from random-effects analysis was determined to be 6.32 (95% CI, 4.02-9.93). Global proportions of positive samples were 0.79 (95% CI, 0.72-0.84) and 0.12 (95% CI, 0.08-0.19) in the case and control groups, respectively. The findings support the association between Merkel cell carcinoma and Merkel cell polyomavirus. However, a non-negligible percentage of positive results have been identified in controls. Some caution must be taken in the interpretation of these results because heterogeneity between studies was found.
Topics: Carcinoma, Merkel Cell; Humans; Merkel cell polyomavirus; Polyomavirus Infections; Skin Neoplasms; Tumor Virus Infections
PubMed: 25919492
DOI: 10.1111/bjd.13870 -
Dermatology and Therapy May 2022Atopic dermatitis (AD) is one of the most common skin diseases, and it may be associated with skin cancer risk. However, there is a controversy pertaining to whether it...
INTRODUCTION
Atopic dermatitis (AD) is one of the most common skin diseases, and it may be associated with skin cancer risk. However, there is a controversy pertaining to whether it implies a greater or decreased risk of skin cancers. We aimed to study the relationship between AD and skin cancer risk.
METHODS
PubMed and Embase databases from their inception to 4 August 2021 were systematically searched.
RESULTS
We evaluated 16 studies involving a total of 9,638,093 participants examining the contribution of AD to skin cancers. Random-effects model was applied to estimate the overall effect sizes. The pooled analysis of 16 studies indicated that AD was significantly associated with an overall increased risk of skin cancer. Subgroup pooled analyses showed that AD was statistically associated with an increased risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). With regard to cohort study, AD was statistically associated with an increased risk of nonmelanoma skin cancer (NMSC), BCC, and SCC, but not melanoma risk. Sensitivity analysis revealed that excluding each study in turn did not alter the overall combined results. No publication bias existed among the studies.
CONCLUSION
It can be concluded that AD is associated with risk of skin cancers; however, this association still needs to be verified in well-designed, worldwide trials (especially prospective, non-Western studies). The mechanism of AD leading to skin cancer is not clear, and further research is needed to explore the possibility of a potential pathogenesis.
PubMed: 35430723
DOI: 10.1007/s13555-022-00720-2 -
Dermatologic Therapy Nov 2021Cemiplimab, a high-affinity, highly potent human monoclonal antibody that binds to the programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) receptor, is the only... (Review)
Review
Cemiplimab, a high-affinity, highly potent human monoclonal antibody that binds to the programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) receptor, is the only drug to attain Food and Drug Administration (FDA) approval and marketing authorization from the European Commission for use in patients with metastatic and locally advanced cutaneous squamous cell carcinoma (CSCC) who are not candidates for curative surgery or curative radiation therapy as a first- or later-line treatment. In pivotal phase II clinical testing, cemiplimab showed rapid and substantial antitumor efficacy and acceptable safety. This systematic review was aimed at evaluating the efficacy and safety of cemiplimab in patients with advanced CSCC. To this end, I reviewed EMBASE, MEDLINE, PubMed, and clinical trial registries/databases by using the following keywords alone or in combination: "cemiplimab," "Libtayo," "cutaneous squamous cell carcinoma," "REGN2810," and "SER439684." Cemiplimab showed clinical efficacy and considerable safety and was associated with low rates of treatment discontinuation (7%) and death (3%). However, the current recommendation is primarily based on only phase II clinical testing due to the absence of an approved comparator agent.
Topics: Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; Carcinoma, Squamous Cell; Humans; Programmed Cell Death 1 Receptor; Skin Neoplasms
PubMed: 34716727
DOI: 10.1111/dth.15184 -
JMIR Dermatology Nov 2023Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by... (Review)
Review
BACKGROUND
Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by the commonality of inflammatory and immune response dysfunction. Studies that have looked into this possible association have reported mixed results.
OBJECTIVE
Given the conflicting literature on this topic, our study sought to evaluate the overall association between rosacea and several cancers commonly investigated in the literature.
METHODS
A systematic review was conducted using the Cochrane, PubMed, Embase, and Ovid databases. Studies were screened independently for inclusion of rosacea and glioma and breast, thyroid, hepatic, or skin cancers. Using information from the articles, rosacea and each cancer were categorized as having a positive, negative, or unclear association.
RESULTS
Our systematic review included 39 full-text studies that investigated the association between rosacea and various malignancies. Among the malignancies of concern, 41% (16/39) of the studies reported an association with basal cell carcinoma, with 2 cohorts revealing an adjusted risk ratio (RR) of 1.50 (95% CI 1.35-1.67) and 0.72 (95% CI 0.56-0.93). In total, 33% (13/39) of the studies reported an association with squamous cell carcinoma, with 2 cohorts revealing an adjusted RR of 1.4 (95% CI 1.02-1.93) and 1.30 (95% CI 0.90-1.88). A total of 8% (3/39) of the studies reported an association between breast cancer and melanoma, with breast cancer cohorts revealing an adjusted RR of 8.453 (95% CI 1.638-43.606), 1.03 (95% CI 0.89-1.20), and 1.36 (95% CI 1.18-1.58) and melanoma cohorts revealing an adjusted RR of 1.10 (95% CI 0.95-1.27), 0.63 (95% CI 0.47-0.85), and 0.96 (95% CI 0.57-1.62). A total of 5% (2/39) of the studies reported an association among nonmelanoma skin cancers, hepatic cancer, and thyroid carcinomas, with nonmelanoma skin cancer cohorts revealing an adjusted RR of 1.36 (95% CI 1.26-1.47) and 2.66 (95% CI 1.53-4.61), hepatic cancer cohorts revealing an adjusted RR of 1.42 (95% CI 1.06-1.90) and 1.32 (95% CI 0.89-1.95), and thyroid carcinoma cohorts revealing an adjusted RR of 1.06 (95% CI 0.68-1.65) and 1.59 (95% CI 1.07-2.36). Only 1 cohort reported an association with glioma, revealing an adjusted RR of 1.36 (95% CI 1.18-1.58). According to our review, patients with rosacea were statistically more likely to have nonmelanoma skin cancers, breast cancer, and glioma. Rosacea was not found to be substantially associated with melanoma. The associations between rosacea and hepatic and thyroid cancers were unclear because of conflicting results.
CONCLUSIONS
The current literature shows that rosacea is significantly associated with increased odds of nonmelanoma skin cancers, glioma, and breast cancer. Rosacea does not appear to be associated with melanoma. Further studies should be conducted to clarify the association between thyroid and hepatic cancers and rosacea.
PubMed: 37938876
DOI: 10.2196/47821 -
JAMA Apr 2023Skin cancer is the most commonly diagnosed cancer in the US. There are different types of skin cancer varying in disease incidence and severity. Basal and squamous cell...
IMPORTANCE
Skin cancer is the most commonly diagnosed cancer in the US. There are different types of skin cancer varying in disease incidence and severity. Basal and squamous cell carcinomas are the most common types of skin cancer but infrequently lead to death or substantial morbidity. Melanomas represent about 1% of skin cancer and cause the most skin cancer deaths. Melanoma is about 30 times more common in White persons than in Black persons. However, persons with darker skin color are often diagnosed at later stages, when skin cancer is more difficult to treat.
OBJECTIVE
To update its 2016 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the benefits and harms of screening for skin cancer in asymptomatic adolescents and adults.
POPULATION
Asymptomatic adolescents and adults who do not have a history of premalignant or malignant skin lesions.
EVIDENCE ASSESSMENT
The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in asymptomatic adolescents and adults.
RECOMMENDATION
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adolescents and adults. (I statement).
Topics: Adolescent; Adult; Humans; Early Detection of Cancer; Mass Screening; Melanoma; Physical Examination; Risk Assessment; Skin Neoplasms; Carcinoma, Basal Cell; Carcinoma, Squamous Cell
PubMed: 37071089
DOI: 10.1001/jama.2023.4342 -
The Journal of Dermatological Treatment Jun 2022Verrucous carcinoma is a rare mucocutaneous malignancy characterized by slow, relentless growth and a low metastasis rate. (Review)
Review
BACKGROUND
Verrucous carcinoma is a rare mucocutaneous malignancy characterized by slow, relentless growth and a low metastasis rate.
OBJECTIVE
Herein we summarize surgical success rates and review newer approaches to the treatment of verrucous carcinomas.
METHODS AND MATERIALS
PubMed electronic searches were performed by B.F. and C.V. using combinations of the following terms: "verrucous carcinoma," "Ackerman tumor," "Buschke Lowenstein," "epithelioma cuniculatum," "carcinoma cuniculatum," "papillomatosis cutis," "treatment," "therapeutics," "management," "mohs surgery," and "excision." A systematic review was conducted on 49 articles in accordance with PRISMA guidelines.
RESULTS
Surgical management remains first-line therapy. Wide local excision is most commonly utilized, with highly variable margins (0.5-3.0 cm) and recurrence rates (4.6-75.0%). Mohs Micrographic Surgery has also been used, especially for recurrent tumors, with an overall recurrence rate of 12.9%.
CONCLUSION
Surgery is the treatment of choice, either by Mohs Micrographic Surgery or wide local excision. However, surgical recurrence rates are high, and tissue-sparing therapies are desirable given the sensitive locations involved. Ultimately, randomized control trials are needed to develop evidence-based guidelines for the management of VCs.
Topics: Carcinoma, Verrucous; Foot Diseases; Humans; Mohs Surgery; Neoplasm Recurrence, Local; Skin; Skin Neoplasms
PubMed: 33849379
DOI: 10.1080/09546634.2021.1914312 -
Diagnostics (Basel, Switzerland) May 2023(1) Background: BCC is a sporadic disease that develops in areas of the skin not exposed to the sun. Perianal BCC, which occurs in the anorectal region, accounts for... (Review)
Review
(1) Background: BCC is a sporadic disease that develops in areas of the skin not exposed to the sun. Perianal BCC, which occurs in the anorectal region, accounts for less than 0.2% of all BCC cases. There have been only a few reported cases of the disease, with fewer than 200 cases reported in total. Given the diagnostic challenges and potential for misdiagnosis, we conducted a systematic review of perianal basal cell carcinoma using real-world data to provide comprehensive and detailed information on the disease. (2) Methods: The study was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2020. Patients' clinical pathologic features, tumor characteristics, treatment modalities, and outcomes were presented. (3) Results: The results of 41 studies involving 140 patients were analyzed. The most common symptoms reported by patients at presentation were anorectal bleeding, pain, and pruritus. Ulceration was the most frequently observed tumor characteristic. The majority of patients underwent local excision as their primary treatment, with only eight patients experiencing a recurrence. Our analysis did not reveal any statistically significant differences in the outcomes of different treatment modalities. (4) Conclusions: Identifying perianal BCC poses a significant challenge as it closely resembles other anal diseases, thereby making it difficult to differentiate between the different conditions. However, a wide local excision with clear margins is considered an effective treatment option for most patients. Alternative treatments, such as radiotherapy, may be recommended for patients who are unable to undergo surgery.
PubMed: 37175041
DOI: 10.3390/diagnostics13091650 -
JPRAS Open Mar 2023Hand basal cell carcinoma is a rare and complex disorder. Due to the hand's anatomical features, managing hand BCC is challenging. Therefore, we have conducted this... (Review)
Review
BACKGROUND
Hand basal cell carcinoma is a rare and complex disorder. Due to the hand's anatomical features, managing hand BCC is challenging. Therefore, we have conducted this systematic review to investigate various clinical characteristics, investigations, and treatment options related to hand BCC. Furthermore, a meta-analysis was used to provide pooled recurrence rates.
METHODS
We conducted this review per the International Prospective Register of Systematic Reviews (PROSPERO) guidelines. This study performed a systematic literature review in February 2022 using the following electronic databases: Cochrane, MEDLINE, and EMBASE. Key terms include hand basal cell carcinoma, basal cell carcinoma, management, outcome, and recurrence. We evaluated articles according to predefined quality criteria.
RESULTS
The study included 9725 patients and 51 published articles. A total of 35 case reports, 2 case series, 1 prospective study, and the remaining retrospective studies were evaluated. An asymptomatic skin lesion was the main complaint. In 10 studies, Moh surgery was the most frequently used treatment method. In the seven studies included in the meta-analysis, the overall incidence rate of recurrence among the included patients was 1.49 cases per year.
CONCLUSION
The optimal extent of surgical treatment is still controversial, though an early biopsy can help identify lesions at an early stage. It is the first study to provide occurrence rates based on a meta-analysis. Developing treatment guidelines for BCC of the hand will be the focus of future research.
PubMed: 36685723
DOI: 10.1016/j.jpra.2022.11.006 -
Archives of Dermatological Research May 2017Some reports suggest that a history of nonmelanoma skin cancer (NMSC) may be associated with increased mortality. NMSCs have very low fatality rates, but the high... (Review)
Review
Some reports suggest that a history of nonmelanoma skin cancer (NMSC) may be associated with increased mortality. NMSCs have very low fatality rates, but the high prevalence of NMSC elevates the importance of the possibility of associated subsequent mortality from other causes. The variable methods and findings of existing studies leave the significance of these results uncertain. To provide clarity, we conducted a systematic review to characterize the evidence on the associations of NMSC with: (1) all-cause mortality, (2) cancer-specific mortality, and (3) cancer survival. Bibliographic databases were searched through February 2016. Cohort studies published in English were included if adequate data were provided to estimate mortality ratios in patients with-versus-without NMSC. Data were abstracted from the total of eight studies from independent data sources that met inclusion criteria (n = 3 for all-cause mortality, n = 2 for cancer-specific mortality, and n = 5 for cancer survival). For all-cause mortality, a significant increased risk was observed for patients with a history of squamous cell carcinoma (SCC) (mortality ratio estimates (MR) 1.25 and 1.30), whereas no increased risk was observed for patients with a history of basal cell carcinoma (BCC) (MRs 0.96 and 0.97). Based on one study, the association with cancer-specific mortality was stronger for SCC (MR 2.17) than BCC (MR 1.15). Across multiple types of cancer both SCC and BCC tended to be associated with poorer survival from second primary malignancies. Multiple studies support an association between NMSC and fatal outcomes; the associations tend to be more potent for SCC than BCC. Additional investigation is needed to more precisely characterize these associations and elucidate potential underlying mechanisms.
Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Neoplasms, Second Primary; Risk Factors; Skin Neoplasms; Survival Analysis; United States
PubMed: 28285366
DOI: 10.1007/s00403-017-1724-5