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Dermatologic Surgery : Official... Aug 2022Sebaceous adenocarcinoma (SAC) mostly occurs in the elderly, and SAC in young and middle-aged population is inadequately investigated.
BACKGROUND
Sebaceous adenocarcinoma (SAC) mostly occurs in the elderly, and SAC in young and middle-aged population is inadequately investigated.
OBJECTIVE
To explore the clinical features and prognosis of young and middle-aged adults with SAC.
MATERIALS AND METHODS
Patients with skin SAC between ages 18 and 59 years from the Surveillance, Epidemiology, and End Results database (1975-2016) were eligible for this study.
RESULTS
Seven hundred thirty-nine cases were identified. The proportion of extraocular SAC in the nonelderly increased from 1975-2005 to 2006-2016 ( p = .001), male predominance was observed in overall patients whereas female predominance in Asian population, and young patients had more head and neck SAC than middle-aged patients ( p = .014). The prognosis of young patients was better than middle-aged patients ( p = .004). Other independent prognostic factors included sex, marital status, tumor size, surgery, chemotherapy, and multiple primary cancer history.
CONCLUSION
An increasing proportion of extraocular SAC was observed in young and middle-aged patients, and the young developed more head and neck SAC than the middle-aged. Female predominance was found in Asian population, and female patients had better prognosis. Younger age and married status indicated better prognosis, and around 20% of young and middle-aged patients might have poorer survival because of Muir-Torre syndrome.
Topics: Adenocarcinoma, Sebaceous; Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Muir-Torre Syndrome; Prognosis; Sebaceous Gland Neoplasms; Skin; Young Adult
PubMed: 35917259
DOI: 10.1097/DSS.0000000000003506 -
JAMA Dermatology Jun 2023Keratinocyte carcinomas are the most common cancers in the US. However, keratinocyte carcinomas are not included in US national cancer registries, and information on the...
IMPORTANCE
Keratinocyte carcinomas are the most common cancers in the US. However, keratinocyte carcinomas are not included in US national cancer registries, and information on the anatomic locations of keratinocyte carcinomas is lacking.
OBJECTIVE
To investigate the anatomic location of keratinocyte carcinomas in the US using a large claims data set.
DESIGN, SETTING, AND PARTICIPANTS
We performed a cohort study using a deidentified, random sample of 4 999 999 fee-for-service Medicare beneficiaries aged 65 years or older (2009-2018).
MAIN OUTCOMES AND MEASURES
Proportion of procedurally treated keratinocyte carcinomas at each anatomic location, identified by linking diagnosis and treatment codes.
RESULTS
A total of 2 415 514 keratinocyte carcinomas were identified in 792 393 beneficiaries. The mean (SD) age was 76.6 (8.1) years, 410 364 (51.8%) were women, and 96.7% were White. Of the 2 415 514 keratinocyte carcinomas, 796 542 could be subtyped into basal cell carcinoma (33.0%), 927 984 into squamous cell carcinoma (38.4%), and 690 988 (28.6%) could not be subtyped. The most common location of squamous cell carcinomas was the head and/or neck (44.3%) followed by upper limbs (26.7%). The most common location of basal cell carcinomas was head and/or neck (63.8%), followed by trunk (14.9%). In women, keratinocyte carcinomas were most common on the head and/or neck (47.3%) followed by upper and lower limb (18.5% and 16.6%, respectively). In men, keratinocyte carcinomas were most common on the head and/or neck (58.7%) followed by upper limb and trunk (17.3% and 11.4%, respectively).
CONCLUSIONS AND RELEVANCE
The results of this large Medicare cohort study highlight the anatomic locations of keratinocyte carcinomas over recent years and show the predominance of lesions occurring at head and/or neck anatomic location. This foundational information on keratinocyte carcinoma anatomic locations in the US is valuable for improved keratinocyte risk factor differentiation and skin cancer surveillance.
Topics: Male; Humans; Aged; Female; United States; Medicare; Cohort Studies; Skin Neoplasms; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Keratinocytes
PubMed: 37074701
DOI: 10.1001/jamadermatol.2023.0611 -
Current Opinion in Otolaryngology &... Apr 2024This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and... (Review)
Review
PURPOSE OF REVIEW
This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and neck nonmelanoma skin cancers (NMSCs), focusing on squamous, basal, and Merkel cell carcinomas.
RECENT FINDINGS
Recent developments underscore the complexity of treatment for NMSC, particularly in the head and neck region. There is a lack of high-level evidence for the management of these tumors, especially in advanced stages. The need to tailor the extent of surgical margins and parotid/neck management to different histotypes, considering the varying risk factors for recurrence, is beginning to emerge in the literature. Moreover, the role of immunotherapy and targeted therapies for locally advanced disease, alongside traditional treatment options, is progressively growing.
SUMMARY
NMSCs represent a heterogeneous group of malignancies with varying treatment complexities and prognoses. Management of NMSC is evolving towards an increasingly personalized strategy within a multidisciplinary therapeutic framework.
Topics: Humans; Carcinoma, Basal Cell; Skin Neoplasms; Prognosis; Head and Neck Neoplasms; Immunotherapy
PubMed: 38193646
DOI: 10.1097/MOO.0000000000000960 -
Indian Journal of Dental Research :... 2021Basal cell carcinoma is the most common cutaneous malignancy which is exclusively observed on sun exposed and hair bearing areas of the face.
INTRODUCTION
Basal cell carcinoma is the most common cutaneous malignancy which is exclusively observed on sun exposed and hair bearing areas of the face.
DIAGNOSIS
We report two rare cases of basal cell carcinoma, which presented as a diagnostic challenge because of rare histopathology.
FINDINGS
Both cases showed pigmentation, while one case resembled adenoid cystic carcinoma because of the glandular and ductal pattern of basaloid cells.
RESULT
We present these cases because of rare histopathologic presentation.
Topics: Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Humans; Skin Neoplasms
PubMed: 35229784
DOI: 10.4103/ijdr.IJDR_227_19 -
Cancer Epidemiology, Biomarkers &... Nov 2023Despite well-established relationships between sun exposure and skin cancer pathogenesis/progression, specific gene-environment interactions in at-risk individuals...
BACKGROUND
Despite well-established relationships between sun exposure and skin cancer pathogenesis/progression, specific gene-environment interactions in at-risk individuals remain poorly-understood.
METHODS
We leveraged a UK Biobank cohort of basal cell carcinoma (BCC, n = 17,221), cutaneous squamous cell carcinoma (cSCC, n = 2,331), melanoma in situ (M-is, n = 1,158), invasive melanoma (M-inv, n = 3,798), and healthy controls (n = 448,164) to quantify the synergistic involvement of genetic and environmental factors influencing disease risk. We surveyed 8,798 SNPs from 190 DNA repair genes, and 11 demographic/behavioral risk factors.
RESULTS
Clinical analysis identified darker skin (RR = 0.01-0.65) and hair (RR = 0.27-0.63) colors as protective factors. Eleven SNPs were significantly associated with BCC, three of which were also associated with M-inv. Gene-environment analysis yielded 201 SNP-environment interactions across 90 genes (FDR-adjusted q < 0.05). SNPs from the FANCA gene showed interactions with at least one clinical factor in all cancer groups, of which three (rs9926296, rs3743860, rs2376883) showed interaction with nearly every factor in BCC and M-inv.
CONCLUSIONS
We identified novel risk factors for keratinocyte carcinomas and melanoma, highlighted the prognostic value of several FANCA alleles among individuals with a history of sunlamp use and childhood sunburns, and demonstrated the importance of combining genetic and clinical data in disease risk stratification.
IMPACT
This study revealed genome-wide associations with important implications for understanding skin cancer risk in the context of the rapidly-evolving field of precision medicine. Major individual factors (including sex, hair and skin color, and sun protection use) were significant mediators for all skin cancers, interacting with >200 SNPs across four skin cancer types.
Topics: Humans; Child; Skin Neoplasms; Carcinoma, Squamous Cell; Biological Specimen Banks; Polymorphism, Single Nucleotide; Carcinoma, Basal Cell; Melanoma; Risk Factors; DNA Repair; United Kingdom; Melanoma, Cutaneous Malignant
PubMed: 37642678
DOI: 10.1158/1055-9965.EPI-23-0545 -
Anais Brasileiros de Dermatologia 2021Lobomycosis is a chronic granulomatous infection caused by the yeast Lacazia loboi, typically found in tropical and subtropical geographical areas. Transmission occurs...
Lobomycosis is a chronic granulomatous infection caused by the yeast Lacazia loboi, typically found in tropical and subtropical geographical areas. Transmission occurs through traumatic inoculation into the skin, especially in exposed areas, of men who work in contact with the soil. Lesions are restricted to the skin and subcutaneous tissue, with a keloid-like appearance in most cases. The occurrence of squamous cell carcinoma on skin lesions with a long evolution is well known; however, there are scarce reports of lobomycosis that developed into squamous cell carcinoma. The authors report a patient from the Brazilian Amazon region, with lobomycosis and carcinomatous degeneration, with an unfavorable outcome, due to late diagnosis.
Topics: Brazil; Humans; Keloid; Lacazia; Lobomycosis; Male; Skin
PubMed: 34579963
DOI: 10.1016/j.abd.2021.05.004 -
Pathobiology : Journal of... 2023GATA3 is a transcription factor involved in epithelial cell differentiation. GATA3 immunostaining is used as a diagnostic marker for breast and urothelial cancer but can...
INTRODUCTION
GATA3 is a transcription factor involved in epithelial cell differentiation. GATA3 immunostaining is used as a diagnostic marker for breast and urothelial cancer but can also occur in other neoplasms.
METHODS
To evaluate GATA3 in normal and tumor tissues, a tissue microarray containing 16,557 samples from 131 different tumor types and subtypes and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry.
RESULTS
GATA3 positivity was found in 69 different tumor types including 23 types (18%) with at least one strongly positive tumor. Highest positivity rates occurred in noninvasive papillary urothelial carcinoma (92-99%), lobular carcinoma (98%), carcinoma of no special type of the breast (92%), basal cell carcinoma of the skin (97%), invasive urothelial carcinoma (73%), T-cell lymphoma (23%), adenocarcinoma of the salivary gland (16%), squamous cell carcinoma of the skin (16%), and colorectal neuroendocrine carcinoma (12%). In breast cancer, low GATA3 staining was linked to high pT stage (p = 0.03), high BRE grade (p < 0.0001), HER2 overexpression (p = 0.0085), estrogen and progesterone receptor negativity (p < 0.0001 each), and reduced survival (p = 0.03).
CONCLUSION
Our data demonstrate that GATA3 positivity can occur in various tumor entities. Low levels of GATA3 reflect cancer progression and poor patient prognosis in breast cancer.
Topics: Humans; Female; Carcinoma, Transitional Cell; Urinary Bladder Neoplasms; Biomarkers, Tumor; Adenocarcinoma; Breast Neoplasms; GATA3 Transcription Factor
PubMed: 36649695
DOI: 10.1159/000527382 -
Eye (London, England) Sep 2020To evaluate the incidence and management of recurrent periocular sebaceous gland carcinoma at a tertiary ocular oncology service in the United Kingdom.
OBJECTIVE
To evaluate the incidence and management of recurrent periocular sebaceous gland carcinoma at a tertiary ocular oncology service in the United Kingdom.
METHODS
This was a retrospective cohort study of 62 patients with sebaceous gland carcinoma treated between 2004 and 2017. A total of 10 eyes were treated for local recurrence. The following variables were recorded: age and sex of patient; tumour location, histological subtype; recurrence type; treatment and outcome.
RESULTS
Of the 62 cases with eyelid SGC, 10 (16%) had recurrences during the study period and satisfied inclusion criteria. There were six (60%) females and four males in the recurrent group. The mean time interval between initial excision and tumour recurrence was 37 months (median 23 months; range 4 to 84 months). Four patients received cryotherapy to the lids and conjunctiva to control recurrent disease and two patients were treated with topical or intralesional chemotherapy. Four patients (40%) underwent orbital exenteration during the study period. Metastasis occurred in 20% over a mean follow-up of 113 months (median 106; range 47-184 months).
CONCLUSIONS
The risk factors for local recurrence of SGC after wide excision with paraffin section control were reported, and an approach to these recurrent lesions was proposed. The results of this study will help guide surgeons dealing with the medical and surgical conundrum of recurrent disease. The risk of recurrence is highest in the first 2 years after initial excision.
Topics: Adenocarcinoma, Sebaceous; Eyelid Neoplasms; Female; Humans; Male; Neoplasm Recurrence, Local; Retrospective Studies; Sebaceous Gland Neoplasms; Sebaceous Glands; United Kingdom
PubMed: 31896805
DOI: 10.1038/s41433-019-0756-9 -
Advances in Experimental Medicine and... 2020Nonmelanoma skin cancers including basal and squamous cell carcinomas (SCC and BCC) represent a significant clinical problem due to their relatively high incidence,... (Review)
Review
Nonmelanoma skin cancers including basal and squamous cell carcinomas (SCC and BCC) represent a significant clinical problem due to their relatively high incidence, imposing an economic burden to healthcare systems around the world. It is accepted that ultraviolet radiation (UVR: λ = 290-400 nm) plays a crucial role in the initiation and promotion of BCC and SCC with UVB (λ = 290-320 nm) having a central role in this process. On the other hand, UVB is required for vitamin D3 (D3) production in the skin, which supplies >90% of the body's requirement for this prohormone. Prolonged exposure to UVB can also generate tachysterol and lumisterol. Vitamin D3 itself and its canonical (1,25(OH)D3) and noncanonical (CYP11A1-intitated) D3 hydroxyderivatives show photoprotective functions in the skin. These include regulation of keratinocyte proliferation and differentiation, induction of anti-oxidative responses, inhibition of DNA damage and induction of DNA repair mechanisms, and anti-inflammatory activities. Studies in animals have demonstrated that D3 hydroxyderivatives can attenuate UVB or chemically induced epidermal cancerogenesis and inhibit growth of SCC and BCC. Genomic and non-genomic mechanisms of action have been suggested. In addition, vitamin D3 itself inhibits hedgehog signaling pathways which have been implicated in many cancers. Silencing of the vitamin D receptor leads to increased propensity to develop UVB or chemically induced epidermal cancers. Other targets for vitamin D compounds include 1,25D3-MARRS, retinoic orphan receptors α and γ, aryl hydrocarbon receptor, and Wnt signaling. Most recently, photoprotective effects of lumisterol hydroxyderivatives have been identified. Clinical trials demonstrated a beneficial role of vitamin D compounds in the treatment of actinic keratosis. In summary, recent advances in vitamin D biology and pharmacology open new exciting opportunities in chemoprevention and treatment of skin cancers.
Topics: Animals; Disease Progression; Humans; Receptors, Calcitriol; Skin; Skin Neoplasms; Ultraviolet Rays; Vitamin D; Vitamins
PubMed: 32918223
DOI: 10.1007/978-3-030-46227-7_13 -
Bioengineered Dec 2021The aim of this study is to explore the role of mammalian target of rapamycin (mTOR) in cutaneous squamous cell carcinoma (CSCC), Bowen's disease (BD), and actinic...
The aim of this study is to explore the role of mammalian target of rapamycin (mTOR) in cutaneous squamous cell carcinoma (CSCC), Bowen's disease (BD), and actinic keratosis (AK) with squamous cell differentiation abnormality and its relationship with the degree of tumor proliferation. Thirty cases of clinical paraffin specimens of CSCC, BD, and AK were each collected from Jinhua Fifth Hospital, while 30 cases of normal skin specimens surgically resected in Department of Plastic Surgery were selected as controls. The expressions of mTOR and Ki-67 in tissues were detected by immunohistochemical staining. The positive expression rate of mTOR in the CSCC group was higher than those in the BD group and AK group ( < 0.05), while it was higher in the BD group and AK group than in the normal skin group ( < 0.05). The CSCC group had a higher positive expression rate of Ki-67 than the AK group ( < 0.01). The results of logistic regression analysis showed that the pathogenic site [odds ratio (OR) = 1.189, 95% confidence interval (95%CI): 1.028-1.381, = 0.021], course of disease (OR = 2.059, 95%CI: 1.036-4.087, = 0.043), and differentiation degree (OR = 1.325, 95%CI: 1.169-1.512, = 0.001) were independent factors for the positive expression of mTOR. OR>1, indicating that the factor is a risk factor. The expression levels of mTOR in CSCC, BD, and AK were positively correlated with the expression level of Ki-67 ( = 0.827, < 0.01, = 0.608, < 0.01, = 0.368, = 0.045). These results suggest that mTOR may be involved in the pathogenesis of CSCC, and related to the proliferation degree of CSCC, as an index reflecting the proliferation status of CSCC.
Topics: Adult; Aged; Aged, 80 and over; Bowen's Disease; Carcinoma, Squamous Cell; Female; Humans; Keratosis, Actinic; Ki-67 Antigen; Logistic Models; Male; Middle Aged; Precancerous Conditions; Skin; Skin Neoplasms; TOR Serine-Threonine Kinases
PubMed: 34874800
DOI: 10.1080/21655979.2021.1984719