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Romanian Journal of Morphology and... 2017Squamous cell carcinoma (SCC) in situ or Bowen's disease (BD) is a slowly progressive malignancy. However, cases of regression have been reported. Recent reviews cover... (Review)
Review
Squamous cell carcinoma (SCC) in situ or Bowen's disease (BD) is a slowly progressive malignancy. However, cases of regression have been reported. Recent reviews cover only certain aspects of this disease; therefore, this paper's aim is to cover all the relevant aspects for medical practice, such as clinical, histological and therapeutic details. BD may affect all regions of the skin and mucosa, but in accordance with the region and etiologic factor, it may embrace different clinical forms, some of them very similar with other skin lesions. Dermoscopy may prove useful for establishing a clinical diagnosis. Several patterns have been encountered and may help distinguishing from other diseases. When in doubt, puncture biopsy or complete excision may be performed in order to obtain histological data that could define BD. Different morphological aspects of the involved components are described in order to reduce the risk of misdiagnose. In order for the approach to be complete, relevant information about treatment has been presented, underlining the pros and cons of each available therapy.
Topics: Bowen's Disease; Carcinoma, Squamous Cell; Female; Humans; Male
PubMed: 28523295
DOI: No ID Found -
International Journal of Molecular... Mar 2019The role of telomere biology and telomerase activation in skin cancers has been investigated in melanoma and basal cell carcinoma but limited evidence is available for... (Review)
Review
The role of telomere biology and telomerase activation in skin cancers has been investigated in melanoma and basal cell carcinoma but limited evidence is available for cutaneous squamous cell carcinoma (cSCC). We will review the current knowledge on the role of telomere and telomerase pathway in cSCC pathogenesis. At the somatic level, both long and short telomere lengths have been described in cSCC. This telomere dichotomy is probably related to two different mechanisms of tumour initiation which determines two tumour subtypes. Telomere shortening is observed during the invasive progression from in situ forms of cSCC, such as Bowen's disease (BD) and actinic keratosis (AK), to invasive cSCC. At the germline level, controversial results have been reported on the association between constitutive telomere length and risk of cSCC. Approximately 75⁻85% of cSCC tumours are characterized by a high level of telomerase activity. Telomerase activation has been also reported in AKs and BD and in sun-damaged skin, thus supporting the hypothesis that UV modulates telomerase activity in the skin. Activating promoter mutations have been identified in 32⁻70% of cSCCs, with the majority showing the UV-signature. No significant correlation was observed between promoter mutations and cSCC clinico-pathological features. However, promoter mutations have been recently suggested to be independent predictors of an adverse outcome. The attention on telomere biology and telomerase activity in cSCC is increasing for the potential implications in the development of effective tools for prognostic assessment and of therapeutic strategies in patients with cutaneous cSCC.
Topics: Bowen's Disease; Carcinoma, Squamous Cell; Disease Progression; Germ Cells; Humans; Keratosis, Actinic; Mutation; Skin Neoplasms; Telomerase; Telomere; Telomere Shortening
PubMed: 30884806
DOI: 10.3390/ijms20061333 -
The Kaohsiung Journal of Medical... Sep 2011Arsenic is a well-known human carcinogen. It also impairs immune functions and activation in many aspects. However, only a small portion of arsenic-exposed population... (Review)
Review
Arsenic is a well-known human carcinogen. It also impairs immune functions and activation in many aspects. However, only a small portion of arsenic-exposed population develops skin abnormalities, including Bowen's disease and skin cancers. Differential immune activation among the individuals might account for the different susceptibilities. In patients with arsenic-induced Bowen's disease, there is a selective CD4 T-cell apoptosis through tumor necrosis factor-alpha pathway, decrease in macrophage differentiation and phagocytosis, reduced Langerhans cell numbers and dendrites, altered regulatory T-cell distribution, and other immune alterations. Several lines of evidence from mouse and fish studies also confirmed the potent and multifaceted effects of arsenic in the immune system. The molecular bases of immunosuppression by arsenic in lymphocytes may include chromosomal and DNA abnormalities, decreased T-cell receptor activation, and the cellular status of oxidation and methylation. This article also reviews the causative and differential role of selective CD4 cell apoptosis and the carcinogenesis of arsenic-induced Bowen's disease.
Topics: Animals; Arsenic; Arsenic Poisoning; Bowen's Disease; Humans; Skin Neoplasms; T-Lymphocytes
PubMed: 21914527
DOI: 10.1016/j.kjms.2011.05.007 -
Indian Dermatology Online Journal 2023Vulvar squamous cell carcinoma with sarcomatoid features is an extremely rare histological variant of squamous cell carcinoma with co-existence of both epithelial and...
Vulvar squamous cell carcinoma with sarcomatoid features is an extremely rare histological variant of squamous cell carcinoma with co-existence of both epithelial and mesenchymal features. A 70-year-old woman presented with genital lesions for 4 months with associated burning and pain. Examination revealed well-defined bilaterally symmetrical hyperpigmented plaques on labia majora, fleshy erythematous growth on labia minora. Biopsy from the fleshy mass was suggestive of sarcomatoid malignancy. However, immunohistochemistry was positive for cytokeratin AE1/AE3 and negative for desmin and smooth muscle actin. Biopsy from hyperpigmented plaque was suggestive of Bowens disease. On the basis of histopathology and immunohistochemistry findings, diagnosis of vulvar sarcomatoid squamous cell carcinoma with Bowens disease was made and patient was started on external beam radiation therapy. Sarcomatoid squamous cell carcinoma of vulva is very rare cancer that has an aggressive and fatal course. Diagnosis has traditionally been difficult due to a large ratio of sarcomatous to squamous cell component. Due to its rarity, there are no distinct guidelines to direct therapy and care.
PubMed: 38099028
DOI: 10.4103/idoj.idoj_696_22 -
Journal of the European Academy of... Jan 2023Keratinocyte skin cancers are the most frequent malignancy, accounting for approximately 30% of all cancers. Although beta genus HPV are the main etiologic agents for... (Review)
Review
Keratinocyte skin cancers are the most frequent malignancy, accounting for approximately 30% of all cancers. Although beta genus HPV are the main etiologic agents for squamous cell carcinoma development in patients with epidermodysplasia verruciformis and organ transplant recipients, their role in non-melanoma skin cancer (NMSC) progression in the general population remains controversial. The aim of our review is to summarize current scientific data and to systematically analyse evidence regarding the role of HPV in keratinocyte skin cancers. A total of 2284 patients were included, of which 724 with actinic keratoses, 290 with Bowen's disease, 949 with cutaneous squamous cell carcinomas and 321 with keratoacanthomas. In the case of actinic keratoses, the majority were positive for beta (n = 372, 58.49%) and gamma HPV (n = 256, 40.25%) and only a few (n = 6, 0.94%) were positive for alpha subtypes. Similarly, most of the cutaneous squamous cell carcinomas were positive for beta (n = 248, 55.98%) and gamma HPV (n = 172, 33.82%) and 23 cases (2.42%) were positive for alpha subtypes. Bowen's disease lesions were mostly positive for beta (n = 43, 55.84%) and alpha HPV (n = 30, 38.96%), in contrast to the gamma genus (n = 4, 5.19%). Keratoacanthomas showed a high distribution among beta genus (n = 79, 50.31%) and an equal proportion between alpha (n = 39, 24.84%) and gamma (n = 39, 24.84%) genera. Studies published so far identifying HPV in keratinocyte skin cancers reflect the difference in detection methods rather than a type-specific tendency towards either actinic keratoses, Bowen's disease, squamous cell carcinoma or keratoacanthoma. On the other hand, recent evidence regarding the role of HPV vaccination in patients with non-melanoma skin cancer brings into perspective the idea of a beta-HPV vaccine or a combined alpha and beta-HPV vaccine that could be used as an adjuvant treatment measure in patients with recalcitrant non-melanoma skin cancer.
Topics: Humans; Bowen's Disease; Keratoacanthoma; Keratosis, Actinic; Papillomavirus Infections; Papillomaviridae; DNA, Viral; Skin Neoplasms; Carcinoma, Squamous Cell; Keratinocytes; Papillomavirus Vaccines
PubMed: 36000380
DOI: 10.1111/jdv.18548 -
The Pan African Medical Journal 2018We here report the case of a16-year old patient, with no particular past medical history, presenting, with skin swelling at the level of the forefoot evolving for 02...
We here report the case of a16-year old patient, with no particular past medical history, presenting, with skin swelling at the level of the forefoot evolving for 02 years, at the Department of Dermatology. Clinical examination showed hard budding cutaneous mass painless on palpation covering the 2, the 3 and the 4, right toes, measuring 4 cm in large diameter. The remainder of the clinical examination was normal, without adenopathies. Skin biopsy was performed at the level of the tumor and histological examination showed carcinoma in situ. Surgical treatment was recommended. Bowen's disease is a relatively rare squamous intraepithelial carcinoma in situ. It mainly affects adults at any age, with predominance in women. The diagnosis is suspected on the basis of clinical examination, but it is confirmed by the anatomo-pathological examination.
Topics: Adolescent; Biopsy; Bowen's Disease; Female; Foot Diseases; Humans; Skin Neoplasms
PubMed: 29632625
DOI: 10.11604/pamj.2018.29.3.14441 -
Giornale Italiano Di Dermatologia E... Dec 2018Photodynamic therapy (PDT), using topically administered photosensitizing agents, is widely approved as a treatment for certain nonmelanoma skin cancers. As a... (Review)
Review
Photodynamic therapy (PDT), using topically administered photosensitizing agents, is widely approved as a treatment for certain nonmelanoma skin cancers. As a tissue-sparing non-surgical modality, there is great potential for PDT to enhance the choice of therapies available to treat, and potentially prevent, skin cancer. Treatment-specific guidelines have assessed the evidence for various photosensitizing agents and light sources, dosimetry, and evaluate reported adverse effects. Discomfort is frequently experienced during treatment but no analgesia was required in most pivotal lesion-directed studies. Durability of response has been assessed with studies of PDT for basal cell carcinomas (BCC) extending to 5 years and beyond, 2 years for Bowen's disease and up to 1 year for actinic keratoses (AK). Disease-specific guidelines consider the place for topical PDT in routine clinical practice recognizing that PDT is typically office/clinic-based and usually initiated by specialists. Where updated guidelines are awaited, national and international consensus publications offer recommendations, including on the use of daylight to activate the photosensitizer for treating AK. Reviewed studies indicate equivalent efficacy of daylight PDT, but greatly reduced pain compared with conventional PDT. Guidelines and consensus publications also consider the place of PDT in treating skin lesions arising in organ transplant recipients and in the potential for PDT to delay/prevent the development of nonmelanoma skin cancers. There is now a substantial evidence-base to support the use of topical PDT in routine clinical practice with daylight PDT indicated for AK, providing suitable outside climate, whilst conventional PDT remains suitable for AK, Bowen's Disease, superficial and certain thin nodular BCC.
Topics: Bowen's Disease; Carcinoma, Basal Cell; Humans; Keratosis, Actinic; Photochemotherapy; Photosensitizing Agents; Practice Guidelines as Topic; Skin Neoplasms
PubMed: 29417799
DOI: 10.23736/S0392-0488.18.05896-0 -
Actas Dermo-sifiliograficas 2012Photodynamic therapy and imiquimod are highly regarded treatments dermatologists frequently prescribe for actinic keratoses, basal cell carcinoma, and Bowen disease. The... (Comparative Study)
Comparative Study Review
Photodynamic therapy and imiquimod are highly regarded treatments dermatologists frequently prescribe for actinic keratoses, basal cell carcinoma, and Bowen disease. The scarcity of evidence from comparative trials prevents us from drawing well-founded conclusions about the efficacy, tolerance, and adverse effects of these therapeutic options or to recommend one over the other in any particular type of lesion or patient. On the other hand, in certain conditions (eg, actinic chelitis, immunosuppression, and basal cell carcinoma affecting the eyelids), there is evidence to support the use of photodynamic therapy or imiquimod even though they might initially seem contraindicated. We critically review and compare the use of these 2 treatments in order to suggest which is more appropriate in specific cases.
Topics: Administration, Topical; Aminoquinolines; Antineoplastic Agents; Bowen's Disease; Carcinoma, Basal Cell; Clinical Trials as Topic; Humans; Imiquimod; Keratosis, Actinic; Photochemotherapy; Remission Induction; Skin Cream; Skin Neoplasms
PubMed: 22178262
DOI: 10.1016/j.ad.2011.10.003 -
Der Hautarzt; Zeitschrift Fur... Apr 2014Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the...
Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the nail apparatus. Bowen disease is probably the most frequent nail malignancy. It is usually seen as a verrucous plaque of the nail fold and nail bed in persons above the age of 40 years. It slowly grows over a period of years or even decades before degenerating to an invasive squamous cell carcinoma. The latter may also occur primarily often as a weeping onycholysis. The next most frequent nail malignancy is ungual melanoma. Those arising from the matrix are usually pigmented and often start with a longitudinal melanonychia whereas those originating from the nail bed remain amelanotic, are often nodular and mistaken for an ingrown nail in an elderly person. The treatment of choice for in situ and early invasive subungual melanomas is generous extirpation of the nail apparatus whereas distal amputation is only indicated for advanced melanomas. In addition to these frequent nail malignancies, nail-specific carcinomas, malignant vascular and osseous tumors, other sarcomas, nail involvement in malignant systemic disorders and metastases may occur. In most cases, they cannot be diagnosed accurately on clinical grounds. Therefore, a high degree of suspicion is necessary in all isolated or single-digit proliferations that do not respond to conservative treatment.
Topics: Antineoplastic Agents; Bowen's Disease; Chemoradiotherapy; Diagnosis, Differential; Humans; Melanoma; Nail Diseases; Skin Neoplasms
PubMed: 24718507
DOI: 10.1007/s00105-013-2705-z -
International Journal of Women's... Mar 2021Dermoscopy is undoubtedly a useful tool to improve diagnostic accuracy and minimize the number of unnecessary biopsies. However, much of the literature on dermoscopy... (Review)
Review
BACKGROUND
Dermoscopy is undoubtedly a useful tool to improve diagnostic accuracy and minimize the number of unnecessary biopsies. However, much of the literature on dermoscopy focuses on findings in lighter-skin phototypes, leaving potential gaps of knowledge regarding its use in skin of color (SoC). As the clinical applications of dermoscopy continue to increase, understanding dermoscopic patterns in SoC is imperative.
OBJECTIVE
This review discusses the literature on dermoscopic findings of neoplasms in SoC, highlighting unique and characteristic dermoscopic features.
METHODS
A literature review was performed using the PubMed database. Case reports, case series, case-control studies, and systematic reviews were included.
RESULTS
A total of 8326 studies were identified based on the selected search terms, and 41 were included in this review based on relevance.
CONCLUSION
There are specific dermoscopic characteristics in SoC for benign nevi, acral lentiginous melanoma, ethnic melanonychia, and dermatofibroma; however, there is a lack of published data about specific features of cutaneous melanoma, subungual melanoma, pigmented basal cell carcinoma, and pigmented squamous cell carcinoma in SoC. Because pigmented basal cell carcinoma, pigmented squamous cell carcinoma, ethnic melanonychia, and acral lentiginous melanoma are diagnosed at later stages in this population, it is important to understand their dermoscopic features. Further descriptive studies are needed to better characterize unique dermoscopic features in neoplasms in SoC.
PubMed: 33937480
DOI: 10.1016/j.ijwd.2020.11.009