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Dermatology Online Journal Nov 2017Bazex syndrome (BS) is a rare paraneoplastic syndrome most frequently associated with squamous cell carcinomas of the upper aerodigestive tractand other tumours....
Bazex syndrome (BS) is a rare paraneoplastic syndrome most frequently associated with squamous cell carcinomas of the upper aerodigestive tractand other tumours. Characteristically, cutaneous lesions precede the diagnosis of malignancy. We report a 72-year-old patient with 1-year history of acral dermatitis. The diagnosis of BS was based on the presence of psoriasiform acral dermatitis and the evidence of two simultaneous tumors (prostate adenocarcinoma and undifferentiated carcinoma ofthe submandibular gland). It is important to have this syndrome in mind since cutaneous features usually precede an underlying neoplasm.
Topics: Adenocarcinoma; Aged; Biopsy; Carcinoma, Basal Cell; Humans; Hypotrichosis; Male; Neoplasms, Multiple Primary; Paraneoplastic Syndromes; Prostatic Neoplasms; Skin; Skin Neoplasms; Submandibular Gland Neoplasms
PubMed: 29447642
DOI: No ID Found -
JAMA Dermatology Jul 2022It has been suggested that Mohs surgery for skin cancer among individuals with limited life expectancy may be associated with needless risk and discomfort, along with...
IMPORTANCE
It has been suggested that Mohs surgery for skin cancer among individuals with limited life expectancy may be associated with needless risk and discomfort, along with increased health care costs.
OBJECTIVE
To investigate patient- and tumor-specific indications considered by clinicians for treatment of nonmelanoma skin cancer in older individuals.
DESIGN, SETTING, AND PARTICIPANTS
This multicenter, prospective cohort study was conducted using data from US private practice and academic centers. Included patients were those older than age 85 years presenting for skin cancer surgery and referred for Mohs surgery, with reference groups of those younger than age 85 years receiving Mohs surgery and those older than age 85 years not receiving Mohs surgery. Data were analyzed from November 2018 through January 2019.
EXPOSURES
Mohs surgery for nonmelanoma skin cancer.
MAIN OUTCOMES AND MEASURES
Reason for treatment selection.
RESULTS
Among 1181 patients older than age 85 years referred for Mohs surgery (724 [61.9%] men among 1169 patients with sex data; 681 individuals aged >85 to 88 years [57.9%] among 1176 patients with age data) treated at 22 sites, 1078 patients (91.3%) were treated by Mohs surgery, and 103 patients (8.7%) received alternate treatment. Patients receiving Mohs surgery were more likely to have tumors on the face (738 patients [68.5%] vs 26 patients [25.2%]; P < .001) and nearly 4-fold more likely to have high functional status (614 patients [57.0%] vs 16 patients [15.5%]; P < .001). Of 15 distinct reasons provided by surgeons for opting to proceed with Mohs surgery, the most common were patient desire for treatment with a high cure rate (712 patients [66.0%]), good or excellent patient functional status for age (614 patients [57.0%]), and high risk associated with the tumor based on histology (433 patients [40.2%]).
CONCLUSIONS AND RELEVANCE
This study found that older patients who received Mohs surgery often had high functional status, high-risk tumors, and tumors located on the face. These findings suggest that timely surgical treatment may be appropriate in older patients given that their tumors may be aggressive, painful, disfiguring, and anxiety provoking.
Topics: Aged; Carcinoma, Basal Cell; Female; Humans; Male; Mohs Surgery; Private Practice; Prospective Studies; Skin; Skin Neoplasms
PubMed: 35612849
DOI: 10.1001/jamadermatol.2022.1733 -
The Journal of Investigative Dermatology Aug 2018
Review
Topics: Animals; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Humans; Middle Aged; Mohs Surgery; Neoplasm Recurrence, Local; Neoplasms, Experimental; Patient Selection; SOX9 Transcription Factor; Skin; Skin Neoplasms; TOR Serine-Threonine Kinases; Treatment Outcome
PubMed: 30032790
DOI: 10.1016/j.jid.2018.06.172 -
Anticancer Research 2008In order to elucidate the role of the receptor tyrosine kinase HER3, the expression characteristics in different tissues of cutaneous malignancies and in normal skin... (Comparative Study)
Comparative Study
BACKGROUND
In order to elucidate the role of the receptor tyrosine kinase HER3, the expression characteristics in different tissues of cutaneous malignancies and in normal skin were compared.
MATERIALS AND METHODS
In this study HER3 expression was evaluated by RT-PCR analysis and immunohistochemistry from different tissue specimens of cutaneous tumors like nevi, primary malignant melanomas, basal cell carcinoma, squamous cell carcinoma and malignant melanoma metastases and normal skin samples and graded into weak, moderate and strong expression. Associations of tumor thickness in these specimens with HER3 expressions were also analyzed.
RESULTS
HER3 expression was found in 63% (10/16) of the basal cell carcinomas, in 4/5 of squamous cell carcinomas and in one Merkel cell carcinoma. Within the group of different malignant melanomas, HER3 expression was detected in 35% of the nodular malignant melanomas (6/17) and in 9/19 of the superficial spreading melanomas, including 2 lentigo malignant melanomas. The majority of melanomas with a higher tumor thickness expressed HER3, and 85% of melanoma metastasis were HER3-positive.
CONCLUSION
HER3 expression was associated with hyperproliferate tumor stages and suggested that HER3 expression could reflect an increased malignant potential in cutaneous lesions.
Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; Melanoma; Neoplasm Metastasis; Nevus; Receptor, ErbB-3; Reverse Transcriptase Polymerase Chain Reaction; Skin; Skin Neoplasms
PubMed: 18507044
DOI: No ID Found -
Photochemistry and Photobiology 2012The mammalian skin is a complex dynamic organ composed of thin multilayered epidermis and a thick underlying connective tissue layer dermis. The epidermis undergoes... (Review)
Review
The mammalian skin is a complex dynamic organ composed of thin multilayered epidermis and a thick underlying connective tissue layer dermis. The epidermis undergoes continuous renewal throughout life. The stems cells uniquely express particular surface markers utilized for their identification, isolation and localization in specific niches in epidermis as well as hair follicles (HFs). The two stage skin carcinogenesis model involves stepwise accumulation of genetic alterations and ultimately leading to malignancy. Whereas early research on skin carcinogenesis focused on the molecular nature of carcinogens and tumor promoters, more recent studies have focused on the identification of the target cells and tumor promoting cells for both chemical and physical carcinogens and promoters. Recent studies support the hypothesis that keratinocyte stem cells are the targets in skin carcinogenesis. In this review, we discuss briefly the localization of stem cells in the epidermis and HFs, and review the possibility that skin papillomas and carcinomas are derived from stem cells, as well as from other cells in the cutaneous epithelium whose stem cell properties are not well known.
Topics: Animals; Biomarkers; Carcinogens; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Dermis; Epidermis; Hair Follicle; Humans; Keratinocytes; Mice; Neoplastic Stem Cells; Papilloma; Skin Neoplasms
PubMed: 22211846
DOI: 10.1111/j.1751-1097.2012.01079.x -
BMJ Case Reports Jun 2022A middle-aged woman presented with a mechanical fall. Physical examination revealed a massive purulent ulcerated lesion spanning her entire back and axilla, which had...
A middle-aged woman presented with a mechanical fall. Physical examination revealed a massive purulent ulcerated lesion spanning her entire back and axilla, which had reportedly been brewing for over a decade. Punch biopsy revealed infiltrative basal cell carcinoma. She was treated with Vismodegib, with a remarkable decrease in the size of the cancer. However, surveillance imaging after 6 months of treatment revealed new bone metastases. In the setting of progressive disease, medical therapy was switched to cemiplimab instead. Basal cell carcinoma is commonly known as a benign tumour of the skin, rarely larger than 5 cm. Here, we discuss the entity of metastatic super giant basal cell carcinoma; this case is one of the largest reported lesions. As locoregional therapy, such as surgery is sometimes not appropriate for such advanced lesions, we discuss the current forefront of therapy including oral hedgehog pathway and check point inhibitors.
Topics: Biopsy; Carcinoma, Basal Cell; Female; Hedgehog Proteins; Humans; Middle Aged; Skin; Skin Neoplasms
PubMed: 35760499
DOI: 10.1136/bcr-2022-249873 -
Journal of Biomedical Optics Jun 2013Confocal laser scanning microscopy (CLSM) represents an emerging technique for the noninvasive histomorphological analysis of skin in vivo and has shown its... (Review)
Review
Confocal laser scanning microscopy (CLSM) represents an emerging technique for the noninvasive histomorphological analysis of skin in vivo and has shown its applicability for dermatological research as well as its value as an adjunct tool in the clinical management of skin cancer patients. Herein, we aim to give an overview on the current clinical indications for CLSM in dermatology and also highlight the diverse applications of CLSM in dermatological research.
Topics: Animal Testing Alternatives; Animals; Bowen's Disease; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cosmetics; Dermatitis, Contact; Dermatology; Humans; Keratosis, Actinic; Laser Therapy; Melanoma; Melanosis; Microscopy, Confocal; Optical Phenomena; Skin; Skin Aging; Skin Diseases; Skin Neoplasms; Tattooing; Ultraviolet Rays
PubMed: 23338938
DOI: 10.1117/1.JBO.18.6.061212 -
In Vivo (Athens, Greece) 2019To investigate the molecular structural disorders of cancerous skin.
AIM
To investigate the molecular structural disorders of cancerous skin.
MATERIALS AND METHODS
Human malignant melanoma and basal cell carcinoma biopsies were used for the investigation. Fourier transform infrared (FT-IR), Raman spectroscopy, and scanning electron microscopy were utilized. Spectral differences between healthy, basal cell carcinoma and melanoma tissues were recorded.
RESULTS
The FT-IR bands of vCH, vCH and Raman vCH of cell membrane lipids were increased in intensity in melanoma due to an increased lipophilic environment. The FT-IR band at 1,744 cm assigned to malondialdehyde can be used as a band diagnostic of cancer progression. The amide I bands at 1,654 cm and 1,650 cm for Raman and FT-IR, respectively were broader in spectra from melanoma, reflecting changes of protein secondary structure from α-helix to β-sheet and random coil. The intensity of the FT-IR band at 1,046 cm was increased in melanoma, suggesting glycosylation of the skin upon cancer development. Another band that might be considered as diagnostic was found at about 815 cm in melanoma and was attributed to Z-DNA configuration. As far as we know, this is the first time that scanning electron microscopy revealed that metal components of titanium alloys from tooth implants were transferred to melanoma tissue taken from the back of one patient.
CONCLUSION
Vibrational spectroscopy highlighted increased glycosylation in melanoma.
Topics: Aged; Biopsy; Carcinoma, Basal Cell; Humans; Malondialdehyde; Melanoma; Middle Aged; Neoplasm Proteins; Protein Structure, Secondary; Skin; Skin Neoplasms; Spectroscopy, Fourier Transform Infrared; Spectrum Analysis, Raman; Melanoma, Cutaneous Malignant
PubMed: 30804143
DOI: 10.21873/invivo.11512 -
Computerized Medical Imaging and... Sep 2023Submucosal invasion depth is a significant prognostic factor when assessing lymph node metastasis and cancer itself to plan proper treatment for the patient....
Submucosal invasion depth is a significant prognostic factor when assessing lymph node metastasis and cancer itself to plan proper treatment for the patient. Conventionally, oncologists measure the invasion depth by hand which is a laborious, subjective, and time-consuming process. The manual pathological examination by measuring accurate carcinoma cell invasion with considerable inter-observer and intra-observer variations is still challenging. The increasing use of medical imaging and artificial intelligence reveals a significant role in clinical medicine and pathology. In this paper, we propose an approach to study invasive behavior and measure the invasion depth of carcinoma from stained histopathology images. Specifically, our model includes adaptive stain normalization, color decomposition, and morphological reconstruction with adaptive thresholding to separate the epithelium with blue ratio image. Our method splits the image into multiple non-overlapping meaningful segments and successfully finds the homogeneous segments to measure accurate invasion depth. The invasion depths are measured from the inner epithelium edge to outermost pixels of the deepest part of particles in image. We conduct our experiments on skin melanoma tissue samples as well as on organotypic invasion model utilizing myoma tissue and oral squamous cell carcinoma. The performance is experimentally compared to three closely related reference methods and our method provides a superior result in measuring invasion depth. This computational technique will be beneficial for the segmentation of epithelium and other particles for the development of novel computer-aided diagnostic tools in biobank applications.
Topics: Humans; Carcinoma, Squamous Cell; Artificial Intelligence; Mouth Neoplasms; Epidermis; Epidermal Cells; Coloring Agents
PubMed: 37611486
DOI: 10.1016/j.compmedimag.2023.102276 -
Medical Ultrasonography Dec 2018To describe the ultrasonographic findings of surface and nodular basal cell skin cancer (BCC) using high frequency ultrasonography.
AIM
To describe the ultrasonographic findings of surface and nodular basal cell skin cancer (BCC) using high frequency ultrasonography.
MATERIALS AND METHODS
We examined 60 primary BCCs in different locations with the High Frequency Ultrasound (HFU) system DUB Skin Scanner using 75 MHz and 30 MHz probes. Epidermis, dermis, and depth of tumors spread in the region of interest (ROI) were measured. Visually unchanged, contralateral skin areas were examined as the control. Results: The surface BCC most often had elongated contours, clear margins and hypoechoic structure, while the nodular BCC had round or oval outlines and diffusely hypo-heterogeneous structure with clear margins. Sclerodermiform BCCs were visualized as hypoechoic areas of irregular shape penetrating in the dermis, with wavy fuzzy margins. The average thickness of the surface BCC in the US examination was 556.28±136.95 μ, the nodular BCC thickness was 2439.71±865.92 μ and the sclerodermiform thickness was 1500±325.33 μ. A statistically significant increase in the average thickness of tumors of the nodularand scleroderma forms was observed in comparison with the surface clinical variant (p<0.05). Hyperechoic inclusions were observed in 11% of the surface BCC's and in the 100% of the nodular BCC's. Their average number was 2±0.57 and 4±4.8, with the average area of 0.03±0.02 mm2 and 0.04±0.03 mm2 (p>0.05), respectively. In the surface BCC, they were mainly located along the periphery of the hypoechoic zones. In nodular BCC, the inclusions had a peripheral and combined (center and peripheral) distribution.
CONCLUSIONS
Ultrasound allows differentiating BCC as diffuse-heterogeneous, hypoechoic, formations in the dermis with distinct contours. Depending on the clinical picture, they differ in form, depth of bedding, as well as in the quantitative ratio and distribution of the point hyperechoic structures in them.
Topics: Aged; Carcinoma, Basal Cell; Female; Humans; Male; Middle Aged; Prospective Studies; Skin; Skin Neoplasms; Ultrasonography
PubMed: 30534655
DOI: 10.11152/mu-1633