RESUMO
SIGNIFICANCE: Multilesional basal cell carcinoma (BCC) are spread on sun exposed skin areas, including arms, face and back. The first-line treatment remains the surgical resection or Mohs surgery. Despite its high complexity, Mohs surgery is well practiced in USA and Germany and presents very good results both in esthetic and in carcinology point of view. Large lesions more than 2 cm remain challenging to remove by topical cream used in photodynamic therapy (PDT). If these larger lesions are not treated in less than 1 month, they could grow deeply in the skin, thus enhancing the risk of reoccurrence and the severity of the disease. Despite this model herein studied, that is non melanoma skin cancer is a good prognostic cancer, the therapy aims to be applied to more aggressive melanoma skin cancers. AIM: Total regression of large cutaneous lesions less than 1 month with no reoccurrence. APPROACH: Tumor induction on murine model bearing a 500 mm3 subcutaneous lesion. Increasing dose of gold nanoparticles at fixed initial concentration C0 = 0.3 mg/mL, infused into the tumor then exposition of the region of interest to NIR medical laser to assess the therapy. One or two intratumoral administration(s) were compared to surgery and control, that is no treatment, laser alone or nanoparticles alone. RESULTS: Gold nanoparticles alone or the NIR laser alone did not induce the tumor regression. The combination of laser and nanoparticles called plasmonic nanophotothermal therapy induced apoptosis. Derma and hypoderm do not show any visible gold nanoparticles and demonstrated a good cicatrization process. CONCLUSION: Plasmonic nanophotothermal therapy using two doses of gold nanoparticles was the only protocol that proved its efficacy on large lesions in 14 days, that is 500 mm3 on a murine model bearing human basal cell carcinoma.
Assuntos
Carcinoma Basocelular , Ouro , Nanopartículas Metálicas , Terapia Fototérmica , Neoplasias Cutâneas , Carcinoma Basocelular/patologia , Carcinoma Basocelular/terapia , Ouro/química , Animais , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Nanopartículas Metálicas/uso terapêutico , Humanos , Camundongos , Terapia Fototérmica/métodos , Linhagem Celular Tumoral , Fotoquimioterapia/métodos , Feminino , Terapia Combinada/métodosRESUMO
OBJECTIVES: To determine the rate skin color is reported in randomized controlled trials (RCTs) involving basal cell carcinoma (BCC) identification and treatment in the top ten dermatology journals. METHODS: A systematic review was conducted of RCTs involving BCC among the top ten dermatology journals, determined by impact factor, from inception to July 11th, 2023. Studies were included if they reviewed the prevention, detection, and treatment of BCC, directly involved patients, and were classified as RCTs. Studies were classified as positive for reporting skin of color (SOC) if the demographic data in the methods or results included any of the following terms: Fitzpatrick scale, race, ethnicity, skin of color, or sunburn tendency. RESULTS: Of the 51 studies identified, only 23 articles reported data pertaining to skin color within the results section (45.1%); whereas 28 articles mentioned skin color somewhere within the text (54.9%). Subgroup analysis was performed, and no statistical significance was found for study location or year of publication. CONCLUSION: Dark skin color can make it more difficult to diagnose skin tumors and it is unknown if race affects response to treatment. Less than 50% of RCTs related to basal cell carcinoma in top international dermatology journals included skin color within the demographic portion of their results section pertaining to study participants. Subgroup analysis demonstrated that studies performed within the United States reported skin color less than half the time (40%). Additionally, there has been no statistically significant difference in reporting over the past 4 decades. Further research is necessary to determine whether low reporting rates of race/skin color in BCC-related RCTS could impact diagnostic or treatment recommendations for patient care in this group.
Assuntos
Carcinoma Basocelular , Dermatologia , Publicações Periódicas como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Cutâneas , Pigmentação da Pele , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Dermatologia/estatística & dados numéricos , Dermatologia/métodos , Fator de Impacto de RevistasRESUMO
The relevance of the problems of diagnosis and treatment of skin cancer is currently determined not only by the high incidence rate, but by the existing difficulties in differential diagnosis and treatment with traditional methods. For localizations of basal cell skin cancer (BCSC) that are "inconvenient" for treatment, such as the external auditory canal, auricle, and wing of the nose, treatment is associated with certain difficulties and the possible appearance of a cosmetic defect, therefore, when choosing a treatment method, the anatomical features of these organs are taken into account. It has been determined that the effectiveness of treatment for primary BCSC of the nose and auricles is higher than recurrent one, and among the various treatment methods, the most effective and radical is the surgical method. The immediate results of treatment of BCSC in the form of PR by surgical method were 86.7%, which is statistically significant compared with other types of treatment (p < 0.05). Long-term treatment results with the surgical method are also higher (77%) compared to other methods, which is also statistically significant (p < 0.05).
Assuntos
Carcinoma Basocelular , Neoplasias Nasais , Neoplasias Cutâneas , Humanos , Carcinoma Basocelular/cirurgia , Carcinoma Basocelular/terapia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patologia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/terapia , Pessoa de Meia-Idade , Resultado do Tratamento , Idoso , Masculino , Feminino , Neoplasias da Orelha/cirurgia , Neoplasias da Orelha/terapia , Neoplasias da Orelha/diagnóstico , Adulto , Idoso de 80 Anos ou maisRESUMO
Skin cancer encompasses a range of cutaneous malignancies, with non-melanoma skin cancers (NMSCs) being the most common neoplasm worldwide. Skin exposure is the leading risk factor for initiating NMSC. Ultraviolet (UV) light induces various genomic aberrations in both tumor-promoting and tumor-suppressing genes in epidermal cells. In conjunction with interactions with a changed stromal microenvironment and local immune suppression, these aberrations contribute to the occurrence and expansion of cancerous lesions. Surgical excision is still the most common treatment for these lesions; however, locally advanced or metastatic disease significantly increases the chances of morbidity or death. In recent years, numerous pharmacological targets were found through extensive research on the pathogenic mechanisms of NMSCs, leading to the development of novel treatments including Hedgehog pathway inhibitors for advanced and metastatic basal cell carcinoma (BCC) and PD-1/PD-L1 inhibitors for locally advanced cutaneous squamous cell carcinoma (cSCC) and Merkel cell carcinoma (MCC). Despite the efficacy of these new drugs, drug resistance and tolerability issues often arise with long-term treatment. Ongoing studies aim to identify alternative strategies with reduced adverse effects and increased tolerability. This review summarizes the current and emerging therapies used to treat NMSC.
Assuntos
Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/tratamento farmacológico , Padrão de Cuidado , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , Microambiente Tumoral , Inibidores de Checkpoint Imunológico/uso terapêutico , AnimaisAssuntos
Carcinoma Basocelular , Neoplasias Orbitárias , Neoplasias Cutâneas , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Basocelular/patologia , Carcinoma Basocelular/terapia , Terapia Combinada , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/terapia , Equipe de Assistência ao Paciente , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/diagnósticoRESUMO
Approximately 5-15% of all dermatologic malignancies manifest in the upper and lower eyelids. The primary types include basal cell carcinoma, squamous cell carcinoma, and sebaceous cell carcinoma, with Merkel cell carcinoma and melanoma following closely behind. Basal cell carcinoma predominantly affects the lower eyelid, yet various other carcinomas, melanomas, metastases, and neoplasms of diverse origins can arise on both upper and lower eyelids. Risk factors such as advanced age, smoking, and notably, exposure to UV light significantly contribute to the development of these eyelid lesions. Despite the increasing incidence, research on dermatologic eyelid malignancies remains limited. However, such study is imperative given that many systemic oncologic malignancies initially present as metastatic eyelid lesions. This paper provides an in-depth exploration of eyelid anatomy, clinical presentation, diagnosis, and treatment management.Key Points: Eyelid metastases represent less than one percent of all eyelid cancers, yet they often serve as the initial indication of an underlying systemic malignancy. Early detection and treatment is crucial in improving prognosis and quality of life for patients. Treatment options encompass a range of modalities, with Mohs surgery as the gold standard for the removal of ocular tumors. Additional treatment options include local excision as well as non-surgical interventions such as radiotherapy, cryotherapy, immunotherapy, and topical medications.
Assuntos
Neoplasias Palpebrais , Humanos , Neoplasias Palpebrais/terapia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/epidemiologia , Neoplasias Palpebrais/patologia , Pálpebras/patologia , Cirurgia de Mohs , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Melanoma/terapia , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/epidemiologia , Carcinoma de Célula de Merkel/terapia , Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/secundário , Carcinoma de Célula de Merkel/patologia , Fatores de Risco , Carcinoma Basocelular/terapia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/secundário , Qualidade de Vida , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias das Glândulas Sebáceas/terapia , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias das Glândulas Sebáceas/patologiaRESUMO
In electrochemotherapy, permeabilization of the cell membrane by electric pulses increases the anti-tumour effect of chemotherapeutics. In calcium electroporation, chemotherapy is replaced by calcium chloride with obvious benefits. This study explores the effect and underlying mechanisms of calcium electroporation on basal cell carcinomas using either high- or low-frequency electroporation. Low-risk primary basal cell carcinomas were treated in local anaesthesia with intratumoral calcium chloride followed by electroporation with high (167 kHz) or low (5 kHz) frequencies. Non-complete responders were retreated after 3 months. The primary endpoint was tumour response 3 months after last calcium electroporation. Plasma membrane calcium ATPase was examined in various cell lines as plasma membrane calcium ATPase levels have been associated with calcium electroporation efficacy. Twenty-two out of 25 included patients complete the study and 7 of these (32%) achieved complete response at 3 months with no difference in efficacy between high- and low-frequency pulses. High-frequency calcium electroporation was significantly less painful (p=0.03). Plasma membrane calcium ATPase was increased 16-32-fold in basal cell carcinoma cell lines compared with 4 other cancer cell lines. Calcium electroporation for low-risk basal cell carcinomas does not fulfil the requirements of a new dermatological basal cell carcinoma treatment but may be useful as adjuvant treatment to surgery in more advanced basal cell carcinomas. The elevated PMCA levels in basal cell carcinomas may contribute to low efficacy.
Assuntos
Carcinoma Basocelular , Eletroquimioterapia , Neoplasias Cutâneas , Humanos , Carcinoma Basocelular/patologia , Carcinoma Basocelular/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Resultado do Tratamento , Eletroquimioterapia/métodos , Linhagem Celular Tumoral , Cloreto de Cálcio/administração & dosagem , Idoso de 80 Anos ou mais , ATPases Transportadoras de Cálcio da Membrana Plasmática/metabolismo , Fatores de Tempo , EletroporaçãoRESUMO
Since the scrotum is rarely exposed to sunlight, basal cell carcinoma (BCC) development in this area is an uncommon occurrence. As result, there is a scarcity of research covering this particular presentation, which poses a diagnostic and therapeutic challenge for clinicians. The objective of this systematic review is to provide a thorough overview of scrotal BCC, including a summary of its clinical characteristics, and microscopic subtypes. It also seeks to discuss the many techniques used in the management of this uncommon clinical presentation. Utilizing data from 1957 to October 2023, a systematic review of PubMed and Wiley Online Library was conducted to identify all cases of scrotal BCC with various presentations and managements. A total of 73 patients were included. The median patient age was 65.9 years (range 42 to 87). All studies were either case reports or case series. Our review shows that treatment with Mohs micrographic surgery (MMS), leads to a superior patient outcome based on anecdotal evidence in select cases. To deepen our understanding of Mohs surgery's efficacy in treating scrotal BCC, it is imperative to conduct more robust research in the form of randomized clinical trials.
Assuntos
Carcinoma Basocelular , Cirurgia de Mohs , Escroto , Neoplasias Cutâneas , Humanos , Escroto/patologia , Escroto/cirurgia , Masculino , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adulto , Resultado do TratamentoRESUMO
OPINION STATEMENT: Non-melanoma skin cancers (NMSCs) are the most common malignancy and surgical excision is considered treatment of choice for the majority of cases. However, surgery can be very extensive in cases of large, multiple, or cosmetic-sensitive tumors located on areas such as scalp and face or genital region, leading to significant functional and cosmetic deficit. Aminolaevulinic acid photodynamic therapy (ALA-PDT) has emerged as a widely used approach in a variety of skin diseases, demonstrating remarkable efficacy in treatment of actinic keratosis, Bowen disease and basal cell carcinoma. Besides, when employed as a preoperative intervention, ALA-PDT effectively reduces tumor size and minimizes subsequent local surgical morbidity. With its minimally invasive nature and proven effectiveness, ALA-PDT holds significant promise as a neoadjuvant treatment option for NMSCs. In cases where the tumor is large, invasive, multiple, or located in cosmetically and functionally sensitive areas, or when considering patient factors such as age, comorbidity, willingness to undergo surgery, and post-operative quality-of-life, surgical intervention or radiotherapy alone may be impracticable or unacceptable. In such scenarios, neoadjuvant ALA-PDT can offer remarkable outcomes. In order to further ensure the maximum benefit of patients from neoadjuvant PDT, collaboration with multidisciplinary teams and whole-process management may be in need.
Assuntos
Terapia Neoadjuvante , Fotoquimioterapia , Neoplasias Cutâneas , Humanos , Fotoquimioterapia/métodos , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/tratamento farmacológico , Terapia Neoadjuvante/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Resultado do Tratamento , Ácido Aminolevulínico/uso terapêutico , Carcinoma Basocelular/terapia , Carcinoma Basocelular/tratamento farmacológico , Gerenciamento Clínico , Terapia Combinada/métodosRESUMO
The interdisciplinary treatment of skin cancer in the head and neck area requires close collaboration between different specialist disciplines. The most common non-melanoma skin cancer tumor entities are cutaneous squamous cell carcinoma and basal cell carcinoma as well as their precursor lesions. One of the less common tumors is Merkel cell carcinoma, which also occurs primarily in light-exposed areas and, in contrast to squamous and basal cell carcinoma, is more likely to metastasize. Due to the low tendency of basal cell carcinoma as well as cutaneous squamous cell carcinoma to metastasize, a cure can often be achieved by surgery. If the tumor growth exceeds certain levels it may require collaboration between dermatology and otorhinolaryngology. The primary goal of this interdisciplinary collaboration is to achieve a functional, cosmetically and aesthetically acceptable result in addition to adequate tumor treatment. Depending on the stage of the tumor and the clinical course, a case may be discussed in an interdisciplinary tumor board in order to determine a personalised, appropriate and adequate treatment concept for each patient, including prevention, therapy and follow-up.
Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Comunicação Interdisciplinar , Neoplasias Cutâneas , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Humanos , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Equipe de Assistência ao Paciente , Carcinoma de Célula de Merkel/terapia , Carcinoma de Célula de Merkel/patologia , Carcinoma de Célula de Merkel/cirurgia , Colaboração Intersetorial , Estadiamento de NeoplasiasRESUMO
Narrow-band TL-01 ultraviolet B phototherapy (TL-01) is an effective and widely used treatment for many skin diseases. The purpose of the investigation was to assess the risk of skin cancers in patients treated with TL-01 phototherapy who have not received any other phototherapy modalities. This cohort study included 4,815 TL-01 treated patients in Finland with psoriasis or atopic dermatitis. Clinical information was collected from the hospital records and linked with Finnish Cancer Registry data. The follow-up started from the first TL-01 treatment and the mean follow-up time was 8.4 years. Standardized incidence ratios were calculated for basal cell carcinoma, cutaneous melanoma, and squamous cell carcinoma. The standardized incidence ratio for basal cell carcinoma was 2.5 (95% confidence interval 1.8-3.5), for cutaneous melanoma 4.0 (95% confidence interval 2.1-6.8) and for squamous cell carcinoma 3.7 (95% confidence interval 1.7-7.0). For basal cell carcinoma and squamous cell carcinoma, the standardized incidence ratios remained similar during the whole follow-up time while the standardized incidence ratio for cutaneous melanoma was markedly higher during the first 5 years of follow-up. In conclusion, an increased incidence of skin cancers was observed among TL-01 treated patients. It should be confirmed in the future whether the skin cancer risk of TL-01 phototherapy will remain high in a longer follow-up.
Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Psoríase , Neoplasias Cutâneas , Terapia Ultravioleta , Humanos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Melanoma/epidemiologia , Melanoma/complicações , Estudos de Coortes , Fototerapia/efeitos adversos , Terapia Ultravioleta/efeitos adversos , Psoríase/tratamento farmacológico , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/terapia , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/terapiaRESUMO
OBJECTIVES: To examine recent changes in the numbers of Medicare-subsidised keratinocyte cancer excisions, particularly for younger people exposed to primary prevention campaigns since the early 1980s. STUDY DESIGN: Retrospective cohort study; analysis of administrative data. SETTING, PARTICIPANTS: Analysis of Medicare Benefits Schedule (MBS) claims data for procedures related to the diagnosis and treatment of keratinocyte cancer in Australia, 2012-2021. MAIN OUTCOME MEASURES: Age-standardised rates for MBS-subsidised claims for first surgical squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) excisions, Mohs surgery, surgical excisions of benign lesions, skin biopsies, and cryotherapy or serial curettage of premalignant and malignant lesions, overall, and by sex, state/territory, and age group; average annual percentage change in rate for time intervals determined by joinpoint regression. RESULTS: In men, the age-standardised rate of BCC/SCC excisions increased by 1.9% (95% confidence interval [CI], 1.4-2.4%) per year during 2012-2019 (from 2931 to 3371 per 100 000 men) and then declined by 3.8% (95% CI, 0.5-7.0%) per year during 2019-2021 (to 3152 per 100 000). In women, the age-standardised rate increased by 2.2% (95% CI, 1.7-2.8%) per year during 2012-2019 (from 1798 to 2093 per 100 000 women); the decline to 1967 excisions per 100 000 women in 2021 was not statistically significant. BCC/SCC excision rates declined for men under 55 years of age (by 1.0-3.4% per year) and women under 45 years of age (by 1.7-2.3% per year). Age-standardised biopsy rates increased during 2012-2021 in all age groups (by 2.8-6.9% per year). CONCLUSIONS: Rates of MBS-subsidised treatment for keratinocyte cancers increased during 2012-2019, but BCC/SCC treatment rates declined among younger Australians, who have probably been exposed to less sunlight than earlier generations because of public health interventions and population-wide lifestyle changes related to technology use.
Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias Cutâneas , Humanos , Estudos Retrospectivos , Masculino , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/terapia , Feminino , Austrália/epidemiologia , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Idoso , Adulto , Queratinócitos/patologia , Idoso de 80 Anos ou mais , Cirurgia de Mohs/estatística & dados numéricos , Adulto Jovem , Crioterapia/estatística & dados numéricos , Fatores EtáriosRESUMO
Basal cell carcinoma (BCC) represents the most prevalent cancer globally. The past decade has witnessed significant advancements in BCC treatment, primarily through bibliometric studies. Aiming to perform a comprehensive bibliometric analysis of BCC treatments to comprehend the research landscape and identify trends within this domain, a dataset comprising 100 scientific publications from the Web of Science Core Collection was analyzed. Country co-operation, journal co-citation, theme bursts, keyword co-occurrence, author co-operation, literature co-citation, and field-specific references were examined using VOSviewer and CiteSpace visualization tools. These articles, published between 2013 and 2020, originated predominantly from 30 countries/regions and 159 institutions, with the USA and Germany at the forefront, involving a total of 1118 authors. The keyword analysis revealed significant emphasis on the hedgehog pathway, Mohs micrographic surgery, and photodynamic therapy. The research shows developed nations are at the forefront in advancing BCC therapies, with significant focus on drugs targeting the hedgehog pathway. This treatment avenue has emerged as a crucial area, meriting considerable attention in BCC therapeutic strategies.
Assuntos
Carcinoma Basocelular , Fotoquimioterapia , Neoplasias Cutâneas , Humanos , Bibliometria , Carcinoma Basocelular/terapia , Proteínas Hedgehog , Neoplasias Cutâneas/terapiaRESUMO
OPINION STATEMENT: Skin tumors commonly seen in dermatology are involved in all layers of the skin and appendages. While biopsy of affected skin remains an essential method to confirm diagnosis and to predicate tumor prognosis, it has its limitations. Recently, photodynamic diagnosis (PDD) has demonstrated high sensitivity in detecting affected skin and mucosal tissues, providing valuable guidance for precision surgery to resect skin and mucosal tumors. In this review, we summarized the literatures concerning the applications of PDD in diagnostic process and treatment of skin and mucosal conditions such as actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Bowen's disease (BD) and extramammary Paget's disease (EMPD). The findings suggest that PDD holds substantial promise for expanding clinical applications and deserves further research exploration.
Assuntos
Fotoquimioterapia , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/etiologia , Fotoquimioterapia/métodos , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Gerenciamento Clínico , Fármacos Fotossensibilizantes/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapiaRESUMO
Basal cell carcinoma (BCC) is the most common skin malignancy, with a higher prevalence in Caucasians than in East Asians. Although there is a lack of epidemiological data in China, it is generally believed that the incidence of BCC in China is increasing due to the aging population. A variety of risk factors are related to the occurrence of BCC, among which ultraviolet rays and gene mutations play a major role, especially the abnormal activation of Hedgehog (Hh) signaling pathway, which is considered to be the most important pathogenesis of BCC. The clinical manifestations of BCC are highly specific, and most experienced doctors can make a preliminary diagnosis by clinical manifestations. Dermoscopy and other imaging methods can greatly improve the accuracy of diagnosis, but there are still some atypical or rare types of BCC that need further confirmation through histopathological examination. This guideline is initiated by the National Clinical Research Center for Skin and Immune Diseases (based on Peking University First Hospital). It has invited a panel of experts consisting of 24 senior dermatologists specializing in dermatologic surgery from the Dermatologic Surgery Group of the Chinese Medical Doctor Association of Dermatology, the Dermatologic Surgery Group of the Dermatology & Venereology Committee, Chinese Association of Integration Medicine, and the Dermatologic Surgery and Cosmetic Branch of Clina Leprosy Association. In addition, experts from the Burn and Plastic Surgery (Maxillofacial), Ophthalmology, Otolaryngology, Head and Neck Surgery, Radiation Therapy, and Pathology were also invited to participate. This panel forms the "Chinese Guideline for the Diagnosis and Treatment of Basal Cell Carcinoma" expert group. Based on the latest domestic and international research findings, the guideline was developed through four rounds of discussions by the expert group and revised to provide valuable references for clinical healthcare providers in the diagnosis and treatment of BCC.
Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Idoso , Proteínas Hedgehog , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Carcinoma Basocelular/etiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Fatores de Risco , ChinaRESUMO
To summarize the current therapies for skin cancers, the Japanese Skin Cancer Society issued the first guidelines for skin cancers, including melanoma, squamous cell carcinoma, basal cell carcinoma (BCC), and extramammary Paget's disease, in 2007. These guidelines were revised in 2015. Herein, we present the English version of the 2021 edition of the Japanese clinical guidelines for BCC. In the latest edition, all procedures were performed according to the Grading of Recommendations, Assessment, Development and Evaluation systems. The clinical questions that could not be answered were selected for further analysis. A comprehensive literature search, systematic review, and recommendations for each clinical question were determined by a multidisciplinary expert panel comprising dermatologists, a plastic and reconstructive surgeon, and a pathologist. Surgical resection is the gold-standard therapy of BCC. Radiotherapy or topical treatments, other than surgical resection, have been used in some cases. Patients with unresectable or metastatic BCC require systemic therapy. Novel agents, such as immune response modifiers or hedgehog pathway inhibitors, are emerging worldwide for the treatment of BCC. Based on these viewpoints, four relevant clinical questions regarding, surgical resection, radiotherapy, topical treatment, and systemic therapy, were raised in this report that aims to help clinicians select suitable therapies for their patients.
Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico , Japão , Dermatologia/normas , Sociedades Médicas/normas , Antineoplásicos/uso terapêutico , População do Leste AsiáticoRESUMO
BACKGROUND: Active surveillance may be considered for low-risk basal cell carcinomas (BCCs) in patients with limited life expectancy; however, estimates of life expectancy are not readily available. Veterans Health Administration's Care Assessment Need (CAN) score may address this problem. OBJECTIVE: We examined the CAN score's performance in predicting 1-, 3-, and 5-year mortality in US veterans with BCC. METHODS: This retrospective cohort study used national Veterans Health Administration's electronic medical record data. The CAN score's performance in the prediction of mortality in veterans with BCC was evaluated based on tests of goodness-of-fit, discrimination, and calibration. RESULTS: For 54,744 veterans with BCC treatment encounters between 2013 and 2018, the CAN score performed well in the prediction of mortality based on multiple tests. A threshold CAN score of 90 had a positive predictive value of 55% for 3-year mortality, clinically useful in identifying patients with intermediate-term survival. LIMITATIONS: The study relied upon the combination of diagnosis codes and procedure codes to identify BCC cases. CONCLUSION: The CAN score has the potential to improve the quality of cancer care for veterans by providing clinicians with an estimate of life expectancy and facilitating conversations in cases where active surveillance can be considered.
Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Veteranos , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Estudos Retrospectivos , Registros Eletrônicos de Saúde , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Carcinoma Basocelular/patologia , Expectativa de VidaRESUMO
Introducción: El carcinoma basocelular es el tumor epitelial maligno más frecuente, pues constituye 60-80 % de todos los cánceres cutáneos. Objetivo: Determinar la respuesta al HeberFERON® en pacientes con carcinoma basocelular. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 90 pacientes con carcinoma basocelular, a quienes se le administró HeberFERON® en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero de 2017 hasta diciembre de 2019. Se analizaron variables demográficas, clínicas y de respuesta al tratamiento. Resultados: La edad promedio fue de 63 años; hubo una mayor incidencia del sexo masculino (58 para 64,4 %) y el fototipo cutáneo II (56 para 62,0 %), con lesiones localizadas en la nariz (42 para 46,7 %), así como un predominio del subtipo clínico nodular (41 para 45,6 %). Se logró el control de la enfermedad en 100,0 % de la casuística. Conclusiones: El HeberFERON® resultó de gran utilidad en los pacientes con carcinoma basocelular, puesto que en más de la mitad de ellos se obtuvo una respuesta completa, con un mínimo de eventos adversos, todos leves y moderados.
Introduction: The basal cell carcinoma is the most frequent epithelial neoplasm, because it constitutes 60-80 % of all the cutaneous cancers. Objective: To determine the answer to HeberFERON® in patients with basal cell carcinoma. Methods: An observational, descriptive and longitudinal study of 90 patients with basal cell carcinoma to whom HeberFERON® was administered was carried out at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from January, 2017 to December, 2019. Some demographic, clinical variables that responded to the treatment were analyzed. Results: The average age was 63 years; there was a higher incidence of the male sex (58 for 64.4 %) and the cutaneous fototype II (56 for 62.0 %), with lesions located in the nose (42 for 46.7 %), as well as a prevalence of the nodular clinical subtype (41 for 45.6 %). The control of the disease was achieved in 100.0 % of the case material. Conclusions: The HeberFERON® was very useful in patients with basal cell carcinoma, since in more than a half of them a complete response was obtained, with a minimum of adverse events, all of them light and moderate.
Assuntos
Neoplasias Cutâneas , Carcinoma Basocelular/terapia , ImunoterapiaRESUMO
RESUMEN Fundamento: El carcinoma basocelular periocular es una lesión tumoral que surge de las células basales de la epidermis y los folículos pilosos, con un alto potencial de destrucción local, pueden ser desfigurantes e invaden el tejido que los rodea dando lugar a deformidades o pérdida de la función del órgano afectado. En orden de aparición es más común en el párpado inferior, el canto medial, el párpado superior y el canto temporal. Objetivo: Describir los resultados de la aplicación del HeberFERON en una serie de casos con carcinoma basocelular periocular que acudieron a consulta de dermatología del Policlínico Centro, de enero de 2017 a diciembre del 2020. Metodología: Se realizó un estudio de serie de casos clínicos con carcinoma basocelular periocular que acudieron a la consulta de dermatología del Policlínico Centro. Se incluyeron 17 casos con diagnóstico clínico, dermatoscópico e histopatológico. Se realizó una evaluación inicial, durante y 16 semanas después del tratamiento; se administró 10.5 UI de HeberFERON 3 veces por semana perilesional e intradérmica hasta completar 9 dosis. Las variables principales fueron la respuesta al tratamiento y la presencia o no de eventos adversos. Resultados: Predominó el sexo masculino, el fototipocutáneo II, la localización en párpado inferior, el subtipo clínico nódulo ulcerativo y el histológico sólido, se logró respuesta completa en la mayoría de los pacientes. Como eventos adversos se presentaron dolor en el sitio de inyección, fiebre, mal estar general, edema y eritema perilesional. Conclusiones: La respuesta al tratamiento fue favorable en la mayoría de los pacientes tratados con HeberFERON.
ABSTRACT Background: Periocular basal cell carcinoma is a tumor lesion arising from the epidermis and hair follicles basal cells, with a high potential local destruction, can be disfiguring and invade the surrounding tissue leading to deformities or loss of function of the affected organ. In order of appearance it is most common in the lower eyelid, medial edge, upper eyelid and temporal edge. Objective: To describe the results of the application of HeberFERON in a case series with periocular basal cell carcinoma who attended dermatology appointment at the Policlínico Centro, from January 2017 to December 2020. Methodology: A series study of clinical cases with periocular basal cell carcinoma who attended the dermatology appointment at the Policlínico Centro was conducted. 17 cases with clinical, dermatoscopic and histopathological diagnosis were included. A baseline evaluation was conducted, during and 16 weeks after treatment; 10.5 IU of HeberFERON was administered 3 times a week perilesional and intradermally until completing 9 doses. The main variables were the treatment response and the presence or absence of adverse events. Results: Male sex, phototypocutaneous II, lower eyelid location, clinical subtype ulcerative nodule and solid histological subtype predominated, complete response was achieved in most patients. Adverse events were pain at the injection site, fever, general malaise, edema and perilesional erythema. Conclusions: Treatment response was favorable in most patients treated with HeberFERON.