Quality of Life in Patients Affected by Facial Basal Cell Carcinoma: Prospective Longitudinal Pilot Study and Validation of Skin Cancer Index in Lithuanian Language.

Purpose: Facial basal cell carcinoma (BCC) poses significant challenges due to its potential for local destruction and impact on quality of life (QoL). Continuous research is necessary to identify novel factors influencing the quality of life within this demographic across diverse cultural settings. The aims of this study were to translate, culturally adapt, and validate the Lithuanian version of Skin Cancer Index, subsequently utilizing this questionnaire in the pilot phase of the study to achieve the following: (1) identify the differences in short- and long-term QoL, (2) establish empirical correlations between SCI scores and aesthetic facial regions, evaluate the potential differences between age, gender, and tumor size groups. Patients and Methods: A prospective longitudinal study was conducted with 100 consecutive patients. The SCI was translated into Lithuanian language, with a rigorous assessment of its psychometric properties to confirm validity. Alongside hypothesis testing, a detailed analysis of variables was conducted. Statistical techniques, including t-tests and ANOVA, were employed to compare scores across demographic and clinical groups, with effect size calculations for further interpretation. Results: Our findings demonstrate that the Lithuanian SCI successfully fulfills the criteria established by the COSMIN checklist. Surgical treatment for facial BCC notably enhances QoL, particularly evident six months post-surgery. Analysis of SCI scores identified demographic and clinical factors associated with lower QoL, including female gender, treatment with skin plasty, and tumor sites in aesthetically sensitive areas like the cheek, nose, and eyelid. Conclusion: The Lithuanian version of the SCI is a reliable and valid tool for assessing QoL in facial BCC patients. Our findings underscore the global relevance of understanding the multifactorial influences on QoL in BCC patients. Early diagnosis, less invasive treatment approaches, and tailored post-operative care are crucial in minimizing the psychological, social, and appearance-related burdens of facial BCC.

Aesthetic Evaluation of Facial Scars in Patients Undergoing Surgery for Basal Cell Carcinoma: A Prospective Longitudinal Pilot Study and Validation of POSAS 2.0 in the Lithuanian Language.

Facial basal cell carcinoma (BCC) surgery enhances the quality of life (QoL) but leaves patients with inferior QoL, presumably caused by scarring, emphasizing the need to understand post-surgery aesthetic satisfaction. This study aimed to validate the Lithuanian version of the Patient and Observer Scar Assessment Scale (POSAS) 2.0 and utilise it to identify scar evaluation differences and correlations among POSAS scores and specific aesthetic facial regions, age, gender, surgery types, and short- and long-term QoL. Employing a prospective longitudinal design, 100 patients with facial scars after surgical BCC removal were enrolled. The validation phase confirmed the translated POSAS 2.0 psychometric properties, while the pilot phase used statistical analyses to compare scores among demographic and clinical groups and evaluate correlations between scar assessment and QoL. The findings indicate that the translated Lithuanian version of POSAS 2.0 exhibits good psychometric properties, revealing insights into aesthetic satisfaction with post-surgical facial scars and their impact on QoL. The Lithuanian version of the POSAS 2.0 was established as a valid instrument for measuring post-surgical linear scars. QoL with scar assessment statistically significantly correlates, 6 months after surgery, with worse scores, particularly notable among women, younger patients, and those with tumours in the cheek region.

The Quality of Life in Surgically Treated Head and Neck Basal Cell Carcinoma Patients: A Comprehensive Review.

In this review, we examine current literature analyzing the impact of surgical treatment on the QoL in patients with head and neck BCC. A comprehensive literature review was performed using the main databases. As many as six out of 322 articles were selected for the final analysis. The selected articles were published in the period between 2004 and 2021, most published within the last two years. All analyzed studies were prospective. Five out of six studies evaluated NMSC consisting of both BCC and SCC, and only one study selectively evaluated the impact of surgical treatment on QoL in patients with craniofacial BCC. Authors of the selected studies reported that QoL improves following the surgery; however, the effect on QoL varies. Patients' age, gender, marital status, education level, and employment status had a stronger correlation with QoL postoperatively, especially during the late follow-up period. Younger patients were more bothered by appearance-related issues. One study concluded that elderly patients did not experience a statistically significant improvement in QoL. This literature review demonstrated that there is no clear consensus on the use of a single disease-specific QoL measurement tool. Furthermore, there is a lack of studies assessing the impact of surgical treatment on QoL exclusively in patients with head and neck BCC and studies analyzing the multivariate correlation between QoL and tumor type, size, anatomic site, and treatment outcomes.

Anxiety, Depression, and Suicidal Ideation amongst Patients with Facial Dermatoses (Acne, Rosacea, Perioral Dermatitis, and Folliculitis) in Lithuania.

BACKGROUND/OBJECTIVE: Skin diseases, especially those with visible manifestation, are considered to cause a major influence on global mental health. Therefore, we determined the prevalence and severity of anxiety, depression, and suicidal ideation in a large sample of patients with facial dermatoses, namely acne, rosacea, folliculitis, and perioral dermatitis. METHODS: The mental health of patients with facial dermatoses and respective controls was assessed using the Hospital Anxiety and Depression Scale and questions concerning suicidal ideation. RESULTS: The study included 543 patients with facial dermatoses and 497 healthy individuals. Anxiety was present in 37.6% of the patients (14.9% of controls), depression in 21.7% (6.8%), and suicidal thoughts in 9.8% (3.2%) (p < 0.001). Acne patients demonstrated the highest anxiety and depression subscale scores (mean ± standard deviation: 7.1 ± 0.25, 95% confidence interval (CI): 6.58-7.56; controls: 5 ± 0.23, 95% CI: 4.57-5.49). In rosacea 30% of the patients had depression symptoms (adjusted odds ratio (OR): 7.216, 95% CI: 4.122-12.632, p < 0.001), while in folliculitis patients 15.4% (OR: 3.138, 95% CI: 1.241-7.936, p = 0.016) had suicidal thoughts. Patients with anxiety symptoms and suicidal thoughts were on average younger than those without (28.3 ± 0.76 vs. 31.2 ± 0.66 years, p = 0.001 and 25.3 ± 0.98 vs. 30.5 ± 0.55 years, p = 0.007, respectively). CONCLUSION: Acne and rosacea are associated with anxiety, depression, and suicidal ideation in Lithuanian patients. Younger patients are more prone to report such symptoms than older ones.

A 12-Year Experience of Hidradenitis Suppurativa Management.

BACKGROUND: Although treatment recommendations for hidradenitis suppurativa (HS) are well known, practical experience implementing them in Lithuania has not been reported yet. OBJECTIVE: To review clinical findings and treatment options used in patients with HS in the largest center of dermatology and venereology in Lithuania from 2005 to 2016. METHODS: A retrospective single-center medical file analysis was conducted on 46 patients with HS. Demographic information, patient history, and treatment results were included in the final analysis. χ Tests were used. Statistical significance was set at P ≤ .05. MAIN RESULTS: Of the 46 patients, 52.2% were male. Percentages of patients with Hurley stages I, II, and III were 41.3%, 30.4%, and 28.3%, respectively. Patients with Hurley III HS were more likely to be smokers and obese. The most commonly prescribed medications were systemic antibiotics (76.1%) and systemic retinoids (37.0%). Systemic corticosteroids (19.6%) were more often prescribed to patients with Hurley III. Surgical procedures were performed in 54.3% of patients. The most common complication of the disease was contracture (13.0%). CONCLUSIONS: This study revealed an association between smoking and obesity and the most severe stage of HS. Results showed that traditional medications used in this study were not effective for severe HS.

Trends of basal cell carcinoma at the Centre of Dermatovenereology of Vilnius University.

INTRODUCTION AND OBJECTIVES: Basal cell carcinoma is the most common locally invasive malignant epidermal neoplasm in humans and its incidence has increased over the last decades worldwide, especially among the Caucasian population. Basal cell carcinoma accounts for about 75% of all skin cancers. Incidence data on basal cell carcinoma is sparse because traditional cancer registries often do not register these tumours. In Lithuania, patients with skin cancer and melanoma were traditionally treated in centralized oncological institutes. From 2006, the Centre of Dermatovenereology at Vilnius University Hospital Santaros Klinikos (Vilnius, Lithuania) provides modern diagnostic and treatment facilities to oncodermatological patients. The objective of the study was to evaluate epidemiological and clinical data of basal cell carcinoma at the Centre of Dermatovenereology during the last 15 years. MATERIALS AND METHODS: Medical documentation of the cases of histologically-proven basal cell carcinoma diagnosed between 2000 and 2015 was analyzed. Epidemiological and clinical evaluation according to the patients' age, sex, and place of residence, as well as tumour localization, its histological type, and treatment options was performed. RESULTS: After the skin lesion biopsy and histopathological examination, a total of 847 basal cell carcinomas were confirmed to 782 patients. During the study period, the total annual number of newly diagnosed basal cell carcinomas rose steadily in our centre: 2.7% between 2000 and 2003, 6.5% between 2004 and 2006, 13.6% between 2007 and 2009, 27.6% between 2010 and 2012, and 49.6% between 2013 and 2015. The biggest part of patients (28.4%) were 70-79 years old, 4.6% - younger than 40, 7.3% - 40-49, 17.1% - 50-59, 27.2% - 60-69, 14.1% - 80-89, and 1.3% ≥90 years old. The average patient age was 66.0 (±13.6). Of these patients, 62.0% were female and 38.0% male; 63.6% were from the capital city, 18.3% from other cities, and 18.2% from rural areas. Basal cell carcinomas occurred most often in the face region 49.0%, followed by the trunk - 29.4%, the scalp and neck - 10.9%, arms and legs - 7.7%, in 2.9% location was not specified and the whole body - 0.1%. The predominant histological type of basal cell carcinomas was nodular (60.6%), other diagnosed types were superficial (22.9%), infiltrative/morpheaform (8.0%), mixed nodular and infiltrative (1.7%), pigmented (0.2%), rare types (micronodular, infundibulocystic, ductal and mixed) - 0.6%; the type was not specified in 6.0% of cases. Nodular, superficial, and infiltrative types were the most common morphological types in all body sites: respectively, in the face - 67.5%, 12.5%, 9.4%; in the scalp and neck region - 77.2%, 14.1%, 5.4%; in the trunk - 49.8%, 37.3%, 7.2%; in extremities - 41.5%, 43.1%, 7.7%. The nodular type was more common among the elderly and its incidence increased with age (p = 0.009), meanwhile, superficial basal cell carcinomas prevailed among younger patients (<40 years), and its incidence decreased with age (p < 0.001). Also, the nodular type was usually found in the areas of the face (p < 0.001) and the scalp and neck (p = 0.045), and the superficial type - in the areas of the trunk (p < 0.001) and extremities, specifically in the hand (p = 0.022). Basal cell carcinomas were mostly treated with surgical excision (79.6%), photodynamic therapy (5.5%; in our centre, this treatment option is available from 2007), and other/combined methods (14.9%). CONCLUSIONS: The results showed that the number of newly diagnosed basal cell carcinomas increased continuously between 2000 and 2015. Basal cell carcinomas in our centre occurred most often among the patients aged 70-79 years. This tumour was more often diagnosed in female than male patients. Most of basal cell carcinomas were located on the chronically sun-exposed skin, such as the face region, and were of the nodular histological type, which is more common among the elderly, while the superficial type is more prevalent among younger patients. The most commonly used treatment option for basal cell carcinoma was surgical excision. Acknowledgment of the tendency of the rising number of basal cell carcinomas, healthcare resources, highlights the need for an effective skin cancer prevention strategy in Lithuania.