ABSTRACT
Molecular profiling of tissue samples in organ transplant recipients (OTRs) may allow early and minimally invasive identification of actinic keratosis (AK). The aim of this study was to compare mRNA expression profiles of 13 genes, as putative genetic biomarkers of AK, before and after treatment using two different field therapies, and to correlate the results with histological and clinical parameters. For this single-centre prospective randomized intra-patient-controlled study, 10 OTRs with AKs were recruited for field therapy with two cycles of methyl-5-aminolevulinate 16% cream-photodynamic therapy (PDT) at one site and imiquimod 5% cream for four weeks at another site. AKs in the PDT area were reduced significantly at one, two, and six months after completion of the treatment (p < 0.001). The effect of imiquimod was weaker but still significant when evaluated during the same intervals (p < 0.001). By comparing the mRNA expression profiles of various genetic markers before, during, and three months after therapy, we observed specific patterns of expression for skin-derived peptidase inhibitor 3 (PI3) and chemokine ligand 27 (CCL27) in all groups, regardless of the treatment modality. Compared to healthy skin, the expression of PI3 was strongly decreased and that of CCL27 increased in AK lesions before therapy. The expression level of both genes showed a significant convergence to values observed in healthy skin in both groups after therapy. The pattern and level of specific gene expression in actinic keratoses could serve as a biomarker.
Subject(s)
Aminolevulinic Acid/analogs & derivatives , Imiquimod/administration & dosage , Keratosis, Actinic/drug therapy , Keratosis, Actinic/genetics , Photochemotherapy/methods , Administration, Topical , Aged , Aminolevulinic Acid/administration & dosage , Biomarkers/analysis , Chemokine CCL27/genetics , Elafin/genetics , Female , Follow-Up Studies , Gene Expression Regulation , Humans , Keratosis, Actinic/pathology , Male , Middle Aged , Prospective Studies , RNA, Messenger/genetics , Reference Values , Severity of Illness Index , Transplant Recipients , Treatment OutcomeSubject(s)
Black or African American/statistics & numerical data , Carcinoma in Situ/ethnology , Carcinoma, Squamous Cell/ethnology , Skin Neoplasms/ethnology , Transplant Recipients , Carcinoma in Situ/etiology , Carcinoma, Squamous Cell/etiology , Humans , Incidence , Melanoma , Organ Transplantation/statistics & numerical data , Population Surveillance , Retrospective Studies , Risk Factors , Skin Neoplasms/etiology , Transplant Recipients/statistics & numerical dataABSTRACT
Malignant cylindroma (cylindromatous carcinoma, cylindrocarcinoma) is the malignant counterpart of benign cylindroma. It is a rare neoplasm, more often developing in the setting of multiple preexisting benign neoplasms. Herein we present an additional case of malignant transformation of the cylindroma diagnosed in an 83-year-old patient with known Brooke-Spiegler syndrome.
