Dermoscopic Pattern of Basal Cell Carcinoma in H- and Non-H-zones.

INTRODUCTION: Basal cell carcinoma (BCC) localized in the H-zone, the region of fusion of embryonic masses, has been associated with a higher risk of deeper invasion and more frequent recurrence. OBJECTIVES: The aim of the study was to compare dermoscopic features of BCC in H and non-H zone that may most appropriately characterize those two locations. METHODS: Dermoscopy images of histopathologically confirmed BCCs from 120 patients were retro-spectively analyzed. Dermoscopy features of BCC in H- and non-H zone were described and a comparative study of the dermoscopic pattern of BCC between the two locations was performed. RESULTS: Of 120 BCC cases included in this study, 41 (34.2%) were located in the H-zone. The most frequent histological type was nodular (51.3% in H- zone and 61.6 % in non-H-zone) followed by superficial (5.1% and 19.8 % in H and non-H-zone respectively).In dermoscopy, there was a higher prevalence of ulceration (73.2% versus 43.6%, P < 0.001) in H-zone and a lower prevalence of brown globules (26.8% versus 53.2%; P = 0.01), when compared with the non-H-zone. CONCLUSIONS: Our results show that dermoscopic features of BCC on the face fulfill a typical pattern regardless of the region, except for the prevalence of the ulceration which is significantly more frequent in H-zone and the brown globules present significantly more often in the non-H-zone It can be hypothesized that H-zone might predispose to more aggressive course of BCC complicated by ulceration and consequently deeper tissue destruction.

Vascular pattern in dermoscopy of basal cell carcinoma in the H- and non-H-zone.

Introduction: Basal cell carcinoma (BCC) located on the face in the H-zone (nose, ears, eyes), the region corresponding to places of fusion of embryonic masses (EFP) has been associated with a higher risk of deeper invasion and more frequent recurrence. Aim: To characterize the dermoscopic image of the vessels of BCC in the H-zone and non-H-zone. Material and methods: A retrospective analysis of vessels in dermoscopic images of 120 BCC cases in the H-zone and non-H-zone (the rest of the face) was conducted. The H-zone consists of the nose, ears, eyes and the non-H-zone of the forehead, cheek, chin and the rest of the face and neck. Results: Of the 120 lesions analysed, there were 41 (34.2%) in the H-zone and 79 (65.8%) in the non-H-zone. Arborizing vessels, as well as the short-fine-telangiectasias were the most predominant types of vessels present, and their frequency in the H- and non-H-zone was comparable. Significant differences were observed for the occurrence of glomerular and comma vessels, both of which occurred less frequently in the H-zone than in the non-H-zone. Conclusions: The dermoscopic morphology of the vessels in BCC tumours in the H- and non-H-zones is generally similar, with differences in the presence of glomerular and comma vessels, which occur more frequently in the non-H-zone.

Recurrence of melanoma in the scar after excised Spitz nevus in a 17-year-old child.

Melanoma in childhood is rare and its diagnosis is more difficult than in adults, as it often presents histologic features overlapping with the Spitz nevus. The authors report the case of a 17-year old boy who was first diagnosed with Spitz nevus, however, the final diagnosis made after the excision of the tumor arising in the scar was changed to melanoma. The case in this present study emphasizes the importance of the differential diagnosis of skin tumors in young patients.

Adhesion Molecules in Non-melanoma Skin Cancers: A Comprehensive Review.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most frequently diagnosed cancers, generating significant medical and financial problems. Cutaneous carcinogenesis is a very complex process characterized by genetic and molecular alterations, and mediated by various proteins and pathways. Cell adhesion molecules (CAMs) are transmembrane proteins responsible for cell-to-cell and cell-to-extracellular matrix adhesion, engaged in all steps of tumor progression. Based on their structures they are divided into five major groups: cadherins, integrins, selectins, immunoglobulins and CD44 family. Cadherins, integrins and CD44 are the most studied in the context of non-melanoma skin cancers. The differences in expression of adhesion molecules may be related to the invasiveness of these tumors, through the loss of tissue integrity, neovascularization and alterations in intercellular signaling processes. In this article, each group of CAMs is briefly described and the present knowledge on their role in the development of non-melanoma skin cancers is summarized.

Density of Langerhans Cells in Nonmelanoma Skin Cancers: A Systematic Review.

Langerhans cells (LCs) are bone marrow-derived dendritic cells (DCs) that represent 2-3% of the entire cell population of the human skin, known to have an ability to present antigens to T lymphocytes. Moreover, there is evidence that LCs are probably capable of inducing the local cytotoxic type T-cell-mediated response against the tumour-associated antigens. In the past two decades, a dramatic increase has been noted in the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to critically assess the results of available studies quantitatively assessing the LCs in nonmelanoma skin cancers and try to establish a conclusion of its possible impact on their future treatment. The PubMed, EMBASE, and the Web of Science databases were searched, which returned 948 citations. After a thorough analysis of full article texts, 30 studies have been chosen, including 11 of the BCC, 12 of the SCC specimens, and 7 analysing both tumour types. There was an overall trend towards slightly higher numbers of LCs in BCC than in SCC; however, these tendencies were discrepant between the studies. We presume that such differences could be caused by various staining techniques with a broad spectrum of specificity, including anti-S100, anti-CD1a, and ATPase activity staining used for LCs identification. We hypothesise that as there is a high inconsistency between the results of the studies, as far as the densities of LCs observed in the specimens are concerned, it seems that the mechanism of the influence of LCs on the antitumoural immune response is complicated. Finally, as at present, there is a paucity of available risk scores for the recurrence or progression of BCC or SCC, the creation of classification stratifying that risk including the density of LCs could bring additional information both for the physician and the patient.