Comparison of skin cancer risk between renal transplant recipients and patients with glomerular diseases in rural Queensland.

INTROUDCTION: There is increased risk of skin cancer in patients with gloermular disease or those with renal transplant. OBJECTIVES: To compare the risk of skin cancer between kidney recipients (KTRs) and patients with glomerular disease (GD). DESIGN: The cohort comprised patients with KTRs (n = 61) and GD (n = 51) in Central and Central West Queensland, Australia. A quantitative cohort study was undertaken to study the risk of skin cancer in rural communities between two subgroups of patients with kidney diseases in relationship to immunosuppression. Statistical analyses of the differences in incidence of skin cancers between the two groups were done by chi-square test, Fisher's exact test, independent t-test and McNemar's test. FINDINGS: KTRs with non-melanoma skin carcinoma (NMSC) increased significantly after treatment with immunosuppressants (pre-transplantation, n = 11 [18.0%], post-transplantation, n = 28 [45.9%]; p < 0.001). There were no differences in number of patients with NMSC observed in the GD group (pre-diagnosis, n = 6 [11.8%], post-diagnosis, n = 7 [13.7%]; p = 1.000). Compared to the risks at 1 year post-immunosuppressants, the incidence of NMSC of KTRs increased significantly at 3 years (20.3% vs. 35.4%, p < 0.001) and 5 years (20.3% vs. 62.2%, p < 0.001) post-immunosuppressants, whereas the increased incidence of NMSC was observed only at 5 years (2.1% vs. 11.8%, p = 0.012) in the GD cohort. The mean cumulative number of NMSC in KTRs increased significantly at 3 years (p = 0.011), and 5 years (p = 0.001) post-immunosuppressants, compared to the risks at 1 year post-immunosuppressants, however, no differences were noted in the GD cohort. DISCUSSION: Immunosuppressants increased the risk of NMSC in KTRs. The increased risk is likely dependent on the intensity and duration of immunosuppressants. CONCLUSION: In patients with a high risk of NMSC, reducing skin cancer risk should be considered in conjunction with the optimisation of treatment.

The Prognostic Role of [18F]FDG PET/CT in Patients with Advanced Cutaneous Squamous Cell Carcinoma Submitted to Cemiplimab Immunotherapy: A Single-Center Retrospective Study.

Background: Baseline 2-deoxy-2[18F]fluoro-d-glucose ([18F]FDG) positron emission tomography (PET)-derived parameters and 12-week metabolic response were investigated as prognostic factors in advanced cutaneous squamous cell carcinoma (cSCC) submitted to cemiplimab immunotherapy. Materials and Methods: Clinical records of 25 cSCC patients receiving cemiplimab, submitted to [18F]FDG positron emission tomography/computed tomography (PET/CT) at baseline and after ∼12 weeks, were retrospectively reviewed. The Kaplan-Meier (KM) method was applied to analyze differences in event-free survival (EFS), and Cox regression analysis was employed to identify the prognostic factors. Results: At the 12-week PET/CT evaluation, 16 patients (64%) were classified as responders (complete or partial response) and 9 (36%) as nonresponders ("unconfirmed progressive metabolic disease") according to immune PET Response Criteria in Solid Tumors (iPERCIST). By KM analysis, baseline metabolic tumor volume (MTV) and total lesion glycolysis (TLG) significantly correlated with the EFS (p < 0.05). Furthermore, the KM analysis showed that the lack of metabolic response at 12 weeks was associated with meaningfully shorter EFS (7.2 ± 1 months in nonresponders vs. 20.3 ± 2.3 months in responders). In Cox multivariate analysis, metabolic response at 12 weeks remained the only predictor of the EFS (p < 0.05). Conclusions: Baseline tumor load (i.e., MTV and TLG) and metabolic response at 12 weeks may have a prognostic impact in cSCC patients treated with cemiplimab.

Multiple cutaneous carcinoma arising from arsenic-containing traditional Chinese medicine in a patient with psoriasis: A case report.

Background: Arsenic exposure is closely related to keratosis and cutaneous carcinoma, but a few studies have focused on patients with psoriasis presenting carcinoma after long-term medication of arsenic-containing traditional Chinese medicine (TCM). Case description: We presented a psoriasis patient showing multiple cutaneous carcinoma arising from arsenic containing TCM. A 60-year-old gentleman with psoriasis for nearly 30 years presented to our department with severe keratosis in hands, trunk and feet. He received oral administration of realgar (with As4S4 as the major component) for at least 15 years. There were keratotic plaques, ulcer and exudate in the middle finger and forefinger of left hand, and middle finger, forefinger and ring finger of the right hand. Moreover, brown papule was seen in right sole, together with keratotic plaques and ulcer in the left heel. Pathological analysis revealed basal cell carcinoma (BCC) in the anterior chest, right hand and right foot, Bowen disease in left hand and right hand, as well as squamous cell carcinomas (SCC) in right hand. Conclusion: This is a rare arsenic-exposure psoriasis patient showed coexistence of Bowen disease in left hand and right hand, BCC in the thoracic site, right hand and right foot, as well as SCC in right hand.

18F-FDG PET-CT in Cutaneous Metastases in Breast Carcinoma: An unusual presentation.

Cutaneous and subcutaneous metastases are an exceedingly rare presentation in various malignancies. These represent poor prognosis and disease progression. Early detection of such findings helps in changing the management plan. 18F-FDG PET-CT has played a key role in deciding treatment plan for patients with breast cancer, by detecting metastatic sites, with a high sensitivity in detecting cutaneous metastases as seen in the following case.

CDX2 expression in primary skin tumors-case series and review of the literature.

CDX2 expression characterizes tumors of gastrointestinal origin, including those of intestinal-type differentiation. In dermatopathology, CDX2 expression is reported in 4 settings: cutaneous metastases from carcinomas of intestinal origin or differentiation, extramammary Paget's disease associated with an underlying colorectal or urothelial tumor, pilomatricomas and pilomatrical carcinomas, and rare primary cutaneous (adeno)squamous carcinomas with intestinal immunophenotype. Over 4 years (10/2017-10/2021), 252 dermatopathology cases with CDX2 immunostain were reviewed, revealing 46 cases with confirmed positive staining. Among them, 11 cases confirmed as primary nonintestinal type cutaneous carcinoma with definitively positive CDX2 nuclear staining were further studied. All cases demonstrated basaloid morphology with atypia, variable necrosis, and brisk mitotic activity. Cases 1-5 had heterogeneous features that cannot be further classified, including 2 cases with neuroendocrine or pseudoglandular/pseudopapillary features, and 1 case with human papillomavirus high-risk E6/E7 ISH positivity. In cases 6 through 11, the diagnosis of pilomatrical carcinoma was supported morphologically. This study substantiates the association of CDX2 with pilomatrical carcinoma. In addition, CDX2 positivity was observed in a subset of basaloid cutaneous carcinomas of ambiguous classification. However, this finding also raises a diagnostic pitfall in clinical diagnostic specificity of the CDX2 immunostain in skin cancers, which can be observed in rare while heterogeneous subsets of primary cutaneous carcinomas with primitive cytomorphology.

VEGF Expression, Cellular Infiltration, and Intratumoral Collagen Levels after Electroporation-Based Treatment of Dogs with Cutaneous Squamous Cell Carcinoma.

Canine cutaneous squamous cell carcinoma (SCC) is the most common type of skin cancer in tropical countries and is generally associated with exposure to solar ultraviolet light. It has a low metastatic rate, and local treatments, such as electrochemotherapy (ECT), promote long-term control or even complete remission. This study aimed to evaluate pre- and post-ECT treatment expression levels of vascular endothelial growth factor (VEGF) and CD31, cellular infiltration, and intratumoral collagen levels in dogs with cutaneous SCC. A prospective nonrandomized clinical study was performed using dogs with spontaneous SCC treated with ECT. Eighteen lesions from 11 dogs were included in the study. The expression levels of VEGF and CD31; cellular infiltration; and intratumoral collagen levels, as determined by Masson's trichrome staining, were not significantly different from pre-treatment measurements on day 21 (p > 0.05). However, among cellular infiltration, the mixed subtype was correlated with better overall survival time when compared to lymphoplasmacytic and neutrophilic infiltration (p < 0.05). In conclusion, ECT had no effect on VEGF expression, cellular infiltration, or intratumoral collagen levels in dogs with cutaneous SCC at the time of evaluation, suggesting that early and late post-ECT-treatment phases should be considered.

A Case of Eccrine Mucinous Carcinoma Involving Scalp.

The report presents a case of a 67-year-old female with a long-standing lump on the scalp. After its excision the histopathology revealed consistency with eccrine mucinous carcinoma. These neoplasms are quite rare with only around 100 cases reported since 1951. The report concludes the importance of encouraging follow-up of cutaneous lesions among patients as well as ongoing research to better identify and manage the tumor.

Cutaneous Head and Neck Cancers in the High-Risk Immunosuppressed Population.

The immunosuppressed (IS) population encompasses a diverse cohort of patients to include iatrogenically immunocompromised organ transplant recipients as well as patients with chronic lymphoid malignancies, human immunodeficiency virus/acquired immunodeficiency syndrome, and autoimmune disorders. Cutaneous cancers in this high-risk patient group are clinically distinct from the general immunocompetent population, showing aggressive behavior with associated poor outcomes. This article reviews the pathogenesis, epidemiology, incidence, prognosis, and special considerations required in managing cutaneous cancers in the IS patient population.

Radix et Rhizoma Ginseng chemoprevents both initiation and promotion of cutaneous carcinoma by enhancing cell-mediated immunity and maintaining redox homeostasis.

BACKGROUND: Radix et Rhizoma Ginseng (thereafter called ginseng) has been used as a medicinal herb for thousands of years to maintain people's physical vitality and is also a non-organ-specific cancer preventive and therapeutic traditional medicine in several epidemiologic and preclinical studies. Owing to few toxic side effects and strong enhancement on body immunity, ginseng has admirable application potential and value in cancer chemoprevention. The study aims at investigating the chemopreventive effects of ginseng on cutaneous carcinoma and the underlying mechanisms. METHODS: The mouse skin cancer model was induced by 7,12-dimethylbenz[a]anthracene/12-O-tetradecanoylphorbol-13-acetate. Ultraperformance liquid chromatography/mass spectrometry was used for identifying various ginsenosides, the main active ingredients of ginseng. Comprehensive approaches (including network pharmacology, bioinformatics, and experimental verification) were used to explore the potential targets of ginseng. RESULTS: Ginseng treatment inhibited cutaneous carcinoma in terms of initiation and promotion. The content of Rb1, Rb2, Rc, and Rd ginsenosides was the highest in both mouse blood and skin tissues. Ginseng and its active components well maintained the redox homeostasis and modulated the immune response in the model. Specifically, ginseng treatment inhibited the initiation of skin cancer by enhancing T-cell-mediated immune response through upregulating HSP27 expression and inhibited the promotion of skin cancer by maintaining cellular redox homeostasis through promoting nuclear translocation of Nrf2. CONCLUSION: According to the study results, ginseng can be potentially used for cutaneous carcinoma as a chemopreventive agent by enhancing cell-mediated immunity and maintaining redox homeostasis with multiple components, targets, and links.

High frequency of cutaneous squamous cell carcinoma in Friesian Milchschaf sheep in Uruguay / Alta frequência de carcinoma cutâneo de células escamosas em ovinos da raça Frisona Milchschaf no Uruguai

This study described five cases of squamous cell carcinoma (SCC) in the pinnae, eyelids, and eyes of Friesian Milchschaf sheep from two flocks raised under extensive conditions in Uruguay. The prevalence values for both flocks were 2.12% and 2.53%, respectively. Macroscopically, single or multiple, nodular, verrucous, or plaque-like neoplasms, with occasional ulceration and bleeding, were observed in the affected areas. Histologically, well- and moderately-differentiated SCCs were diagnosed in three and two cases, respectively. The Milchschaf breed is native of Germany, and its individuals present white non-pigmented skin with the face and legs clear of fleece, thus adapted to areas with lower solar radiation. Additionally, in the German breeding systems, animals remain indoors for long periods. The increased exposure time to higher levels of solar radiation of the Uruguayan extensive production systems may be a predisposing factor for the development of SCC in this sheep breed. In Uruguay, there is more solar radiation and the production systems provide less protection against sunlight compared with the German production system. The high frequency of SCC should be considered prior to introducing European breeds with non-pigmented skin in Uruguay and other countries of the region.(AU)

Descreveram-se carcinomas de células escamosas (CCE) nas orelhas, pálpebras e olhos em cinco ovinos da raça Frisona Milchschaf em dois rebanhos de criação extensiva no Uruguai. A prevalência nos rebanhos foi de 2,12% e 2,53%. Macroscopicamente se observaram lesões focais ou multifocais, com aumento de volume, nodulares, verrucosas ou em placas, com ocasionais ulcerações e hemorragias. Apresentavam aspecto verrucoso, por vezes com superfície ulcerada e firmes ao corte. De acordo com as características histológicas da neoplasia, as lesões foram classificadas em CCEs bem diferenciados em três casos e moderadamente diferenciados em dois casos. Esta raça é nativa da Alemanha, caracterizada pela face deslanada e pele branca despigmentada. Na Alemanha, há menores níveis de radiação solar do que no Uruguai e seu sistema de produção é mais intensivo, com permanência dos animais confinados durante longos períodos. O aumento do tempo de exposição a níveis mais elevados de radiação solar pode ser um fator predisponente para o desenvolvimento de CCEs nesta raça em sistemas extensivos de produção no Uruguai. Neste País há mais radiação solar e os sistemas produtivos fornecem menos proteção contra a luz solar, em relação ao sistema de produção alemão. A alta frequência de CEE deveria ser levada em consideração para quem decide introduzir no Uruguai e outros países da região. raças europeias com a face despigmentada.(AU)

Diet phytochemicals and cutaneous carcinoma chemoprevention: A review.

Cutaneous carcinoma, which has occupied a peculiar place among worldwide populations, is commonly responsible for the considerably increasing morbidity and mortality rates. Currently available medical procedures fail to completely avoid cutaneous carcinoma development or to prevent mortality. Cancer chemoprevention, as an alternative strategy, is being considered to reduce the incidence and burden of cancers through chemical agents. Derived from dietary foods, phytochemicals have become safe and reliable compounds for the chemoprevention of cutaneous carcinoma by relieving multiple pathological processes, including oxidative damage, epigenetic alteration, chronic inflammation, angiogenesis, etc. In this review, we presented comprehensive knowledges, main molecular mechanisms for the initiation and development of cutaneous carcinoma as well as effects of various diet phytochemicals on chemoprevention.

Trends of skin cancer mortality after transplantation in the United States: 1987 to 2013.

BACKGROUND: Solid organ transplant recipients are at increased risk of skin cancer, but population-based mortality data are limited. OBJECTIVE: Mortality and predictors of skin cancer death posttransplantation were investigated. METHODS: All US organ transplant recipients between 1987 and 2013, identified through the Organ Procurement and Transplantation Network Standard Transplant Analysis and Research file, were included. Mortality and hazard ratios (HR) were calculated for the overall population and patient subgroups. RESULTS: The overall mortality was 5308 per 100,000 person-years and the skin cancer-specific mortality was 35.27 per 100,000 person-years. Risk factors associated with skin cancer death included thoracic versus abdominal transplantation (HR 2.90, 95% confidence interval [CI] 2.52-3.34), age over 50 years (HR 2.86, CI 2.43-3.38), white race (HR 6.29, CI 4.63-8.53), and male sex (HR 1.85, CI 1.57-2.19). Mortality was highest for malignant melanoma (mortality of 11.48), followed by squamous cell carcinoma (mortality of 4.94) and Merkel cell carcinoma (mortality of 4.59). LIMITATIONS: Limitations of this study included potential underreporting and misclassification of death from skin cancer in the data set. CONCLUSION: Mortality from posttransplantation skin cancer is reported. Older patients, male patients, white patients, and thoracic transplant recipients had increased mortality from skin cancer.

Epigenetic alterations in metastatic cutaneous carcinoma.

BACKGROUND: Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the 2 most common cutaneous carcinomas. Molecular profiles predicting metastasis of these cancers have not been identified. METHODS: Epigenetic profiles of 37 primary cases of cutaneous SCC and BCC were quantified via the Illumina Goldengate Cancer Panel. Differential protein expression by metastatic potential was analyzed in 110 total cases by immunohistochemical (IHC) staining. RESULTS: Unsupervised hierarchical clustering analysis revealed that metastatic BCCs had a methylation profile resembling cutaneous SCCs. Metastatic cutaneous SCCs were found to be hypermethylated at FRZB (median methylation: 46.7% vs 4.7%; p = 4 × 10(-5) ). Metastatic BCCs were found to be hypomethylated at MYCL2 (median methylation: 3.8% vs 83.4%; p = 1.9 × 10(-6) ). Immunohistochemical staining revealed few differences between metastatic and nonmetastatic cancers. CONCLUSION: Metastatic primary BCCs and cutaneous SCCs had distinct epigenetic profiles when compared to their nonmetastatic counterparts. Epigenetic profiling may prove useful in future diagnosis and prevention of advanced nonmelanoma skin cancers.

A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy.

A rare case report of Aggressive Digital Adenocarcinoma (ADPCa) is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC), marjolin's ulceration/squamous cell carcinoma (MSCC) and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

Identificación de microRNAs en carcinoma cutáneo de células escamosas (CCE) / Identification of microRNAs in cutaneous squamous cell carcinoma (cSCC)

El carcinoma cutáneo de células escamosas (CCE) es el segundo cáncer de piel ms común en humanos, el cual puede llegar a ser invasivo y mostrar un curso agresivo. El CCE inicia en las células escamosas de la capa epidérmica. Así mismo, la epidermis se compone de tejido queratinizado que se regenera continuamente a partir de células basales y reemplaza a las células muertas. Estudios sobre el proceso de diferenciación celular, muestran que los microRNAs (miRNAs) están involucrados en el proceso de formación de la piel, y se ha reportado que alteraciones en la transcripción, procesamiento y expresión de los miRNAs afecta a la señalización celular, esencial en la proliferación, invasión, apoptosis y diferenciación células malignas. Los miRNAs son una familia de reguladores epigenéticos de pequeñas moléculas endógenas no codificantes de RNAs de aproximadamente 25 nucleótidos de longitud, y están involucrados en la patogénesis de cáncer en humanos como reguladores de factores de crecimiento transformantes y metástasis. Se hizo una revisión sistemática usando las principales bases de datos bibliográficas (PubMed/MEDLINE, Science) y revistas públicas en internet. Los criterios de inclusión y exclusión fueron predefinidos (carcinoma cutáneo, miRNAs, biogénesis) y también un conjunto de variables para analizar las características de los artículos seleccionados (expresión y el papel de los miRNAs en el CCE, que no han sido bien estudiadas).

The cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer in humans, which can become invasive and show an aggressive course. CSCC starts in the epidermal layer of squamous cells. Also, the epidermis is composed of keratinized tissue that continuously regenerate from basal cells and replace the dead cells. Studies about cell differentiation process, shows that microRNAs (miRNAs) are involved in the process of skin formation, and has been reported that alterations intranscription, processing and expression of miRNAs, affect the function of the cell signaling, essential the proliferation, invasion, apoptosis and differentiation of malignant cells. MiRNAs are an epigenetic regulators family of small noncoding endogenous molecules of RNAs, about 25 nucleotides in length, and are involved in the pathogenesis of human cancer in the regulation of transformant growth factors and metastasis. We performed a systematic review using major electronic bibliographic databases (PubMed/MEDLINE, Sciencie) and public journals on the internet. Inclusion and exclusion criteria were pre-defined (cutaneous carcinoma, miRNAs, and biogenesis) and also a set of variables to analyze the characteristics of the selected reports (the expression and role of miRNAs in the cSCC, what has not been well studied).

Application effect of mental nursing on perioperative nursing of patients with cutaneous carcinoma / 中国实用护理杂志

Objective To observe the application effect of mental nursing on perioperative nursing of patients. Methods 66 patients with cutaneous carcinoma were randomly divided into the conventional nurs-ing group and the psychological intervention group. The conventional nursing group received perioperative mu-fine nursing,the psychological intervention group was given mental intervention before,during and after operation based on routine nursing. The anxiety value was measured before and 30 minutes after the operation, pain de-gree was assessed 30 minutes after the operation,the results underwent t test and X2 teat. Results Compared to the conventional nursing group, the anxiety value before the operation and 30 minutes pestoperation as well as pain degree 30 minutes pestoperation of the psychological intervention group were significantly decreased. Conclusions Mental nursing of patients with cutaneous carcinoma can efficiently eliminate or re-duco patients' psychologic obstacle and significantly reduce patients' painful feeling.