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Murgia G, Denaro N, Boggio F, Nazzaro G, Benzecry V, Bortoluzzi P, Passoni E, Garrone O, Marzano A. Basosquamous Carcinoma: Comprehensive Clinical and Histopathological Aspects, Novel Imaging Tools, and Therapeutic Approaches. Cells 2023; 12:2737. [PMID: 38067165 PMCID: PMC10706022 DOI: 10.3390/cells12232737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Basosquamous carcinoma (BSC), an uncommon and aggressive nonmelanoma skin cancer exhibiting characteristics ranging from basal cell carcinoma (BCC) to squamous cell carcinoma (SCC), is a subject of controversy in terms of its classification, pathogenesis, histologic morphology, biologic behavior, prognosis, and management. This narrative review is based on an electronic search of English-language articles in PubMed that included the terms "basosquamous carcinoma" and/or "metatypical carcinoma of the skin" in their titles. The review aims to succinctly present and assess current data on the epidemiology, clinical presentation, dermoscopic, LC-OCT, and histopathologic characteristics, as well as the genetics and management of BSC, providing insight into this intriguing entity. As a conclusion, dermoscopy, deep incisional biopsies, and immunohistologic techniques should be applied in clinically suspicious lesions to achieve an early diagnosis and better prognosis of this tumor. Surgical treatments, including wide excision and Mohs' micrographic surgery, remain the treatment of choice. Finally, Hedgehog pathway inhibitors and checkpoint inhibitors, must be thoroughly investigated with large controlled trials, since they may offer an alternative solution to irresectable or difficult-to-treat locally advanced cases of basosquamous carcinoma.
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Affiliation(s)
- Giulia Murgia
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
| | - Nerina Denaro
- Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (N.D.)
| | - Francesca Boggio
- Department of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Gianluca Nazzaro
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
| | - Valentina Benzecry
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
| | - Paolo Bortoluzzi
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
| | - Emanuela Passoni
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
| | - Ornella Garrone
- Oncology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (N.D.)
| | - Angelo Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.N.); (V.B.); (P.B.); (E.P.); (A.M.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20133 Milan, Italy
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Bozsányi S, Boostani M, Farkas K, Hamilton-Meikle P, Varga NN, Szabó B, Vasanits F, Kuroli E, Meznerics FA, Lőrincz K, Holló P, Bánvölgyi A, Wikonkál NM, Paragh G, Kiss N. Optically Guided High-Frequency Ultrasound to Differentiate High-Risk Basal Cell Carcinoma Subtypes: A Single-Centre Prospective Study. J Clin Med 2023; 12:6910. [PMID: 37959375 PMCID: PMC10648659 DOI: 10.3390/jcm12216910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common type of skin cancer in the Caucasian population. Currently, invasive biopsy is the only way of establishing the histological subtype (HST) that determines the treatment options. Our study aimed to evaluate whether optically guided high-frequency ultrasound (OG-HFUS) imaging could differentiate aggressive HST BCCs from low-risk tumors. METHODS We conducted prospective clinical and dermoscopic examinations of BCCs, followed by 33 MHz OG-HFUS imaging, surgical excision, and a histological analysis. We enrolled 75 patients with 78 BCCs. In total, 63 BCCs were utilized to establish a novel OG-HFUS risk classification algorithm, while 15 were employed for the validation of this algorithm. The mean age of the patients was 72.9 ± 11.2 years. Histology identified 16 lesions as aggressive HST (infiltrative or micronodular subtypes) and 47 as low-risk HST (superficial or nodular subtypes). To assess the data, we used a one-sided Fisher's exact test for a categorical analysis and a Receiver Operating Characteristic (ROC) curve analysis to evaluate the diagnostic accuracy. RESULTS OG-HFUS distinguished aggressive BCC HSTs by their irregular shape (p < 0.0001), ill-defined margins (p < 0.0001), and non-homogeneous internal echoes (p = 0.004). We developed a risk-categorizing algorithm that differentiated aggressive HSTs from low-risk HSTs with a higher sensitivity (82.4%) and specificity (91.3%) than a combined macroscopic and dermoscopic evaluation (sensitivity: 40.1% and specificity: 73.1%). The positive and negative predictive values (PPV and NPV, respectively) for dermoscopy were 30.2% and 76.8%, respectively. In comparison, the OG-HFUS-based algorithm demonstrated a PPV of 94.7% and an NPV of 78.6%. We verified the algorithm using an independent image set, n = 15, including 12 low-risk and 3 high-risk (high-risk) with two blinded evaluators, where we found a sensitivity of 83.33% and specificity of 91.66%. CONCLUSIONS Our study shows that OG-HFUS can identify aggressive BCC HSTs based on easily identifiable morphological parameters, supporting early therapeutic decision making.
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Affiliation(s)
- Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Phyllida Hamilton-Meikle
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Boglárka Szabó
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Flóra Vasanits
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Enikő Kuroli
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
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Dermoscopic Clues of Histopathologically Aggressive Basal Cell Carcinoma Subtypes. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020349. [PMID: 36837550 PMCID: PMC9964036 DOI: 10.3390/medicina59020349] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
Background: The group of histopathologically aggressive BCC subtypes includes morpheaform, micronodular, infiltrative and metatypical BCC. Since these tumors are at increased risk of recurring, micrographically controlled surgery is considered the best therapeutic option. Although dermoscopy significantly improves the clinical recognition of BCC, scarce evidence exists on their dermoscopic criteria. Aim: To investigate the dermoscopic characteristics of histopathologically aggressive BCC subtypes. Materials and Methods: Dermoscopic images of morpheaform, micronodular, infiltrative and metatypical BCC were analyzed for the presence of predefined variables. Descriptive and analytical statistics were performed. Results: Most histopathologically aggressive BCCs were located on the head and neck. Infiltrative was the most common subtype. All subtypes, except micronodular BCC, rarely displayed dermoscopic pigmentation. The most frequent dermoscopic features of infiltrative BCC were arborizing vessels (67.1%), shiny white structures (48.6%) and ulceration (52.9%). The features prevailing in morpheaform BCC were arborizing vessels (68.4%), ulceration (n = 12, 63.2%) and white porcelain areas (47.4%). Micronodular BCC was typified by milky red structureless areas (53.8%), arborizing vessels (53.8%), short fine telangiectasias (50%), ulceration (46.2%) and blue structures (57.7%). The most common findings in metatypical BCC were arborizing vessels (77.8%), shiny white structures (66.7%), ulceration (62.9%) and keratin mass (29.6%). Limitations: Study population of only white skin and relatively small sample size in some groups. Conclusions: Our study provided data on the clinical, dermoscopic and epidemiological characteristics of histopathologically aggressive BCCs.
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Gürsel Ürün Y, Fiçicioğlu S, Ürün M, Can N. Clinical, Dermoscopic and Histopathological Evaluation of Basal Cell Carcinoma. Dermatol Pract Concept 2023; 13:dpc.1301a4. [PMID: 36892362 PMCID: PMC9946123 DOI: 10.5826/dpc.1301a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Dermoscopy aids in identifying histopathological subtypes and the presence of clinically undetectable pigmentation in basal cell carcinoma (BCC). OBJECTIVES To investigate the dermoscopic features of BCC subtypes and better understand non-classical dermoscopic patterns. METHODS Clinical and histopathological findings were recorded by a dermatologist who was blinded to the dermoscopic images. Dermoscopic images were interpreted by two independent dermatologists blinded to the patients' clinical and histopathologic diagnosis. Agreement between the two evaluators and with histopathological findings was evaluated using Cohen's kappa coefficient analysis. RESULTS The study included a total of 96 BBC patients with 6 histopathologic variants: nodular (n=48, 50%), infiltrative (n=14, 14.6%), mixed (n=11, 11.5%), superficial (n=10, 10.4%), basosquamous (n=10, 10.4%), and micronodular (n=3, 3.1%). Clinical and dermoscopic diagnosis of pigmented BCC showed high agreement with histopathological diagnosis. The most common dermoscopic findings according to subtype were as follows: nodular BCC: shiny white-red structureless background (85.4%), white structureless areas (75%), and arborizing vessels (70.7%); infiltrative BCC: shiny white-red structureless background (92.9%), white structureless areas (78.6%), arborizing vessels (71.4%); mixed BCC: shiny white-red structureless background (72.7%), white structureless areas (54.4%), and short fine telangiectasias (54.4%); superficial BCC: shiny white-red structureless background (100%), short fine telangiectasias (70%); basosquamous BCC: shiny white-red structureless background (100%), white structureless areas (80%), keratin masses (80%); micronodular BCC: short fine telangiectasias (100%). CONCLUSIONS In this study, arborizing vessels were the most common classical dermoscopic feature of BCC, while shiny white-red structureless background and white structureless areas were the most frequent non-classical dermoscopic features.
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Affiliation(s)
- Yıldız Gürsel Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Sezin Fiçicioğlu
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Mustafa Ürün
- Departments of Dermatology and Venereology, Trakya University, Edirne, Turkey
| | - Nuray Can
- Departments of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey
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Assessment of Basal Cell Carcinoma Using Dermoscopy and High Frequency Ultrasound Examination. Diagnostics (Basel) 2022; 12:diagnostics12030735. [PMID: 35328289 PMCID: PMC8947530 DOI: 10.3390/diagnostics12030735] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 01/27/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common form of cutaneous neoplasia in humans, and dermoscopy may provide valuable information for histopathological classification of BCC, which allows for the choice of non-invasive topical or surgical therapy. Similarly, dermoscopy may allow for the identification of incipient forms of BCC that cannot be detected in clinical examination. The importance of early diagnosis using the dermoscopy of superficial BCC forms is proven by the fact that despite their indolent clinical appearance, they can be included in high-risk BCC forms due to the rate of postoperative recurrence. Nodular pigmentary forms of BCCs present ovoid gray-blue nests or multiple gray-blue dots/globules associated with arborized vessels, sometimes undetectable on clinical examination. The management of BCC depends on this, as pigmentary forms have been shown to have a poor response to photodynamic therapy. High frequency ultrasound examination (HFUS) aids in the diagnosis of BCC with hypoechoic tumour masses, as well as in estimating tumour size (thickness and diameter), presurgical margin delineation, and surgical planning. The examination is also useful for determining the invasion of adjacent structures and for studying local recurrences. The use of dermoscopy in combination with HFUS allows for optimisation of the management of the oncological patient.
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Cappilli S, Cinotti E, Lenoir C, Tognetti L, Perez‐Anker J, Rubegni P, Puig S, Malvehy J, Perrot JL, del Marmol V, Peris K, Suppa M. Line‐field confocal optical coherence tomography of basosquamous carcinoma: A case series with histopathological correlation. J Eur Acad Dermatol Venereol 2022; 36:1214-1218. [DOI: 10.1111/jdv.18038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- S Cappilli
- Università Cattolica del Sacro Cuore, Dermatologia Rome Italy
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - E Cinotti
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD) Paris France
| | - C Lenoir
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - L Tognetti
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
| | - J Perez‐Anker
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - P Rubegni
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
| | - S Puig
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - J Malvehy
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - JL Perrot
- Department of Dermatology University Hospital of Saint‐Etienne Saint‐Etienne France
| | - V del Marmol
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - K Peris
- Università Cattolica del Sacro Cuore, Dermatologia Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - M Suppa
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD) Paris France
- Department of Dermatology Institut Jules Bordet Université Libre de Bruxelles Brussels Belgium
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Gundogdu M, Botsalı A. Evaluation of dermatoscopic findings of alopecia areata and tinea capitis in pediatric patients. J Cosmet Dermatol 2022; 21:2273-2278. [PMID: 35119189 DOI: 10.1111/jocd.14828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 12/04/2021] [Accepted: 01/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Pediatric patients often reveal localized alopecic foci on the scalp. The essential point upon approaching a child with localized alopecia is distinguishing the two most common causes, alopecia areata and tinea capitis, as their treatments are entirely different. Although potassium hydroxide examination is the preferred method for their clear distinction, dermatoscopy is also emerging as a rapid diagnostic tool. This study aimed to assess and compare the dermatoscopic findings of alopecia areata and tinea capitis. MATERIALS AND METHODS Enrolled in this study were 34 children with tinea capitis and 21 children with alopecia areata admitting to a single-center outpatient clinic between 2017-2021. The authors confirmed all children's diagnoses by an integrative evaluation of clinical features, potassium hydroxide examination results, and treatment response patterns. Clinical features and the variables of interest (dermatoscopic findings) were investigated through the medical records and the baseline dermatoscopic images. RESULTS The most common dermatoscopic finding within the tinea capitis cohort was comma hairs, detected in 33 (97.1%) of the patients. Other findings of the tinea capitis group included squamation (n=31, 91.2%), broken and dystrophic hairs (n=30, 88.2%), corkscrew hairs (n=24, 70.6%), zigzag hairs (n=18, 52.9%), and pigtail hairs (n=9, 26.5%). The most common dermatoscopic finding within the alopecia areata cohort was exclamation mark hairs (n=13, 61.9%), that was followed by black dots (n=9, 42.9%), yellow dots (n=8, 38.1%), vellus hairs (n=6, 28.6%), and broken and dystrophic hairs (n=5, 23.8%). CONCLUSION Among the detailed evaluation of dermatoscopic findings of tinea capitis and alopecia areata patients, the only overlapping feature was dystrophic and broken hairs that could be present in both diseases; but were more common within the TC group than within the AA group (88.2% vs. 23.8%).
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Affiliation(s)
- M Gundogdu
- Ordu State Hospital, Dermatology and Venereology Outpatient Clinic, Ordu, Turkey
| | - A Botsalı
- Dermatology Department, Gulhane Training and Research Hospital, Health Sciences University, Ankara, Turkey
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Basosquamous Carcinoma: A Commentary. Cancers (Basel) 2021; 13:cancers13236146. [PMID: 34885255 PMCID: PMC8656992 DOI: 10.3390/cancers13236146] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/21/2021] [Accepted: 12/04/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Basosquamous carcinoma is a rare, aggressive non-melanoma skin cancer with features that lie between those of basal cell carcinoma and squamous cell carcinoma. A lot of controversy has been raised around the classification, pathogenesis, histologic morphology, biologic behavior, prognosis and management of this tumor. This is a narrative review based on articles published on PubMed in English language which had in their title the terms “basosquamous carcinoma” and/or “metatypical carcinoma of the skin”. The aim of this review was to summarize and evaluate the latest data of the English literature regarding epidemiology, clinical presentation, dermoscopic and histopathologic characteristics, as well as the genetics and management of BSC to better characterize basosquamous skin lesions. Abstract Basosquamous carcinoma is a rare, aggressive non-melanoma skin cancer with features that lie between those of basal cell carcinoma and squamous cell carcinoma. A lot of controversy has been raised around the classification, pathogenesis, histologic morphology, biologic behavior, prognosis and management of this tumor. This is a narrative review based on an electronic search of articles published in PubMed in English language which had in their title the terms “basosquamous carcinoma” and/or “metatypical carcinoma of the skin”. The aim of this review was to summarize and evaluate current data regarding epidemiology, clinical presentation, dermoscopic and histopathologic characteristics, as well as the genetics and management of BSC, in order to shed some more light onto this intriguing entity. As a conclusion, dermoscopy, deep incisional biopsies and immunohistologic techniques (Ber-EP4) should be applied in clinically suspicious lesions in order to achieve an early diagnosis and better prognosis of this tumor. Surgical treatments, including wide excision and Mohs’ micrographic surgery, remain the treatment of choice. Finally, vismodegib, a Hedgehog pathway inhibitor, must be thoroughly investigated, with large controlled trials, since it may offer an alternative solution to irresectable or difficult-to-treat, locally advanced cases of basosquamous carcinoma.
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Petreanu CA, Șerban ED, Constantin MM, Savu C, Zariosu AV, Deleanu OC, Bucur S, Constantin T. Basal cell carcinoma-not always the 'good guy': Case report of a life-threatening basosquamous carcinoma and review of the literature. Exp Ther Med 2021; 22:1158. [PMID: 34504603 DOI: 10.3892/etm.2021.10592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/28/2021] [Indexed: 11/05/2022] Open
Abstract
Cutaneous basosquamous carcinoma is a variant of basal cell carcinoma that is characterized by histopathological features of both basal and squamous cell carcinoma. Due to its local invasiveness, high frequency of recurrence, and its metastatic potential, it is considered to be one of the most aggressive subtypes of basal cell carcinoma. We present the case of an 81-year-old male who was admitted to the hospital with incessant hemorrhage arising from a cutaneous tumor that later proved to be a basosquamous carcinoma. Due to the COVID-19 pandemic at the time, the patient did not seek medical attention as soon as the bleeding was observed, although he did present when the symptom increased in intensity and became incessant. To our knowledge, this is the first case report of a cutaneous basosquamous carcinoma that presents with a massive life-threatening hemorrhage tumor, thus endangering the patient's life. The clinical and histopathological features, the behavior and the treatment of cutaneous basosquamous carcinoma are further reviewed in this article.
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Affiliation(s)
- Cornel Adrian Petreanu
- Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,1st Department of Thoracic Surgery, 'Prof. Dr. Marius Nasta' Institute of Pneumophtisiology, 050159 Bucharest, Romania
| | - Elena-Daniela Șerban
- 2nd Department of Dermatology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
| | - Maria-Magdalena Constantin
- 2nd Department of Dermatology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cornel Savu
- Department of Thoracic Surgery, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,1st Department of Thoracic Surgery, 'Prof. Dr. Marius Nasta' Institute of Pneumophtisiology, 050159 Bucharest, Romania
| | - Alexandru Victor Zariosu
- 1st Department of Thoracic Surgery, 'Prof. Dr. Marius Nasta' Institute of Pneumophtisiology, 050159 Bucharest, Romania
| | - Oana Claudia Deleanu
- Department of Pneumophtisiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,2nd Department of Pneumophtisiology, 'Prof. Dr. Marius Nasta' Institute of Pneumophtisiology, 050159 Bucharest, Romania
| | - Stefana Bucur
- 2nd Department of Dermatology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Traian Constantin
- Department of Urology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Urology, 'Prof. Dr. Th. Burghele' Hospital, 050659 Bucharest, Romania
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10
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Ungureanu L, Cosgarea I, Şenilǎ S, Vasilovici A. Role of Dermoscopy in the Assessment of Basal Cell Carcinoma. Front Med (Lausanne) 2021; 8:718855. [PMID: 34490305 PMCID: PMC8417571 DOI: 10.3389/fmed.2021.718855] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Basal cell carcinoma is one of the most common cancers in white people, with a continuous increase worldwide. Dermoscopy, a non-invasive technique, allows early diagnosis based on the presence of typical vascular structures, pigmented structures, and ulceration and the absence of specific melanocytic structures. Moreover, dermoscopy is useful in basal cell carcinoma management, enabling the differentiation between multiple histological subtypes, between pigmented and non-pigmented variants and allowing a more accurate assessment of surgical margins. After non-ablative therapies, dermoscopy allows the accurate detection of residual disease. The purpose of this review is to highlight the dermoscopic features encountered in basal cell carcinoma and to outline the role of dermoscopy for diagnosis and therapeutic response in this cancer.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Cosgarea
- Department of Dermatology, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Simona Şenilǎ
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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11
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Michalak-Stoma A, Małkińska K, Krasowska D. Usefulness of Dermoscopy to Provide Accurate Assessment of Skin Cancers. Clin Cosmet Investig Dermatol 2021; 14:733-746. [PMID: 34234499 PMCID: PMC8254521 DOI: 10.2147/ccid.s305924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/13/2021] [Indexed: 11/23/2022]
Abstract
Seborrheic keratosis (SK) is the most common benign tumour of epidermal origin. In most cases, it is simple to recognize in the clinical examination. However, sometimes SK can be a problematic lesion. We present the cases of two patients with seborrheic keratosis in whom we diagnosed the skin cancer through dermoscopic and histopathological examinations. The article aims to draw attention to the need for dermoscopic examinations to be included for an accurate assessment of the nevi not only by dermatologists but also not-specialized doctors. We would like to underline that many skin cancers share the similar features of malignancy, and competence and capability to interpret the dermoscopic pictures correctly are important for early recognition of malignant lesion. Very often malignant skin cancers can be hidden among benign lesions like seborrheic keratosis or they can be imitators of benign lesions. Amongst all cases of imposing SK, basal cell carcinoma, squamous cell carcinoma, melanoma is the most important differential diagnosis, of which their dermoscopic features will be discussed in this article.
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Affiliation(s)
- Anna Michalak-Stoma
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, 20-080, Poland
| | - Katarzyna Małkińska
- Department of Dermatology, Venereology and Paediatric Dermatology, Samodzielny Publiczny Szpital Kliniczny No 1, Lublin, 20-080, Poland
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, 20-080, Poland
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12
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Sgouros D, Rigopoulos D, Panayiotides I, Apalla Z, Arvanitis DK, Theofili M, Theotokoglou S, Syrmali A, Theodoropoulos K, Pappa G, Damaskou V, Stratigos A, Katoulis A. Novel Insights for Patients with Multiple Basal Cell Carcinomas and Tumors at High-Risk for Recurrence: Risk Factors, Clinical Morphology, and Dermatoscopy. Cancers (Basel) 2021; 13:3208. [PMID: 34198960 PMCID: PMC8269292 DOI: 10.3390/cancers13133208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Basal cell carcinoma (BCC) quite frequently presents as multiple tumors in individual patients. Neoplasm's risk factors for local recurrence have a critical impact on therapeutic management. OBJECTIVE To detect risk factors for multiple BCCs (mBCC) in individual patients and to describe clinical and dermatoscopic features of low- and high-risk tumors. MATERIALS & METHODS Our study included 225 patients with 304 surgically excised primary BCCs. All patients' medical history and demographics were recorded. Clinical and dermatoscopic images of BCCs were evaluated for predefined criteria and statistical analyses were performed. RESULTS Grade II-III sunburns before adulthood (OR 2.146, p = 0.031) and a personal history of BCC (OR 3.403, p < 0.001) were the major predisposing factors for mBCC. Clinically obvious white color (OR 3.168, p < 0.001) and dermatoscopic detection of white shiny lines (OR 2.085, p = 0.025) represented strongly prognostic variables of high-risk BCC. Similarly, extensive clinico-dermatoscopic ulceration (up to 9.2-fold) and nodular morphology (3.6-fold) raise the possibility for high-risk BCC. On the contrary, dermatoscopic evidence of blue-black coloration had a negative prognostic value for high-risk neoplasms (light OR 0.269, p < 0.001/partial OR 0.198, p = 0.001). CONCLUSIONS Profiling of mBCC patients and a thorough knowledge of high-risk tumors' clinico-dermatoscopic morphology could provide physicians with important information towards prevention of this neoplasm.
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Affiliation(s)
- Dimitrios Sgouros
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Ioannis Panayiotides
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Zoe Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, 54643 Thessaloniki, Greece;
| | - Dimitrios K. Arvanitis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Melpomeni Theofili
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Sofia Theotokoglou
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Anna Syrmali
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Konstantinos Theodoropoulos
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Georgia Pappa
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
| | - Vasileia Damaskou
- 2nd Department of Pathology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (I.P.); (V.D.)
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (D.R.); (A.S.)
| | - Alexander Katoulis
- 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (M.T.); (S.T.); (A.S.); (K.T.); (G.P.); (A.K.)
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13
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Álvarez-Salafranca M, Ara M, Zaballos P. Dermoscopy in Basal Cell Carcinoma: An Updated Review. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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14
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Ertop Doğan P, Akay BN, Okçu Heper A, Rosendahl C, Erdem C. Dermatoscopic findings and dermatopathological correlates in clinical variants of actinic keratosis, Bowen's disease, keratoacanthoma, and squamous cell carcinoma. Dermatol Ther 2021; 34:e14877. [PMID: 33583118 DOI: 10.1111/dth.14877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 01/02/2023]
Abstract
Non-melanoma skin cancer (NMSC), predominantly squamous cell carcinoma (SCC) and basal cell carcinoma, is increasing worldwide. Dermatoscopy, which is one of the non-invasive diagnostic techniques, is important for early diagnosis of NMSC. In this study we aimed to determine dermatoscopic features of keratinocyte derived tumors including actinic keratosis (AK), Bowen's disease (BD), keratoacanthoma (KA), and SCC and correlate the dermatoscopic findings with pathology. A total of 242 lesions from 169 patients were included in the study and dermatoscopic and dermatopathological findings of the lesions were retrospectively studied. Revised pattern analysis was used for the dermatoscopic evaluation. Among 242 lesions, 145 were clinically flat (86 AK, 30 BD, and 29 SCC). Presence of vessels, ulceration, fiber sign, keratin mass, and blood spots decreased the probability of a lesion being AK. When the differential diagnosis was considered between KA and SCC vs AK and BD; vessel presence, ulceration, fiber sign, blood spots, white structureless, keratin, and centred vessels favored the diagnosis of KA and SCC. Our results may contribute to the determination of the lesions to be biopsied in patients with multiple AK on chronically sun damaged skin. In non-pigmented lesions when a final diagnosis cannot be established, knowledge of dermatopathologic and dermatoscopic correlation may significantly assist interpretation of dermatoscopic patterns and clues.
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Affiliation(s)
- Pelin Ertop Doğan
- Faculty of Medicine, Dermatology Department, Ankara University, Ankara, Turkey
| | - Bengü Nisa Akay
- Faculty of Medicine, Dermatology Department, Ankara University, Ankara, Turkey
| | - Aylin Okçu Heper
- Faculty of Medicine, Pathology Department, Ankara University, Ankara, Turkey
| | - Cliff Rosendahl
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Cengizhan Erdem
- Faculty of Medicine, Dermatology Department, Ankara University, Ankara, Turkey
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15
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Álvarez-Salafranca M, Ara M, Zaballos P. Dermoscopy in Basal Cell Carcinoma: An Updated Review. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:330-338. [PMID: 33259816 DOI: 10.1016/j.ad.2020.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
Dermoscopy is a noninvasive technique that has been demonstrated to improve diagnostic accuracy in basal cell carcinoma (BCC). The first dermoscopic model for the diagnosis of BCC, based mainly on the identification of pigmented structures, was described by Menzies et al., and since then dermoscopy has generated an abundance of literature useful to routine clinical practice. From a practical perspective, dermoscopic structures associated with BCC can be classified as pigmented, vascular, or nonpigmented/nonvascular. One of the most recent applications of dermoscopy in BCC is as an aid to predicting histologic subtype and essentially differentiating between superficial and nonsuperficial BCC. It can also, however, help raise suspicion of more aggressive variants with a higher risk of recurrence. A thorough dermoscopic examination during follow-up of patients with actinic damage or a history of multiple BCCs can facilitate the detection of very incipient lesions and significantly impact treatment and prognosis.
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Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - M Ara
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, España
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16
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Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study. Sci Rep 2020; 10:18475. [PMID: 33116191 PMCID: PMC7595159 DOI: 10.1038/s41598-020-72732-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/28/2020] [Indexed: 11/09/2022] Open
Abstract
Basosquamous carcinoma (BSC) is a rare non-melanoma skin cancer that shares the characteristic features of both basal and squamous cell carcinomas (BCC, SCC). Our research enables better characterization of BSC in comparison to high-risk subtypes of BCC and SCC. Paper includes a retrospective analysis of BSC cases regarding sex, age, number of tumors and anatomical distribution in comparison to BCC and SCC evaluating the differences and defining the implications. Histologically confirmed carcinomas recorded between 1999 and 2019 were studied. 181 diagnosed BSC cases were identified, making this study the largest cohorts of BSC patients reported worldwide. Most cases were reported on head and neck. Analysis of facial anatomic distribution shows that most commonly affected sites were the nose (43%) and the cheek (25%). The age at excision of metatypical BCC was higher than those of low-risk BCC (P < 0.05), however similar to high-risk BCC (P = 0.20). We revisited that the concept of BSC is the most similar to high-risk subtypes of BCC. Patients with diagnosed BSC have higher risk of second nonmelanoma skin cancer. Therefore, the frequency of follow-up examination should be adjusted to the individual risk of another skin cancer.
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17
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Di Altobrando A, Patrizi A, Dika E, Savoia F. Cauliflower-like exophytic mass on the skin: polypoid melanoma. Clinical, dermoscopic, and histologic features. An Bras Dermatol 2020; 95:748-750. [PMID: 33041156 PMCID: PMC7672400 DOI: 10.1016/j.abd.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/13/2020] [Indexed: 11/28/2022] Open
Abstract
Polypoid melanoma is a variant of nodular melanoma, whose poor prognosis depends on its thickness and the presence of ulceration at the time of diagnosis. The authors report two cases of polypoid melanoma, presenting as broad, cauliflower-like, polypoid masses. Dermoscopy was characterized by a multicolored pattern, atypical polymorphic vessels, and the fiber sign. Clinical and dermoscopic features can help to diagnose polypoid melanoma and exclude other possible differential diagnoses. However, histology remains mandatory to confirm the diagnostic suspicion.
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Affiliation(s)
- Ambra Di Altobrando
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
| | - Annalisa Patrizi
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Emi Dika
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Francesco Savoia
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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18
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Wang S, Fang H, Tong W, Wang H, Teng B. Coexistence of Basaloid Squamous Cell Carcinoma and Large Cell Neuroendocrine Carcinoma in the Larynx: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2020; 101:NP199-NP202. [PMID: 32921173 DOI: 10.1177/0145561320956479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Basaloid squamous cell carcinoma and large cell neuroendocrine carcinoma are not common in head and neck, these tumors rarely occur in the larynx but both have highly aggressive clinical behavior and a high mortality rate. The diagnosis is complicated by these tumors' atypical clinical and pathological features. This case details a coexistence of basaloid squamous cell carcinoma and large cell neuroendocrine carcinoma of a woman in the larynx. The patient underwent endoscopy- and coblation-assisted transoral microsurgery to achieve hyoid horizontal epiglottidectomy and has no recurrence after 12 months of follow-up.
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Affiliation(s)
- Sanchun Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, 154454The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Hongyan Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, 154454The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Weifang Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, 154454The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Hongyan Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, 154454The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Bo Teng
- Department of Otorhinolaryngology, Head and Neck Surgery, 154454The Second Hospital of Jilin University, Changchun, Jilin, China
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19
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Akay BN, Atak MF, Okcu Heper A, Farabi B. Cutaneous leishmaniasis dermatoscopically mimicking basosquamous carcinoma in a solid organ transplant recipient. Dermatol Ther 2020; 33:e13915. [PMID: 32594633 DOI: 10.1111/dth.13915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Bengu Nisa Akay
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet Fatih Atak
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Aylin Okcu Heper
- Pathology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Banu Farabi
- Dermatology Department, Ankara University School of Medicine, Ankara, Turkey.,Robert Wood Johnson Medical Center, Rutgers University, New Brunswick, New Jersey, USA
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20
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Abstract
Basal cell carcinoma (BCC) is the most common malignancy and the incidence is rising. BCCs have low mortality but can cause significant morbidity primarily through local destruction. The pathogenesis is linked to the interplay between environmental and patient-derived characteristics. There are multiple therapeutic modalities, and appropriate selection requires knowledge of complications, cosmetic outcomes, and recurrence rates. This article reviews the epidemiology, staging, treatment, and prevention of BCC.
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Affiliation(s)
- Dennis P Kim
- Mohs Micrographic Surgery, Brigham and Women's Faulkner Hospital, 1153 Centre Street, Suite 4J, Jamaica Plain, MA 02130-3446, USA
| | - Kylee J B Kus
- Oakland University William Beaumont School of Medicine, 586 Pioneer Drive, Rochester, MI 48309-4482, USA
| | - Emily Ruiz
- High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women's Cancer Center, Mohs and Dermatologic Surgery Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, 1153 Centre Street, Suite 4J, Jamaica Plain, MA 02130-3446, USA.
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21
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Shukla S, Khachemoune A. Reappraising basosquamous carcinoma: a summary of histologic features, diagnosis, and treatment. Arch Dermatol Res 2020; 312:605-609. [PMID: 32166375 DOI: 10.1007/s00403-020-02058-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
Basosquamous carcinoma (BSC) is a malignant and aggressive neoplasm with unclear molecular etiology. It is often misdiagnosed as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) on biopsy as there are unclear histologic criteria for this neoplasm. It has been interchangeably referred to as metatypical BCC and collision tumor, although these entities are different. On histology, BSC consists of basal cells with areas with nests of squamous cells and an intermediate transition zone. The nature of this transition zone is not clearly defined in literature; however, Ber-EP4 staining is diagnostic for BSC. A gradation of Ber-EP4 staining from strongly positive in basaloid areas to weakly positive in an intermediate zone is demonstrated (no staining of squamous areas). Treatment with an array of modalities including wide local excision, Mohs surgery, radiotherapy, and palliative chemotherapy has been performed. We recommend further molecular studies in understanding the genetic mechanisms leading to BSC. For the purpose of good clinical practice, multiple biopsies and immunohistochemical studies should be performed to avoid sampling error that can lead to a misdiagnosis of BSC.
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Affiliation(s)
- Shweta Shukla
- Brooklyn Campus of the VA NY Harbor Healthcare System, 800 Poly Place, Brooklyn, NY, 11209, USA.,SUNY downstate medical center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA
| | - Amor Khachemoune
- Brooklyn Campus of the VA NY Harbor Healthcare System, 800 Poly Place, Brooklyn, NY, 11209, USA. .,SUNY downstate medical center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA.
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22
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Williams NM, Rajabi-Estarabadi A, Long J, Gurnani P, Al-Asgah E, Nouri K. Cells to Surgery Quiz: December 2019. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Weber P, Tschandl P, Sinz C, Kittler H. Dermatoscopy of Neoplastic Skin Lesions: Recent Advances, Updates, and Revisions. Curr Treat Options Oncol 2018; 19:56. [PMID: 30238167 PMCID: PMC6153581 DOI: 10.1007/s11864-018-0573-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OPINION STATEMENT Dermatoscopy (dermoscopy) improves the diagnosis of benign and malignant cutaneous neoplasms in comparison with examination with the unaided eye and should be used routinely for all pigmented and non-pigmented cutaneous neoplasms. It is especially useful for the early stage of melanoma when melanoma-specific criteria are invisible to the unaided eye. Preselection by the unaided eye is therefore not recommended. The increased availability of polarized dermatoscopes, and the extended use of dermatoscopy in non-pigmented lesions led to the discovery of new criteria, and we recommend that lesions should be examined with polarized and non-polarized dermatoscopy. The "chaos and clues algorithm" is a good starting point for beginners because it is easy to use, accurate, and it works for all types of pigmented lesions not only for those melanocytic. Physicians, who use dermatoscopy routinely, should be aware of new clues for acral melanomas, nail matrix melanomas, melanoma in situ, and nodular melanoma. Dermatoscopy should also be used to distinguish between different subtypes of basal cell carcinoma and to discriminate highly from poorly differentiated squamous cell carcinomas to optimize therapy and management of non-melanoma skin cancer. One of the most exciting areas of research is the use of dermatoscopic images for machine learning and automated diagnosis. Convolutional neural networks trained with dermatoscopic images are able to diagnose pigmented lesions with the same accuracy as human experts. We humans should not be afraid of this new and exciting development because it will most likely lead to a peaceful and fruitful coexistence of human experts and decision support systems.
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Affiliation(s)
- Philipp Weber
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Philipp Tschandl
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christoph Sinz
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Harald Kittler
- Department of Dermatology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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24
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Basosquamous Carcinoma: A Single Centre Clinicopathological Evaluation and Proposal of an Evidence-Based Protocol. J Skin Cancer 2018; 2018:6061395. [PMID: 29973992 PMCID: PMC6008864 DOI: 10.1155/2018/6061395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/08/2018] [Accepted: 04/24/2018] [Indexed: 11/22/2022] Open
Abstract
Basosquamous carcinoma (BSC) is an uncommon skin malignancy with significant invasive and metastatic potential. There are currently no clear management guidelines. This study evaluates the management and outcomes of patients diagnosed with BSC over a 7-year period. We present an evidence-based unit protocol for the management of BSC. All patients treated for BSC between 2009 and 2015 were reviewed. Data collected included patient demographics, tumour-specific information, management strategy, presence of recurrence or metastasis, and details of follow-up. 74 patients were identified, making this one of the largest cohorts of BSC patients reported. Mean age at diagnosis was 75.4 years, with a male:female ratio of 1.6:1. The most common tumour site was the head and neck (n=43, 58.1%). All tumours were graded at pT1 (n=51) or pT2 (n=23). Inadequate excision occurred in 17 patients (23%). Mean excision margins were >4mm peripherally and deep. Inadequately excised BSCs were further treated with wide local excision (n=6) or radiotherapy (n=5), or both (n=1). There were no cases of local recurrence or metastatic disease. This study demonstrates a cohort of patients with BSCs that appear less aggressive than previously reported. Current management with surgical excision appears to produce adequate results. However, an evidence-based guideline is still lacking.
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What is this patient's unusual skin lesion? JAAPA 2018; 31:54-56. [PMID: 29846317 DOI: 10.1097/01.jaa.0000533664.65202.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Oliveira A, Zalaudek I. Reflectance confocal microscopic presentation of basosquamous carcinoma. J Eur Acad Dermatol Venereol 2017. [DOI: 10.1111/jdv.14415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Oliveira
- Department of Dermatology; Hospital de Santa Maria; Lisboa Portugal
- Centro Académico de Medicina de Lisboa; Universidade de Lisboa; Lisboa Portugal
| | - I. Zalaudek
- Department of Dermatology; Medical University of Graz; Graz Austria
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Elmahi H, Lahlou A, Baybay H, Gallouj S, Mernissi FZ, Reggad FZ, Harmouch T. [The role of dermoscopy in the diagnosis of basosquamous carcinoma]. Pan Afr Med J 2016; 25:252. [PMID: 28293368 PMCID: PMC5337263 DOI: 10.11604/pamj.2016.25.252.11345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/15/2016] [Indexed: 11/11/2022] Open
Abstract
Basosquamous carcinoma (BSC) is a rare skin cancer which has areas of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) and a transition zone between them. However, dermoscopic features of BSC are not well described in the literature, except for two studies. The aim of this case study was to better identify and clarify the role of dermoscopy in the diagnosis of BSC, although histological confirmation is necessary.
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Affiliation(s)
- Hakima Elmahi
- Département de Dermatologie, CHU Hassan II, Fès, Maroc
| | - Asmae Lahlou
- Département de Dermatologie, CHU Hassan II, Fès, Maroc
| | - Hanane Baybay
- Département de Dermatologie, CHU Hassan II, Fès, Maroc
| | - Salim Gallouj
- Département de Dermatologie, CHU Hassan II, Fès, Maroc
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