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Koumprentziotis IA, Rompoti N, Liopyris K, Nicolaidou E, Stratigos A. Photodynamic Therapy for the Treatment of Basal Cell Carcinoma: A Comprehensive Review of Randomized Controlled Trials. Dermatol Pract Concept 2024; 14:dpc.1402a105. [PMID: 38810046 PMCID: PMC11136039 DOI: 10.5826/dpc.1402a105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is the most common skin cancer worldwide and has been reported to have a rising incidence in the last years. Multiple therapeutic modalities are approved for the treatment of BCC, making it difficult for physicians to choose the most suitable option for every patient. Photodynamic therapy (PDT) using either 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) as photosensitizing agents is an established treatment option for low-risk BCC. OBJECTIVES This review aims to summarize the available evidence from randomized clinical trials (RCTs) that utilize either ALA or MAL PDT and compare it with other treatment modalities. The main outcomes related to the effectiveness, adverse events, cosmetic outcomes and pain sensation, along with data from long-term follow-ups will be presented and discussed. METHODS Thorough literature searches were conducted through the electronic databases ClinicalTrials. gov and Pubmed/MEDLINE from inception up to 28 March 2023. Only studies in English were included. All relevant data were extracted accordingly from the eligible studies. RESULTS Eight RCTs included superficial BCC (sBCC) alone, 7 included nodular BCC (nBCC), 2 included both sBCC and nBCC and 1 included BCC of unspecified subtype. Follow-up duration ranged from 3 months to 5 years. Both ALA-PDT and MAL-PDT demonstrated acceptable efficacy, adverse events, cosmetic outcomes and pain sensation while no major differences were observed between them. PDT was less effective than surgery but with better reported cosmetic outcomes. CONCLUSIONS PDT is a safe and efficacious treatment option for sBCC and to a lesser extent nBCC.
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Affiliation(s)
- Ioannis-Alexios Koumprentziotis
- 1 Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Natalia Rompoti
- 1 Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Liopyris
- 1 Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Electra Nicolaidou
- 1 Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexander Stratigos
- 1 Department of Dermatology and Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Kunstfeld R, Nguyen VA. New therapeutic developments for basal cell carcinoma. J Dtsch Dermatol Ges 2023; 21:382-385. [PMID: 37070499 DOI: 10.1111/ddg.15020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/22/2023] [Indexed: 04/19/2023]
Abstract
In 2013, systemic therapy was introduced into the treatment of locally advanced (laBCC) and metastatic basal cell carcinoma (mBCC). Meanwhile, immunotherapy has been approved in this indication as well. Additional immunotherapies and other classes of drugs including combination regimens are currently being investigated in clinical trials. These agents might considerably expand the therapeutic armamentarium for laBCC and mBCC in the future.
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Affiliation(s)
- Rainer Kunstfeld
- University Hospital for Dermatology, Medical University Vienna, Vienna, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology and Allergology, Medical University Innsbruck, Innsbruck, Austria
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3
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Kranz S, Brunnmeier G, Yilmaz P, Thamm J, Schiele S, Müller G, Key C, Welzel J, Schuh S. Optical coherence tomography-guided Nd:YAG laser treatment and follow-up of basal cell carcinoma. Lasers Surg Med 2023; 55:257-267. [PMID: 36740365 DOI: 10.1002/lsm.23638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Basal cell carcinoma (BCC) is the most common skin tumor with an annually increasing incidence. Standard care requires several visits for diagnosis and treatment. Optical coherence tomography (OCT) as a diagnostic tool increases the sensitivity (95%) and specificity (77%) of the diagnosis of BCC. Although laser therapy is not the standard of care, the long-pulsed 1064 nm Nd:YAG laser seems to be a promising option. However, data are scarce. The published papers had a short follow-up (FU) time and used to some extent inferior methods to detect complete tumor clearance. To address this research gap, this study evaluates the efficiency of laser treatment by FU OCT. We pursue a patient-focused approach and combine OCT with Nd:YAG laser treatment in one procedure. MATERIALS AND METHODS The study was conducted as a prospective, single-center trial that recruited biopsy-confirmed or OCT-proven BCC with a tumor thickness of less than 1.2 mm. Patients underwent two or three repeated sessions with the Nd:YAG laser (5-6 mm spot, fluence of 120-140 J/cm2 , pulse duration of 8-10 milliseconds). Each BCC was assessed at baseline, and 3 and 12 months after laser treatment by clinical image, dermoscopy, and OCT. Incomplete tumor clearance (ITC) was defined as a clearly detectable BCC on the OCT image or a biopsy-confirmed BCC in the treated area. RESULTS Forty-five patients completed the 12-month FU (46.7% women; median age of 74.0 [52-88] years) with a total number of 78 BCC lesions. At baseline, all patients had their BCC diagnosed by OCT (tumor thickness of 0.6 [0.4; 0.8] mm), 15.4% lesions were additionally diagnosed by histopathology. The most common subtype of BCC was superficial (48.7%), followed by nodular (47.4%) and infiltrative (3.8%). ITC rate after the treatment using Nd:YAG laser was 30.8% (95% CI: 20.8%-42.2%) (24/78) after 3 months and 7.4% (95% CI: 2.1%-17.9%) (4/54) after 12 months. ITC was not associated with histological subtype, tumor thickness, or location. If ITC was detected, the lesion was treated again. Out of 19 lesions with at least one additional laser treatment, 7 lesions (36.8%) suffered from incomplete tumor removal. In 46.7% of the treated lesions, the cosmetic outcome was rated as moderate or severe scarring after 12 months. CONCLUSION Our results demonstrate that the ITC rate of BCC treated with the Nd:YAG laser is much higher (up to one-third) than reported, although the laser settings were identical to prior studies. This is especially evident at the 3-month FU. In addition, we witnessed a larger number of side effects and a worse cosmetic outcome compared to previous studies.
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Affiliation(s)
- Stefanie Kranz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Gisela Brunnmeier
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Pelinsu Yilmaz
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Janis Thamm
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Stefan Schiele
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Faculty of of Mathematics and Natural Sciences, Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Clara Key
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, Augsburg University Hospital, Augsburg, Germany
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Joura MI, Koszorú K, Czintner D, Sárdy M. [Geriatric dermatology]. Z Gerontol Geriatr 2023; 56:35-41. [PMID: 34989815 PMCID: PMC9876847 DOI: 10.1007/s00391-021-02006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/26/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND With an ageing society the incidences of skin diseases increase. OBJECTIVE The most important skin diseases in geriatric patients are discussed. MATERIAL AND METHODS A literature search was conducted using the PubMed database and standard dermatological textbooks. RESULTS Skin diseases in geriatric patients are often more susceptible to external influences and can be affected by visceral diseases. Due to a delayed diagnosis, malignant skin diseases in geriatric patients are first diagnosed at a higher stage. CONCLUSION Physiological skin changes are to be treated with appropriate care. In the case of unclear skin changes, a timely dermatological check-up is to be done.
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Affiliation(s)
- Marie Isolde Joura
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Semmelweis Universität Budapest, Mária utca 41, 1085, Budapest, Ungarn.
| | - Kamilla Koszorú
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Semmelweis Universität Budapest, Mária utca 41, 1085, Budapest, Ungarn
| | - Dóra Czintner
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Semmelweis Universität Budapest, Mária utca 41, 1085, Budapest, Ungarn
| | - Miklós Sárdy
- Klinik für Dermatologie, Venerologie und Dermatoonkologie, Semmelweis Universität Budapest, Mária utca 41, 1085, Budapest, Ungarn
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Chatzikonstantinou G, Diefenhardt M, Fleischmann M, Meissner M, Scherf C, Trommel M, Ramm U, Rödel C, Tselis N, Licher J. Customized 3D-printed molds for high dose-rate brachytherapy in facial skin cancer: First clinical experience. J Dtsch Dermatol Ges 2023; 21:35-41. [PMID: 36657038 DOI: 10.1111/ddg.14944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/05/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Radiotherapy of elderly, frail patients with facial skin cancer in proximity to critical organs is challenging. This is the first report on clinical experience with facial skin cancer treated by individualized 3D-printer-based mold high-dose-rate (HDR) brachytherapy (BT). PATIENTS AND METHODS Fifteen patients not eligible for radical surgery or definitive external beam radiotherapy (EBRT) were treated with 3D-printer-based mold HDR-BT. Patient selection and treatment were in accordance with multidisciplinary tumor board recommendations. Clinical response, toxicity and cosmesis were analyzed. RESULTS Median age was 77 years. Histology revealed squamous cell carcinoma in seven, basal cell carcinoma in five, melanoma in situ in one, Lentigo maligna in one, and melanoma in one patient, respectively. Median prescription dose was 39 Gy delivered in once-daily fractions of 3 Gy. After a median follow-up of 12.2 months, local recurrence was observed in one patient with melanoma in situ. Apart from one grade 4 cataract, no other > grade 2 late toxicity was documented. CONCLUSIONS HDR-BT with 3D-printer-based molds for facial skin cancer is a well-tolerated and safe treatment option for elderly, frail patients not eligible for radical surgery or definitive EBRT due to functional inoperability or tumor location.
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Affiliation(s)
- Georgios Chatzikonstantinou
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Markus Diefenhardt
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.,Frankfurt Cancer Institute, Frankfurt am Main, Germany
| | - Maximilian Fleischmann
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Markus Meissner
- Department of Dermatology, Venereology and Allergology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Christian Scherf
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Martin Trommel
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Ulla Ramm
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Claus Rödel
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.,Frankfurt Cancer Institute, Frankfurt am Main, Germany.,German Cancer Research Center (DKFZ), Heidelberg, German Cancer Consortium (DKTK), Partner Site Frankfurt am Main, Frankfurt am Main, Germany
| | - Nikolaos Tselis
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Jörg Licher
- Department of Radiotherapy and Oncology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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Chatzikonstantinou G, Diefenhardt M, Fleischmann M, Meissner M, Scherf C, Trommel M, Ramm U, Rödel C, Tselis N, Licher J. 3D-gedruckte Moulagen für die individualisierte HDR-Brachytherapie kutaner Malignome im Gesichtsbereich: Erste klinische Erfahrungen. J Dtsch Dermatol Ges 2023; 21:35-43. [PMID: 36721945 DOI: 10.1111/ddg.14944_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/05/2022] [Indexed: 02/02/2023]
Affiliation(s)
| | - Markus Diefenhardt
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main.,Frankfurter Krebsinstitut
| | - Maximilian Fleischmann
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Markus Meissner
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Christian Scherf
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Martin Trommel
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Ulla Ramm
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Claus Rödel
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main.,Frankfurter Krebsinstitut.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutsches Krebskonsortium (DKTK), Partnerstandort Frankfurt am Main
| | - Nikolaos Tselis
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
| | - Jörg Licher
- Klinik für Strahlentherapie und Onkologie, Universitätsklinikum, Goethe-Universität, Frankfurt am Main
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Lütgerath C, Weiß C, Böer‐Auer A. Klinisch‐pathologische Merkmale und histologische Tumorreste in Reexzisionspräparaten unvollständig resezierter Basalzellkarzinome. J Dtsch Dermatol Ges 2022; 20:1476-1484. [DOI: 10.1111/ddg.14884_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022]
Affiliation(s)
| | - Christel Weiß
- Medizinische Statistik Biomathematik und Informationsverarbeitung Universitätsmedizin Mannheim
| | - Almut Böer‐Auer
- Dermatologikum Hamburg GmbH Hamburg
- Klinik für Hautkrankheiten Universitätsklinikum Münster
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8
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Lütgerath C, Weiß C, Böer‐Auer A. Clinicopathological features and histological tumor residues in re‐excision specimens of incompletely resected basal cell carcinomas. J Dtsch Dermatol Ges 2022; 20:1476-1483. [DOI: 10.1111/ddg.14884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/29/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | - Christel Weiß
- Department of Medical Statistics and Biomathematics University Medical Centre Mannheim Germany
| | - Almut Böer‐Auer
- Dermatologikum Hamburg GmbH Hamburg Germany
- Department of Dermatology University Medical Centre Münster Germany
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9
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Shavlokhova V, Vollmer M, Gholam P, Saravi B, Vollmer A, Hoffmann J, Engel M, Freudlsperger C. Deep Learning on Basal Cell Carcinoma In Vivo Reflectance Confocal Microscopy Data. J Pers Med 2022; 12:jpm12091471. [PMID: 36143256 PMCID: PMC9506260 DOI: 10.3390/jpm12091471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Extended skin malignancies of the head and neck region are among the most common cancer types and are associated with numerous diagnostic and therapeutical problems. The radical resection of skin cancer in the facial area often leads to severe functional and aesthetic impairment, and precise margin assessments can avoid the extensive safety margins. On the other hand, the complete removal of the cancer is essential to minimize the risk of recurrence. Reliable intraoperative assessments of the wound margins could overcome this discrepancy between minimal invasiveness and safety distance in the head and neck region. With the help of reflectance confocal laser microscopy (RCM), cells can be visualized in high resolution intraoperatively. The combination with deep learning and automated algorithms allows an investigator independent and objective interpretation of specific confocal imaging data. Therefore, we aimed to apply a deep learning algorithm to detect malignant areas in images obtained via in vivo confocal microscopy. We investigated basal cell carcinoma (BCC), as one of the most common entities with well-described in vivo RCM diagnostic criteria, within a preliminary feasibility study. Patients and Methods: We included 62 patients with histologically confirmed BCC in the head and neck region. All patients underwent in vivo confocal laser microscope scanning. Approximately 382 images with BCC structures could be obtained, annotated, and proceeded for further deep learning model training. Results: A sensitivity of 46% and a specificity of 85% in detecting BCC regions could be achieved using a convolutional neural network model (“MobileNet”). Conclusion: The preliminary results reveal the potential and limitations of the automated detection of BCC with in vivo RCM. Further studies with a larger number of cases are required to obtain better predictability.
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Affiliation(s)
- Veronika Shavlokhova
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michael Vollmer
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Patrick Gholam
- Department of Dermatology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Babak Saravi
- Department of Orthopedics and Trauma Surgery, Medical Centre—Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, 79106 Freiburg, Germany
- Correspondence:
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Michael Engel
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Megna M, Fornaro L, Potestio L, Luciano MA, Nocerino M, Delfino M, Guarino M, Fabbrocini G, Camela E. Efficacy and Safety of Anti-TNF Biosimilars for Psoriasis in Pediatric and Geriatric Populations: A 72-Week Real-Life Study. Psoriasis (Auckl) 2022; 12:199-204. [PMID: 35844291 PMCID: PMC9278721 DOI: 10.2147/ptt.s365493] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/19/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To determine the efficacy and safety of adalimumab (ADA) and etanercept (ETA) biosimilars in elderly and children with psoriasis. Methods A real-life retrospective observational study was conducted on pediatric (<18 years) and geriatric (≥65 years) psoriasis patients treated with anti-TNF biosimilar agents referring to the Psoriasis Unit of the University of Naples Federico II, Italy, from January 2018 to January 2022. At baseline, demographic characteristics (age and sex), data on psoriasis duration and severity (measured by Psoriasis Area Severity Index [PASI] and body surface area [BSA]), presence of psoriatic arthritis if applicable, comorbidities, and previous psoriasis treatments were recorded. Patients were monitored by regular follow-ups (week 12, 24, 48 and 72) through clinical and haematological assessments and adverse events (AEs) were registered. Results A total of 11 children and 23 elderly psoriasis patients were enrolled. Concerning children, 6 (54.5%) were under ADA biosimilar and 5 (45.5%) under ETA biosimilar. ETA and ADA biosimilars were equally effective and safe for up to 72 weeks (mean PASI and BSA < 3). No significant AEs were reported, and none discontinued treatment. In the elderly, 15 (65.2%) were treated with ADA biosimilar and 8 (34.8%) with ETA biosimilar. ETA and ADA biosimilars were equally effective up to 72 weeks (mean PASI < 4 and mean BSA < 5%). AEs (mainly mild) were registered in 9 subjects (39.1%). Also, 4 (17.4%) patients discontinued biologicals for secondary lack of efficacy (3, 75%) or AEs (1, 25%). Conclusion Our study found that ADA and ETA biosimilars are effective and safe for the treatment of moderate-to-severe psoriasis in children and the elderly. No statistically significant efficacy and safety differences were found between ADA and ETA biosimilars in both children and the elderly. Geriatric patients displayed a higher discontinuation rate and side effects than the pediatric counterpart even if without approaching statistical significance.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Luigi Fornaro
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Maria Antonietta Luciano
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Mariateresa Nocerino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Mario Delfino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Maria Guarino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Elisa Camela
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
- Correspondence: Elisa Camela, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Naples, NA, 80131, Italy, Tel +39 - 081 – 7462457, Fax +39 - 081 – 7462442, Email
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11
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Naik PP, Desai MB. Basal Cell Carcinoma: A Narrative Review on Contemporary Diagnosis and Management. Oncol Ther 2022; 10:317-335. [PMID: 35729457 PMCID: PMC9681969 DOI: 10.1007/s40487-022-00201-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/26/2022] [Indexed: 12/16/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common, accounting for 80–90% of skin cancers. It arises from the basal layer of the epidermis and its appendages. A complex interplay of environmental, phenotypic and genetic variables leads to the development of BCC. Literature has documented several clinical subtypes of BCC, the most common of which are nodular, superficial and morpheaform. Expeditious diagnosis and analysis are essential for improving the outcome of BCC. Preventive measures, particularly when implemented in childhood and adolescence, may play a critical role. Due to its low metastatic potential, treatment for BCC mostly focuses on local management. The standard treatment of basal cell carcinoma involved complete removal of the lesion by excision or Mohs surgery. In special circumstances, basal cell carcinoma can be treated with cryosurgery, electrodesiccation and curettage, topical medications and photodynamic therapy. This review aimed to evaluate the contemporary diagnosis and management of basal cell carcinoma.
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Affiliation(s)
- Piyu Parth Naik
- European Board of Dermatology and Venereology (UEMS-EBDV), Specialist Dermatologist, Medical Director, Department of Dermatology, Saudi-German Hospital and Clinic, Opposite Burj Al Arab, Dubai, UAE
| | - Munaf B. Desai
- Department of Histopathology, University Hospital Dorset NHS Foundation Trust, Bournemouth, UK
- Former Laboratory Director, Specialist histopathologist at Saudi-German Hospital Dubai, Dubai, UAE
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12
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[Occult basal cell carcinoma intermingling with seborrheic keratosis of the eyelid : A clinicopathological case report]. DIE OPHTHALMOLOGIE 2022; 119:636-638. [PMID: 34043084 DOI: 10.1007/s00347-021-01407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 01/26/2023]
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13
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoscopically narrowed surgical margins for head and neck basal cell carcinoma: A retrospective case-control study. J Dtsch Dermatol Ges 2022; 20:807-816. [PMID: 35581699 PMCID: PMC9321004 DOI: 10.1111/ddg.14757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) can cause extensive tissue damage if untreated. Complete surgical excision is the treatment of choice, but especially in the head-and neck area, defining both radical and healthy skin sparing surgical margins is complex. MATERIALS AND METHODS Excised, small (≤ 1 cm), BCCs of the head and neck were retrospectively analyzed, comparing histological properness of surgical margins after clinical-dermatoscopical preoperative evaluation (cases), vs. clinical evaluation only (controls) and recurrences. RESULTS Of 281 BCCs: 6 % (8/139) of cases and 8 % (12/142) of controls had unproper deep margins; 4 % (5/139) of cases, 20 % (29/142) of controls had unproper lateral margins (P < 0.001). Surgical 3 mm lateral margins were unproper in 0 % (15/66) of cases, 15 % (10/66) of controls (P > 0.005); surgical 1-2 mm lateral margins were unproper in 7 % (5/73) of cases, 25 % (19/76) of controls (P < 0.01). Of cases excised at 3 mm, 1-2 mm, and controls, 1.5 %, 0 %, and 7.7 % recurred, respectively. CONCLUSIONS BCC excision at 3 mm may be appropriate in the head and neck for small, dermatoscopically well-defined and non-aggressive BCCs, attaining surgical cure rates of 100 % and 1.5 % recurrences. Excision at 1-2 mm should be reserved only for BCCs in very difficult-to-treat areas, as the surgical cure rate was only 93 %.
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Affiliation(s)
- Astrid Herzum
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Martina Burlando
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Pietro Paolo Tavilla
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Claudia Micalizzi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Mattia Fabio Molle
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Emanuele Cozzani
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Aurora Parodi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
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14
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoskopisch kontrollierte, schmalere Resektionsränder bei Basalzellkarzinomen an Kopf und Hals: Retrospektive Fallkontrollstudie. J Dtsch Dermatol Ges 2022; 20:807-817. [PMID: 35711047 DOI: 10.1111/ddg.14757_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund: Unbehandelt kann das Basalzellkarzinom (BCC) erhebliche Gewebezerstörungen verursachen. Die komplette chirurgische Exzision ist die Behandlung der Wahl. Allerdings stellt es besonders im Gesichts- und Halsbereich eine Herausforderung dar, den Tumor vollständig zu entfernen und möglichst viel gesundes Gewebe zu erhalten. Material und Methoden: Bereits exzidierte kleine BCC (≤ 1 cm) von Kopf oder Hals wurden retrospektiv analysiert. Verglichen wurde die histologisch kontrolliert angemessene Breite des Resektionsrandes nach präoperativer dermatoskopischer Untersuchung (Fälle) im Vergleich zur rein klinischen Untersuchung (Kontrollen), sowie die Rezidivrate. Ergebnisse: Bei 281 BCC: 6 % (8/139) der Fälle und 8 % (12/142) der Kontrollen zeigten inadäquate basale Resektionsränder; 4 % (5/139) der Fälle und 20 % (29/142) der Kontrollen zeigten inadäquate laterale Resektionsränder (P < 0.001). Laterale Resektionsränder von 3 mm waren in 0 % (15/66) der Fälle, jedoch in 15 % (10/66) der Kontrollen inadäquat (P >0.005); laterale Resektionsränder von 1-2 mm waren in 7 % (5/73) der Fälle und in 25 % (19/76) der Kontrollen inadäquat (P < 0.01). Rezidive traten in den Fällen mit 3 mm Resektionsrand in 1,5 % auf, in den Fällen mit 1-2 mm Resektionsrand bei 0 %, und bei den Kontrollen bei 7,7 %. Schlussfolgerung: Für BCC im Kopf- und Halsbereich erscheint ein Resektionsrand von 3 mm angemessen, sofern das BCC klein, dermatoskopisch gut definiert und wenig aggressiv ist. Hier zeigten sich operative Heilungsraten von 100 % mit 1,5 % Rezidiven. Resektionsränder von 1-2 mm sollten nur für BCC in sehr schwierig zu behandelnden Bereichen in Betracht gezogen werden, da die Heilungsrate hier nur bei 93 % lag.
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Affiliation(s)
- Astrid Herzum
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Martina Burlando
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Pietro Paolo Tavilla
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Claudia Micalizzi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Mattia Fabio Molle
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Emanuele Cozzani
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Aurora Parodi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
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15
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Steeb T, Reinhardt L, Harlaß M, Heppt MV, Meier F, Berking C. Assessment of the Quality, Understandability, and Reliability of YouTube Videos as a Source of Information on Basal Cell Carcinoma: Web-Based Analysis. JMIR Cancer 2022; 8:e29581. [PMID: 35275067 PMCID: PMC8956995 DOI: 10.2196/29581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/07/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background Patients with skin cancer increasingly watch online videos to acquire disease-related information. Until now, no scientific evaluation of the quality of videos available for German-speaking patients with basal cell carcinoma (BCC) has been performed. Objective In this study, we aimed to identify and evaluate videos about BCC provided on YouTube. Methods A video search on YouTube was conducted in July 2020, using German BCC-related keywords (eg, “Basalzellkarzinom,” “Basaliom,” “weißer hautkrebs,” and “heller hautkrebs”). The first three pages (ie, 60 videos) were searched by two independent researchers for each keyword. Two authors evaluated videos that met the predefined eligibility criteria. The quality of the information of the videos was evaluated using the DISCERN tool and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The reliability was assessed with the JAMA (Journal of the American Medical Association) criteria score. Subgroup differences were identified using the Kruskal-Wallis test. Results A total of 41 videos were included in the evaluation. The mean assessment scores were as follows: DISCERN, 3.3 (SD 0.80); GQS, 3.8 (SD 1.1); JAMA, 27.74% (SD 22.1%); understandability, 70.8% (SD 13.3%); and actionability, 45.9% (SD 43.7%). These values indicated that the videos were of medium to good quality and had good understandability, low actionability, and poor reliability. The quality of videos provided by health professionals was significantly higher than that of videos provided by laypersons. Conclusions Optimization of health-related videos about BCC is desirable. In particular, adaptation to reliability criteria is necessary to support patient education and increase transparency.
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Affiliation(s)
- Theresa Steeb
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Lydia Reinhardt
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Matthias Harlaß
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Markus Vincent Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Friedegund Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Carola Berking
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
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16
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Gust C, Schuh S, Welzel J, Daxenberger F, Hartmann D, French LE, Ruini C, Sattler EC. Line-Field Confocal Optical Coherence Tomography Increases the Diagnostic Accuracy and Confidence for Basal Cell Carcinoma in Equivocal Lesions: A Prospective Study. Cancers (Basel) 2022; 14:cancers14041082. [PMID: 35205830 PMCID: PMC8870684 DOI: 10.3390/cancers14041082] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 12/05/2022] Open
Abstract
Simple Summary Basal cell carcinoma is the most frequently occurring type of skin cancer. Its treatment can be either local or surgical depending on its subtype and extension, with early recognized and superficial cases being easier to treat. Some of them, however, display unspecific features, making diagnosis difficult. Non-invasive devices such as line-field confocal optical coherence tomography (LC-OCT) are able to recognize morphological features of different BCC subtypes with a good correlation to histopathology. We decided to study their application to clinically doubtful BCC cases. Abstract Diagnosing clinically unclear basal cell carcinomas (BCCs) can be challenging. Line-field confocal optical coherence tomography (LC-OCT) is able to display morphological features of BCC subtypes with good histological correlation. The aim of this study was to investigate the accuracy of LC-OCT in diagnosing clinically unsure cases of BCC compared to dermoscopy alone and in distinguishing between superficial BCCs and other BCC subtypes. Moreover, we addressed pitfalls in false positive cases. We prospectively enrolled 182 lesions of 154 patients, referred to our department to confirm or to rule out the diagnosis of BCC. Dermoscopy and LC-OCT images were evaluated by two experts independently. Image quality, LC-OCT patterns and criteria, diagnosis, BCC subtype, and diagnostic confidence were assessed. Sensitivity and specificity of additional LC-OCT were compared to dermoscopy alone for identifying BCC in clinically unclear lesions. In addition, key LC-OCT features to distinguish between BCCs and non-BCCs and to differentiate superficial BCCs from other BCC subtypes were determined by linear regressions. Diagnostic confidence was rated as “high” in only 48% of the lesions with dermoscopy alone compared to 70% with LC-OCT. LC-OCT showed a high sensitivity (98%) and specificity (80%) compared to histology, and these were even higher (100% sensitivity and 97% specificity) in the subgroup of lesions with high diagnostic confidence. Interobserver agreement was nearly perfect (95%). The combination of dermoscopy and LC-OCT reached a sensitivity of 100% and specificity of 81.2% in all cases and increased to sensitivity of 100% and specificity of 94.9% in cases with a high diagnostic confidence. The performance of LC-OCT was influenced by the image quality but not by the anatomical location of the lesion. The most specific morphological LC-OCT criteria in BCCs compared to non-BCCs were: less defined dermoepidermal junction (DEJ), hyporeflective tumor lobules, and dark rim. The most relevant features of the subgroup of superficial BCCs (sBCCs) were: string of pearls pattern and absence of epidermal thinning. Our diagnostic confidence, sensitivity, and specificity in detecting BCCs in the context of clinically equivocal lesions significantly improved using LC-OCT in comparison to dermoscopy only. Operator training for image acquisition is fundamental to achieve the best results. Not only the differential diagnosis of BCC, but also BCC subtyping can be performed at bedside with LC-OCT.
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Affiliation(s)
- Charlotte Gust
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
| | - Sandra Schuh
- Department of Dermatology and Allergy, University Hospital, 86179 Augsburg, Germany; (S.S.); (J.W.)
| | - Julia Welzel
- Department of Dermatology and Allergy, University Hospital, 86179 Augsburg, Germany; (S.S.); (J.W.)
| | - Fabia Daxenberger
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
| | - Daniela Hartmann
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
| | - Lars E. French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33125, USA
| | - Cristel Ruini
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
- PhD School in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Correspondence: (C.R.); (E.C.S.); Tel.: +49-(0)89-4400-56010 (C.R.)
| | - Elke C. Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337 Munich, Germany; (C.G.); (F.D.); (D.H.); (L.E.F.)
- Correspondence: (C.R.); (E.C.S.); Tel.: +49-(0)89-4400-56010 (C.R.)
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17
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Hoffmann JC, Schön MP. Integrin α E(CD103)β 7 in Epithelial Cancer. Cancers (Basel) 2021; 13:6211. [PMID: 34944831 PMCID: PMC8699740 DOI: 10.3390/cancers13246211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 01/22/2023] Open
Abstract
Interactions of both the innate and the adaptive immune system with tumors are complex and often influence courses and therapeutic treatments in unanticipated ways. Based on the concept that CD8+T cells can mediate important antitumor effects, several therapies now aim to amplify their specific activity. A subpopulation of CD8+ tissue-resident T lymphocytes that express the αE(CD103)β7 integrin has raised particular interest. This receptor presumably contributes to the recruitment and retention of tumor-infiltrating immune cells through interaction with its ligand, E-cadherin. It appears to have regulatory functions and is thought to be a component of some immunological synapses. In TGF-rich environments, the αE(CD103)β7/E-cadherin-interaction enhances the binding strength between tumor cells and infiltrating T lymphocytes. This activity facilitates the release of lytic granule contents and cytokines as well as further immune responses and the killing of target cells. Expression of αE(CD103)β7 in some tumors is associated with a rather favorable prognosis, perhaps with the notable exception of squamous cell carcinoma of the skin. Although epithelial skin tumors are by far the most common tumors of fair-skinned people, there have been very few studies on the distribution of αE(CD103)β7 expressing cells in these neoplasms. Given this background, we describe here that αE(CD103)β7 is scarcely present in basal cell carcinomas, but much more abundant in squamous cell carcinomas with heterogeneous distribution. Notwithstanding a substantial number of studies, the role of αE(CD103)β7 in the tumor context is still far from clear. Here, we summarize the essential current knowledge on αE(CD103)β7 and outline that it is worthwhile to further explore this intriguing receptor with regard to the pathophysiology, therapy, and prognosis of solid tumors.
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Affiliation(s)
- Johanna C. Hoffmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Michael P. Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075 Göttingen, Germany;
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, 37075 Göttingen, Germany
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18
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Known and new facts on basal cell carcinoma. J Dtsch Dermatol Ges 2021; 19:1021-1041. [PMID: 34288482 PMCID: PMC8361778 DOI: 10.1111/ddg.14580] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumor in light‐skinned people and amounts to about 75 % of all cases of skin cancer. Increasing incidence rates have been reported for decades all over the world. The main risk factors include UV radiation, male sex, light skin type, advanced age, long‐term immunosuppression, a positive individual or family history, and certain genodermatoses. BCC metastasizes only rarely, and its mortality is low, but it is associated with significant morbidity. Genetic mutations especially in the hedgehog pathway play an important role in BCC pathogenesis. Non‐invasive procedures such as optical coherence tomography or confocal laser scan microscopy are increasingly utilized for diagnostics in addition to visual inspection and dermatoscopy, but only in exceptional cases can histological confirmation of the diagnosis be dispensed with. Various clinical and histological subtypes have been defined. Differentiating between BCC with high and low risk of recurrence has a significant influence on the choice of treatment. Most BCC can be treated effectively and safely with standard surgery, or in selected cases with topical treatment. Locally advanced and metastasized BCC must be treated with radiation or systemic therapy. Radiation is also an option for older patients with contraindications for surgery. The hedgehog inhibitors vismodegib and sonidegib are currently approved for systemic therapy of BCC in Europe. Approval for the PD1 inhibitor cemiplimab as second‐line therapy is expected in the near future.
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Affiliation(s)
- Magdalena Seidl-Philipp
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nina Frischhut
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nicole Höllweger
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Matthias Schmuth
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
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19
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Effective systemic treatment of advanced periocular basal cell carcinoma with sonidegib. Graefes Arch Clin Exp Ophthalmol 2021; 259:3821-3822. [PMID: 34338845 PMCID: PMC8589764 DOI: 10.1007/s00417-021-05311-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
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20
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Bekanntes und Neues zum Basalzellkarzinom. J Dtsch Dermatol Ges 2021; 19:1021-1043. [PMID: 34288462 DOI: 10.1111/ddg.14580_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Magdalena Seidl-Philipp
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nina Frischhut
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nicole Höllweger
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Matthias Schmuth
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Van Anh Nguyen
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
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21
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Grupp M, Illes M, Mentzel J, Simon JC, Paasch U, Grunewald S. Schnittrandkontrolle von Basalzellkarzinomen mittels
ex‐vivo
konfokaler Laserscanmikroskopie mit digitaler Farbbearbeitung – Anwendung in der Routinediagnostik. J Dtsch Dermatol Ges 2021; 19:685-693. [PMID: 33979047 DOI: 10.1111/ddg.14374_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Margarethe Grupp
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Monica Illes
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Julia Mentzel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Jan C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Uwe Paasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Sonja Grunewald
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
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22
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Bosche FD, Merté RL, Metze D, Eter N, Mihailovic N. [Pigmented eyelid tumor of unclear dignity]. Ophthalmologe 2021; 118:280-282. [PMID: 32620977 PMCID: PMC7935824 DOI: 10.1007/s00347-020-01132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Ralph-Laurent Merté
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Dieter Metze
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster, Deutschland
| | - Nicole Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
| | - Natasa Mihailovic
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstr. 15, 48149, Münster, Deutschland
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23
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Grupp M, Illes M, Mentzel J, Simon JC, Paasch U, Grunewald S. Routine application of ex vivo confocal laser scanning microscopy with digital staining for examination of surgical margins in basal cell carcinomas. J Dtsch Dermatol Ges 2021; 19:685-692. [PMID: 33768732 DOI: 10.1111/ddg.14374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Ex vivo confocal laser scanning microscopy (CLSM) allows histologic examination of native tissue based on tissue reflection and nuclear fluorescence staining. The newly introduced digital staining process almost perfectly mimics conventional hematoxylin and eosin (HE) slides. The aim was to evaluate the new method in clinical routine, with regard to quality of findings and time requirements, in the examination of surgical margins of basal cell carcinomas. PATIENTS AND METHODS 78 patients with 101 basal cell carcinomas were prospectively enrolled. Surgery was performed either with complete margin control (n = 60) or as elliptical excision (n = 41). Immediately after excision specimens were scanned with CLSM and then routinely processed by conventional histopathology. Blinded evaluation of images and slides was performed by a dermatopathologist. RESULTS Basal cell carcinomas were excellently recognizable by CLSM directly after excision, and the use of digital staining did not require any adjustment of the examiner's visualization preferences. CLSM images showed a sensitivity of 73.6 % and a specificity of 96.5 % compared to conventional HE stained slides. Erroneous findings were often due to limited assessment potential in cases where the epidermis could not be fully visualized. CONCLUSIONS CLSM with digital HE staining is very well suited to diagnose basal cell carcinomas and their incision margins even under routine conditions and thus represents a tissue-saving alternative to rapid cryostat sectioning.
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Affiliation(s)
- Margarethe Grupp
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Monica Illes
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Julia Mentzel
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Jan C Simon
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Uwe Paasch
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
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Mahajan S, Kalaivani M, Sethuraman G, Khaitan BK, Verma KK, Gupta S. A retrospective comparative study of outcome with surgical excision and repair versus nonsurgical and ablative treatments for basal cell carcinoma. Indian J Dermatol Venereol Leprol 2021; 87:348-356. [PMID: 33666033 DOI: 10.25259/ijdvl_170_19] [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: 02/01/2019] [Accepted: 01/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are few studies on basal cell carcinoma (BCC) from India. Long-term follow-up is available in only one study and the aesthetic outcome of treatment has not been evaluated in Indian patients. AIMS In this retrospective study on BCC, we compared treatment failure, recurrence rates and aesthetic outcomes on long-term follow-up between surgical excision and repair, and nonsurgical and ablative treatments. METHODS Records of patients with BCC treated in the dermatologic surgery clinic over the past 10 years were analyzed. Patients with histopathologically confirmed BCC who could be contacted were evaluated for recurrence, treatment failure, overall satisfaction and aesthetic outcomes by global aesthetic improvement scale. RESULTS Out of 98 patients, 72 were contactable. Four patients received both nonsurgical and ablative treatments and surgical excision and repair sequentially and were excluded. The mean age of patients was 57.9 ± 15.8 years (24-90 years) and the male: female ratio was 1.6:1. The most common site involved was the face (72.1%) followed by trunk and scalp, and the most common type of BCC was the pigmented superficial type (33.8%), followed by the pigmented noduloulcerative type (16.2%). There was no significant difference between the groups in the number of high-risk cases. The mean follow-up period was 37.1 ± 31.4 (range, 4-120) months. Fifty one patients were treated with surgical excision and repair, and 17 with nonsurgical and ablative treatments (9-imiquimod, 5-cryotherapy, 4-radiotherapy). Treatment failure was seen in 5 (7.4%) patients, all in the nonsurgical and ablative treatments group (P = 0.0006). Recurrence was seen in 2 (2.9%) patients, both in the surgical excision and repair group (P > 0.05). Mean patient satisfaction was significantly higher with surgical excision and repair, though there was no significant difference in the Global Aesthetic Improvement Scale between the groups. LIMITATIONS The sample size was low. Only telephonic and pictorial assessments were done where the patient could not come for follow-up. CONCLUSIONS Surgical excision and repair was associated with better outcomes than nonsurgical and ablative treatments. Treatment failures and adverse events were high with nonsurgical and ablative treatments. The recurrence rate was low.
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Affiliation(s)
- Soniya Mahajan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Gomathy Sethuraman
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Binod Kumar Khaitan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushal Kumar Verma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Fania L, Sampogna F, Ricci F, Hyeraci M, Paradisi A, Palese E, Di Lella G, Pallotta S, Panebianco A, Candi E, Dellambra E, Abeni D. Systemic Photoprotection in Skin Cancer Prevention: Knowledge among Dermatologists. Biomolecules 2021; 11:biom11020332. [PMID: 33672113 PMCID: PMC7926776 DOI: 10.3390/biom11020332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Systemic photoprotection (i.e., administration of substances such as nicotinamide, carotenoids, and vitamin D) may be important to reduce photocarcinogenesis or to support long-term protection against UV irradiation. Clinical trials showed that oral nicotinamide is effective in reducing the onset of new nonmelanoma skin cancers (NMSCs), while other oral photoprotectors failed to achieve the reduction of new melanoma or NMSC formation in humans. The aim of this study was to summarize the current state of knowledge of systemic photoprotection and to evaluate the knowledge and attitude of dermatologists regarding these treatments. Methods: The survey was conducted on a sample of dermatologists recruited according to a snowball sampling procedure. The questionnaire consisted of a first part asking for characteristics of the participant and a second part with 12 specific questions on their knowledge about systemic photoprotection, particularly their knowledge of astaxanthin, β-carotene, nicotinamide, and vitamin D3. Results: One hundred eight dermatologists answered the survey. Most of them (85.2%) stated that oral photoprotectors have a role in the prevention of skin cancer, and responses mainly mentioned nicotinamide. More than half of them (54.6%) had prescribed all the considered oral photoprotectors, but the majority of them had prescribed nicotinamide, mainly for 2 to 3 months during summer, almost invariably (n = 106) associated with topical photoprotectors. Most dermatologists (>80%) were aware of scientific publications demonstrating an effect of systemic photoprotectors on NMSC. Conclusions: Most Italian dermatologists have positive views on oral photoprotection in skin cancer and are aware of the demonstrated potential of nicotinamide in the prevention of NMSCs.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
- Correspondence: ; Tel.: +39-0666-464-571
| | - Francesca Sampogna
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Francesco Ricci
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Mariafrancesca Hyeraci
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35121 Padua, Italy;
| | - Andrea Paradisi
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
- Dermatology Unit, “Cristo Re” General Hospital, 00167 Rome, Italy
| | - Enzo Palese
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Giovanni Di Lella
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Sabatino Pallotta
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Annarita Panebianco
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Eleonora Candi
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Elena Dellambra
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
| | - Damiano Abeni
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167 Rome, Italy; (F.S.); (F.R.); (A.P.); (E.P.); (G.D.L.); (S.P.); (A.P.); (E.C.); (E.D.); (D.A.)
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Abstract
Photodynamic therapy (PDT) is a licensed and established procedure for the treatment of actinic keratosis, basal cell carcinoma, and Bowen's disease, but there are several new and clinically relevant developments and trends. These concern on the one hand the main components of PDT, which are the photosensitizer and the light source. Furthermore, modifications and therapy combinations have been developed that lead to an improved therapeutic efficacy. An important aspect of field-directed PDT is also skin cancer prevention. Finally, PDT has been used successfully for nonlicensed indications including inflammatory diseases and skin rejuvenation. This article focuses on these new developments and on recent guideline recommendations.
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Affiliation(s)
- R-M Szeimies
- Klinik für Dermatologie und Allergologie, Klinikum Vest GmbH, Akademisches Lehrkrankenhaus der Ruhr-Universität Bochum, Dorstener Str. 151, Recklinghausen, 45657, Deutschland.
| | - S Karrer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
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Fania L, Didona D, Morese R, Campana I, Coco V, Di Pietro FR, Ricci F, Pallotta S, Candi E, Abeni D, Dellambra E. Basal Cell Carcinoma: From Pathophysiology to Novel Therapeutic Approaches. Biomedicines 2020; 8:biomedicines8110449. [PMID: 33113965 PMCID: PMC7690754 DOI: 10.3390/biomedicines8110449] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common human cancer worldwide, and is a subtype of nonmelanoma skin cancer, characterized by a constantly increasing incidence due to an aging population and widespread sun exposure. Although the mortality from BCC is negligible, this tumor can be associated with significant morbidity and cost. This review presents a literature overview of BCC from pathophysiology to novel therapeutic approaches. Several histopathological BCC subtypes with different prognostic values have been described. Dermoscopy and, more recently, reflectance confocal microscopy have largely improved BCC diagnosis. Although surgery is the first-line treatment for localized BCC, other nonsurgical local treatment options are available. BCC pathogenesis depends on the interaction between environmental and genetic characteristics of the patient. Specifically, an aberrant activation of Hedgehog signaling pathway is implicated in its pathogenesis. Notably, Hedgehog signaling inhibitors, such as vismodegib and sonidegib, are successfully used as targeted treatment for advanced or metastatic BCC. Furthermore, the implementation of prevention measures has demonstrated to be useful in the patient management.
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Affiliation(s)
- Luca Fania
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Correspondence:
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, 35043 Marburg, Germany;
| | - Roberto Morese
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Irene Campana
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Valeria Coco
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Romana Di Pietro
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Francesca Ricci
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Sabatino Pallotta
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Eleonora Candi
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Damiano Abeni
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
| | - Elena Dellambra
- Istituto Dermopatico dell’Immacolata-IRCCS, via dei Monti di Creta 104, 00167 Rome, Italy; (R.M.); (I.C.); (V.C.); (F.R.D.P.); (F.R.); (S.P.); (E.C.); (D.A.); (E.D.)
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[Surgical techniques in the treatment of basal cell carcinoma-a prospective investigation]. Hautarzt 2020; 71:960-968. [PMID: 32930855 PMCID: PMC7686215 DOI: 10.1007/s00105-020-04685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Hintergrund Basalzellkarzinome sind die häufigsten epithelialen Hauttumoren und eine häufige Indikation für dermatologische Eingriffe. Trotz der Etablierung medikamentöser Therapieoptionen stellt die Operation weiterhin die Therapie der Wahl dar. Hierbei stehen verschiedene Möglichkeiten zur Verfügung, die von der Kürettage bis hin zu komplexen dermatochirurgischen Eingriffen reichen. Neben dem Hauptaspekt der geringen lokalen Rezidivraten sind auch ästhetische Faktoren und die Anzahl der Eingriffe für die Wahl der Therapie wichtig. Methoden In dieser Studie wurden 347 Patienten mit 398 Basalzellkarzinomen (nodulärer Typ, Durchmesser bis 10 mm) prospektiv untersucht. Die Patienten wurden randomisiert in 2 Behandlungsarme eingeteilt: In einer Gruppe wurden die Tumoren kürettiert, in der anderen Gruppe exzidiert. Als Kontrolle dienten Patienten, die im gleichen Untersuchungszeitraum 3‑D-histologisch kontrolliert operiert wurden. Ergebnisse Die höchste lokale Rezidivrate wurde nach der Kürettage (14,0 %) beobachtet, während die Gruppe mit 3‑D-Histologie die niedrigste Rezidivrate (0,9 %; p < 0,001) aufwies. In der 3‑D-Gruppe waren mehr Re-Exzisionen erforderlich, um eine vollständige Entfernung des Tumors zu erreichen, als in der Gruppe mit histologischen Serienschnitten. Die Patienten bewerteten das ästhetische Ergebnis am besten nach der Kürettage. Die mittlere Nachbeobachtungszeit betrug 3,9 Jahre. Schlussfolgerung Die Wahl der chirurgischen Therapie bei kleinen nodulären Basalzellkarzinomen hängt von den individuellen Gegebenheiten ab. 3‑D-histologisch kontrollierte Exzisionen mit Wundverschluss nach vollständiger Tumorentfernung zeigten in unserer Studie die geringste Rezidivrate. Aber auch die Kürettage stellt eine mögliche chirurgische Therapieoption mit minimalem Aufwand und einer akzeptablen Rezidivrate dar, die zu guten ästhetischen Ergebnissen führen kann.
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Effective treatment of locally advanced periocular basal cell carcinoma with oral hedgehog pathway inhibitor? Graefes Arch Clin Exp Ophthalmol 2020; 258:2335-2337. [PMID: 32514773 PMCID: PMC7550312 DOI: 10.1007/s00417-020-04779-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 04/29/2020] [Accepted: 06/01/2020] [Indexed: 01/18/2023] Open
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Volz A, Häusermann P, Navarini AA, Volz T. Temporär gestielte nasolabiale Schwenklappenplastik mit Flügeln zur Rekonstruktion kombinierter Nasenspitzen‐Columella‐Defekte. J Dtsch Dermatol Ges 2020; 18:644-647. [DOI: 10.1111/ddg.14111_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andreas Volz
- Dermatologie am Rhein Basel Schweiz
- Dermatologische Klinik Universitätsspital Basel Schweiz
| | - Peter Häusermann
- Dermatologie am Rhein Basel Schweiz
- Dermatologische Klinik Universitätsspital Basel Schweiz
| | | | - Thomas Volz
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein Fakultät für Medizin Technische Universität München Deutschland
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Volz A, Häusermann P, Navarini AA, Volz T. Two-stage pedicled interpolation flap with wings for reconstruction of combined nasal tip/columella defects. J Dtsch Dermatol Ges 2020; 18:644-647. [PMID: 32447814 DOI: 10.1111/ddg.14111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andreas Volz
- Dermatologie am Rhein, Basel, Switzerland.,Department of Dermatology, Basel University Hospital, Basel, Switzerland
| | - Peter Häusermann
- Dermatologie am Rhein, Basel, Switzerland.,Department of Dermatology, Basel University Hospital, Basel, Switzerland
| | | | - Thomas Volz
- Department of Dermatology and Allergology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Niebel D, Sirokay J, Hoffmann F, Fröhlich A, Bieber T, Landsberg J. Clinical Management of Locally Advanced Basal-Cell Carcinomas and Future Therapeutic Directions. Dermatol Ther (Heidelb) 2020; 10:835-846. [PMID: 32383019 PMCID: PMC7367955 DOI: 10.1007/s13555-020-00382-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Indexed: 01/19/2023] Open
Abstract
Treatment of choice for nodular basal-cell carcinomas (BCCs) is complete excision, implying that small lesions are of minor concern. Metastasis is very rare (< 1%). However, locally advanced basal-cell carcinomas (laBCCs), which are ineligible for surgery or radiation, are a therapeutic challenge. First-generation Smoothened (SMO) inhibitors (vismodegib, sonidegib) have been approved for treatment, but common side effects limit their use. Numerous new compounds are being investigated in clinical trials as potential therapeutic alternatives, among them second-generation SMO inhibitors, other Hedgehog signaling pathway inhibitors, immune-checkpoint inhibitors and intralesional modalities such as oncolytic viruses. Neoadjuvant treatment regimens open another field. This article deals with the clinical management of laBCCs, based on the description of an illustrative case from our department featuring multiple extensive lesions of the scalp. In this short review we will discuss therapeutic options and implications for the future. Some of the new strategies might potentially evolve as alternatives in the management of genodermatoses such as basal-cell carcinoma syndrome, if proven effective and safe.
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Affiliation(s)
- Dennis Niebel
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany.
| | - Judith Sirokay
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany
| | - Friederike Hoffmann
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany
| | - Anne Fröhlich
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany
| | - Thomas Bieber
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany
| | - Jennifer Landsberg
- Clinic for Dermatology and Allergy, University Hospital Bonn, 53127, Bonn, Germany
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Ferrara F, Lacava R, Barisani A, Messori S, Patrizi A, Bardazzi F, Vaccari S. Kombinierte CO
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‐Laser‐ und photodynamische Therapie erhöht die Wirksamkeit der Behandlung von Basalzellkarzinomen. J Dtsch Dermatol Ges 2019; 17:1251-1256. [DOI: 10.1111/ddg.14004_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Francesca Ferrara
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Rossella Lacava
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Alessia Barisani
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Stefano Messori
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Annalisa Patrizi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Federico Bardazzi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Sabina Vaccari
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
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Ferrara F, Lacava R, Barisani A, Messori S, Patrizi A, Bardazzi F, Vaccari S. Combined CO 2 laser and photodynamic therapy enhances the efficacy of treatment of basal cell carcinomas. J Dtsch Dermatol Ges 2019; 17:1251-1256. [PMID: 31814292 DOI: 10.1111/ddg.14004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES In selected cases, conventional photodynamic therapy (C-PDT) is a valid alternative to surgery for the treatment of basal cell carcinoma (BCC). However, it is limited to superficial BCCs. Pretreatment of BCCs with ablative lasers may enhance its efficacy. We evaluated the C-PDT and CO2 laser combination therapy for the treatment of superficial and nodular BCCs. PATIENTS AND METHODS In this prospective, interventional, monocentric study, patients affected by BCC were treated with CO2 laser therapy, using a continuous superpulsed CO2 laser for nodular BCCs and a fractional CO2 laser for superficial BCCs. All patients were subsequently treated with photodynamic therapy using methyl aminolevulinate cream and an Aktilite CL128® (Galderma) lamp. RESULTS 32 patients (20 males, 12 females) aged from 45 to 96 years (with a total of 181 BCCs) were treated using a CO2 laser combined with C-PDT. A 100 % cure rate was achieved at three months, with no signs of relapse in 97.2 % of the cases during the mean follow-up period (10.7 months, range 4 to 18 months). We observed mild adverse reactions and good aesthetic results. CONCLUSIONS We recommend this combination therapy in selected cases, based on its high efficacy, good aesthetic results and few side effects.
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Affiliation(s)
- Francesca Ferrara
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Rossella Lacava
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessia Barisani
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Messori
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Federico Bardazzi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Fukumoto T, Fukumoto R, Oka M, Horita N. Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis. J Eur Acad Dermatol Venereol 2019; 33:2050-2057. [DOI: 10.1111/jdv.15796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/27/2019] [Indexed: 01/24/2023]
Affiliation(s)
- T. Fukumoto
- Gene Expression and Regulation Program The Wistar Institute Philadelphia PA USA
- Division of Dermatology Department of Internal Related Kobe University Graduate School of Medicine Kobe Japan
| | - R. Fukumoto
- Research Center for Advanced Science and Technology The University of Tokyo Tokyo Japan
| | - M. Oka
- Division of Dermatology Tohoku Medical and Pharmaceutical University Sendai Japan
| | - N. Horita
- Department of Pulmonology Yokohama City University Graduate School of Medicine Kanazawa Yokohama Japan
- National Human Genome Research Institute National Institutes of Health Bethesda MD USA
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