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Chgari O, Wahnou H, Ndayambaje M, Moukhfi F, Benkhnigue O, Marnissi F, Limami Y, Oudghiri M. Orbea variegata (L.) Haw in skin carcinogenesis: insights from an in vivo male Swiss mouse model study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2024; 87:630-645. [PMID: 38741420 DOI: 10.1080/15287394.2024.2354790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Skin cancer is the most widespread type of malignant tumor representing a major public health concern. Considering the numerous side effects associated with conventional treatments, phytotherapy may be regarded as a viable medicinal alternative. This study aimed to investigate the therapeutic potential of Orbea variegata (L.) Haw, an ornamental plant, in treating skin cancer using an animal model induced by a combination of ultraviolet (UV) irradiation and sulfuric acid treatment. The hydroethanolic extract of Orbea variegata underwent phytochemical characterization, identifying the presence of reducing sugars, coumarins, alkaloids, flavonoids, tannins, and saponins through qualitative screening. Quantitative analysis demonstrated significant amounts of phenolic compounds (29.435 ± 0.571 mg GAE/g of dry extract), flavonoids (6.711 ± 0.272 mg QE/g of dry extract), and tannins (274.037 ± 11.3 mg CE/g of dry extract). The administration the hydroethanolic extract in two concentrations (1 or 2 g/kg) to male Swiss mice exhibited no marked adverse effects, as evidenced by serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzyme activity levels. In addition, the extract significantly reduced skin hyperplasia and inflammation induced by UV/sulfuric acid treatment as noted in tissue analyses and decreased protein expression of nuclear proliferation marker (Ki-67). This improvement was associated with a marked decrease in oxidative stress, as indicated by diminished lipid peroxidation levels, and restoration of the activity of endogenous antioxidant enzyme catalase (CAT) to control levels. Our findings demonstrated the potential of Orbea variegata hydroethanolic extract to be considered as a treatment for skin cancer, exhibiting its apparent safety and efficacy in reducing inflammation and carcinogenesis in a UV/sulfuric acid-induced Swiss mouse model, attributed to its phytochemical content and associated antioxidant activities.
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Affiliation(s)
- Oumaima Chgari
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Hicham Wahnou
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Martin Ndayambaje
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Fatimazahra Moukhfi
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Ouafae Benkhnigue
- Department of Botany and Plant Ecology, Scientific Institute, Mohammed V University in Rabat, Rabat, Morocco
| | - Farida Marnissi
- Laboratory of Pathological Anatomy, Ibn Rochd University Hospital-Casablanca, Casablanca, Morocco
| | - Youness Limami
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Mounia Oudghiri
- Laboratory of Immunology and Biodiversity, Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
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Krönert MIC, Schwarzenböck SM, Kurth J, Heuschkel M, Krause BJ, Emmert S, Tietze JK. Patient-Orientated Evaluation of Treatment of Non-Melanoma Skin Cancer with Rhenium-188 Compared to Surgery. Healthcare (Basel) 2024; 12:921. [PMID: 38727478 PMCID: PMC11083370 DOI: 10.3390/healthcare12090921] [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: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative. METHODS In this monocentric pilot study, 19 patients suffering from NMSC were treated with RSCT. Most of these patients had also experienced surgery, either because they developed a new NMSC in aftercare, or they had suffered previously from NMSC. Three RSCT-treated patients, who had no exposure to surgery so far, were paired with three matched patients, who had received surgery. We sought to evaluate and compare the patients' experience with both treatments. A questionnaire assessed patients' perceptions regarding side effects, aesthetic outcomes, wound care, fear of complications, and personal treatment preferences. Patients evaluated the different parameters of their either RSCT- or surgery-treated lesions on a scale from 0-10. RESULTS Patients were more afraid of complications before surgery than before RSCT (p = 0.04). Treatment with RSCT caused significantly less pain on treatment day (mean 0.56) than surgery (mean 2.32) (0 no pain, 10 maximum pain) (p = 0.02) and 14 days after the procedure (mean 0.89 versus mean 2.47) (p = 0.02). On day 14, RSCT-treated lesions were also significantly less itchy (mean 0.34) than after surgery (mean 1.50). Most patients were very satisfied with the aesthetic outcome after both RSCT (mean 8.42) and surgery (mean 8.31) (p = 0.89). In the case of a new NMSC, the majority of patients who experienced both treatments would rather be treated primarily with RSCT (44%) or would consider both options (31%); only 19% preferred surgery. CONCLUSION Patients evaluated RSCT as less painful than surgery. The aesthetic outcomes of both treatments were comparable. For pain-sensitive patients, RSCT might be a preferable treatment option.
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Affiliation(s)
- Maila I. C. Krönert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
| | - Sarah M. Schwarzenböck
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Jens Kurth
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Martin Heuschkel
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Bernd J. Krause
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
| | - Julia K. Tietze
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. ENVIRONMENTAL RESEARCH 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Iliescu C, Beiu C, Slavu I, Racoviță A, Orlov Slavu C. Clinical Insights and Dermatological Recommendations for Non-Melanoma Skin Cancers (NMSCs) in Long-Term Hydroxyurea (HU) Therapy. Cureus 2024; 16:e57133. [PMID: 38681414 PMCID: PMC11055605 DOI: 10.7759/cureus.57133] [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] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Hydroxyurea (HU), an anti-metabolite ribonucleotide reductase inhibitor, is commonly used to treat several myeloproliferative disorders, including polycythemia vera. However, patients receiving long-term treatment with HU may experience a variety of cutaneous side effects, with non-melanoma skin cancers (NMSCs) emerging as the most challenging and destructive. HU-induced carcinogenesis can be attributed to both the drug's mutagenic potential and impaired DNA repair following damage by external triggers such as ultraviolet light. We report a unique case of multiple aggressive NMSCs distributed within sun-exposed areas in an 81-year-old woman receiving chronic therapy with HU for 15 years. The case draws the clinician's attention to the increased incidence of NMSCs in this population and highlights the need for regular dermatologic monitoring. We also elaborate relevant insights and recommendations to assist healthcare providers in managing HU-related NMSCs development and progression.
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Affiliation(s)
- Carmen Iliescu
- Dermatology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Cristina Beiu
- Oncologic Dermatology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Iulian Slavu
- General Surgery, "Prof. Dr. Agrippa Ionescu" Emergency Clinical Hospital, Bucharest, ROU
| | - Andreea Racoviță
- Dermatology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Cristina Orlov Slavu
- Oncology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
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Anand S, Hasan T, Maytin EV. Treatment of nonmelanoma skin cancer with pro-differentiation agents and photodynamic therapy: Preclinical and clinical studies (Review). Photochem Photobiol 2024. [PMID: 38310633 DOI: 10.1111/php.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/30/2023] [Accepted: 01/16/2024] [Indexed: 02/06/2024]
Abstract
Photodynamic therapy (PDT) is a nonscarring cancer treatment in which a pro-drug (5-aminolevulinic acid, ALA) is applied, converted into a photosensitizer (protoporphyrin IX, PpIX) which is then activated by visible light. ALA-PDT is now popular for treating nonmelanoma skin cancer (NMSC), but can be ineffective for larger skin tumors, mainly due to inadequate production of PpIX. Work over the past two decades has shown that differentiation-promoting agents, including methotrexate (MTX), 5-fluorouracil (5FU) and vitamin D (Vit D) can be combined with ALA-PDT as neoadjuvants to promote tumor-specific accumulation of PpIX, enhance tumor-selective cell death, and improve therapeutic outcome. In this review, we provide a historical perspective of how the combinations of differentiation-promoting agents with PDT (cPDT) evolved, including Initial discoveries, biochemical and molecular mechanisms, and clinical translation for the treatment of NMSCs. For added context, we also compare the differentiation-promoting neoadjuvants with some other clinical PDT combinations such as surgery, laser ablation, iron-chelating agents (CP94), and immunomodulators that do not induce differentiation. Although this review focuses mainly on the application of cPDT for NMSCs, the concepts and findings described here may be more broadly applicable towards improving the therapeutic outcomes of PDT treatment for other types of cancers.
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Affiliation(s)
- Sanjay Anand
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Edward V Maytin
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Dermatology and Plastic Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Kowalski S, Karska J, Tota M, Skinderowicz K, Kulbacka J, Drąg-Zalesińska M. Natural Compounds in Non-Melanoma Skin Cancer: Prevention and Treatment. Molecules 2024; 29:728. [PMID: 38338469 PMCID: PMC10856721 DOI: 10.3390/molecules29030728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
The elevated occurrence of non-melanoma skin cancer (NMSC) and the adverse effects associated with available treatments adversely impact the quality of life in multiple dimensions. In connection with this, there is a necessity for alternative approaches characterized by increased tolerance and lower side effects. Natural compounds could be employed due to their safety profile and effectiveness for inflammatory and neoplastic skin diseases. These anti-cancer drugs are often derived from natural sources such as marine, zoonotic, and botanical origins. Natural compounds should exhibit anti-carcinogenic actions through various pathways, influencing apoptosis potentiation, cell proliferation inhibition, and metastasis suppression. This review provides an overview of natural compounds used in cancer chemotherapies, chemoprevention, and promotion of skin regeneration, including polyphenolic compounds, flavonoids, vitamins, alkaloids, terpenoids, isothiocyanates, cannabinoids, carotenoids, and ceramides.
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Affiliation(s)
- Szymon Kowalski
- Faculty of Medicine, Wroclaw Medical University, Pasteura 1, 50-367 Wroclaw, Poland; (S.K.); (M.T.); (K.S.)
| | - Julia Karska
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10, 50-367 Wroclaw, Poland;
| | - Maciej Tota
- Faculty of Medicine, Wroclaw Medical University, Pasteura 1, 50-367 Wroclaw, Poland; (S.K.); (M.T.); (K.S.)
| | - Katarzyna Skinderowicz
- Faculty of Medicine, Wroclaw Medical University, Pasteura 1, 50-367 Wroclaw, Poland; (S.K.); (M.T.); (K.S.)
| | - Julita Kulbacka
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland
- Department of Immunology and Bioelectrochemistry, State Research Institute Centre for Innovative Medicine, Santariškių 5, 08410 Vilnius, Lithuania
| | - Małgorzata Drąg-Zalesińska
- Department of Human Morphology and Embryology, Division of Histology and Embryology, Faculty of Medicine, Wroclaw Medical University, T. Chalubińskiego 6a, 50-368 Wroclaw, Poland;
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Wang J, Sims KD, Ackley SF, Chen R, Kobayashi LC, Hayes‐Larson E, Mayeda ER, Buto P, Zimmerman SC, Graff RE, Glymour MM. Association of cancer history with structural brain aging markers of Alzheimer's disease and related dementias risk. Alzheimers Dement 2024; 20:880-889. [PMID: 37811979 PMCID: PMC10916958 DOI: 10.1002/alz.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Cancer survivors are less likely than comparably aged individuals without a cancer history to develop Alzheimer's disease and related dementias (ADRD). METHODS In the UK Biobank, we investigated associations between cancer history and five structural magnetic resonance imaging (MRI) markers for ADRD risk, using linear mixed-effects models to assess differences in mean values and quantile regression to examine whether associations varied across the distribution of MRI markers. RESULTS Cancer history was associated with smaller mean hippocampal volume (b = -19 mm3 , 95% CI = -36, -1) and lower mean cortical thickness in the Alzheimer's disease signature region (b = -0.004 mm, 95% CI = -0.007, -0.000). Quantile regressions indicated individuals most vulnerable to ADRD were more affected by cancer history. DISCUSSION Some brain MRI markers associated with ADRD risk were elevated in adults with a history of cancer. The magnitude of the adverse associations varied across quantiles of neuroimaging markers, and the pattern suggests possible harmful associations for individuals already at high ADRD risk. HIGHLIGHTS We found no evidence of an inverse association between cancer history and ADRD-related neurodegeneration. Cancer history was associated with smaller mean hippocampal volume and lower mean cortical thickness in the Alzheimer's disease signature region. Quantile regressions indicated individuals most vulnerable to ADRD were more affected by cancer history.
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Affiliation(s)
- Jingxuan Wang
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Kendra D. Sims
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Sarah F. Ackley
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Ruijia Chen
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lindsay C. Kobayashi
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Eleanor Hayes‐Larson
- Department of EpidemiologyFielding School of Public HealthUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Elizabeth Rose Mayeda
- Department of EpidemiologyFielding School of Public HealthUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Peter Buto
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Scott C. Zimmerman
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Rebecca E. Graff
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - M. Maria Glymour
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Jain M, Chang SW, Singh K, Kurtansky NR, Huang SL, Chen HH, Chen CSJ. High-resolution full-field optical coherence tomography microscope for the evaluation of freshly excised skin specimens during Mohs surgery: A feasibility study. JOURNAL OF BIOPHOTONICS 2024; 17:e202300275. [PMID: 37703431 PMCID: PMC10841241 DOI: 10.1002/jbio.202300275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/18/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023]
Abstract
Histopathology for tumor margin assessment is time-consuming and expensive. High-resolution full-field optical coherence tomography (FF-OCT) images fresh tissues rapidly at cellular resolution and potentially facilitates evaluation. Here, we define FF-OCT features of normal and neoplastic skin lesions in fresh ex vivo tissues and assess its diagnostic accuracy for malignancies. For this, normal and neoplastic tissues were obtained from Mohs surgery, imaged using FF-OCT, and their features were described. Two expert OCT readers conducted a blinded analysis to evaluate their diagnostic accuracies, using histopathology as the ground truth. A convolutional neural network was built to distinguish and outline normal structures and tumors. Of the 113 tissues imaged, 95 (84%) had a tumor (75 basal cell carcinomas [BCCs] and 17 squamous cell carcinomas [SCCs]). The average reader diagnostic accuracy was 88.1%, with a sensitivity of 93.7%, and a specificity of 58.3%. The artificial intelligence (AI) model achieved a diagnostic accuracy of 87.6 ± 5.9%, sensitivity of 93.2 ± 2.1%, and specificity of 81.2 ± 9.2%. A mean intersection-over-union of 60.3 ± 10.1% was achieved when delineating the nodular BCC from normal structures. Limitation of the study was the small sample size for all tumors, especially SCCs. However, based on our preliminary results, we envision FF-OCT to rapidly image fresh tissues, facilitating surgical margin assessment. AI algorithms can aid in automated tumor detection, enabling widespread adoption of this technique.
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Affiliation(s)
- Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shu-Wen Chang
- Graduate Institute of Photonics and Optoelectronics, National Taiwan University, Taipei, Taiwan
| | - Kiran Singh
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nicholas R. Kurtansky
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sheng-Lung Huang
- Graduate Institute of Photonics and Optoelectronics, National Taiwan University, Taipei, Taiwan
| | - Homer H. Chen
- Graduate Institute of Communication Engineering, National Taiwan University, Taipei, Taiwan
| | - Chih-Shan Jason Chen
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Hauppauge, New York
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Welch C, Kazim SF, Esce A, Bowers C, Syme N, Boyd N. Frailty as a Predictor of Post-Surgical Outcomes in Patients With Cutaneous Malignancies of the Scalp and Neck Requiring Flap Reconstruction. Ann Otol Rhinol Laryngol 2024; 133:7-13. [PMID: 37345503 DOI: 10.1177/00034894231180959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Investigate the ability of frailty status to predict post-surgical outcomes in patients with cutaneous malignancies of the scalp and neck undergoing flap reconstruction. METHODS National Surgical Quality Improvement Program database was used to isolate patients with cutaneous malignancies of the scalp and neck who underwent surgical resection between 2015 to 2019. Univariate and multivariate analyses were performed to determine if frailty score correlated with negative post-operative outcomes. Receiver operating characteristic (ROC) curves allowed testing of the discriminative performance of age versus frailty. RESULTS This study demonstrated an independent correlation between frailty and major complications as well as non-home discharge. In ROC curve analysis, frailty demonstrated superior discrimination compared to age for predicting major complications. CONCLUSION Our study demonstrated an association between increasing frailty and major complications as well as the likelihood of a non-home discharge. When compared to age, frailty was also shown to be a better predictor of major complications.
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Affiliation(s)
- Christopher Welch
- Department of Surgery, Division of Otolaryngology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Syed Faraz Kazim
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Antoinette Esce
- Department of Surgery, Division of Otolaryngology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Christian Bowers
- Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Noah Syme
- Department of Surgery, Division of Otolaryngology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Nathan Boyd
- Department of Surgery, Division of Otolaryngology, University of New Mexico School of Medicine, Albuquerque, NM, USA
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Sordi E, Piscitelli P, Albanese C, Melcarne A, Tardio A, Quarta F, Greco E, Miani A, Falco A, De Matteis E, Congedo M, Civino A. Incidence of Non-Melanoma Skin Cancers in Salento (Southern Italy): A 15-Year Retrospective Analysis from the Cancer Registry of Lecce. EPIDEMIOLOGIA 2023; 5:1-10. [PMID: 38534803 DOI: 10.3390/epidemiologia5010001] [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: 08/31/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Non-melanoma skin cancers (NMSCs) include basal cell carcinoma (BCC) and squamous-cell carcinoma (SCC), as well as a wide range of rare skin tumors. NMSCs is the most frequently diagnosed type of tumor among Caucasians. We aimed at estimating the incidence and mortality of NMSCs in the Salento area (Lecce province, Southern Italy), whose population is assumed to experience heavy and frequent sun exposure due to climatic/environmental factors, both for working and leisure activities. MATERIALS AND METHODS We computed the incidence of NMSCs in the Province of Lecce by examining the comprehensive real-world data collected by the local cancer registry, which covers all the 830,000 inhabitants, over a period of fifteen years (from 2003 to 2017), with a focus on the latest 5 years (2013-2017) for the analysis of the different histologic morphologies of these tumors. The incidence of NMSCs has been described in terms of absolute frequencies, crude rates and age-adjusted direct standardized rates (DSR). Joinpoint analysis was used to examine temporal trends in the incidence of NMSCs and estimate annual percent changes (APCs). RESULTS During the period of 2003-2017, the incidence of NMSCs reached a direct standardized rate (DSR) of 162.62 per 100,000 in men (mortality 1.57 per 100,000) and 89.36 per 100,000 in women (mortality 0.52 per 100,000), respectively. The incidence significantly increased among both men and women across the entire period. Basal cell carcinoma (BCC), with its different morphologies, represented about 67.6% of the NMSCs in men (n = 2139 out of a total of 3161 tumors observed between 2013 and 2017) and about 75.8% of the NMSCs in women (n = 1718 out of a total of 2264 tumors from 2013 to 2017), thus accounting for the vast majority of NMSCs. The results are consistent with the literature data carried out both at national and international level. CONCLUSIONS Proper monitoring of this phenomenon through timely reporting and recording of all new NMSC cases is necessary to develop new preventive strategies.
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Affiliation(s)
| | - Prisco Piscitelli
- Local Health Authority ASL Le, 73100 Lecce, Italy
- Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy
| | - Carla Albanese
- Experimental Zooprophylactic Institute of Apulia and Basilicata (IZSPB), 71121 Foggia, Italy
| | | | - Anna Tardio
- Local Health Authority ASL Le, 73100 Lecce, Italy
| | | | - Enrico Greco
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, 34100 Trieste, Italy
- Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy
| | - Alessandro Miani
- Italian Society of Environmental Medicine (SIMA), 20123 Milan, Italy
| | - Andrea Falco
- Department of Health Sciences, European University of Madrid, 28670 Madrid, Spain
| | | | | | - Adele Civino
- Local Health Authority ASL Le, 73100 Lecce, Italy
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11
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Alkhatib B, Waler A, Welch M, McCarthy J, Nam A, Friedman HI. Clinical Observation or Further Excision: A Retrospective Review of Margin-positive Squamous and Basal Cell Carcinomas. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5473. [PMID: 38111724 PMCID: PMC10727568 DOI: 10.1097/gox.0000000000005473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/11/2023] [Indexed: 12/20/2023]
Abstract
Background Patients determined to have margin-positive nonmelanoma skin cancer (NMSC) after initial shave or punch biopsy performed by a primary care physician or dermatologist are commonly referred to extirpative surgeons for definitive removal. Not infrequently, the residual tumor is not appreciable, and the exact location of the lesion is indiscernible. The consulting surgeon must decide to excise the presumed lesion or clinically monitor for recurrence. Methods This single-center, retrospective review examined patients with squamous and basal cell carcinomas referred over a 5-year period to two senior authors. Results In total, 233 patients had a total of 312 lesions excised. Thirty-nine (12.5%) of these lesions (in 33 patients) demonstrated no residual tumor on pathologic examination. Twelve patients were managed nonoperatively (5.15%) and observed to have had no tumor recurrence with a mean observation period of 14.66 months (range 1-54 months). Thus, approximately 19.3% of all patients referred had no residual tumor. Conclusion Based on our observations and low proclivity for metastases, nonoperative monitoring of NMSC may be a reasonable option for certain lesions less than 1 cm that are undiscernible at the time of referral.
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Affiliation(s)
- Bailey Alkhatib
- From the University of South Carolina School of Medicine Columbia, Columbia, S.C
| | - Alexandria Waler
- Division of Plastic Surgery Prisma Health/University of South Carolina School of Medicine
| | - Madelyn Welch
- From the University of South Carolina School of Medicine Columbia, Columbia, S.C
| | - Jack McCarthy
- Division of Plastic Surgery Prisma Health/University of South Carolina School of Medicine
| | - Arthur Nam
- Division of Plastic Surgery Prisma Health/University of South Carolina School of Medicine
| | - Harold I Friedman
- From the University of South Carolina School of Medicine Columbia, Columbia, S.C
- Division of Plastic Surgery Prisma Health/University of South Carolina School of Medicine
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12
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Tampouratzi E, Asonitis K, Katsantonis J, Talaiporou K, Sfaelos K. Preoperative and postoperative evaluation of survivin in peripheral blood of patients with non-melanoma skin cancers. A pilot study. J DERMATOL TREAT 2023; 34:2147390. [PMID: 36369849 DOI: 10.1080/09546634.2022.2147390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Konstantinos Asonitis
- Department of Internal Medicine, Réseau Hospitalier Neuchâtelois, Neuchâtel, Switzerland
| | - John Katsantonis
- Department of Dermatology and Venereology, Tzaneio General Hospital, Piraeus, Greece
| | - Kyriakos Talaiporou
- Department of Business Administration, University of Western Attica, Athens, Greece
| | - Konstantinos Sfaelos
- Department of Skin & Venereal Diseases, Faculty of Medicine, University of Ioannina, Ioannina, Greece
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13
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Zeng Q, Chen C, Chen D, Zhang G, Wang X. Non-Surgical Therapeutic Strategies for Non-Melanoma Skin Cancers. Curr Treat Options Oncol 2023; 24:1978-1993. [PMID: 38095778 DOI: 10.1007/s11864-023-01154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/11/2024]
Abstract
OPINION STATEMENT Non-melanoma skin cancer (NMSC) is a globally prevalent skin disease, with basal cell carcinoma and squamous cell carcinoma accounting for 99% of NMSC cases. While surgical excision is the most common approach, numerous non-surgical therapies have rapidly advanced in recent years. In cases of low-risk NMSC, alongside surgical excision, priority should be given to physical therapy and photodynamic therapy. Physical therapy modalities, exemplified by electrodessication and curettage, emerge as safe and efficacious alternatives. In juxtaposition, photodynamic therapy, albeit relatively more costly, assumes preference for patients exhibiting heightened cosmetic concerns owing to the scarring risks inherent to physical therapy and surgical excision. Notably, the combination of curettage and photodynamic therapy has exhibited remarkable efficacy in the treatment of nodular basal cell carcinoma. Additionally, for elderly patients who may be intolerant to stimulation, modified photodynamic therapy offers an almost painless option. When surgery is unavoidable, photodynamic therapy can be a valuable adjunct, allowing for a more conservative surgical approach, either before or after the procedure. Radiotherapy holds a prominent role in comprehensive treatment strategies, especially for patients ineligible for surgical intervention or those with lesions precluding further surgical measures. In cases of NMSC exhibiting perineural invasion or lymphovascular involvement, adjunctive radiotherapy is advised; however, potential adverse effects necessitate careful consideration. For advanced NMSC cases where surgery and physical therapy fall short, immunotherapy provide viable solutions. Systemic therapy employing Hedgehog pathway inhibitors can be considered for patients with distant metastatic basal cell carcinoma, despite its low incidence, or individuals with locally advanced lesions who are not surgical candidates, or those encountering recurrences after resection and radiotherapy. However, close monitoring of disease progression and adverse reactions is crucial. In this evolving landscape of NMSC treatment, personalized and multidisciplinary approaches are key, ensuring optimal outcomes while prioritizing patient safety and satisfaction.
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Affiliation(s)
- Qingyu Zeng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200040, China
| | - Chengqian Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200040, China
| | - Diyan Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200040, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200040, China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200040, China.
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14
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Kim S, Day CM, Song Y, Holmes A, Garg S. Innovative Topical Patches for Non-Melanoma Skin Cancer: Current Challenges and Key Formulation Considerations. Pharmaceutics 2023; 15:2577. [PMID: 38004557 PMCID: PMC10674480 DOI: 10.3390/pharmaceutics15112577] [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: 10/18/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Non-melanoma skin cancer (NMSC) is the most prevalent malignancy worldwide, with approximately 6.3 million new cases worldwide in 2019. One of the key management strategies for NMSC is a topical treatment usually utilised for localised and early-stage disease owing to its non-invasive nature. However, the efficacy of topical agents is often hindered by poor drug penetration and patient adherence. Therefore, various research groups have employed advanced drug delivery systems, including topical patches to overcome the problem of conventional topical treatments. This review begins with an overview of NMSC as well as the current landscape of topical treatments for NMSC, specifically focusing on the emerging technology of topical patches. A detailed discussion of their potential to overcome the limitations of existing therapies will then follow. Most importantly, to the best of our knowledge, this work unprecedentedly combines and discusses all the current advancements in innovative topical patches for the treatment of NMSC. In addition to this, the authors present our insights into the key considerations and emerging trends in the construction of these advanced topical patches. This review is meant for researchers and clinicians to consider utilising advanced topical patch systems in research and clinical trials toward localised interventions of NMSC.
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Affiliation(s)
| | | | | | | | - Sanjay Garg
- Centre for Pharmaceutical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia; (S.K.); (C.M.D.); (Y.S.); (A.H.)
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15
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Matts PJ, Nash JF. Sunscreens - another endangered species? Int J Cosmet Sci 2023; 45 Suppl 1:20-32. [PMID: 37799079 DOI: 10.1111/ics.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 10/07/2023]
Abstract
Skin cancer continues to increase in incidence year-on-year and represents the most common form of cancer across the globe. Every human undergoes premature ageing, particularly on the face, neck and hands. Both phenomena are driven primarily by chronic, daily exposure to solar ultraviolet radiation (UVR). While sunscreen products play a primary role in the prevention of UVR skin damage, the active ingredients, i.e., UVR filters, are facing unprecedented challenges in the coming 10 years and their future is by no means certain. This article, therefore, reviews afresh the facts around photoprotection and the role of sunscreen products in the prevention of acute (sunburn) and chronic (cancer, photoageing) skin damage and compares/contrasts these with various emerging questions and opinions around UVR filter technology. We present a passionate defence of this remarkable technology, but also attempt to imagine a world without it.
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Affiliation(s)
- Paul J Matts
- The Procter & Gamble Company, Reading, Berkshire, UK
| | - J Frank Nash
- The Procter & Gamble Company, Cincinnati OH, USA
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16
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Rowse BM, Yu ACX, Faulkner H, Sandler G, Howle JR, Ch'ng S, Rao PJ, Varey AHR. Does preoperative imaging for scalp non-melanocytic skin cancer accurately predict invasion of the cranial vault? A systematic review and meta-analysis. ANZ J Surg 2023; 93:1970-1977. [PMID: 37303266 DOI: 10.1111/ans.18566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE This study aimed to determine the diagnostic accuracy of CT and MRI in the preoperative detection of bone involvement for non-melanoma skin cancers (NMSCs) located on the scalp. This study further aimed to evaluate the predictive value of these imaging modalities in determining the need for craniectomy and to identify gaps in the existing literature. METHODS Electronic searches of the MEDLINE, Embase, Cochrane and Google Scholar databases were performed for English language studies of any type. Studies reporting detection or exclusion of histopathologically confirmed bone involvement through preoperative imaging were identified according to PRISMA guidelines. Studies reporting dural involvement, non-scalp tumours, and lacking tumour type(s) or outcome data were excluded. Outcomes were preoperative imaging result and histopathologically confirmed bone invasion. Meta-analysis was performed and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated (excluding case report and MRI data due to insufficient quality and quantity respectively). RESULTS Four studies with a total of 69 patients were included in the final review, of which two studies totalling 66 patients were included in the meta-analysis. Preoperative CT had a sensitivity of 38%, specificity of 98%, PPV of 90% and NPV of 73%. CONCLUSIONS The available data suggests that a preoperative CT finding of calvarial involvement by a scalp NMSC is likely to be real, but the absence of such a finding is unreliable. Current evidence suggests that preoperative imaging cannot exclude the necessity for craniectomy and future research is needed, particularly on the role of MRI.
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Affiliation(s)
- Benjamin M Rowse
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Ann C X Yu
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Harrison Faulkner
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Gideon Sandler
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Julie R Howle
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Sydney Ch'ng
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Department of Plastic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Head & Neck Cancer Institute, Chris O'Brien Lifehouse Cancer Institute, Sydney, New South Wales, Australia
| | - Prashanth J Rao
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, New South Wales, Australia
| | - Alexander H R Varey
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Department of Plastic Surgery, Westmead Hospital, Sydney, New South Wales, Australia
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17
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Woodie BR, Neltner SA, Pauley AG, Fleischer AB. Years of dermatology experience and geographic region are associated with outlier performance of excision or destruction for nonmelanoma skin cancer. J DERMATOL TREAT 2023; 34:2192839. [PMID: 36932466 DOI: 10.1080/09546634.2023.2192839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Treatments for nonmelanoma skin cancer (NMSC) include excision (surgical removal) and destruction (cryotherapy or curettage with or without electrodesiccation) in addition to other methods. Although cure rates are similar between excision and destruction for low-risk NMSCs, excision is substantially more expensive. Performing destruction when appropriate can reduce costs while providing comparable cure rate and cosmesis. OBJECTIVE To identify characteristics associated with exclusive (outlier) performance of excision or destruction for NMSC. METHODS The study consisted of malignant excision and destruction procedures submitted by dermatologists to Medicare in 2019. Proportions of services for each method were analyzed with respect to geographic region, years of dermatology experience, median income of the practice zip code, and rural-urban commuting area code. RESULTS Fewer years of experience predicted a higher proportion of excisions (R2=.7, p<.001) and higher odds of outlier excision performance. Outlier performance of excision was associated with practicing in the South, Midwest, and West, whereas outlier performance of destruction was associated with practicing in the Northeast and Midwest. CONCLUSIONS Dermatologists with less experience or in certain geographic regions performed more malignant excision relative to destruction. As the older population of dermatologists retires, the cost of care for NMSC may increase.
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Affiliation(s)
- Brad R Woodie
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Scott A Neltner
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Annabella G Pauley
- Department of Mathematics, West Virginia University, Morgantown, West Virginia
| | - Alan B Fleischer
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
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18
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Devarajan N, Nathan J, Mathangi R, Mahendra J, Ganesan SK. Pharmacotherapeutic values of berberine: A Chinese herbal medicine for the human cancer management. J Biochem Mol Toxicol 2023; 37:e23278. [PMID: 36588295 DOI: 10.1002/jbt.23278] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/27/2022] [Accepted: 12/02/2022] [Indexed: 01/03/2023]
Abstract
Berberine (BBR), a traditional Chinese phytomedicine extracted from various parts of Berberis plants, is an isoquinoline alkaloid used for centuries to treat diabetes, hypercholesterolemia, hypertension, and so forth. It has recently received immense attention worldwide to treat cancer due to its potent pro-apoptotic, antiproliferative, and anti-inflammatory properties. BBR efficiently induces tumor apoptosis, replicative quiescence and abrogates cell proliferation, epithelial-mesenchymal transition, tumor neovascularization, and metastasis by modulating diverse molecular and cell signaling pathways. Furthermore, BBR could also reverse drug resistance, make tumor cells sensitive to current cancer treatment and significantly minimize the harmful side effects of cytotoxic therapies. This review comprehensively analyzed the pharmacological effects of BBR against the development, growth, progression, metastasis, and therapy resistance in wide varieties of cancer. Also, it critically discusses the significant limitations behind the development of BBR into pharmaceuticals to treat cancer and the future research directions to overcome these limitations.
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Affiliation(s)
- Nalini Devarajan
- Central Research Laboratory, Meenakshi Academy of Higher Education and Research - MAHER (Deemed to be University), Chennai, Tamilnadu, India
| | - Jhansi Nathan
- Zebrafish Developmental Biology Laboratory, AUKBC Research Centre for Emerging Technologies, Anna University, Chennai, Tamil Nadu, India
| | - Ramalingam Mathangi
- Department of Biochemistry, Sree Balaji Dental College and Hospital, BIHER, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Senthil Kumar Ganesan
- Laboratory of Functional Genomics, Structural Biology & Bioinformatics Division, CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal, India
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Russo GM, Russo A, Urraro F, Cioce F, Gallo L, Belfiore MP, Sangiovanni A, Napolitano S, Troiani T, Verolino P, Sica A, Brancaccio G, Briatico G, Nardone V, Reginelli A. Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment. Diagnostics (Basel) 2023; 13:diagnostics13040793. [PMID: 36832281 PMCID: PMC9955870 DOI: 10.3390/diagnostics13040793] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. For radiologists, it is still difficult to treat patients with advanced nonmelanoma skin cancer. Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. The risk is especially elevated among those who previously received systemic treatment or phototherapy. Systemic treatments, including biologic therapies and methotrexate (MTX), are effective in managing immune-mediated diseases; however, they may increase susceptibility to NMSC due to immunosuppression or other factors. Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. The patient treatment response improved with advent and utilization of immunotherapy and different immune-specific criteria are established to standardized evaluation criteria of clinical trials but none of them have been utilized routinely with immunotherapy. The advent of immunotherapy has also arisen new critical issues for radiologists, such as atypical response pattern, pseudo-progression, as well as immune-related adverse events that require early identification to optimize and improve patient prognosis and management. It is important for radiologists to have knowledge of the radiologic features site of the tumor, clinical stage, histological subtype, and any high-risk features to assess immunotherapy treatment response and immune-related adverse events.
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Affiliation(s)
- Gaetano Maria Russo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
- Correspondence:
| | - Anna Russo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Fabrizio Cioce
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Luigi Gallo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Stefania Napolitano
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Teresa Troiani
- Unit of Plastic Surgery, Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80120 Naples, Italy
| | - Pasquale Verolino
- Unit of Plastic Surgery, Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80120 Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Gabriella Brancaccio
- Unit of Dermatology, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Giulia Briatico
- Unit of Dermatology, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Valerio Nardone
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy
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20
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Himawan A, Vora LK, Permana AD, Sudir S, Nurdin AR, Nislawati R, Hasyim R, Scott CJ, Donnelly RF. Where Microneedle Meets Biomarkers: Futuristic Application for Diagnosing and Monitoring Localized External Organ Diseases. Adv Healthc Mater 2023; 12:e2202066. [PMID: 36414019 DOI: 10.1002/adhm.202202066] [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: 08/16/2022] [Revised: 11/03/2022] [Indexed: 11/24/2022]
Abstract
Extracellular tissue fluids are interesting biomatrices that have recently attracted scientists' interest. Many significant biomarkers for localized external organ diseases have been isolated from this biofluid. In the diagnostic and disease monitoring context, measuring biochemical entities from the fluids surrounding the diseased tissues may give more important clinical value than measuring them at a systemic level. Despite all these facts, pushing tissue fluid-based diagnosis and monitoring forward to clinical settings faces one major problem: its accessibility. Most extracellular tissue fluid, such as interstitial fluid (ISF), is abundant but hard to collect, and the currently available technologies are invasive and expensive. This is where novel microneedle technology can help tackle this significant obstacle. The ability of microneedle technology to minimally invasively access tissue fluid-containing biomarkers will enable ISF and other tissue fluid utilization in the clinical diagnosis and monitoring of localized diseases. This review attempts to present the current pursuit of the application of microneedle systems as a diagnostic and monitoring platform, along with the recent progress of biomarker detection in diagnosing and monitoring localized external organ diseases. Then, the potential use of various microneedles in future clinical diagnostics and monitoring of localized diseases is discussed by presenting the currently studied cases.
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Affiliation(s)
- Achmad Himawan
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK.,Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | | | - Andi Dian Permana
- Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Sumarheni Sudir
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Airin R Nurdin
- Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia.,Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia
| | - Ririn Nislawati
- Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia.,Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia
| | - Rafikah Hasyim
- Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Makassar, 90245, Indonesia
| | - Christopher J Scott
- Patrick G Johnson Centre for Cancer Research, Queen's University Belfast, Belfast, BT97BL, UK
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK
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21
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Yu L, Moloney M, Zheng S, Rogers J. High resolution dermal ultrasound (US) combined with superficial radiation therapy (SRT) versus non-image guided SRT or external beam radiotherapy (XRT) in early-stage epithelial cancer: a comparison of studies. BMC Cancer 2023; 23:98. [PMID: 36707774 PMCID: PMC9883932 DOI: 10.1186/s12885-023-10577-z] [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: 09/08/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To compare the effectiveness of high-resolution dermal ultrasound (US) guided superficial radiotherapy (SRT) to non-image-guided radiotherapy in the treatment of early-stage Non-Melanoma Skin Cancer (NMSC). METHODS A high-resolution dermal ultrasound (US) image guided form of superficial radiation therapy (designated here as US-SRT) was developed in 2013 where the tumor configuration and depth can be visualized prior to, during, and subsequent to treatments, using a 22 megahertz (MHz) dermal ultrasound (US) with a doppler component. We previously published the results using this technology to treat 2917 early-stage epithelial cancers showing a high local control (LC) rate of 99.3%. We compared these results with similar American studies from a comprehensive literature search used in an article/guideline published by American Society of Radiation Oncology (ASTRO) on curative radiation treatment of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and squamous cell carcinoma in-situ (SCCIS) lesions from 1988 to 2018. Only U.S. based studies with greater than 100 cases with similar patient/lesion characteristics and stages treated by external beam, electron, or superficial/orthovoltage radiation therapy were included in the criteria for selection. The resultant 4 studies had appropriate comparable cases identified and the data analyzed/calculated with regard to local control. Logistic regression analysis was performed comparing each study to US-SRT individually and collectively with stratification by histology (BCC, SCC, and SCCIS). RESULTS US-SRT LC was found to be statistically superior to each of the 4 non-image-guided radiation therapy studies individually and collectively (as well as stratified by histology subtype) with p-values ranging from p < 0.0001 to p = 0.0438. CONCLUSIONS Results of US-SRT in local control were statistically significantly superior across the board versus non-image-guided radiation modalities in treatment of epithelial NMSC and should be considered a new gold standard for treatment of early-stage cutaneous BCC, SCC, and SCCIS.
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Affiliation(s)
- Lio Yu
- Laserderm Dermatology, 327 Middle Country Rd, Smithtown, NY 11787 USA
| | - Mairead Moloney
- grid.260914.80000 0001 2322 1832New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY USA
| | - Songzhu Zheng
- grid.36425.360000 0001 2216 9681Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY USA
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Anticancer acumens of three Annona species: a proportional review. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04306-5. [PMID: 36670184 DOI: 10.1007/s00432-022-04306-5] [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: 07/18/2022] [Accepted: 08/15/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Cumulative pattern of cancer could be seen in day-to-day life with each passing year and, it is becoming a great matter of concern especially to the scientific community worldwide. Alternative treatment methods for various types of cancer are in place and, being continuously worked out. Plant-derived natural substances have shown great results in combating cancer in comparison to chemo and radiotherapies which are toxic besides having serious side effects. In continuation, Annona species, native to America, Africa, Asia and Australia have been used in folk medicines and, are reported to have many anti-carcinogenic substances. METHODS For a prudent understanding of Annona species against various cancers, comparative investigation and analysis of three species viz., A. cherimola, A. muricata, and A. squamosa was undertaken through a detailed review of the in-attendance subject. The major scientific biomedical literature databases were consulted and the information available from 2011 until January 2021 was taken into account. RESULTS Studies on anti-cancer activities along with the thorough analysis of the findings and the pieces of evidence supporting their anti-proliferative, apoptosis, G1 cell cycle arrest and cytotoxic effects are described. A. muricata displayed maximum number of anti-cancer activities being revealed by most of its parts with the lowest IC50 values against various cancer cell lines compared to A. cherimola and A. squamosa. On account of the findings, it is advocated that, further detailed studies on anti-cancer explorations of Annona species could be proved fruitful in paving new and innovative methodologies for novel anti-cancer drug discovery and development.
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Tran A, Desai S, Mraz Robinson D. From ancient Egypt to the dermatologic office: An overview of skin substitutes and modern-day applications in dermatologic surgery. Health Sci Rep 2023; 6:e1067. [PMID: 36694835 PMCID: PMC9843239 DOI: 10.1002/hsr2.1067] [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: 11/08/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
Skin grafting (specifically xenografting) dates back to as early as 1500 before Christ (BC) in the Ebers papyrus, an Egyptian medical papyrus. In 1503, the use of human skin allograft was described in the manuscript of Branca of Sicily, and among the Hindu Tilemaker Caste approximately 2500-3000 years ago, surgeons repaired defects secondary to nose amputations of those who committed adultery and thievery. Over the years, many advancements in skin grafts/substitutes and their applications have propelled the field to focus on better graft survival, contracture prevention, cosmesis, and quality of life. We provide a general overview of skin substitutes (SS) with a particular focus on placental SS and their current applications in dermatologic surgery.
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Affiliation(s)
- Alison Tran
- Menter Dermatology Research InstituteBaylor University Medical CenterDallasTexasUSA,Heights DermatologyHoustonTexasUSA
| | | | - Deanne Mraz Robinson
- Modern DermatologyWestportConnecticutUSA,Yale School of MedicineDepartment of DermatologyNew HavenConnecticutUSA
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24
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Jaklitsch E, Thames T, de Campos Silva T, Coll P, Oliviero M, Ferris LK. Clinical Utility of an AI-powered, Handheld Elastic Scattering Spectroscopy Device on the Diagnosis and Management of Skin Cancer by Primary Care Physicians. J Prim Care Community Health 2023; 14:21501319231205979. [PMID: 37933569 PMCID: PMC10631325 DOI: 10.1177/21501319231205979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Patients with lesions suspicious for skin cancer often present to primary care physicians (PCPs), who may have limited training in skin cancer diagnosis. OBJECTIVE To measure the impact of an adjunctive handheld device for PCPs that employs elastic scattering spectroscopy (ESS) on the diagnosis and management of skin cancer. METHODS Fifty-seven PCPs evaluated 50 clinical images of skin lesions (25 malignant and 25 benign), first without and then with knowledge of the handheld ESS device output, and in each case indicated if a lesion was likely to be benign or malignant. RESULTS The diagnostic sensitivity of the PCPs with and without the use of the ESS device was 88% (95% CI, 84%-92%) and 67% (95% CI, 62%-72%), respectively (P < .0001). In contrast, no significant difference was observed in the diagnostic specificity. The management sensitivity of the physicians with and without the use of the ESS device was 94% (95% CI, 91%-96%) and 81% (95% CI, 77%-85%), respectively (P = .0009). Similarly, no significant difference was observed in the management specificity. CONCLUSION The use of the ESS device may have the potential to help improve skin cancer diagnosis and confidence in management decision-making in a primary care setting.
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Affiliation(s)
- Erik Jaklitsch
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Margaret Oliviero
- Dermatology Department, Skin and Cancer Associates, Plantation, FL, USA
| | - Laura Korb Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, USA
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25
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Ozbey R. Basal cell skin cancers: Retrospective analysis of 67 cases. J Cosmet Dermatol 2022; 21:7007-7012. [PMID: 36208006 DOI: 10.1111/jocd.15441] [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: 08/02/2022] [Revised: 08/23/2022] [Accepted: 10/03/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common skin cancer and originates from the basal layer of the epidermis. It is most common in the head and neck region. It usually grows slowly and rarely metastasizes. The gold standard treatment is surgical excision. AIMS In this study, it was aimed to discuss the demographic and medical data of patients treated with the diagnosis of BCC. PATIENTS/METHODS Sixty-seven tumors of 55 patients who were operated for BCC in our clinic between 2016 and 2020 were retrospectively analyzed. Demographic and medical data were analyzed. RESULTS The tumor was most commonly localized to the nose. The most common (50%) histological type was the nodular type. Recurrence occurred in one of our patients (1.5%). Surgical margin positivity was observed in six patients. CONCLUSIONS Basal cell carcinomas are most common in the head and neck region. Its frequency increases with age and is more common in men. In our patients, 98.5% of the tumors were located in the head and neck, and 89.5% were over 60 years of age. Nodular is the most common type of BCC, and the most common nodular type was detected in our study. Surgical margin positivity is observed between 9% and 37.2% after surgery, and the recurrence rate is around 5%. In our study, surgical margin positivity was 9% and recurrence was 1.5%. Evaluating the excision margins carefully in a well-lit environment and taking into account cosmetic concerns, obtaining an adequately intact surgical margin in one go may lead to the ideal treatment result.
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Affiliation(s)
- Rafet Ozbey
- Department of Plastic Surgery, Inonu University Turgut Ozal Medical Center, Malatya, Turkey
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26
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In Vivo Dosimetry for Superficial High Dose Rate Brachytherapy with Optically Stimulated Luminescence Dosimeters: A Comparison Study with Metal-Oxide-Semiconductor Field-Effect Transistors. RADIATION 2022. [DOI: 10.3390/radiation2040026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of the study was to calibrate and commission optically-stimulated luminescence dosimeters (OSLDs) for in vivo measurements in contact-based 192Ir treatments for superficial high dose rate (HDR) brachytherapy in place of metal-oxide-semiconductor field-effect transistors (MOSFETs). Dose linearity and dose rate dependence were tested by varying source-to-OSLD distance and dwell time. Angular dependence was measured using a solid water phantom setup for OSLD rotation. A group of OSLDs were readout 34 consecutive times to test readout depletion while OSLDs were optically annealed using a mercury lamp for 34.7 h. End-to-end tests were performed using a Freiburg flap and Valencia applicator. OSLD measurements were compared to MOSFETs and treatment planning system (TPS) doses. OSLD response was supralinear for doses above 275 cGy. They were found to be independent of dose rate and dependent on the incident angle in edge-on scenarios. OSLDs exhibited minimal readout depletion and were successfully annealed after 24 h of illumination. Freiburg flap measurements agreed well with the TPS. For the Valencia, OSLDs showed to be the more accurate system over MOSFETs, with a maximum disagreement with the TPS being 0.09%. As such, OSLDs can successfully be used in place of MOSFETs for in vivo dosimetry for superficial HDR brachytherapy.
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27
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Dacus D, Stancic S, Pollina SR, Rifrogiate E, Palinski R, Wallace NA. Beta Human Papillomavirus 8 E6 Induces Micronucleus Formation and Promotes Chromothripsis. J Virol 2022; 96:e0101522. [PMID: 36129261 PMCID: PMC9555153 DOI: 10.1128/jvi.01015-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Cutaneous beta genus human papillomaviruses (β-HPVs) are suspected to promote the development of nonmelanoma skin cancer (NMSC) by destabilizing the host genome. Multiple studies have established the genome destabilizing capacities of β-HPV proteins E6 and E7 as a cofactor with UV. However, the E6 protein from β-HPV8 (HPV8 E6) induces tumors in mice without UV exposure. Here, we examined a UV-independent mechanism of HPV8 E6-induced genome destabilization. We showed that HPV8 E6 reduced the abundance of anaphase bridge resolving helicase, Bloom syndrome protein (BLM). The diminished BLM was associated with increased segregation errors and micronuclei. These HPV8 E6-induced micronuclei had disordered micronuclear envelopes but retained replication and transcription competence. HPV8 E6 decreased antiproliferative responses to micronuclei and time-lapse imaging revealed HPV8 E6 promoted cells with micronuclei to complete mitosis. Finally, whole-genome sequencing revealed that HPV8 E6 induced chromothripsis in nine chromosomes. These data provide insight into mechanisms by which HPV8 E6 induces genome instability independent of UV exposure. IMPORTANCE Some beta genus human papillomaviruses (β-HPVs) may promote skin carcinogenesis by inducing mutations in the host genome. Supporting this, the E6 protein from β-HPV8 (8 E6) promotes skin cancer in mice with or without UV exposure. Many mechanisms by which 8 E6 increases mutations caused by UV have been elucidated, but less is known about how 8 E6 induces mutations without UV. We address that knowledge gap by showing that 8 E6 causes mutations stemming from mitotic errors. Specifically, 8 E6 reduces the abundance of BLM, a helicase that resolves and prevents anaphase bridges. This hinders anaphase bridge resolution and increases their frequency. 8 E6 makes the micronuclei that can result from anaphase bridges more common. These micronuclei often have disrupted envelopes yet retain localization of nuclear-trafficked proteins. 8 E6 promotes the growth of cells with micronuclei and causes chromothripsis, a mutagenic process where hundreds to thousands of mutations occur in a chromosome.
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Affiliation(s)
- Dalton Dacus
- Division of Biology, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
| | - Steven Stancic
- Veterinary Diagnostic Laboratory, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
| | - Sarah R Pollina
- Division of Biology, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
| | - Elizabeth Rifrogiate
- Division of Biology, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
| | - Rachel Palinski
- Veterinary Diagnostic Laboratory, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
- Diagnostic Medicine/Pathobiology, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
| | - Nicholas A Wallace
- Division of Biology, Kansas State Universitygrid.36567.31, Manhattan, Kansas, USA
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Ramelyte E, Nägeli MC, Hunger R, Merat R, Gaide O, Navarini AA, Cozzio A, Wagner NB, Maul LV, Dummer R. Swiss Recommendations for Cutaneous Basal Cell Carcinoma. Dermatology 2022; 239:122-131. [PMID: 36137524 PMCID: PMC9808659 DOI: 10.1159/000526478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/16/2022] [Indexed: 01/26/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer in Switzerland and worldwide. Most BCCs can be treated in a curative setting. However, patients can develop locally destructive and, rarely, metastatic tumors that require a different treatment approach. The clinical subtype of individual lesions provides prognostic information and influences management decisions. Surgical excision, topical therapies, and radiotherapy are highly effective in the majority of subtypes as well as in low- and high-risk diseases. For patients with low-risk diseases and superficial tumors not amenable to surgery, several nonsurgical alternatives are available. Systemic therapy is indicated for high-risk BCCs, which are not amenable to either surgery or radiotherapy. Hedgehog pathway inhibitors (HHI) are currently approved. Other therapeutic options such as immune checkpoint inhibitors show promising results in clinical trials. This first version of Swiss recommendations for diagnosis and management of BCC was prepared through extensive literature review and an advisory board consensus of expert dermatologists and oncologists in Switzerland. The present guidelines recommend therapies based on a multidisciplinary team approach and rate of recurrence for individual lesions. Based on the risk of recurrence, two distinct groups have been identified: low-risk (easy-to-treat) and high-risk (difficult-to-treat) tumors. Based on these classifications, evidence-based recommendations of available therapies are presented herein.
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Affiliation(s)
- Egle Ramelyte
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland,*Egle Ramelyte,
| | - Mirjam C. Nägeli
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland,**Mirjam C. Nägeli,
| | - Robert Hunger
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Rastine Merat
- Division of Dermatology and Venereology, Geneva University Hospital, Geneva, Switzerland
| | - Olivier Gaide
- Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Antonio Cozzio
- Clinic of Dermatology, Venereology and Allergology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Nikolaus B. Wagner
- Clinic of Dermatology, Venereology and Allergology, St. Gallen Hospital, St. Gallen, Switzerland
| | - Lara Valeska Maul
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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Gene Regulations upon Hydrogel-Mediated Drug Delivery Systems in Skin Cancers-An Overview. Gels 2022; 8:gels8090560. [PMID: 36135270 PMCID: PMC9498739 DOI: 10.3390/gels8090560] [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] [Received: 07/31/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
The incidence of skin cancer has increased dramatically in recent years, particularly in Caucasian populations. Specifically, the metastatic melanoma is one of the most aggressive cancers and is responsible for more than 80% of skin cancer deaths around the globe. Though there are many treatment techniques, and drugs have been used to cure this belligerent skin cancer, the side effects and reduced bioavailability of drug in the targeted area makes it difficult to eradicate. In addition, cellular metabolic pathways are controlled by the skin cancer driver genes, and mutations in these genes promote tumor progression. Consequently, the MAPK (RAS-RAF-MEK-ERK pathway), WNT and PI3K signaling pathways are found to be important molecular regulators in melanoma development. Even though hydrogels have turned out to be a promising drug delivery system in skin cancer treatment, the regulations at the molecular level have not been reported. Thus, we aimed to decipher the molecular pathways of hydrogel drug delivery systems for skin cancer in this review. Special attention has been paid to the hydrogel systems that deliver drugs to regulate MAPK, PI3K-AKT-mTOR, JAK-STAT and cGAS-STING pathways. These signaling pathways can be molecular drivers of skin cancers and possible potential targets for the further research on treatment of skin cancers.
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30
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Souto EB, da Ana R, Vieira V, Fangueiro JF, Dias-Ferreira J, Cano A, Zielińska A, Silva AM, Staszewski R, Karczewski J. Non-melanoma skin cancers: physio-pathology and role of lipid delivery systems in new chemotherapeutic treatments. Neoplasia 2022; 30:100810. [PMID: 35649306 PMCID: PMC9160356 DOI: 10.1016/j.neo.2022.100810] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022]
Abstract
Non-melanoma carcinoma has high incidence rates and has two most common subtypes: basal cell carcinoma and squamous cell carcinoma. This type of carcinoma is usually not fatal; however, it can destroy sensory organs such as the nose, ears, and lips. The treatment of these injuries using non-invasive methods is thus strongly recommended. Some treatments for non-melanoma carcinoma are already well defined, such as surgery, cryosurgery, curettage and electrode section, and radiotherapy; however, these conventional treatments cause inflammation and scarring. In the non-surgical treatment of non-melanoma carcinoma, the topical administration of chemotherapeutic drugs contributes for an effective treatment with reduced side effects. However, the penetration of anticancer drugs in the deeper layers of the skin is required. Lipid delivery systems (liposomes, solid lipid nanoparticles, nanostructured lipid carriers) have been developed to overcome epidermal barrier of the skin and to allow the drugs to reach tumor cells. These lipid nanoparticles contribute to control the release profile of the loaded chemotherapeutic drugs, maintaining their stability and increasing death of tumor cells. In this review, the characteristics of non-melanoma carcinoma will be discussed, describing the main existing treatments, together with the contribution of lipid delivery systems as an innovative approach to increase the effectiveness of topical therapies for non-melanoma carcinomas.
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Affiliation(s)
- Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; REQUIMTE/UCIBIO, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - Raquel da Ana
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Vânia Vieira
- Faculty of Health Sciences, University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Porto, Portugal
| | - Joana F Fangueiro
- Faculty of Health Sciences, University Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150, Porto, Porto, Portugal
| | - João Dias-Ferreira
- Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Amanda Cano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08007 Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN2UB), 08007 Barcelona, Spain
| | - Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznań, Poland
| | - Amélia M Silva
- Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal; Centre for Research and Technology of Agro-Environmental and Biological Sciences, CITAB, UTAD, Quinta de Prados, P-5001-801 Vila Real, Portugal
| | - Rafał Staszewski
- Department of Hypertension Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jacek Karczewski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland; Department of Gastroenterology, Dietetics and Internal Diseases, H. Swiecicki University Hospital, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
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Benkhaled S, Van Gestel D, Gomes da Silveira Cauduro C, Palumbo S, del Marmol V, Desmet A. The State of the Art of Radiotherapy for Non-melanoma Skin Cancer: A Review of the Literature. Front Med (Lausanne) 2022; 9:913269. [PMID: 35833108 PMCID: PMC9272768 DOI: 10.3389/fmed.2022.913269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Due to the general aging population and the fashion trend of sun exposure, non-melanoma skin cancer (NMSC) is rising. The management of NMSC is difficult and necessitates a multidisciplinary team (i.e., pathologists, dermatologists, medical oncologists, surgeons, and radiation oncologists). When surgery is not an option or will cause unacceptably functional morbidity, radiation therapy (RT) may be a preferable tissue-preserving option. Whether used alone or in conjunction with other treatments, RT has been shown to be quite effective in terms of cosmetic results and local control. Contact hypofractionated RT, brachytherapy, and electronic brachytherapy are all promising new treatments. However, rigorous, randomized trials are missing, explaining the disparity in dose, fractionation, and technique recommendations. Therefore, it is essential that interdisciplinary teams better understand RT modalities, benefits, and drawbacks. Our review will provide the role and indications for RT in patients with NMSC.
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Affiliation(s)
- Sofian Benkhaled
- Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium
- *Correspondence: Sofian Benkhaled
| | - Dirk Van Gestel
- Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium
| | | | - Samuel Palumbo
- Department of Radiation-Oncology, Jolimont Hospital, La Louvière, Belgium
| | - Veronique del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Antoine Desmet
- Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium
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Yang W, Liu L, Yang W, Wang D. Surgery combined with photodynamic therapy vs. surgery alone for the treatment of non-melanoma skin cancer and actinic keratosis: a retrospective cohort study. Dermatol Ther 2022; 35:e15652. [PMID: 35716107 DOI: 10.1111/dth.15652] [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: 12/28/2020] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment for some non-melanoma skin cancers (NMSC) and actinic keratosis. OBJECTIVES To compare recurrence-free survival (RFS) rates between surgery alone and surgery with postoperative PDT in patients with NMSC in China. METHODS & MATERIALS This retrospective cohort study included patients with pathologically confirmed NMSC or actinic keratosis treated by surgical excision with/without PDT. A total of 125 patients were included, including 72 patients (43 females) aged 57-75 years in the surgery alone group and 53 patients (32 females) aged 61-76 years in the surgery+PDT group. RESULTS The most common NMSC types were squamous cell carcinoma and basal cell carcinoma, the most common lesion site was the head and neck, and the vast majority of patients had a primary disease and solitary lesions. There were no significant differences between groups in baseline characteristics. RFS rates in the surgery alone and surgery+PDT groups were, respectively, 100.0% and 98.1% at 1 week, 98.6% and 98.1% at 4 weeks, 97.2% and 98.1% at 8 weeks, 97.2% and 98.1% at 12 weeks, and 90.3% and 90.4% at 24 weeks, with no significant differences between groups. CONCLUSION Adjuvant PDT after surgical excision of NMSC or actinic keratosis does not provide short-term improvement in RFS, but the results need to be confirmed by a formal randomized controlled trial.
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Affiliation(s)
- Wanjun Yang
- Department of Dermatology and STD, Panzhihua Central Hospital, Panzhihua, Sichuan Province, China
| | - Lihua Liu
- Department of Dermatology and STD, Panzhihua Central Hospital, Panzhihua, Sichuan Province, China
| | - Wenfeng Yang
- Department of Dermatology and STD, Panzhihua Central Hospital, Panzhihua, Sichuan Province, China
| | - Daiwen Wang
- Department of Pathology, Panzhihua Central Hospital, Panzhihua, Sichuan Province, China
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The Use and Technique of Sentinel Node Biopsy for Skin Cancer. Plast Reconstr Surg 2022; 149:995e-1008e. [PMID: 35472052 DOI: 10.1097/prs.0000000000009010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Understand the indications for and prognostic value of sentinel lymph node biopsy in skin cancer. 2. Learn the advantages and disadvantages of various modalities used alone or in combination when performing sentinel lymph node biopsy. 3. Understand how to perform sentinel lymph node biopsy in skin cancer patients. SUMMARY Advances in technique used to perform sentinel lymph node biopsy to assess lymph node status have led to increased accuracy of the procedure and improved patient outcomes.
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Tuominen S, Ukkola-Vuoti L, Riihilä P, Knuutila JS, Kähäri VM, Lassenius M, Ranki T, Pousar K, Vassilev L, Vuoti S, Mattila K. Retrospective, Registry-based, Cohort Investigation of Clinical Outcomes in Patients with Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma in Finland. Acta Derm Venereol 2022; 102:adv00693. [PMID: 35356995 PMCID: PMC9574685 DOI: 10.2340/actadv.v102.2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Most cases of keratinocyte cancer can be treated effectively with surgery. However, survival is reduced in patients with advanced disease. This retrospective cohort study evaluated overall survival of patients with invasive keratinocyte cancers, and high-risk features for progression of the disease and mortality in Finnish patients in a real-world setting. A total of 43,143 patients with keratinocyte cancer types of basal cell carcinoma and 10,380 with cutaneous squamous cell carcinoma were identified nationwide. More detailed patient records were available for a subset of patients (basal cell carcinoma n = 5,020 and cutaneous squamous cell carcinoma n = 1,482) from a regional database. Fifty percent of patients with advanced cutaneous squamous cell carcinoma died approximately 4.5 years after diagnosis. Multivariable models suggested that risk factors for keratinocyte cancer progression were male sex, presence of comorbidities, immunosuppression, and pre-cancerous lesions, while risk factors for disease-specific mortality were advanced disease stage with immunosuppression, other malignancies, and consecutive surgical excisions. These results suggest that identifying patient and tumour factors associated with poor disease outcome could be important when determining appropriate treatment and follow-up; however, further studies are necessary.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Kalle Mattila
- Department of Oncology and radiotherapy, University of Turku and Turku University Hospital, FIN-20520 Turku, Finland.
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35
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Sinikumpu SP, Jokelainen J, Keinänen-Kiukaanniemi S, Huilaja L. Skin cancers and their risk factors in older persons: a population-based study. BMC Geriatr 2022; 22:269. [PMID: 35361154 PMCID: PMC8973875 DOI: 10.1186/s12877-022-02964-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/18/2022] [Indexed: 01/09/2023] Open
Abstract
Background The number of skin cancer is increasing rapidly. However, little is known about the risk factors of skin cancer in older persons. Our objectives were to determine the risk factors for skin cancer or its precursors in an older population. More specifically, to study the association of new skin cancers with previous skin cancer, sex, age, Fitzpatrick’s skin type, history of outdoor work and socioeconomic status (SES). Methods In this retrospective cross-sectional study of a large, well documented historical cohort data set a total body skin examination (TBSE) was performed for 552 participants aged between 70 and 93 years by dermatologists. The information gathered was augmented with health register data and self-reported data. The associations between skin cancer and its risk factors were studied by using the logistic regression analyses. Results According to the TBSE skin cancer/precursor was present in 25.5% of participants and was more common in males than in females (34.5% vs 20.2%, p < 0.001). Previous skin cancer increased the risk of subsequent skin cancer 2.6-fold (OR 2.56, 95% CI 1.43-4.55) and male sex nearly 2-fold (1.97, 95% CI 1.26-3.08). Specific risk factors for the first occurrence of skin cancer were male sex and outdoor work. There was also association between skin cancer and age and socioeconomic status. Conclusions TBSE is recommend for physicians treating older persons to allow early recognition of skin cancers or their precursors. Older males need particularly close attention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02964-1.
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Affiliation(s)
- Suvi-Päivikki Sinikumpu
- Department of Dermatology, Oulu University Hospital, P.B.20, FIN-90029 OYS, Oulu, Finland. .,Medical Research Center, PEDEGO Research Group, University of Oulu, Oulu, Finland.
| | - Jari Jokelainen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, Faculty of Medicine University of Oulu, Oulu, Finland.,Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
| | - Laura Huilaja
- Department of Dermatology, Oulu University Hospital, P.B.20, FIN-90029 OYS, Oulu, Finland.,Medical Research Center, PEDEGO Research Group, University of Oulu, Oulu, Finland
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36
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Tchernev G, Lozev I, Batashki I, Kandathil LJ, Oliveira N, Cardoso JC. Double hatchet flap as adequate dermatosurgical approach for tumours of the occipital scalp zone: presentation of two cases. Dermatol Reports 2022; 14:9487. [PMID: 36199895 PMCID: PMC9527692 DOI: 10.4081/dr.2022.9487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Tumors of the scalp remain a serious challenge for clinicians since poor locoregional skin elasticity hinders the ability to utilise certain flaps, limiting the choice of reconstructive techniques available. As a result, surgical restoration of medium to large-sized defects are left to the discretion of the surgeon, who with a comprehensive knowledge of restorative techniques, along with the advantages, limitations as well as a sound understanding of the locoregional anatomy, can make thorough decisions on the choice of which flap is best suited for the defect. Here we present two cases where the double hatchet flap was employed as a dermatosurgical approach in order to provide exceptional cosmetic results. On dermatological examination, both patients presented with a medium to large- sized tumour formation but were otherwise in good health. Both underwent radical, widelocal excision, followed by reconstructive manipulation in the form of a double hatchet flap to close the defect. Postoperative follow- up reported positive signs of wound healing with aesthetically pleasing results. Finally, we discuss the use of various flaps in such conditions while providing evidence for the double hatchet flap as a possible alternative that provides perfect aesthetic results as seen in our cases. Such a complex surgical intervention requires the expertise of a multidisciplinary team in order to achieve an overall successful outcome.
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37
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García-Montero P, de Gálvez-Aranda MV, Blázquez-Sánchez N, Rivas-Ruíz F, Millán-Cayetano JF, García-Harana C, de Troya Martín M. Quality of Life During Treatment for Cervicofacial Non-melanoma Skin Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:196-202. [PMID: 32500453 DOI: 10.1007/s13187-020-01781-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Non-melanoma skin cancer (NMSC), despite its low mortality, can impose a significant psychological burden on patients. The aim of the present study is to examine the evolution of the quality of life (QOL) in patients with cervicofacial NMSC during treatment. This prospective cohort study was conducted to a group of patients with cervicofacial NMSC, confirmed by skin biopsy. These patients completed the Skin Cancer Index questionnaire at the time of diagnosis and at 1 week, 1 month and 6 months after treatment began. Data for these patients' demographic characteristics and variables related to the type of tumour, the treatment received and the evolution of the condition were recorded. The study group was composed of 220 patients. At the time of diagnosis, the overall mean score for QOL was 54.1 (SD 21.9); for the social appearance component, it was 76.7 (SD 26.2), and for the emotional component, it was 23 (SD 25.1). Six months after treatment began, the overall mean score was 61 (SD19.1), that for social appearance, 85 (SD 20.6), and that for the emotional component, 27.4 (SD 26.6). All the differences were statistically significant (p < 0.05). The results obtained show that during the treatment period, it is at the time of diagnosis when patients with cervicofacial NMSC undergo the greatest deterioration in their QOL. In comparison with the findings obtained in previous studies, our population obtained lower overall scores in the questionnaires and less improvement during follow-up.
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Affiliation(s)
- Pablo García-Montero
- Dermatology Department, Hospital Costa del Sol, Autovía A7-Km 187, Marbella, Málaga, Spain.
- University of Malaga, Malaga, Spain.
| | | | - Nuria Blázquez-Sánchez
- Dermatology Department, Hospital Costa del Sol, Autovía A7-Km 187, Marbella, Málaga, Spain
| | - Francisco Rivas-Ruíz
- Research Unit, Hospital Costa del Sol, Marbella, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | | | - Cristina García-Harana
- Dermatology Department, Hospital Costa del Sol, Autovía A7-Km 187, Marbella, Málaga, Spain
- University of Malaga, Malaga, Spain
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38
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Khan NH, Mir M, Qian L, Baloch M, Ali Khan MF, Rehman AU, Ngowi EE, Wu DD, Ji XY. Skin cancer biology and barriers to treatment: Recent applications of polymeric micro/nanostructures. J Adv Res 2022; 36:223-247. [PMID: 35127174 PMCID: PMC8799916 DOI: 10.1016/j.jare.2021.06.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 12/15/2022] Open
Abstract
Background Skin cancer has been the leading type of cancer worldwide. Melanoma and non-melanoma skin cancers are now the most common types of skin cancer that have been reached to epidemic proportion. Based on the rapid prevalence of skin cancers, and lack of efficient drug delivery systems, it is essential to surge the possible ways to prevent or cure the disease. Aim of review Although surgical modalities and therapies have been made great progress in recent years, however, there is still an urgent need to alleviate its increased burden. Hence, understanding the precise pathophysiological signaling mechanisms and all other factors of such skin insults will be beneficial for the development of more efficient therapies. Key scientific concepts of review In this review, we explained new understandings about onset and development of skin cancer and described its management via polymeric micro/nano carriers-based therapies, highlighting the current key bottlenecks and future prospective in this field. In therapeutic drug/gene delivery approaches, polymeric carriers-based system is the most promising strategy. This review discusses that how polymers have successfully been exploited for development of micro/nanosized systems for efficient delivery of anticancer genes and drugs overcoming all the barriers and limitations associated with available conventional therapies. In addition to drug/gene delivery, intelligent polymeric nanocarriers platforms have also been established for combination anticancer therapies including photodynamic and photothermal, and for theranostic applications. This portfolio of latest approaches could promote the blooming growth of research and their clinical availability.
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Key Words
- 5-ALA, 5-aminolevulinic acid
- 5-FU, 5-fluorouracil
- AIDS, Acquired immune deficiency syndrome
- BCC, Basal cell carcinoma
- BCCs, Basal cell carcinomas
- Basal cell carcinoma
- CREB, response element-binding protein
- DDS, Drug delivery system
- DIM-D, Di indolyl methane derivative
- Drug delivery
- GNR-PEG-MN, PEGylated gold nanorod microneedle
- Gd, Gadolinium
- Gene delivery
- HH, Hedgehog
- HPMC, Hydroxypropyl methylcellulose
- IPM, Isopropyl myristate
- MCIR, Melanocortin-1 receptor
- MNPs, Magnetic nanoparticle
- MNs, Microneedles
- MRI, Magnetic Resonance Imaging
- MSC, Melanoma skin cancer
- Microneedles
- Mn, Manganese
- NMSC, Non melanoma skin cancer
- NPs, Nano Particles
- OTR, Organ transplant recipients
- PAMAM, Poly-amidoamines
- PAN, Polyacrylonitrile
- PATCH1, Patch
- PCL, Poly (ε-caprolactone)
- PDT, Photodynamic therapy
- PEG, Polyethylene glycol
- PLA, Poly lactic acid
- PLA-HPG, Poly (d-l-lactic acid)-hyperbranched polyglycerol
- PLGA, Poly (lactide-co-glycolide) copolymers
- PLL, Poly (L-lysine)
- Polymeric nanocarriers
- QDs, Quantum dots
- SC, Skin cancer
- SCC, Squamous cell Carcinoma
- SMO, Smoothen
- SPIO, Superparamagnetic iron oxide
- Squamous cell carcinoma
- UV, Ultra Violet
- cAMP, Cyclic adenosine monophosphate
- dPG, Dendritic polyglycerol
- hTERT, Human telomerase reverse transcriptase
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Affiliation(s)
- Nazeer Hussain Khan
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Life Sciences. Henan University, Kaifeng, Henan 475004, China
| | - Maria Mir
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Lei Qian
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Mahnoor Baloch
- School of Natural Sciences, National University of Science and Technology, Islamabad 44000, Pakistan
| | - Muhammad Farhan Ali Khan
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Asim-ur- Rehman
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Ebenezeri Erasto Ngowi
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Department of Biological Sciences, Faculty of Sciences, Dar es Salaam University College of Education, Dar es Salaam 2329, Tanzania
| | - Dong-Dong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Stomatology, Henan University, Kaifeng, Henan 475004, China
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Key Laboratory of Infection and Biological Safety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
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39
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Outpatient Nonmelanoma Skin Cancer Excision and Reconstruction: A Clinical, Economical, and Patient Perception Analysis. PLASTIC AND RECONSTRUCTIVE SURGERY - GLOBAL OPEN 2022; 10:e3925. [PMID: 35083100 PMCID: PMC8785937 DOI: 10.1097/gox.0000000000003925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 09/27/2021] [Indexed: 10/26/2022]
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40
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Kim S, Fouladian P, Afinjuomo F, Song Y, Youssef SH, Vaidya S, Garg S. Effect of plasticizers on drug-in-adhesive patches containing 5-fluorouracil. Int J Pharm 2022; 611:121316. [PMID: 34838623 DOI: 10.1016/j.ijpharm.2021.121316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/07/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
Topical patches containing 5-fluorouracil (5-FU) are a feasible alternative to overcome the shortcomings of commercial cream for the treatment of non-melanoma skin cancer (NMSC). Plasticizers are a critical component of drug-in-adhesive (DIA) patches as they can significantly affect the mechanical, adhesive and drug release characteristics of the patches. Eudragit® E (EuE) is a methacrylate-based cationic copolymer capable of producing flexible and adhesive films for topical application. In this study, the effect of plasticizers on the mechanical, adhesive and 5-FU release characteristics of EuE-based patches was comprehensively evaluated. While the elongation at break (%) and adhesion of the films were significantly increased with increasing triacetin, dibutyl sebacate (DBS) and triethyl citrate (TEC) concentrations, the tensile strength showed an inverse relationship. EuE plasticized with 40% triacetin, 30% DBS or 40% w/w TEC produced elastic and adhesive films most suitable for topical application. In vitro release studies of the 5-FU-loaded patches demonstrated an initial burst release pattern during the first 10 min followed by a slow release over 120 min. In summary, this study provides important information on effect of plasticizers for preparation of EuE-based patches with desired mechanical, adhesive and release characteristics of 5-FU towards their potential application in the treatment of NMSC.
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Affiliation(s)
- Sangseo Kim
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Paris Fouladian
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Franklin Afinjuomo
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Yunmei Song
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Souha H Youssef
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Sachin Vaidya
- Central Adelaide Local Health Network, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia
| | - Sanjay Garg
- Pharmaceutical Innovation and Development Group (PIDG), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.
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41
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Non-Melanoma Skin Cancer: Statistical Associations between Clinical Parameters. CURRENT HEALTH SCIENCES JOURNAL 2022; 48:110-115. [PMID: 35911940 PMCID: PMC9289586 DOI: 10.12865/chsj.48.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022]
Abstract
Non-melanoma skin cancer (NMSC) represent an important health problem in medical practice. This is the most frequent type of cancer and its incidence is constantly increasing. Basal cell carcinoma and squamous cell carcinoma constitute the majority of NMSC, respectively 70% and 25% of total cases. The present retrospective study was conducted over a one-year period and included 439 cases of NMSC, of which 336 BCC and 103 SCC. We analyzed a series of clinical parameters: gender, age, tumor size and tumor topography. The statistical analysis of the investigated parameters indicated gender-age associations for BCC, and topography-gender, as well as topography-age for SCC.
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42
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Yasmeen, Iqubal MK, Khan MA, Agarwal NB, Ali J, Baboota S. Nanoformulations-based advancement in the delivery of phytopharmaceuticals for skin cancer management. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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43
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Mazzoni D, Muir J. Response to "Interventions for basal cell carcinoma: abridged Cochrane systematic reviews and GRADE assessments". Br J Dermatol 2021; 186:751. [PMID: 34748638 DOI: 10.1111/bjd.20878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/06/2021] [Indexed: 12/01/2022]
Abstract
We read with interest the Cochrane review exploring management of basal cell carcinoma (BCC).1 Despite being the most common of all malignancies, few studies met the requirements for inclusion in this analysis. Even then, the evidence from randomised control trials was mainly low to moderate. According to the Cochrane review website, "Each Cochrane Review is a systematic review that has been prepared and supervised by a Cochrane Review Group (editorial team). It attempts to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question."
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Affiliation(s)
- D Mazzoni
- Royal Brisbane and Women's Hospital, Queensland, Australia.,Mater Hospital, Brisbane, Queensland, Australia
| | - J Muir
- Mater Hospital, Brisbane, Queensland, Australia.,South East Dermatology, Brisbane, Queensland, Australia
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Sharma M, Asare M, Largo-Wight E, Merten J, Binder M, Lakhan R, Batra K. Testing Multi-Theory Model (MTM) in Explaining Sunscreen Use among Florida Residents: An Integrative Approach for Sun Protection. Healthcare (Basel) 2021; 9:healthcare9101343. [PMID: 34683023 PMCID: PMC8544567 DOI: 10.3390/healthcare9101343] [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: 08/13/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 12/02/2022] Open
Abstract
Florida residents have the second highest incidence of skin cancer in the nation. Sunscreen usage was found to be the one of the most effective integrative health approaches for reducing risk of skin cancer. Given the limited information on the likelihood of adopting and continuing sunscreen usage behavior, this cross-sectional study aimed to examine the correlates of initiating and sustaining sunscreen usage behavior among Florida dwellers, using the fourth-generation, multi-theory model (MTM) of behavior change. A web-based survey containing 51 questions was emailed to Florida residents aged 18 years or above, who were randomly selected from the state voter file. Psychometric validity of the survey instrument was established using structural equation modeling, and Cronbach’s alpha values were calculated for assessing the internal consistency. An independent-samples-t-test and hierarchical multiple regression tests were used to analyze the data. The results indicated that participants who engaged in sunscreen usage behavior, participatory dialogue (β = 0.062, p < 0.05), behavioral confidence (β = 0.636, p < 0.001), and changes in the physical environment (β = 0.210, p < 0.001) were statistically significant and accounted for 73.6% of the variance in initiating sunscreen usage behavior. In addition, the constructs of emotional transformation (β = 0.486, p < 0.001) and practice for change (β = 0.211, p < 0.001), as well as changes in the social environment (β = 0.148, p < 0.001) were significant predictors of maintaining sunscreen usage behavior and contributed to 59% of variance in sustenance. These findings offer a valuable insight regarding the applicability of MTM models to guiding public health interventions promoting sunscreen usage and preventing UV radiation risk and related skin cancer.
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Affiliation(s)
- Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA;
| | - Matthew Asare
- Department of Public Health, Baylor University, Waco, TX 76798, USA;
| | - Erin Largo-Wight
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (J.M.)
- Institute of Environmental Research and Education, University of North Florida, Jacksonville, FL 32224, USA
| | - Julie Merten
- Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA; (E.L.-W.); (J.M.)
| | - Mike Binder
- Department of Political Science and Public Administration, University of North Florida, Jacksonville, FL 32224, USA;
| | - Ram Lakhan
- Department of Health and Human Performance, Berea College, Berea, KY 40404, USA;
| | - Kavita Batra
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Correspondence:
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45
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Fania L, Samela T, Moretta G, Ricci F, Dellambra E, Mancini M, Sampogna F, Panebianco A, Abeni D. Attitudes among dermatologists regarding non-melanoma skin cancer treatment options. Discov Oncol 2021; 12:31. [PMID: 35201447 PMCID: PMC8777506 DOI: 10.1007/s12672-021-00421-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/04/2021] [Indexed: 12/27/2022] Open
Abstract
Non-melanoma skin cancers include basal and squamous cell carcinoma. These tumors have become an important health issue for their high incidence and for the morbidity, especially if untreated for a long period. Over the last 20 years, therapeutic approaches for these tumours have been improved and tailored. In this survey we provided data from one hundred and ten Italian dermatologists regarding knowledge and attitude towards different therapeutic approaches on non-melanoma skin cancers. In our study, we observed that surgery and imiquimod 5% cream were the most used treatment by dermatologists for basal cell carcinoma, while, surgery was the most common treatment for cutaneous squamous cell carcinoma. Furthermore, we observed some differences regarding the prescribed therapies in the different Italian geographical areas (i.e., Mohs' surgery and electrochemotherapy were more frequently used in Northern compared to Central and Southern Italy whereas immunotherapy was more used in Southern compared to Northern and Central Italy) and even considering the year of specialization of the dermatologists (i.e., immunotherapy with cemiplimab was prescribed mainly by dermatologists with 10-19 years of specialization). However, for locally advanced and metastatic forms of basal and squamous cell carcinoma, Hedgehog Pathway Inhibitors and anti- Programmed cell death protein antibody treatment, respectively, were used in line with the newest evolution of therapies regarding this topic. Considering the importance of skin cancers and its progressive increase in incidence, it is crucial to improve the knowledge of different therapeutic approaches among dermatologists.
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Affiliation(s)
- Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy.
| | - Tonia Samela
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Gaia Moretta
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Francesco Ricci
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Elena Dellambra
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Mara Mancini
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Francesca Sampogna
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Annarita Panebianco
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
| | - Damiano Abeni
- IDI-IRCCS, Dermatological Research Hospital, Via dei Monti di Creta 104, 00167, Rome, Italy
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46
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Venanzi Rullo E, Maimone MG, Fiorica F, Ceccarelli M, Guarneri C, Berretta M, Nunnari G. Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management. Front Oncol 2021; 11:689789. [PMID: 34422644 PMCID: PMC8371466 DOI: 10.3389/fonc.2021.689789] [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: 04/01/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.
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Affiliation(s)
- Emmanuele Venanzi Rullo
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Grazia Maimone
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Fiorica
- Department of Radiation Oncology and Nuclear Medicine, State Hospital "Mater Salutis" Azienda Unità Locale Socio Sanitaria (AULSS) 9, Legnago, Italy
| | - Manuela Ceccarelli
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Claudio Guarneri
- Unit of Dermatology, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Massimiliano Berretta
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Giovannacci I, Meleti M, Garbarino F, Cesinaro AM, Mataca E, Pedrazzi G, Reggiani C, Paganelli A, Truzzi A, Elia F, Giacomelli L, Magnoni C. Correlation between Autofluorescence Intensity and Histopathological Features in Non-Melanoma Skin Cancer: An Ex Vivo Study. Cancers (Basel) 2021; 13:cancers13163974. [PMID: 34439130 PMCID: PMC8393486 DOI: 10.3390/cancers13163974] [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: 06/30/2021] [Revised: 07/24/2021] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Non-melanoma skin cancers (NMSC) are the most prevalent neoplasms worldwide, especially in the Caucasian population. Radical surgical excision is considered the therapeutic gold standard, while incomplete tumor removal is invariably associated with recurrence and the need for reintervention. Autofluorescence (AF) spectroscopy has recently been investigated for early diagnosis of NMSC and assessment of tumor margins. Understanding changes in AF intensity in association with peculiar histological features could improve the diagnostic accuracy of skin fluorescence spectroscopy. The main goal of our work was to investigate the correlation between the intensity of cutaneous AF and the histopathological features of NMSC. The intensity of fluorescence emission in tissues obtained from NMSC samples was approximately 4 times lower than that in healthy conditions. In fact, mean AF intensity for BCC group was 4.5 and 4.4 for SCCs, with further variability being recorded according to histopathologic subtypes. Histopathological features such as hyperkeratosis, neoangiogenesis, fibrosis and elastosis are statistically associated with a decrease in AF intensity. Our data suggest that such tissue alterations could be responsible for the difference in AF emission between neoplastic and healthy tissue. These results support the potential application of AF as a useful non-invasive diagnostic tool for NMSCs. Abstract Non-melanoma skin cancer (NMSC) is the most common malignant tumor affecting fair-skinned people. Increasing incidence rates of NMSC have been reported worldwide, which is an important challenge in terms of public health management. Surgical excision with pre-operatively identified margins is one of the most common and effective treatment strategies. Incomplete tumor removal is associated with a very high risk of recurrence and re-excision. Biological tissues can absorb and re-emit specific light wave-lengths, detectable through spectrophotometric devices. Such a phenomenon is known as autofluorescence (AF). AF spectroscopy has been widely explored for non-invasive, early detection of NMSC as well as for evaluation of surgical margins before excision. Fluorescence-aided diagnosis is based on differences in spectral characteristics between healthy and neoplastic skin. Understanding the biological basis of such differences and correlating AF intensity to histological features could improve the diagnostic accuracy of skin fluorescence spectroscopy. The primary objective of the present pre-clinical ex vivo study is to investigate the correlation between the intensity of cutaneous AF and the histopathological features of NMSC. Ninety-eight lesions suggestive for NMSCs were radically excised from 75 patients (46 M; 29 F; mean age: 79 years). After removal, 115 specific reference points on lesions (“cases”; 59 on BBC, 53 on SCC and 3 on other lesions) and on peri-lesional healthy skin (controls; 115 healthy skin) were identified and marked through suture stitches. Such reference points were irradiated at 400–430 nm wavelength, and resulting emission AF spectra were acquired through spectrophotometry. For each case, AFIR (autofluorescence intensity ratio) was measured as the ratio between the number of photons emitted at a wavelength ranging between 450 and 700 nm (peak: 500 nm) in the healthy skin and that was captured in the pathological tissue. At the histological level, hyperkeratosis, neoangiogenesis, cellular atypia, epithelial thickening, fibrosis and elastosis were quantified by light microscopy and were assessed through a previously validated grading system. Statistical correlation between histologic variables and AFIR was calculated through linear regression. Spectrometric evaluation was performed on 230 (115 cases + 115 controls) reference points. The mean AFIR for BCC group was 4.5, while the mean AFIR for SCC group was 4.4 and the fluorescence peaks at 500 nm were approximately 4 times lower (hypo-fluorescent) in BCCs and in SCCs than in healthy skin. Histological variables significantly associated with alteration of AFIR were fibrosis and elastosis (p < 0.05), neoangiogenesis, hyperkeratosis and epithelial thickening. Cellular atypia was not significantly associated with alteration of AFIR. The intensity of fluorescence emission in neoplastic tissues was approximately 4 times lower than that in healthy tissues. Histopathological features such as hyperkeratosis, neoangiogenesis, fibrosis and elastosis are statistically associated with the decrease in AFIR. We hypothesize that such tissue alterations are among the possible biophysical and biochemical bases of difference in emission AF between neoplastic and healthy tissue. The results of the present evaluation highlighted the possible usefulness of autofluorescence as diagnostic, non-invasive and real-time tool for NMSCs.
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Affiliation(s)
- Ilaria Giovannacci
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
| | - Marco Meleti
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Federico Garbarino
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Anna Maria Cesinaro
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.M.C.); (E.M.)
| | - Ema Mataca
- Department of Anatomic Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.M.C.); (E.M.)
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery and Robust Statistics Academy, University of Parma, 43121 Parma, Italy;
| | - Camilla Reggiani
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Alessia Paganelli
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Arianna Truzzi
- School of Dentistry, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (F.E.)
| | - Federica Elia
- School of Dentistry, University of Modena and Reggio Emilia, 41124 Modena, Italy; (A.T.); (F.E.)
| | | | - Cristina Magnoni
- Department of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (I.G.); (F.G.); (C.R.); (A.P.)
- Correspondence: ; Tel.: +39-059-422-2464; Fax: +39-059-422-4271
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Kortam S, Merkher Y, Kramer A, Metanes I, Ad-El D, Krausz J, Har-Shai Y, Weihs D. Rapid, quantitative prediction of tumor invasiveness in non-melanoma skin cancers using mechanobiology-based assay. Biomech Model Mechanobiol 2021; 20:1767-1774. [PMID: 34120276 DOI: 10.1007/s10237-021-01475-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
Non-melanoma skin cancers, including basal and squamous cell carcinomas (BCC and SCC), are the most common malignancies worldwide. BCC/SCC cancers are generally highly localized and can be surgically excised; however, invasive tumors may be fatal. Current diagnosis of skin cancer and prognosis of potential invasiveness are based mainly on clinical-pathological factors of the biopsied lesions. SCC invasiveness is also predicted by histomorphological factors, such as the degree of differentiation or the mitotic index, while BCCs are typically considered non-invasive. The above subjective measures do not provide direct, objective prognosis of cellular invasiveness in each specific sample. Hence, we have developed a mechanobiology-based approach to rapidly determine sample invasiveness. Here, cells from 15 fresh tissue samples of suspected non-melanoma skin cancer were seeded on physiological-stiffness (2.4 kPa) synthetic gels, and within 1-h invasive cell subsets were observed to push/indent the gel surface; clinicopathological results were separately obtained using standard protocols. The percentage of indenting cells from invasive (26.2 ± 2.4%) and non-invasive (4.8 ± 0.5%) SCC samples differed significantly (p < 0.0001), with well-separated invasiveness cutoffs of, respectively, > 12% and < 5%. The mechanical invasiveness directly agrees with the SCC cell-differentiation state, where over 3.3-fold more (p < 0.0001) cells from moderately differentiated samples indent the gels as compared to well-differentiated cell samples. In BCCs, < 20% of cells typically indented, and a highly migratory, desmoplastic sample was identified with 46%. By providing rapid, quantitative, early prognosis of invasiveness and potential metastatic risk, our rapid technology may facilitate informed (bed-side) decision making and choice of disease-management protocols on the time-scale of the initial diagnosis and surgical excision.
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Affiliation(s)
- Sally Kortam
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, 3200003, Haifa, Israel
| | - Yulia Merkher
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, 3200003, Haifa, Israel
| | - Aviv Kramer
- The Unit of Plastic Surgery, The Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine,, Technion-Israel Institute of Technology, Haifa, Israel
| | - Issa Metanes
- The Unit of Plastic Surgery, The Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine,, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dean Ad-El
- The Department of Plastic and Reconstructive Surgery & Burns, Petach Tikva and the Faculty of Medicine, Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Judit Krausz
- The Department of Pathology, Ha-Emek Medical Center, Afula, Israel
| | - Yaron Har-Shai
- The Unit of Plastic Surgery, The Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport Faculty of Medicine,, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daphne Weihs
- Faculty of Biomedical Engineering, Technion-Israel Institute of Technology, 3200003, Haifa, Israel.
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The Impact of and Adaptations Due to the COVID-19 Pandemic on the Histopathological Diagnosis of Skin Pathologies, Including Non-Melanocyte and Melanoma Skin Cancers-A Single-Center Study in Romania. ACTA ACUST UNITED AC 2021; 57:medicina57060533. [PMID: 34071770 PMCID: PMC8226979 DOI: 10.3390/medicina57060533] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 01/10/2023]
Abstract
Background and Objectives: The COVID-19 pandemic has globally affected health systems and services. Non-melanoma skin cancers (NMSCs) are the most common malignancies around the world. This study aimed to analyze the differences in the benign and malignant histopathological diagnoses performed on radical excision skin tumors and skin biopsies in the dermatopathology ward in Mures Clinical County Hospital, Targu Mures, Romania, 1 year prior to and during the COVID-19 pandemic, to emphasize the changes in the diagnostic process as per the new regulations. Materials and Methods: A total of 1168 histopathological diagnoses were included in the study—302 from the COVID-19 period and 866 from the non-COVID-19 period—considering the number, type, and frequency of the histopathological diagnoses as variables to be analyzed. Results: In the COVID-19 period, out of the 55 NMSC and melanoma histopathological diagnoses, 50.9% (n = 28) were BCCs, 20% (n = 11) were SCCs, 10.9% (n = 6) were basosquamous cell carcinomas, and 18.18% (n = 10) were melanoma cases. Regarding the non-COVID-19 period, out of the 173 NMSC and melanoma histopathological diagnoses, 46.82% (n = 81) were BCCs, 22.54% (n = 39) were SCCs, 7.51% (n = 13) were basosquamous cell carcinomas, and 23.12% (n = 40) were melanoma cases. Conclusions: During the COVID-19 pandemic, a decrease in histopathological diagnoses at the dermatopathology ward in our hospital was observed, for both benign and malignant pathologies, especially for NMSCs and melanomas, compared to the same period 1 year prior to the pandemic.
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Downregulation of ARMC8 promotes tumorigenesis through activating Wnt/β-catenin pathway and EMT in cutaneous squamous cell carcinomas. J Dermatol Sci 2021; 102:184-192. [PMID: 34016486 DOI: 10.1016/j.jdermsci.2021.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Aberrant expression of Armadillo repeat containing 8 (ARMC8) plays crucial roles in tumor growth and metastasis of various cancers. The specific role of ARMC8 in cutaneous squamous cell carcinoma (cSCC) is yet to be elucidated. OBJECTIVE The present study aimed to investigate the molecular mechanisms of ARMC8 and epithelial-mesenchymal transition (EMT) in cSCC development and provide translational insights for future therapeutics. METHODS cSCC tumor specimens were used to determine the ARMC8 by immunohistochemistry. Three cSCC cell lines including HSC-1, HSC-5 and A431 as well as BALB/C mouse tumor model was utilized to study the potential mechanisms in tumorigenesis. RESULTS Our data identified ARMC8 as a direct downstream target of miR-664. We found that ARMC8 was remarkably low expression in cSCC patient specimens and cSCC cell lines. Knockdown of ARMC8 promotes tumorigenic behaviors such as increased cell proliferation, migration and invasion capacities in vitro and enhanced tumorigenicity in xenograft mouse model. Whereas ARMC8 over-expression inhibits tumorigenesis in cSCC. Together, it revealed ARMC8 functions as a tumor suppressor via restraining Wnt/β-catenin pathway and epithelial-mesenchymal transition in cSCC. CONCLUSION Our data verifies that aberrant expression of ARMC8 plays a vital role in carcinogenesis of cSCC. And overexpression of ARMC8 will facilitate future development of cSCC therapeutic interventions.
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