Expression of p63 and Cyclooxygenase-2 and Their Correlation in Skin Tumors

To study the expression of p63 and cyclooxygenase-2 （cox-2） in skin tumors and evaluate the correlation between p63 and cox-2, the expressions of cox-2 and p63 were measured by streptavidin-peroxidase complex immunohistochemical technique in 17 cases of skin squamous cell carcinoma （ SCC ） , 19 cases of Bowen＇s disease（Bowen）, 11 cases of actinic keratosis（AK）, 12 cases of seborreic keratosis（SK） and 13 specimens of normal skin. Our results showed that the expression of p63 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while the expression of p63 in seborreic keratosis was significantly higher than that in normal skin. The expression of cox-2 in skin squamous cell carcinoma, Bowen＇s disease and actinic keratosis were significantly higher than that in seborreic keratosis, while no statistical difference was noted in the expression of cox-2 between seborreic keratosis and normal skin. Cox-2 expression was positively correlated with the high p63 expression in malignant skin tu- mors. The increased expression of cox-2 and p63 may play an important role in the development of skin tumors and work synergetically in malignant skin tumors.

The Frequency of Skin Tumors and Infections in Patients with Autoimmune Diseases

Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.

Clinical Efficacy and Adverse Reactions of Photodynamic Therapy in the Treatment of Malignant Skin Tumors and Precancerous Skin Diseases

The purpose of the study was to investigate the efficacy and safety of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases.First of all,100 patients with malignant skin tumor and pre-cancer skin disease admitted to our hospital from January 20,2018 to September 18,2018 were selected,and all of them adopted photodynamic therapy.The 100 patients included 40 cases of basal cell carcinoma,14 cases of squamous cell carcinoma,7 cases of proliferative erythema,9 cases of Bowen’s disease and 39 cases of solar keratosis.Among the 100 patients,77 cases had excellent curative effect,18 cases had good effect and 5 cases had poor effect,and the overall effective rate was 95%(95/100).After 6 months of follow-up,5 cases of basal cell carcinoma,2 cases of squamous cell carcinoma,0 cases of proliferative erythra,1 case of Bowen’s disease and 3 cases of solar keratosis recurred,with an overall recurrence rate of 14%(14/100).The adverse reactions of pruritus were 90%(90/100),81%(81/100),90%(90/100)and 3%(3/100).Therefore,the application of photodynamic therapy in the treatment of malignant skin tumors and precancerous skin diseases is not only effective,but also safe and not easy to relapse.

Biomedical overview of melanin.1.Updating melanin biology and chemistry,physico-chemical properties,melanoma tumors,and photothermal therapy

Melanins(eumelanin,pheomelanin,and allomelanin)represent a very,if not themost,important group of biological pigments.Their biological roles are multiple,from photoprotection to antioxidant activity,heavy metal disposal or the myriad uses of color in organisms across all Phyla.In the first part of this review,eumelanin biology and some chemical aspects will be presented,as well as key physico-chemical features that make this biological pigment so interesting.The principal characteristics of the melanocyte,the melanin-synthesizing cell in mammals,will also be introduced.Transformed melanocytes are the cause of one of the most devastating known cancers:the malignant melanoma.Epidemiology and molecular signaling aspects will be presented next,as well as the principal advances in promising oncotherapies designed and applied for the treatment of melanoma.In particular,on account of the photo-physical properties of melanin,special details will be provided regarding the use of photothermal therapy for melanoma treatment.

Calcium Glucarate Prevents Tumor Formation in Mouse Skin

Objective Calcium Glucarate (Cag), Ca salt of D-glucaric acid is a naturally occurring non-toxic compound present in fruits, vegetables and seeds of some plants, and suppress tumor growth in different models. Due to lack of knowledge about its mode of action its uses are limited in cancer chemotherapy thus the objective of the study was to study the mechanism of action of Cag on mouse skin tumorigenesis. Methods We have estimated effect of Cag on DMBA induced mouse skin tumor development following complete carcinogenesis protocol. We measured, epidermal transglutaminase activity (TG), a marker of cell differentiation after DMBA and/or Cag treatment and [3H] thymidine incorporation into DNA as a marker for cell proliferation. Results Topical application of Cag suppressed the DMBA induced mouse skin tumor development. Topical application of Cag significantly modifies the critical events of proliferation and differentiation TG activity was found to be reduced after DMBA treatment. Reduction of the TG activ

A New Hybrid Model for Segmentation of the Skin Lesion Based on Residual Attention U-Net

Skin segmentation participates significantly in various biomedical applications,such as skin cancer identification and skin lesion detection.This paper presents a novel framework for segmenting the skin.The framework contains two main stages:The first stage is for removing different types of noises from the dermoscopic images,such as hair,speckle,and impulse noise,and the second stage is for segmentation of the dermoscopic images using an attention residual U-shaped Network(U-Net).The framework uses variational Autoencoders(VAEs)for removing the hair noises,the Generative Adversarial Denoising Network(DGAN-Net),the Denoising U-shaped U-Net(D-U-NET),and Batch Renormalization U-Net(Br-U-NET)for remov-ing the speckle noise,and the Laplacian Vector Median Filter(MLVMF)for removing the impulse noise.In the second main stage,the residual attention u-net was used for segmentation.The framework achieves(35.11,31.26,27.01,and 26.16),(36.34,33.23,31.32,and 28.65),and(36.33,32.21,28.54,and 27.11)for removing hair,speckle,and impulse noise,respectively,based on Peak Signal Noise Ratio(PSNR)at the level of(0.1,0.25,0.5,and 0.75)of noise.The framework also achieves an accuracy of nearly 94.26 in the dice score in the process of segmentation before removing noise and 95.22 after removing different types of noise.The experiments have shown the efficiency of the used model in removing noise according to the structural similarity index measure(SSIM)and PSNR and in the segmentation process as well.

Medical images classification for skin cancer using quantitative image features with optical coherence tomography

Optical coherence tomography(OCT)is employed in the diagnosis of skin cancer.Particularly,quantitative image features extracted from OCT images might be used as indicators to classify the skin tumors.In the present paper,we investigated intensity-based,texture-based and fractalbased features for automatically classifying the melanomas,basal cell carcinomas and pigment nevi.Generalized estimating equations were used to test for differences between the skin tumors.A modified p value of<0.001 was considered statistically significant.Significant increase of mean and median of intensity and significant decrease of mean and median of absolute gradient were observed in basal cell carcinomas and pigment nevi as compared with melanomas.Significant decrease of contrast,entropy and fractal dimension was also observed in basal cell carcinomas and pigment nevi as compared with melanomas.Our results suggest that the selected quantitative image features of OCT images could provide useful information to differentiate basal cell carcinomas and pigment nevi from the melanomas.Further research is warranted to determine how this approach may be used to improve the classification of skin tumors.

Fine needle aspiration analysis of misdiagnosis of 2 cases with skin singular leiomyoma

This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.

Clinical Study of Aminolevulinic Acid-mediated Acid Photodynamic Therapy Combined with Surgical Therapy of Skin Malignant Tumor

The purpose of the study was to analyze the effects of aminolevulinic acid-mediated photodynamic therapy(ALA-PDT)combined with surgery and its prognostic implications.Firstly,70 cases of skin malignant tumors admitted to the dermatology department of our hospital from January 2017 to December 2018 were selected and divided into observation group and control group according to the random number table,with 35 patients in each group.Observation group adopted the ALA-PDT combined with surgery therapy,and control group adopted surgery therapy.Two groups of patients were last follow-up to December 2019.The results showed that the total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05),indicating that based on the basis of conventional surgical treatment,combined use of ALA-PDT can effectively improve the clinical therapeutic effect and better promote the patient’s health recovery.Therefore,combined with surgical treatment,ALA-PDT can improve the clinical efficacy of skin malignant tumors with fewer adverse reactions,high safety,low recurrence rate and ideal long-term prognosis.

Facial basal cell carcinoma:A retrospective study of 67 cases

BACKGROUND Basal cell carcinoma(BCC)is a slow-growing malignant tumor characterized by local invasiveness but an exceptionally rare metastatic potential.It ideally affects sun-exposed skin of older patients with more propensity for the facial region.AIM To evaluate the different clinicopathological characteristics of the facial BCC and the efficacy and safety of diode laser for the treatment of these lesions.METHODS We retrospectively reviewed facial BCC lesions of<1.5 cm in diameter and subjected them to diode laser ablation during the period from September 2016 to August 2021 at Al-Ramadi Teaching Hospital,Ramadi City,Iraq.Data matching the age,gender,duration,site,and clinical and histological types were registered for every subject.The functional and aesthetic outcomes and complications following diode laser ablation for each patient were also recorded.RESULTS Of 67 patients with facial BCC,there was 65.67%from the age group≥60 years and 58.21%males.The mean duration of the lesions was 5.15±1.836 mo.The most involved location was the nose(29.85%).About half of the cases belong to the noduloulcerative type.Solid histological type comprises 40.3%of the cases,while the least was keratotic(13.4%).Moreover,65.2%of the solid cases were from the age group≤60 years and 38.6%of the adenoid type from the age group>60 years(P value=0.007).Excellent aesthetic and functional outcomes were reported in all cases after 6 mo of follow-up.Few complications were reported after diode laser ablation.CONCLUSION Facial BCC was mostly seen in the elderly and men.The mean duration was 5.15 mo.The nose was the commonest involved site.Noduloulcerative lesions were seen in approximately half of the lesions.The age of the patients determined the histological type of the lesion(solid type was mostly seen in the age group≤60 years,while,adenoid in the age group>60 years).Diode laser ablation showed excellent functional and aesthetic outcomes following a 6-mo follow-up.

Darier-Ferrand Dermofibrosarcoma: A Case Report of a Cervical Localization

Darier-Ferrand dermatofibrosarcoma (DFS) is a cutaneous mesenchymal tumor of intermediate malignancy. It is a rare but not exceptional tumor, accounting for 0.1% of malignant skin tumors. Histological examination is essential for diagnosis. Wide surgical excision is the standard treatment. DFS is a tumor whose prognosis and evolutionary risk are mainly linked to the delay in diagnosis and the quality of the first excision. Late diagnosis makes excision and reconstruction surgery difficult. The chances of recovery in the case of well-performed primary surgery are significantly greater than in the case of salvage surgery. To improve prognosis, early, codified, multidisciplinary management is essential. In our African context, and especially in the case of patients living in rural areas, errant diagnoses are often found hence the importance of raising awareness and providing information to healthcare personnel. We report a case of an enlarged left supraclavicular Darier-Ferrand dermatofibrosarcoma. The patient had come for a late consultation at a stage when the tumour was large. The CT scan was a great help in the pre-operative phase. The patient underwent complete surgical excision, the postoperative course was straightforward and the histology of the surgical specimen confirmed the diagnosis. The resection margins were healthy. The patient is alive at one year with no recurrence or metastasis.

Diagnostic capacity of skin tumor artificial intelligence-assisted decision-making software in real-world clinical settings

Background:Youzhi artificial intelligence(AI)software is the AI-assisted decision-making system for diagnosing skin tumors.The high diagnostic accuracy of Youzhi AI software was previously validated in specific datasets.The objective of this study was to compare the performance of diagnostic capacity between Youzhi AI software and dermatologists in real-world clinical settings.Methods:A total of 106 patients who underwent skin tumor resection in the Dermatology Department of China-Japan Friendship Hospital from July 2017 to June 2019 and were confirmed as skin tumors by pathological biopsy were selected.Dermoscopy and clinical images of 106 patients were diagnosed by Youzhi AI software and dermatologists at different dermoscopy diagnostic levels.The primary outcome was to compare the diagnostic accuracy of the Youzhi AI software with that of dermatologists and that measured in the laboratory using specific data sets.The secondary results included the sensitivity,specificity,positive predictive value,negative predictive value,F-measure,and Matthews correlation coefficient of Youzhi AI software in the real-world.Results:The diagnostic accuracy of Youzhi AI software in real-world clinical settings was lower than that of the laboratory data(P<0.001).The output result of Youzhi AI software has good stability after several tests.Youzhi AI software diagnosed benign and malignant diseases by recognizing dermoscopic images and diagnosed disease types with higher diagnostic accuracy than by recognizing clinical images(P=0.008,P=0.016,respectively).Compared with dermatologists,Youzhi AI software was more accurate in the diagnosis of skin tumor types through the recognition of dermoscopic images(P=0.01).By evaluating the diagnostic performance of dermatologists under different modes,the diagnostic accuracy of dermatologists in diagnosing disease types by matching dermoscopic and clinical images was significantly higher than that by identifying dermoscopic and clinical images in random sequence(P=0.022).The diagnostic accuracy of dermatologists in the diagnosis of benign and malignant diseases by recognizing dermoscopic images was significantly higher than that by recognizing clinical images(P=0.010).Conclusion:The diagnostic accuracy of Youzhi AI software for skin tumors in real-world clinical settings was not as high as that of using special data sets in the laboratory.However,there was no significant difference between the diagnostic capacity of Youzhi AI software and the average diagnostic capacity of dermatologists.It can provide assistant diagnostic decisions for dermatologists in the current state.

The Influence of Different Surgical Schemes on the Healing and Cosmetic Effects of Skin Lesions

Objective To analyze the effects of different surgical procedures on the healing and cosmetic effects of skin lesions.Methods 102 patients with skin defects after skin tumor resection in our hospital from January 2018 to December 2019 were selected and randomly divided into observation group and control group.The control group was treated with a traditional skin flap transplantation,while the observation group was treated with a skin stretch closure device.The effective rate,bleeding volume,wound healing time,total scar length,short-term and long-term complications and patient satisfaction were compared between the two groups.Results The effective rates of the observation group and the control group were 90.2%and88.24%,there was no significant difference in the treatment efficiency between the two groups(P>0.05),but there were significant differences in the amount of bleeding,the time of wound healing and the total length of postoperative scars between the two groups(all P<0.05);the short-term complication rates of the observation group and the control group were 5.88%and 19.61%,and long-term complications rate was 1.96%and 13.73%.The difference in the incidence of short-term and long-term complications between the two groups was statistically significant(all P<0.05);the satisfaction rate of patients in the observation group and the control group was 90.2%and 72.55%,the difference was statistically significant(P<0.05).Conclusion The former can effectively shorten wound healing time and scar length,reduce the incidence of short-term and long-term complications,and improve patients’satisfaction with the treatment,which is worthy of promotion.

Deep learning-based,computer-aided classifier developed with dermoscopic images shows comparable performance to 164 dermatologists in cutaneous disease diagnosis in the Chinese population

Background:Diagnoses of Skin diseases are frequently delayed in China due to lack of dermatologists.A deep learning-based diagnosis supporting system can facilitate pre-screening patients to prioritize dermatologists’efforts.We aimed to evaluate the classification sensitivity and specificity of deep learning models to classify skin tumors and psoriasis for Chinese population with a modest number of dermoscopic images.Methods:We developed a convolutional neural network(CNN)based on two datasets from a consecutive series of patients who underwent the dermoscopy in the clinic of the Department of Dermatology,Peking Union Medical College Hospital,between 2016 and 2018,prospectively.In order to evaluate the feasibility of the algorithm,we used two datasets.Dataset I consisted of 7192 dermoscopic images for a multi-class model to differentiate three most common skin tumors and other diseases.Dataset II consisted of 3115 dermoscopic images for a two-class model to classify psoriasis from other inflammatory diseases.We compared the performance of CNN with 164 dermatologists in a reader study with 130 dermoscopic images.The experts’consensus was used as the reference standard except for the cases of basal cell carcinoma(BCC),which were all confirmed by histopathology.Results:The accuracies of multi-class and two-class models were 81.49%±0.88%and 77.02%±1.81%,respectively.In the reader study,for the multi-class tasks,the diagnosis sensitivity and specificity of 164 dermatologists were 0.770 and 0.962 for BCC,0.807 and 0.897 for melanocytic nevus,0.624 and 0.976 for seborrheic keratosis,0.939 and 0.875 for the"others"group,respectively;the diagnosis sensitivity and specificity of multi-class CNN were 0.800 and 1.000 for BCC,0.800 and 0.840 for melanocytic nevus,0.850 and 0.940 for seborrheic keratosis,0.750 and 0.940 for the"others"group,respectively.For the two-class tasks,the sensitivity and specificity of dermatologists and CNN for classifying psoriasis were 0.872 and 0.838,1.000 and 0.605,respectively.Both the dermatologists and CNN achieved at least moderate consistency with the reference standard,and there was no significant difference in Kappa coefficients between them(P>0.05).Conclusions:The performance of CNN developed with relatively modest number of dermoscopic images of skin tumors and psoriasis for Chinese population is comparable with 164 dermatologists.These two models could be used for screening in patients suspected with skin tumors and psoriasis respectively in primary care hospital.

Expression of glycoprotein non-metastatic melanoma protein B in cutaneous malignant and benign lesions： a tissue microarray study

Background Glycoprotein non-metastatic melanoma protein B （GPNMB） plays an important role in the pathogenesis of inflammatory and malignant diseases. We investigated the expression of GPNMB in benign and malignant skin diseases. Methods Tissue microarray was performed in the skin tissues of 102 cases including malignant melanoma （MM）, squamous cell carcinoma （SCC）, basal cell carcinoma （BCC）, and benign dermatosis. The expression of GPNMB in the tissues was detected by immunohistochemistry. Twenty cases of normal skin and adjacent neoplastic normal skin tissues were selected as controls. Results GPNMB was positively stained in skin malignancies （38/50, 76%）, which was significantly higher than that in the control and the benign skin tissues （P=0.001 and 〈0.001 respectively）. GPNMB was positively stained in MM （13/15, 87%） and SCC （16/20, 80%） （P 〈0.001）. Significant higher expression of GPNMB was observed in patients aged 〉65 years than those less than 65 years （n=11 and n=9 respectively, P=0.027）. No significant difference of the expression rates was observed between normal control and BCC; however, stronger intensity was detected in the latter. Negative or weak expression was observed in the controls. Conclusion Over-expression of GPNMB correlated strongly and might play an important role in the pathogenesis of MM and SCC.

Real-time monitoring of tumor vascular disruption induced by radiofrequency assisted gadofullerene

The anti-vascular therapy has been extensively studied for high performance tumor therapy by suppressing the tumor angiogenesis or cutting off the existing tumor vasculature. We have previously reported a novel anti-tumor treatment technique using radiofrequency （RF）-assisted ga- dofullerene nanocrystals （GFNCs） to selectively disrupt the tumor vasculature. In this work, we further revealed the changes on morphology and functionality of the tumor vas-culature during the high-performance RF-assisted GFNCs treatment in vivo. Here, a dearly evident mechanism of this technique in tumor vascular disruption was elucidated. Based on the H22 tumor bearing mice with dorsal skin flap chamber （DSFC） mode] and the dynamic contrast enhanced magnetic resonance imaging （DCE-MRI） technique, it was revealed that the GFNCs would selectively inset in the gaps of tumor vas-culature due to the innately incomplete structures and unique microenvironment of tumor vasculature,＇ and they damaged the surrounding endothelia cells excited by the RF to induce a phase transition accompanying with size expansion. Soon afterwards, the blood flow of the tumor blood vessels was permanently shut off, causing the entire tumor vascular net- work to collapse within 24 h after the treatment. The RF-as- sistant GFNCs technique was proved to aim at the tumor vasculatnre precisely, and was harmless to the normal vascu- lature. The current studies provide a rational explanation on the high efficiency anticancer activity of the RF-assisted GFNCs treatment, suggesting a novel technique with potent clinical application.