Peroxidative Activity in Patients with Skin Basal Cell Carcinoma

Oxidative status assessment is an initial step in tumor related studies. To the best of our knowledge, this is the first study considering oxidative activity of both serum and tissue specimens in human basal cell carcinoma (BCC), which is the most common tumor in the world. Concentration of Malondialdehide (MDA) in human basal cell carcinoma (BCC) and individually matched normal skin tissue were examined with spectrophotometery method. Fresh normal and cancerous skin paired tissue was obtained from 60 patients who underwent curative BCC resection at one center in Tehran (Razi hospital). Serum Concentration of Malondialdehide (MDA) in these patients and 55 normal subjects were also measured. MDA level in cancerous tissue of patients with skin BCC (1.0 ± 0.14 ng/g) was significantly (p = 0.001) higher than normal neighboring skin tissue (0.3 ± 0.07 ng/g). A remarkable (Not significant, P = 0.18) increase was found in the serum MDA level in patients with skin BCC (8.0 ± 2.3 ng/ml) in comparison with the control subjects (7.3 ± 2.9 ng/ml). A significant positive correlation (r = 0.276, p = 0.03) was found between Serum MDA and skin tissue MDA for non-affected skin tissue (normal neighboring skin), whereas no significant correlation (p > 0.05) was found for cancerous tissue. Cut-point of 5.2 ng/ml of serum MDA concentration showed a screening sensitivity of 95%. There is an active oxidative process in BCC lesions. Serum MDA concentration can be used either as a screening test or a predictor for tissue MDA concentration.

Gold Standard for Skin Cancer Treatment: Surgery (Mohs) or Microscopic Molecular-Cellular Therapy (Curaderm)?

Non-melanoma skin cancers or keratinocyte cancers such as basal cell carcinoma and squamous cell carcinoma make up approximately 80% and 20% respectively, of skin cancers with the 6 million people that are treated annually in the United States. 1 in 5 Americans and 2 in 3 Australians develop skin cancer by the age of 70 years and in Australia it is the most expensive, amassing $1.5 billion, to treat cancers. Non-melanoma skin cancers are often self-detected and are usually removed by various means in doctors’ surgeries. Mohs micrographic surgery is acclaimed to be the gold standard for the treatment of skin cancer. However, a novel microscopic molecular-cellular non-invasive topical therapy described in this article, challenges the status of Mohs procedure for being the acclaimed gold standard.

Unique Clinical Features of Curaderm when Treating Skin Cancers

Basal cell carcinoma is the most common form of skin cancer and the most frequently occurring form of all cancers. Conventional treatments to remove or destroy basal cell carcinoma are indiscriminate and also remove or destroy normal skin cells resulting in compromised cosmetic outcomes. Consequences of these treatments include body-image issues, anxiety, post-traumatic stress disorder, depression, and poorer quality of social and family life. A progressive topical cream formulation, Curaderm, containing the natural BEC glycoalkaloids, have shown to have advantages over conventional treatments. However, comprehensive clinical features of the skin cancer lesions during treatment with Curaderm have to date not been reported. This report shows that using unpublished data from a large number of patients with varying sizes, types and locations of basal cell carcinomas when treated with Curaderm in a phase 3 trial, an initial increase in size of the lesions occur, followed by a reverse course, leading to complete removal of the skin cancer. The specificity and mode of action of Curaderm explains the superior cosmetic outcomes when compared with conventional therapies.

The Value of Excipients and the Required Understanding of the Biological System in Product Development: An Impactful Example of Curaderm, a Topical Skin Cancer Treatment

The incidences of nonmelanoma skin cancer are increasing worldwide, and the ongoing war on its treatment necessitates the development of effective and non-invasive methods. Through basic and clinical research, non-invasive treatments like Curaderm have been developed, leading to improved quality of life for patients. Excipients, previously considered inactive ingredients, play a crucial role in enhancing the performance of topical formulations. The development of Curaderm emphasizes the importance of understanding the interactions between active ingredients, excipients, and the biological system to create effective and affordable pharmaceutical formulations. The systematic approach taken in the development of Curaderm, starting from the observation of the anticancer activity of natural solasodine glycosides and progressing through toxicological and efficacy studies in cell culture, animals, and humans, has provided insights into the pharmacokinetics and pharmacodynamics of solasodine glycosides. It is crucial to determine these pharmacological parameters within the skin’s biological system for maximal effectiveness and cost-effectiveness of a skin cancer treatment. Curaderm, as a topical treatment for nonmelanoma skin cancer, offers benefits beyond those obtained from other topical treatments, providing hope for improved quality of life for patients.

Curaderm, the Long-Awaited Breakthrough for Basal Cell Carcinoma

Background: Basal cells form a continuous cell layer at the bottom of the epidermis, which is the outermost layer of the skin. Basal cell carcinoma occurs when a mutation occurs in the DNA of a basal cell. The mutation inhibits apoptosis—the programmed cell death mechanism. The cell continues to multiply but does not die, resulting in a change in the skin, such as a growth or sore that will not heal. Basal cell carcinoma is the most common form of skin cancer and the most frequently occurring form of all cancers. Key words searched for the database of this communication were: Curaderm, BEC 5, cancer, skin cancer, basal cell carcinoma, nonmelanoma skin cancer, solamargine, solasonine and solasodine glycosides. Treatments: Several types of treatments are available to remove or destroy basal cell carcinoma. All currently used treatments are indiscriminate and also remove or destroy normal skin cells resulting in compromised cosmetic outcomes. Development of Curaderm Pharmacotherapy: Curaderm pharmacotherapy discriminates and specifically activates apoptosis at the molecular level in cancer cells but not in normal cells. Accordingly, Curaderm pharmacotherapy for basal cell carcinoma effectively and safely treats virtually all types, sizes and lesion locations. This review describes studies from the inception of Curaderm pharmacotherapy and covers the discovery of the anti-cancer effects, mode of action, preclinical, clinical and field applications with emphasis on efficacy, safety, compliance, tolerance, cost effectiveness and especially cosmetic outcome. In 2018 Curaderm was approved by the European Health Authorities as a Medical Device Class 1 for the indication “Topical Treatment with Keratolytic Action, and Antineoplastic Activity in the Treatment and Healing of Localized Basal Cell Carcinoma of the Skin”.

Clinicopathological Pattern of Basal Cell Carcinoma among Sudanese Patients

Background: Basal cell carcinoma (BCC) is a frequently diagnosed skin cancer with variable histopathological types. BCC was not widely studied in Sudan as it is in the Caucasian population. Objectives: To appraise the clinical and histopathological aspects of BCC of the skin in Sudan. Materials and methods: A retrospective descriptive analysis of 84 histologically diagnosed BCC specimens seen at three hospitals in four-year duration were reviewed and classified into histological variants according to the WHO classification 2006. Data were analyzed using Statistical Package for the Social Sciences, version 23.0. Results: The mean age (±SD) of the study participants was 56 (±1.75) years, ranging from 20 to 92 years and 63.1% were females (Female to male ratio 1.7:1). The most common incidence was among the age group 51 - 60 years. The face was the primary tumor site in 89.3% with a predilection for the nasal area (31% of those in the face), followed by the trunk (6%). Out of the total, 54.8% were histologically categorized as nodular/solid, while infiltrative accounts for 11.9% followed by the superficial type (8.3%). Surgical margins were involved in 34.5% of cases and peri-neural invasion was seen in 3.6% of cases, mostly were of the infiltrative variant. Conclusion: BCC in Sudan is commonly present in the head as solid nodular histopathological variant which is correlated with worldwide distribution but has slightly younger age and female predominance;thus further studies are needed to assess risk factors in Sudanese patients and improve approaches for earlier diagnosis and better management.

Eyelid Basal Cell Carcinoma Arising on the Site of a Congenital Port Wine Hemangioma

Purpose:Only one previous case of eyelid basal cell carcinoma arising in a facial port wine stain without previous local radiotherapy has been reported.We now report a second case.Methods:A 42-year-old female patient with eyelid basal cell carcinoma developing within a facial port wine stain underwent incisional biopsy,surgical excision and repair.Results:The patient had a mass at the inner canthus of the left eye for two years.She had a left facial congenital port wine hemangioma involving the left eyelid,for which no topical treatment had been given.Clinical examination disclosed a 1.5 ×1.2 cm ulcerated skin mass with irregular borders in the medial canthal region involving the medial aspect of both upper and lower left eyelids.Incisional biopsy revealed basal cell carcinoma.She underwent surgical excision by Mohs'.technique and subsequent reconstructive eyelid surgery.The wound healed well postoperatively.At 2 years of follow up the patient showed no recurrence.Conclusion:Patients with congenital facial port wine stain may develop basal cell carcinoma,and should be regularly monitored.

Prognostic factors correlation between the cell cycle phases and apoptosis in basal cell carcinoma

Basal cell carcinoma (BCC) is the most common skin malignancy, are found in various forms depending on their clinical and biological behavior. The objective of study was analyzed the phases of the cell cycle and correlations between BCC of low and high risk of recurrence and correlation prognostic factors. The quantity of content DNA in tissues of normal skin, showed small amount of cells in apoptosis and mostly in phase quiescent and rare aneuploidy cells. In BCC, apoptosis was higher in the BCC at high risk than low risk, probably due to their high rates of cell proliferation, and present of aneuploidy cells, when compared to the average percentage of aneuploidy. The DNA content from cells of normal skin shows that the majority is in the quiescent phase;compatible with tissues that are is refreshing. There is presence of apoptosis in the epidermis by probable normal process of differentiation. The aneuploidy in BCC showed a direct correlation with the degree of tumor aggressiveness.

5-氨基酮戊酸光动力疗法联合咪喹莫特对皮肤基底细胞癌的疗效及对血清可溶性Fas、FasL水平的影响

目的探究5-氨基酮戊酸光动力疗法联合咪喹莫特对皮肤基底细胞癌的疗效及对血清可溶性Fas、FasL水平的影响。方法选取接受手术治疗的皮肤基底细胞癌患者96例,按随机数表法将其分为联合组(48例)与对照组(48例)。对照组患者单独采用5-氨基酮戊酸光动力疗法治疗6周,联合组患者采用5-氨基酮戊酸光动力疗法联合咪喹莫特涂抹治疗,持续治疗6周。比较两组患者治疗结束后临床疗效、伤口愈合情况、不良反应发生率以及患者治疗前后生活质量(GQOLI-74)评分及血清可溶性Fas和FasL水平。结果治疗结束后,联合组患者总有效率和伤口愈合率均高于对照组,差异有统计学意义(P<0.05)。治疗结束后,联合组和对照组患者生活质量各维度评分均升高,且联合组高于对照组,差异有统计学意义(P<0.05);联合组和对照组患者血清可溶性Fas和FasL水平均降低,且联合组低于对照组;差异有统计学意义(P<0.05)。治疗期间,联合组患者不良反应发生率与对照组相当,差异无统计学意义(P>0.05)。结论相比于单纯采用5-氨基酮戊酸光动力疗法治疗,5-氨基酮戊酸光动力疗法联合咪喹莫特涂抹治疗皮肤基底细胞癌临床效果更明显,可以降低血清可溶性Fas和FasL水平,提高患者生活质量。

Claudin1、Claudin4在皮肤基底细胞癌组织中的表达水平及临床意义

目的探究Claudin1、Claudin4在皮肤基底细胞癌组织中的表达水平及临床意义。方法收集92例皮肤基底细胞癌患者临床资料。比较皮肤基底细胞癌组织与癌旁组织中Claudin1、Claudin4表达水平,分析皮肤基底细胞癌组织中Claudin1、Claudin4表达及与临床病理特征的关系,进一步分析Claudin1与Claudin4的相关性。结果皮肤基底细胞癌组织Claudin1、Claudin4阳性表达率分别为76.09%、81.52%,癌旁组织Claudin1、Claudin4阳性表达率分别为38.04%、43.48%,皮肤基底细胞癌组织Claudin1、Claudin4阳性表达率显著高于癌旁组织(P<0.05)。Claudin1、Claudin4阳性表达与性别无显著相关性,与年龄≥65岁、TNM分期为Ⅳ期、淋巴结转移、肿瘤低分化相关。Claudin1与Claudin4呈显著正相关关系,γ=0.342,P=0.010。结论Claudin1、Claudin4在皮肤基底细胞癌组织中的阳性表达率较高,且与年龄、TNM分期、淋巴结转移、肿瘤分化程度相关。Claudin1与Claudin4呈显著正相关关系。

误诊为色素痣的其他疾病140例分析

目的分析其他相关疾病误诊为色素痣原因,并探讨防范措施,提高临床诊断水平。方法回顾性分析2019年1月—2022年12月宣城市人民医院病理数据库中140例初诊为色素痣,但经组织病理检查排除色素痣诊断的患者临床及组织病理资料。结果误诊为皮肤色素痣140例,男55例,女85例,年龄(46.64±15.27)岁。皮损发生部位:头面颈部55例,躯干部44例,四肢22例,手足部13例,外阴6例。经组织病理诊断为脂溢性角化病70例,血管角皮瘤9例,基底细胞癌8例,皮肤纤维瘤7例,角质层出血6例,寻常疣4例,表皮囊肿4例,表皮鳞状上皮增生3例,皮赘3例,日光性角化病2例,恶性黑素瘤2例,皮脂腺增生2例,毛发上皮瘤2例,汗孔瘤2例,钙化上皮瘤2例,其他14例。结论多种疾病与色素痣临床特征相似,临床误诊率较高,综合临床特征、皮肤镜检查、皮肤组织病理检查等可明确诊断,提高诊断率。

NF-κB抑制剂APDC对人皮肤基底细胞癌迁移的影响

目的探究NF-κB抑制剂APDC对人皮肤基底细胞癌(BCC)的迁移影响及机制。方法用MTT法检测NF-κB抑制剂APDC对人BCC细胞增殖活性的影响。通过细胞划痕和Transwell侵袭实验观察应用NF-κB抑制剂后BCC细胞生长特性的变化,应用RT-qPCR检测不同浓度APDC抑制剂对TE354.T细胞中NF-κB mRNA表达情况的影响,最后通过免疫印迹法探究对细胞中NF-κB蛋白表达的影响。结果NF-κB抑制剂APDC对TE354.T细胞的增殖有抑制作用,且呈剂量依赖性,有效抑制TE354.T细胞的迁移能力和侵袭能力,随时间呈剂量依赖性,同时对TE354.T细胞NF-κB mRNA水平有抑制作用,呈正相关,且NF-κB蛋白表达有所降低。结论NF-κB抑制剂APDC能够抑制BCC的细胞增殖,影响BCC NF-κB蛋白和mRNA水平表达,且有效抑制皮肤基底细胞癌的迁移和侵袭能力。

Topical Curaderm^BEC5Therapy for Periocular Nonmela-noma Skin Cancers: A Review of Clinical Outcomes

Approximately 5 to 10 percent of all skin cancers occur in the periocular region. Basal cell carcinoma is the most frequent malignant periocular tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma, and malignant melanoma. Nonmelanoma skin tumors at the periocular area often cause disfigurement with destruction of soft conjunctival tissue. Many therapeutic methods have been recommended to combat the morbidity and mortality associated with these lesions. Excisions with frozen-section control or Mohs micrographic surgery are regarded as the gold-standard treatments for periocular basal cell and squamous cell carcinomas. However, these treatment modalities have various limitations and reconstruction surgery is often associated with these treatment options. The chemotherapeutic agents solasodine rhamnosides in a cream formulation CuradermBEC5 are specific, effective and safe treatments for nonmelanoma skin cancers with excellent cosmesis. The antineoplastic mode of action is by apoptosis. In this review it is shown that CuradermBEC5 also treats periocular basal cell carcinoma and squamous cell carcinoma with impressive cosmetic outcomes and no reconstructive surgery is required.

Management and Clinico-Pathologic Aspects of Non-Melanoma Skin Cancer of the Head and Neck: A Retrospective Institutional Based Study at the Egyptian National Cancer Institute

Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012. The mean follow-up was 6 months (1 - 84 months). Results: 117 males and 83 females with 90% ≥ 50 years old. The scalp (27.5%), the periorbital region (13%), the cheek (12.5%) and the nose (12.5%) are the main anatomical sites affected. BCC represented 71.5% with nodular type (79%) predominance;SCC represented 21% with GII (61.1%) the commonest grade. Surgery was the main modality of treatment (93%) with local flaps only (63.9%) and primary closure (14.7%) were the main surgical options following wide local excision. Positive and close margins were detected in 23.5% of excised specimens. No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons.

皮肤基底细胞癌、鳞状细胞癌及脂溢性角化病临床和超声特点

目的 观察皮肤基底细胞癌(BCC)、鳞状细胞癌(SCC)及脂溢性角化病(SK)的临床和超声特征。方法 回顾性分析68例BCC(69处病变)、44例SCC(44处病变)和27例SK(28处病变)患者资料,观察其临床及超声特征。结果 BCC组及SCC组位于曝光部位病变占比高于SK组(P均<0.017)。3组病变最大径、累及深度、累及皮肤层次、病变形态、多发点状高回声、病变基底部边界、后方回声、血流信号及淋巴结转移差异均有统计学意义(P均<0.05);SCC组病变最大径和累及深度均大于BCC组和SK组(P均<0.017);SK组形态规则病变占比大于SCC组(P<0.017);仅BCC组病变表现为多发点状高回声(P均<0.017);SCC组淋巴结转移发生率高于BCC组(P<0.017);SK组病变多仅累及表皮,且基底部边界多清晰,而BCC组和SCC组病变多浸润至真皮层或皮下组织(P均<0.017),且与BCC组相比,SCC组更易侵犯皮下组织(P<0.017);SK组病变多无血流信号或仅有少量血流信号,而BCC组多为中等血流信号、SCC组多为丰富血流信号(P均<0.017)。结论 皮肤SK可发生于全身多部位,仅累及皮肤表皮层,病变基底光滑,与真皮层分界清晰,内未见或仅见少量血流信号。BCC和SCC好发于头面部等曝光部位,均可表现为低回声病变,基底部边界不清,侵及真皮层或皮下组织,BCC内可见多发特征性点状高回声,而SCC体积较大、浸润更深、血流信号更丰富。

基于多学科诊疗的《皮肤基底细胞癌诊疗专家共识(2021)》解读

基底细胞癌是最常见的皮肤恶性肿瘤,且发病率呈快速上升趋势,2021年9月,中华医学会皮肤性病学分会皮肤肿瘤研究中心、中国医师协会皮肤科医师分会皮肤肿瘤学组发布《皮肤基底细胞癌诊疗专家共识(2021)》。本共识从基底细胞癌的流行病学、发病机制、临床表现、辅助检查、病理、治疗前评估、治疗、预后及随访宣教多个方面进行了阐述,对促进我国皮肤基底细胞癌患者的规范化诊疗具有重要指导意义。本文将基于多学科诊疗对本共识中重点内容包括临床病理表现、治疗前评估及治疗进展等进行详细解读。

不同皮损表现的皮肤基底细胞癌临床误诊探析

目的探讨皮肤基底细胞癌(BCC)的临床特点、诊断方法、鉴别诊断方法和误诊原因、防范措施。方法回顾性分析2017年1月—2021年3月收治的曾误诊的皮肤BCC 9例的临床资料。结果本组9例以出现面部、头部、足部和手部皮疹5个月~12年,近期明显增大就诊;皆有长期日光暴露史,4例有刺伤、烫伤等外伤史;就诊初期外院考虑脂溢性角化病4例,黑色素瘤3例,鳞状细胞癌2例,误诊时间10~20 d。入我院后,经组织病理学及免疫组织化学检查证实诊断为皮肤BCC,其中浅表型4例、色素型3例、结节溃疡型2例;均予手术完整切除肿瘤,术后嘱局部外用氟尿嘧啶预防复发,并避免日光过强照射;术后随访4个月,9例皆恢复良好,无复发及术后并发症发生。结论皮肤BCC在未行组织病理学检查前极易误诊为其他皮肤疾病。加强对其相关知识学习,了解其临床特点及诊断、鉴别诊断方法,仔细询问病史,及时行相关检查,可减少或避免皮肤BCC早期误诊。

肿瘤微环境在皮肤癌发生发展中的作用及相关治疗研究进展

目前,皮肤癌发病率高居不下且仍缺乏有效的治疗方案。肿瘤微环境是肿瘤发生发展的局部环境,由肿瘤相关成纤维细胞、肿瘤相关脂肪细胞、免疫细胞、内皮细胞和神经元等细胞成分及细胞外基质等非细胞成分组成,具有低氧、酸性和免疫抑制等特点,影响皮肤癌进展,并对维持皮肤癌异质性和耐药性起重要作用。靶向肿瘤微环境是对抗耐药性和降低皮肤癌死亡率的有效途径。本综述主要介绍肿瘤微环境中细胞外基质、相关基质细胞及低氧和酸性环境对皮肤癌进展的影响,讨论靶向肿瘤微环境的途径和方法,为皮肤癌治疗提供新思路。

谱域光学相干层析成像定量表征皮肤癌组织结构

皮肤癌等疾病的发生严重危害身体健康,为研究皮肤癌组织皮下结构变化与动态监测皮肤癌发生过程对皮肤结构的影响,采用谱域光学相干层析成像(spectral domain optical coherence tomography,SD-OCT)技术研究离体基底细胞癌皮肤组织,建立裸鼠背脊皮翼视窗(dorsal skin fold window chamber,DSFC)黑色素瘤模型.通过层析扫描对病变组织皮下结构进行图像重构,分别获得了皮肤样品一维扫描信号、二维层析图像和三维结构图像.对比分析发现,基底细胞癌皮肤外部形态无明显变化,内部组织存在无散射信号区域,二维层析图像中表现为椭圆形状黑色巢穴.黑色巢穴病灶区位于皮肤表皮下层区域,长度约155.972μm,宽度约150.192μm.同时,通过对DSFC黑色素瘤模型连续11 d的动态监测,发现伴随黑色素瘤细胞的分裂增殖,皮肤表面出现肿瘤状隆起,皮下毛细血管逐渐清晰.在二维OCT图像中,光学系统光束穿透能力受到限制,在肿瘤种植后不同时间节点位置的层析成像深度呈现衰减区域,而且皮肤层OCT信号增强,可能因为黑色素瘤的生长并不断向上侵袭所致.实验结果表明,离体基底细胞癌皮肤组织内部形态发生显著变化,出现无OCT信号黑色病灶区域;裸鼠在体黑色素瘤的动态发展对皮肤组织产生影响,不同的时间节点,皮肤层具有不同的OCT影像表现.该研究为基底细胞癌的诊断和治疗提供了图像和数据依据,同时动态监测黑色素瘤过程也对皮肤癌病变过程研究具有重要意义.

PDT联合手术治疗皮肤基底细胞癌的效果观察

目的 探讨光动力疗法(PDT)联合手术治疗皮肤基底细胞癌(BCC)的效果。方法 回顾性分析100例BCC患者的病历有关资料,按治疗方式的不同分为2组,行手术治疗的50例患者为对照组,行PDT联合手术治疗的50例患者为观察组。2组均连续治疗2个月。对比2组临床疗效、细胞免疫功能、美容效果、生活质量、并发症发生率。结果 观察组治疗总有效率[96.00%(48/50)]、美容优良率[96.00%(48/50)]高于对照组[84.00%(42/50)、82.00%(41/50)],并发症发生率[6.00%(3/50)]低于对照组[20.00%(10/50)],有统计学差异(P<0.05)。治疗后,观察组CD_(3)^(+)、CD_(4)^(+)与GQOLI-74内各维度评分[(62.67±6.51)%、(44.69±4.38)%、(79.43±4.24)分、(78.72±3.65)分、(78.66±3.74)分、(80.64±4.38)分]均高于对照组[(55.89±5.43)%、(38.52±3.63)%、(71.49±3.58)分、(70.64±3.19)分、(71.56±3.08)分、(73.55±3.69)分],CD_(8)^(+)[(28.72±1.87)%]低于对照组[(32.25±2.43)%],有统计学差异(P<0.05)。结论 PDT联合手术治疗BCC可改善患者细胞免疫功能,加快伤口愈合,提高美容效果与生活质量,且并发症较少,安全可行,值得临床大力推广。