Background Actinic keratosis is the most prevalent premalignant skin disorder in the white population. Current guidelines provide no clear recommendations about preferred treatments. Methods The parameters;effectivene...Background Actinic keratosis is the most prevalent premalignant skin disorder in the white population. Current guidelines provide no clear recommendations about preferred treatments. Methods The parameters;effectiveness, treatment duration, recurrence, side effects and cost of treatment were investigated for three frequently used topical therapies which were then compared with a most recent developed topical therapy. Published clinical data obtained from the literature was used to compare these parameters for 5-fluorouracil, imiquimod and diclofenac and relate them with the newly developed Curaderm. Results A wide variation in the concentrations of the active anti-keratotic ingredients, application frequency, duration of treatment, recurrence rates and cost of treatment exist between the different topical therapies. The efficacy rates and side effects were less variable. Overall, Curaderm is the most suitable treatment for actinic keratosis. Clinical evidence is presented illustrating the effects of Curaderm on field-directed treatments and solitary treatments of actinic keratoses. Conclusions Current medical guidelines do not provide clear recommendations on which treatment approach for actinic keratosis is preferred. Direct head-to-head comparison between treatments with emphasis on efficacy, safety, treatment duration, compliance, convenience, cosmetic outcome, patient acceptance and cost should be available to the patient, the practising physician, healthcare system and should assist in therapeutic treatment guidelines and policymaking. Given the very favourable profiles of these parameters with Curaderm when compared with other home-based treatments, it should be considered that Curaderm is first-in-line.展开更多
While actinic keratoses(AKs) have been considered precancerous until recently for being able to turn into squamous cell carcinomas(SCCs), it is now agreed that it would be more appropriate to call them cancerous. Alth...While actinic keratoses(AKs) have been considered precancerous until recently for being able to turn into squamous cell carcinomas(SCCs), it is now agreed that it would be more appropriate to call them cancerous. Although not all AKs turn into SCC and some of them may even have a spontaneous regression, there is an obvious association between SCC and AK. Approximately 90% of SCs have been reported to develop from AKs and AKs are the preinvasive form of SCCs. The presence of two or more AKs on a photodamaged skin is an indicator of field cancerization and represents an increased risk of invasive SCC. All lesions should be treated since it cannot be foreseen which of the lesions will regress and which will progress to SCC. AK can be a single lesion or it can involve multiple lesions in a field of cancerization; thus, AK treatment is grouped under two headings:(1) Lesion-specific treatment; and (2) Field-targeted treatment. Lesion-specific treatments are practicable in patients with a small number of clinically visible and isolated lesions. These treatments including cryotherapy, surgical excision, shave excision, curettage and laser are based on physical destruction of the visible lesions. Field-targeted treatments are effective in the treatment of visible lesions, subclinical lesions and keratinocyte changes in the areas surrounding the visible lesions. Field targeted treatment options are topical imiquimod cream, 5% 5-fluorouracil cream, ingenol mebutate, diclofenac gel, resimiquimod and photodynamic therapy.展开更多
Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon....Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon.Here,we present a case of MCC that occurred based on widespread actinic keratosis(AK)in a Chinese female.Case report:An 82-year-old woman presented with two rapidly enlarging and rupture lesions on the face for 1 year.Biopsy was suggestive of squamous cell carcinoma(SCC)on the forehead and MCC on the left cheek.The patient had a history of generalized AK for 3 years.The lesion on the left cheek was also revealed as an AK by histopathological examination 1 year ago.Complete surgical resection was performed to remove the two malignancies.Discussion:The co-occurrence of AK,SCC,and MCC in a Chinese woman is unusual.Immunohistopathological examination is vital for correct diagnosis.The three tumors,in this case,may originate from two different precursor cells and are affected by the same carcinogen.Alternatively,they may come from the same pluripotent epidermal stem cells,and chronic exposure to ultraviolet light and Merkel cell polyomavirus lead to the formation of different types of tumors.The coexist of MCC with other cutaneous tumors provided a train of thought for exploring the origin of MCC.Conclusion:We reported a rare co-existence phenomenon of MCC associated with AK and SCC.Hence,long-term follow-up and early treatment are imperative for patients with premalignant lesions,such as widespread AK.展开更多
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-inv...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.展开更多
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 ann...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.展开更多
Objective:The aim of the study was to compare the effects of photodynamic therapy(PDT) with δ-aminolevulinic acid(ALA) for patients with different kinds of skin cancers and pre-cancers.Methods:The present study enrol...Objective:The aim of the study was to compare the effects of photodynamic therapy(PDT) with δ-aminolevulinic acid(ALA) for patients with different kinds of skin cancers and pre-cancers.Methods:The present study enrolled seventyfive cases,which included 17 cases of actinic keratosis(AK),9 cases of Bowen's disease,11 cases of superficial basal cell carcinomas(BCC),23 cases of nodule basal cell carcinomas and 15 cases of squamous cell carcinomas(SCC),and every patient had single lesion.All patients were treated with 20% ALA topically and He-Ne laser weekly for three times,and followed up 1-3 years.Results:After therapy,the rates of complete reaction(CR) were 100% in AK lesions,77.8% in Bowen's diseases,90.9% in superficial BCCs,47.8% in nodule BCCs,and 50.3% in SCCs,which had significant differences among these five kinds of lesions(H = 18.27,P < 0.05).The therapeutic effectiveness of ALA-PDT for AK was superior to that of Bowen's disease(Q = 4.364,P < 0.05),superficial BCC(Q = 5.55,P < 0.01),SCC(Q = 8.94,P < 0.01) and nodule BCC(Q = 17.91,P < 0.01);the effect of Bowen's disease was better than that of SCC(Q = 7.8,P < 0.01),nodule BCC(Q = 13.44,P < 0.01);the effect of superficial BCC was better than that of SCC(Q = 9.73,P < 0.01),nodule BCC(Q = 16.28,P < 0.01),but similar with Bowen's disease(Q = 0.96,P > 0.05);the effect of SCC was better than that of nodule BCC(Q = 17.74,P < 0.01).Conclusion:Our study shows that therapeutic effectiveness of ALA-PDT for AK is best in five diseases,and Bowen's disease and superficial BCC are secondary,while nodule BCC and SCC are at the bottom.展开更多
文摘Background Actinic keratosis is the most prevalent premalignant skin disorder in the white population. Current guidelines provide no clear recommendations about preferred treatments. Methods The parameters;effectiveness, treatment duration, recurrence, side effects and cost of treatment were investigated for three frequently used topical therapies which were then compared with a most recent developed topical therapy. Published clinical data obtained from the literature was used to compare these parameters for 5-fluorouracil, imiquimod and diclofenac and relate them with the newly developed Curaderm. Results A wide variation in the concentrations of the active anti-keratotic ingredients, application frequency, duration of treatment, recurrence rates and cost of treatment exist between the different topical therapies. The efficacy rates and side effects were less variable. Overall, Curaderm is the most suitable treatment for actinic keratosis. Clinical evidence is presented illustrating the effects of Curaderm on field-directed treatments and solitary treatments of actinic keratoses. Conclusions Current medical guidelines do not provide clear recommendations on which treatment approach for actinic keratosis is preferred. Direct head-to-head comparison between treatments with emphasis on efficacy, safety, treatment duration, compliance, convenience, cosmetic outcome, patient acceptance and cost should be available to the patient, the practising physician, healthcare system and should assist in therapeutic treatment guidelines and policymaking. Given the very favourable profiles of these parameters with Curaderm when compared with other home-based treatments, it should be considered that Curaderm is first-in-line.
文摘While actinic keratoses(AKs) have been considered precancerous until recently for being able to turn into squamous cell carcinomas(SCCs), it is now agreed that it would be more appropriate to call them cancerous. Although not all AKs turn into SCC and some of them may even have a spontaneous regression, there is an obvious association between SCC and AK. Approximately 90% of SCs have been reported to develop from AKs and AKs are the preinvasive form of SCCs. The presence of two or more AKs on a photodamaged skin is an indicator of field cancerization and represents an increased risk of invasive SCC. All lesions should be treated since it cannot be foreseen which of the lesions will regress and which will progress to SCC. AK can be a single lesion or it can involve multiple lesions in a field of cancerization; thus, AK treatment is grouped under two headings:(1) Lesion-specific treatment; and (2) Field-targeted treatment. Lesion-specific treatments are practicable in patients with a small number of clinically visible and isolated lesions. These treatments including cryotherapy, surgical excision, shave excision, curettage and laser are based on physical destruction of the visible lesions. Field-targeted treatments are effective in the treatment of visible lesions, subclinical lesions and keratinocyte changes in the areas surrounding the visible lesions. Field targeted treatment options are topical imiquimod cream, 5% 5-fluorouracil cream, ingenol mebutate, diclofenac gel, resimiquimod and photodynamic therapy.
文摘Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon.Here,we present a case of MCC that occurred based on widespread actinic keratosis(AK)in a Chinese female.Case report:An 82-year-old woman presented with two rapidly enlarging and rupture lesions on the face for 1 year.Biopsy was suggestive of squamous cell carcinoma(SCC)on the forehead and MCC on the left cheek.The patient had a history of generalized AK for 3 years.The lesion on the left cheek was also revealed as an AK by histopathological examination 1 year ago.Complete surgical resection was performed to remove the two malignancies.Discussion:The co-occurrence of AK,SCC,and MCC in a Chinese woman is unusual.Immunohistopathological examination is vital for correct diagnosis.The three tumors,in this case,may originate from two different precursor cells and are affected by the same carcinogen.Alternatively,they may come from the same pluripotent epidermal stem cells,and chronic exposure to ultraviolet light and Merkel cell polyomavirus lead to the formation of different types of tumors.The coexist of MCC with other cutaneous tumors provided a train of thought for exploring the origin of MCC.Conclusion:We reported a rare co-existence phenomenon of MCC associated with AK and SCC.Hence,long-term follow-up and early treatment are imperative for patients with premalignant lesions,such as widespread AK.
文摘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.
文摘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.
文摘Objective:The aim of the study was to compare the effects of photodynamic therapy(PDT) with δ-aminolevulinic acid(ALA) for patients with different kinds of skin cancers and pre-cancers.Methods:The present study enrolled seventyfive cases,which included 17 cases of actinic keratosis(AK),9 cases of Bowen's disease,11 cases of superficial basal cell carcinomas(BCC),23 cases of nodule basal cell carcinomas and 15 cases of squamous cell carcinomas(SCC),and every patient had single lesion.All patients were treated with 20% ALA topically and He-Ne laser weekly for three times,and followed up 1-3 years.Results:After therapy,the rates of complete reaction(CR) were 100% in AK lesions,77.8% in Bowen's diseases,90.9% in superficial BCCs,47.8% in nodule BCCs,and 50.3% in SCCs,which had significant differences among these five kinds of lesions(H = 18.27,P < 0.05).The therapeutic effectiveness of ALA-PDT for AK was superior to that of Bowen's disease(Q = 4.364,P < 0.05),superficial BCC(Q = 5.55,P < 0.01),SCC(Q = 8.94,P < 0.01) and nodule BCC(Q = 17.91,P < 0.01);the effect of Bowen's disease was better than that of SCC(Q = 7.8,P < 0.01),nodule BCC(Q = 13.44,P < 0.01);the effect of superficial BCC was better than that of SCC(Q = 9.73,P < 0.01),nodule BCC(Q = 16.28,P < 0.01),but similar with Bowen's disease(Q = 0.96,P > 0.05);the effect of SCC was better than that of nodule BCC(Q = 17.74,P < 0.01).Conclusion:Our study shows that therapeutic effectiveness of ALA-PDT for AK is best in five diseases,and Bowen's disease and superficial BCC are secondary,while nodule BCC and SCC are at the bottom.