Results of Carbon Ion Radiotherapy for Skin Carcinomas in 33 Patients

Purpose: To evaluate outcome and toxicity after carbon ion radiotherapy (RT) in skin carcinomas. Patients and Methods: Between November 2006 to September 2008,

Squamous cell carcinoma of the skin: Emerging need for novel biomarkers

The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous cell carcinoma(cSCC).Important risk factors for the development and progression of cSCC include ultraviolet radiation,chronic skin ulcers and immunosuppression.Due to the role of cumulative long-term sun exposure,cSCC is usually a disease of the elderly,but the incidence is also growing in younger individuals due to increased recreational exposure to sunlight.Although clinical diagnosis of cSCC is usually easy and treatment with surgical excision curable,it is responsible for the majority of NMSC related deaths.Clinicians treating skin cancer patients are aware that certain cSCCs grow rapidly and metastasize,but the underlying molecular mechanisms responsible for the aggressive progression of a subpopulation of cSCCs remain incompletely understood.Recently,new molecular markers for progresprogression of cSCC have been identified.

Meis1 Is Required for c-Met Inhibition to Suppress Cell Proliferation of Skin Squamous Cell Carcinoma Cells

Previous studies have shown that Meis1 plays an important role in the pathogenesis of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Meis1 belongs to the TALE family, the members of which are used as biomarkers for AML. Meis1 has been shown to play a functional role in epithelial tissues, such as skin. However, its functions in skin carcinogenesis remain poorly understood. On the other hand, the c-Met inhibitor SU11274 has been identified through drug screening with HOXA9/Meis1-induced AML cell lines. SU11274 altered cell proliferation and the cell cycle status in human AML cell lines. Thus, we hypothesized that the effects of SU11274 are dependent on Meis1 and that its knockdown may diminish the effects of SU11274 not only in AML cell lines, but also in skin cancer cell lines. In order to test our hypothesis, we established Meis1 knockdown cell lines using two skin squamous cell carcinoma cell lines (B9 and D3) and treated these cell lines with SU11274. The results obtained showed that SU11274 suppressed cell proliferation by modulating cell cycle progression in the presence of Meis1, but not in its absence. Furthermore, an expression analysis showed that SU11274 activated the transcription of Meis1, which led to the transcription of Hif1α and Cdkn2a (p16Ink4a and p19Arf). These results suggest that Meis1 is required for the c-Met inhibitor SU11274 to suppress the proliferation of the skin squamous cell carcinoma cell lines.

Skin Nodules as a First Presentation of Metastatic Invasive Lobular Carcinoma: Case Presentation

Primary breast carcinoma is the most common cause of cutaneous metastases in adult females, comprising about one fourth of patients with the disease. Although CM usually manifests as a late event in the course of a known neoplasm, they are rarely the presenting sign of an undiagnosed malignancy. Invasive Lobular carcinoma is known to be more likely to spread to unusual sites.

Scrotal Skin Metastases of Renal Cell Carcinoma: A Case Report

Cutaneous metastasis from renal cell carcinoma is believed to be rare. We present a 66-year-old man operated for kidney cancer 20 years ago and has consulted for a scrotal lesion that had started 20 days. The physical examination revealed an erythematous lesion. A biopsy of the scrotal skin was made. We found a scrotal metastasis of renal cell carcinoma.

Advances in Etiology and Treatment of Cutaneous Squamous Cell Carcinoma

Cutaneous Squamous Cell Carcinoma (CSCC) is a common skin malignancy with increasing incidence year by year and is the leading cause of death in patients with skin tumors other than melanoma. The pathogenesis of Cutaneous Squamous Cell Carcinoma has not yet been clarified, limiting the development of related molecular targeted therapies. Surgical resection, radiotherapy, photodynamic therapy and gene therapy can be selected according to the site of disease and histological differentiation. This article reviews the research on the etiology, pathogenesis and treatment of squamous cell carcinoma in recent years.

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.

Multikinase inhibitor-associated hand-foot skin reaction as a predictor of outcomes in patients with hepatocellular carcinoma treated with sorafenib

AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.

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.

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.

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”.

Recurrent and Invasive Primary Squamous Cell Carcinoma of the Chest Wall: A Case Report

Squamous cell carcinoma is a type of skin cancer with abnormal proliferation of keratinocytes. Its incidence reaches approximately 20% of cases of non-melanoma skin cancer, which has increased in recent decades due to growth in life expectancy, increased sun exposure, the use of tanning beds and improved detection of this type of tumors. We present a patient who was diagnosed with a squamous cell skin carcinoma in the chest wall, treated initially with surgical resection. A few years recurred in the same place, so the patient received radiotherapy with poor response. Ultimately a new surgical approach was performed with a wide margin resection by a multidisciplinary surgical team. Multidisciplinary management in this type of procedure is important so that the long-term result is optimal for the patient.

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.

Sentinel Node in Cutaneous Squamous Cell Carcinoma of the Trunk and Extremities: Experience in a Latin American Reference Center

This paper aims to assess the use of the sentinel node technique in squamous cell carcinoma (SCC) of the trunk and extremities in a Latin American oncology reference center. The descriptive retrospective cohort study included 60 patients diagnosed with SCC of the trunk and extremities, submitted to surgical treatment of the primary tumor and sentinel node biopsy at the breast and soft tissue tumor services of the National Institute of Cancerology (Bogotá, Colombia) over a period of 6 years. The sentinel node was identified in 96.6% (58/60) of the patients. The sentinel node pathology report was negative in 81.7% (49), positive in 15% (9). There were no complications due to the procedure in 85% of the patients. The mean recurrence-free survival time was 8.3 months (CI 95% 5.0 to 11.5 months) in patients with positive sentinel node and 58.6 months (CI 95% 47.8 to 69.3 months) in patients with negative results. Only 4 of 49 patients (8.1%) with negative sentinel node had regional relapse. The study evidenced that the sentinel node technique in patients with high-risk SCC of the trunk and extremities is an adequate staging tool for the lymph node chain, with a low rate of associated complications. This opens an interesting opportunity for prospective cohort studies that can demonstrate statistically significant differences.

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.

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.

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。

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.

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。