Home About us Contact | |||
Skin Cancers (skin + cancers)
Kinds of Skin Cancers Selected AbstractsSentinel Lymph Node Biopsy for High-Risk Nonmelanoma Skin CancersDERMATOLOGIC SURGERY, Issue 7 2007RACHEL E. SAHN BACKGROUND Although the utility of the sentinel lymph node biopsy (SLNB) in the staging of melanoma is well established, its usefulness in high-risk nonmelanoma skin cancer (NMSC) is yet to be determined. OBJECTIVE The objective was to report our experience with patients who underwent SLNB for the staging of a high-risk NMSC. MATERIALS AND METHODS We identified 13 patients with a high-risk NMSC who underwent SLNB between 1998 and 2006 and conducted a retrospective review of their medical records and tumor pathology. Their status as regards tumor recurrence and survival was obtained when possible. RESULTS Of 13 patients, 9 had squamous cell carcinoma (SCC), 2 had sebaceous gland carcinoma, 1 had porocarcinoma, and 1 had atypical fibroxanthoma. All SLNB were negative for metastatic disease, but 1 appeared to be a false-negative finding. CONCLUSION Compared to melanoma, SCC of the skin are much less predictable as regards their tendency to metastasize to the regional lymph nodes. Although the SLNB appears to be a reliable staging procedure for NMSC (especially SCC), the yield may be too low to justify its routine use in this patient population. More data are needed to determine when a SLNB is justified in the management of NMSC. [source] Curettage prior to Mohs' Micrographic Surgery for Previously Biopsied Nonmelanoma Skin Cancers: What Are We Curetting?DERMATOLOGIC SURGERY, Issue 1 2005Comparative Study, Prospective, Retrospective Background Curettage prior to excision and Mohs' micrographic surgery for nonmelanoma skin cancer is performed based on the assumption that the curette will remove softer, more friable tumor-infiltrated dermis and leave structurally intact normal skin. This assumption, however, has not been objectively examined in the dermatologic surgery literature. Objective We performed a study to examine the ability of curettage to selectively remove and delineate nonmelanoma skin cancer prior to Mohs' micrographic surgery. Methods The study included 150 previously biopsied basal cell and squamous cell carcinomas less than 1.5 cm in size. We conducted (1) a retrospective study of 50 tumors curetted prior to Mohs' surgery by a surgeon who routinely curettes preoperatively; (2) a prospective study in which a surgeon who routinely does not curette preoperatively curetted 50 tumors prior to Mohs' surgery; and (3) a comparative historical group of 50 noncuretted tumors treated with Mohs' surgery by the latter surgeon. All curetted tissue was evaluated histologically. Results Only 50% of the curetted tissue demonstrated the presence of tumor in the curettings, but in 76% of these, the curette left residual tumor at the surgical margins. Of the other 50% in which the curette removed only non,cancer-containing skin, 34% had tumor present at the surgical margin. Overall, the curette removed tumor, leaving no residual tumor at the surgical margins in only 12% of lesions. Comparison with historical noncuretted tumors operated on by the same surgeon showed that curettage did not affect the mean number of stages or the proportion of tumors requiring more than one stage for histologic clearance. Conclusion Although curettage may be helpful in debulking friable skin prior to Mohs' micrographic surgery, it does not reliably delineate the extent of a tumor. MING H. JIH, MD, PHD, PAUL M. FRIEDMAN, MD, LEONARD H. GOLDBERG, MD, AND ARASH KIMYAI-ASADI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Rhinophyma and Coexisting Occult Skin CancersDERMATOLOGIC SURGERY, Issue 2 2001Michael E. Lutz MD Background. Although coexistent tumors have been reported in patients with rhinophyma, few reports have described the coexistence of rhinophyma and an occult infiltrating squamous cell carcinoma (SCC). Objective. Preoperatively and during rhinophymaplasty, recognition of subtle changes can suggest an underlying malignancy. Methods. A large infiltrating SCC was noted during electrosurgical rhinophymaplasty. Mohs micrographic surgery was performed to clear the tumor. Results. The patient was tumor-free with no evidence of recurrence at 1-year follow-up. Conclusion. In the evaluation of changing rhinophyma or subtle changes in tissue noted during rhinophymaplasty, physicians must consider the possibility of an underlying malignancy. [source] Cyclooxygenase-2 Expression in Murine and Human Nonmelanoma Skin Cancers: Implications for Therapeutic Approaches,PHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 1 2002Kathy P. An ABSTRACT Inflammatory stimuli result in the production of cutaneous eicosanoids, which are known to contribute to the process of tumor promotion. Cyclooxygenase (COX), the rate-limiting enzyme for the production of prostaglandins (PG) from arachidonic acid, exists in at least two isoforms, COX-1 and COX-2. COX-1 is constitutively expressed in most tissues and plays various physiological roles, whereas increased COX-2 expression is known to occur in several types of epithelial neoplasms. Enhanced PG synthesis is a potential contributing factor in UVB-induced nonmelanoma skin cancers (NMSC). Increased COX-2 staining occurs in murine skin neoplasms after chronic exposure to carcinogenic doses of UVB. In this study, immunohistochemical and Western blot analyses were employed to assess longitudinally COX-2 expression in a standard mouse UVB complete carcinogenesis protocol and in human basal cell carcinomas (BCC) and squamous cell carcinomas (SCC). During UVB irradiation of mice, COX-2 expression consistently increased in the hyperplastic skin, the benign papillomas and the SCC. COX-2 expression was also increased in human actinic keratoses, SCC and BCC as well as in murine SCC and BCC. The pattern of COX-2 expression was quite variable, occurring in a patchy distribution in some lesions with staining confined mainly to suprabasal cell layers. In general, COX-2 expression progressively became more extensive in benign papillomas and well-differentiated murine SCC. The staining was predominantly cytoplasmic and perinuclear in some focal areas in tissue stroma around both murine and human tumors. Western blot analysis confirmed negative COX-2 expression in normal skin, whereas acute UVB exposure resulted in increased enzyme expression, which continued to increase in developing papillomas and SCC. Because of the evidence indicating a pathogenic role for eicosanoids in murine and human skin neoplasms, we performed studies to assess the anti-inflammatory and anticarcinogenic effects of green tea extracts, which are potent antioxidants. Acute exposure of the human skin to UVB (minimum erythema dose × 4) caused a transient enhancement of the COX-2 expression, which reverted to baseline within hours; however, in murine skin the expression persisted for several days. Pretreatment with the topically applied green tea extract (1 mg/cm2) largely abrogated the acute COX-2 response to UVB in mice or humans. In summary, enhanced COX-2 expression serves as a marker of epidermal UVB exposure for murine and human NMSC. These results suggest that COX-2 inhibitors could have potent anticarcinogenic effects in UVB-induced skin cancer. [source] No Evidence for Microsatellite Instability in Immunodeficiency-Related Skin CancersAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2010C. Borie No abstract is available for this article. [source] Melanoma Patients: Follow-Up Exams Improve Surival of Second Skin CancersCA: A CANCER JOURNAL FOR CLINICIANS, Issue 4 2001Article first published online: 31 DEC 200 No abstract is available for this article. [source] Malignancy after Heart Transplantation: Analysis of 24-Year Experience at a Single CenterJOURNAL OF CARDIAC SURGERY, Issue 5 2009Tahir Yagdi M.D. The incidence, spectrum, risk factors, and clinical impact of posttransplant malignancy were investigated in a cohort of patients with long-term follow-up at a single center. Methods: Data for 835 patients who underwent heart transplantation between 1979 and 2002 and survived beyond one month were retrospectively evaluated for posttransplant skin cancer, solid organ tumors, and lymphoma. Results: One hundred thirty-nine malignancies developed in 126 patients (15.1%). Skin cancer, solid organ tumors, and lymphoma represented 49%, 27%, and 24% of the malignancies, respectively. Mean patient age at transplantation for patients developing skin cancer, solid organ tumor, and lymphoma were 50 years, 51 years, and 46 years, respectively (p = 0.024). Risk factors for skin cancer were: age greater than 40 at transplantation, number of treated rejection episodes in the first year after transplantation, and smoking history. Variables associated with solid organ malignancy development were age and smoking history. There was no variable related to the development of posttransplant lymphoma. Median survival after diagnosis of skin cancer, solid organ tumor, and lymphoma were 5.0 years, 0.3 years, and 0.7 years, respectively (p < 0.001). Conclusions: Posttransplant malignancies have different risk factors and variable clinical impact. Older age at transplantation, smoking history, and more episodes of treated rejection were related to increased incidence of nonlymphoid malignancy incidence after heart transplantation, whereas no variable was associated with lymphoid malignancy. Skin cancers have a benign course, while solid organ malignancies and lymphomas carry an unfavorable prognosis. [source] Matrix metalloproteinase-26 is present more frequently in squamous cell carcinomas of immunosuppressed compared with immunocompetent patientsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2009Tiina Kuivanen Background: Skin cancers are the most frequent malignancies in organ transplant recipients (OTRs). Squamous cell carcinomas (SCCs) occur 65,250 times more frequently in OTRs and tend to be aggressive in behavior. Because matrix metalloproteinases (MMPs) have a central role in tumorigenesis and invasion, we investigated the epithelial and stromal MMP and tissue inhibitor of MMP (TIMP) expression profile in SCCs of immunosuppressed (IS) compared with immunocompetent (IC) patients to determine if differences could explain the more aggressive behavior of SCCs in OTRs. Methods: Matched pairs from 20 SCCs of IS and IC patients were studied using immunohistochemistry for MMP-1, MMP-7, MMP-8, MMP-9, MMP-13 and MMP-26 and TIMP-1 and TIMP-3. Results: Among all MMPs studied, only staining for MMP-26 was significantly more intense in cancer cells of the post-transplant group compared with the IC group (p = 0.01), whereas MMP-9 expression was more abundant in stromal macrophages surrounding SCCs of IC patients (p = 0.02). MMP-26 expression in cancer cells (p = 0.04) and that of MMP-9 in neutrophils (p = 0.005) were more abundant in SCCs of patients using cyclosporine. Conclusions: We conclude that MMP-26 and MMP-9 may contribute to the more aggressive behavior of SCCs in OTRs. [source] Skin Cancer in Organ Transplant Recipients,Where Do We Stand Today?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2008C. Ulrich Skin cancers are the most frequent malignancies in organ transplant recipients (OTR), with 95% being nonmelanoma skin cancers (NMSC), especially squamous (SCC) and basal cell carcinomas. Most OTR with a first SCC subsequently develop multiple NMSC within 5 years, highlighting the concept of ,field cancerization', and are also at high risk for noncutaneous cancers. In order to reduce the tumor burden in these patients, their management requires an interdisciplinary approach including revision of immunosuppression, new dermatological treatments and adequate education about photoprotection in specialized dermatology clinics for OTR. Whereas surgery remains the gold-standard therapy for NMSC, noninvasive methods have shown promising results to treat superficial keratoses and subclinical lesions on large body areas. Although the threshold of skin cancer necessitating revision of immunosuppression is debated, this measure should be envisaged at the occurrence of the first SCC, or in case of multiple non-SCC NMSC. While the role of immunosuppressants in the occurrence of NMSC is widely recognized, the best immunosuppressive strategies remain to be defined. Presently, randomized prospective studies assess the burden of new skin tumors, as well as graft and patient survival, in patients with one or several NMSC after the introduction of mTOR (mammalian target of rapamycin) inhibitors. [source] Contribution of Dermatologic Surgery in WarDERMATOLOGIC SURGERY, Issue 1 2010MAJOR J. SCOTT HENNING DO BACKGROUND Despite the large contribution by dermatology to military readiness, there have been no published reports regarding dermatologic surgery or skin cancer in the combat environment. OBJECTIVE To outline the contribution of dermatologic surgery, including skin cancer and benign tumors, to deployed service men and women in Operation Iraqi Freedom. METHODS A retrospective chart review was performed of all dermatology visits at the 86th Combat Support Hospital, Ibn Sina, Iraq, between January 15, 2008 and July 15, 2008. RESULTS Two thousand six hundred ninety-six patients were seen in the combat dermatology clinic during the 6-month period reviewed; 8% (205/2,696) of the total visits were for skin cancer, and another 129 patients were treated for actinic keratosis. The specific diagnoses were basal cell carcinoma (n=70), in situ and invasive squamous cell carcinoma (n=68), mycosis fungoides (n=1), bowenoid papulosis (n=1), and in situ and invasive melanoma (n=9). Benign lesions and tumors accounted for 14% (357/2,696) of total patient visits. Three hundred seven surgeries were performed during the 6-month period (178 skin cancers and 129 benign lesions), and 20 patients were referred for Mohs micrographic surgery. The surgical complications included five postoperative wound infections (1 methicillin-resistant Staphylococcus aureus), one wound dehiscence, and seven allergic contact dermatitis. CONCLUSIONS To the authors' knowledge, this is the first publication regarding skin cancer and dermatologic surgery in the combat setting. This report outlines the important contribution of dermatologic surgery in the combat environment. The authors have indicated no significant interest with commercial supporters. [source] Fractional Cryosurgery for Skin CancerDERMATOLOGIC SURGERY, Issue 11 2009JOSE CARLOS ALMEIDA GONÇALVES MD BACKGROUND Cryosurgical treatment of facial skin cancers 10 mm or larger in diameter can originate retractile scars that may alter physiognomic features. OBJECTIVES To treat skin cancers 10 mm or larger in diameter on the face with a cryosurgical method that prevents retractile scars. Also, to clarify the differences between this method and Zacarian's segmental cryosurgery. METHODS AND MATERIALS Fractional cryosurgery is performed in stages. First, the center of the lesion is frozen, reducing its size, then this procedure is repeated as necessary until the tumor diameter is smaller than 10 mm, at which point the standard cryosurgical procedure is performed. Eighty-seven basal cell carcinomas (BCCs) and nine squamous cell carcinomas (SCCs) of the face (65 of which were orbital or periocular) measuring between 9 and 45 mm were treated. RESULTS The cure rate of BCCs was related to tumor size. All SCCs were cured without recurrence. Global mean follow-up was 4.5 years. CONCLUSION Fractional cryosurgery does not cause deformity, and the final scar has no relation to the mass of the original tumor but instead corresponds to the size of the lesion preceding the last cryosurgical procedure. [source] Mohs Micrographic Surgery: How ACMS Fellowship Directors PracticeDERMATOLOGIC SURGERY, Issue 5 2009ANGELA S. CASEY MD BACKGROUND Mohs micrographic surgery (MMS) is widely employed in the removal of skin cancer. As this technique becomes more widely employed, it is useful to establish the patterns of care provided by American College of Mohs Surgery (ACMS),approved fellowship directors. OBJECTIVE To compile and analyze data collected annually by the ACMS to determine practice patterns and trends in MMS as performed by ACMS-approved fellowship directors. MATERIALS AND METHODS A retrospective study of case logs from 50 fellowship directors obtained from the ACMS detailing case volume, type of cancer treated, location, lesion size, wound size, number of stages, referral percentage, and type of repairs performed. RESULTS Annual case volume per surgeon has increased linearly. The incidence of squamous cell carcinoma treated using MMS is rising steadily. The size of lesions treated using MMS has decreased slightly over several decades, as has the number of stages of MMS taken per lesion. The majority of MMS performed by fellowship directors is for skin cancer on the face. Dermatologic surgeons perform most of their own reconstructions. Academic and private fellowship practice patterns are nearly identical. CONCLUSIONS ACMS-approved fellowship directors use MMS mainly for facial skin cancers, and they perform most of their own reconstructions. Practice patterns for most fellowship directors are similar. Private fellowships and academic fellowships are similar in scope and practice. [source] Multiple Primary Acral Melanomas in African-Americans: A Case Series and Review of the LiteratureDERMATOLOGIC SURGERY, Issue 1 2007ANGELA C. S. HUTCHESON MD BACKGROUND Although melanoma accounts for only 4% to 5% of all skin cancers in the United States, it causes most skin cancer,related deaths. We describe a unique group of African-American patients with multiple primary acral lentiginous melanomas (ALMs). OBJECTIVE The purpose of this study was to review the case histories and management of a cohort of patients in the Mohs practice of our dermatologic surgeon with multiple primary ALM. METHODS This is a case series of patients with multiple ALM identified by chart review from 2000 to 2005. A thorough review of the literature was performed. RESULTS Four patients, all African-American, were identified with multiple ALM. All patients were managed with excision or Mohs micrographic surgery utilizing permanent sections. None of the patients with ALM had melanomas at nonacral sites or other types of skin cancer. Several had acral melanosis. Information in the literature on patients with multiple primary acral melanomas was insufficient. CONCLUSION Patients with multiple acral melanomas have not, to our knowledge, been reported thus far. It can be extrapolated from current literature, however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any. [source] Squamous Cell Carcinoma of the Lower Lip: Exact Location Match in SiblingsDERMATOLOGIC SURGERY, Issue 12 2005Dogan Tuncali MD Background. In recent years, genetic contribution to the development of skin cancers is under the magnifying glass of several authors and is now regarded as the main initial etiology in carcinogenesis. Objective. Two siblings who had squamous cell carcinoma of the lower lip showing an exact location match are presented. Patients. They did not share common environmental factors, and there was no history of tobacco and/or alcohol abuse. Conclusions. It would be scientifically deceptive to draw generous conclusions for the cases here, other than being a very interesting and unusual coincidence, because further evaluation could not be done to scientifically prove a possible genetic contribution. DOGAN TUNCALI, MD, NURTEN YAVUZ, MD, AHMET TERZIOGLU, MD, AND GÜRCAN ASLAN, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Why Are There Differences in the Perceived Safety of Office-Based Surgery?DERMATOLOGIC SURGERY, Issue 11 2004John G. Hancox MD Background. Office-based surgery has become an important method of health-care delivery, but there is controversy about its safety and which practitioners should perform it. Several states have already or are preparing to enact legislation regulating office-based surgery. Objective. The objective was to discuss recent literature pertaining to the safety of office surgery and to discuss reasons why there are perceived differences in its safety. Methods. The pertinent literature is reviewed. Results. The majority of studies suggest that office surgery is safe. A recent study that found to the contrary may have methodologic flaws. Conclusion. The medical and legislative community should seek to scientifically examine office surgery. Overregulation or loss of office surgery would have a tremendous impact on the management of skin cancers and the delivery of quality cosmetic and laser surgery. [source] Cold Air Analgesia in Photodynamic Therapy of Basal Cell Carcinomas and Bowen's Disease: An Effective Addition to Treatment: A Pilot StudyDERMATOLOGIC SURGERY, Issue 1 2004FACD, John Pagliaro MB Background. There is considerable interpatient variability in pain tolerance during and after treatment of skin cancer with photodynamic therapy (PDT). Additionally, erythema and edema are common, with mild crusting and healing over 1 to 2 weeks. Objective. To determine whether concurrent cold air analgesia improves the tolerability of PDT. Method. Twenty-six patients with two similar superficial skin cancers were treated with PDT. One lesion was treated with cold air analgesia and the other without. Patients rated their pain during treatment using the Wong Baker Faces Pain Scale and detailed duration of posttreatment pain. At week 2, the inflammatory response was assessed. Result. A statistically significant difference in the analgesia group was shown with respect to the mean duration of pain and the level of erythema after the first treatment as well as pain scores during the second treatment. Conclusion. Patient acceptance of PDT for treatment of nonmelanoma skin cancer is improved with lessened morbidity assessed with concurrent use of cold air analgesia to the treatment field. [source] An Alternate Approach for Harvesting Mohs Specimens with a Flexible ScalpelDERMATOLOGIC SURGERY, Issue 10 2001Andrew T. Jaffe MD Background. Mohs micrographic surgery is a highly successful technique for removing skin cancers while conserving normal tissue. However, conservation of the deep margins can often be difficult to achieve when using a standard scalpel. An inability to conserve normal tissue at the deep margins can greatly impact the complexity of repair, duration of surgery, aesthetic result, and patient morbidity. Objective. To find an alternative method of obtaining Mohs specimens that offers greater control of the depth of incision when compared to the standard scalpel. Methods. We utilized a flexible scalpel to obtain Mohs levels on patients with superficial cutaneous malignancies in anatomic locations where careful conservation of the deep margins would allow for less extensive repair. Results. For those patients who had tumor-free margins after one level of Mohs surgery, the shallower defects achieved with the flexible scalpel allowed for excellent cosmetic outcomes and decreased patient operative time and morbidity. Conclusion. The flexible scalpel is both effective and efficient in obtaining thin Mohs specimens when conservation of the deep margin is of utmost importance. [source] Contribution of genetic factors for melanoma susceptibility in sporadic US melanoma patientsEXPERIMENTAL DERMATOLOGY, Issue 5 2009M. Laurin Council To examine the contribution of rare and common variation within known MM genes in sporadic US MM patients, coding regions of known MM susceptibility genes [cyclin-dependent kinase inhibitor 2A (CDKN2A), cyclin-dependent kinase 4, melanocortin 1 receptor (MC1R) and tyrosinase (TYR)] were resequenced in 109,135 MM cases. The significance of variants was examined by comparing their frequencies in 390 cancer-free controls. Potential deleterious mutations in CDKN2A were found in two patients and two others had variants of unknown significance. Cases were more likely than controls to harbour the MC1R,R' variants known or predicted to alter its function (P = 0.002), particularly the R160W variant (P = 0.0035). The associated TYR R402Q variant (rs1126809*A) was found in 29% of cases, similar to what has been described previously. One MM patient with a family history of MM, who had developed other skin cancers, was homozygous for a novel TYR variant (P406L) of unknown significance. Hence, rare variants in TYR may be important risk factors for skin cancer. [source] Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodesHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2007FRANZCR, Michael J. Veness MMed (Clin Epi) Abstract Nonmelanoma skin cancers occur at an epidemic rate in Australia and are increasing in incidence worldwide. In most patients, local treatment is curative. However, a subset of patients will be diagnosed with a high-risk cutaneous squamous cell carcinoma (SCC) and are defined as patients at increased risk of developing metastases to regional lymph nodes. Patients with high-risk SCC may be identified based on primary lesion and patient factors. Most cutaneous SCC arises on the sun-exposed head and neck. The parotid and upper cervical nodes are common sites for the development of metastases arising from ear, anterior scalp, temple/forehead, or scalp SCC. The mortality and morbidity associated with high-risk cutaneous SCC is usually a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Patients with operable nodal disease have traditionally been recommended for surgery. The efficacy of adjuvant radiotherapy has previously been questioned based on weak evidence in the early literature. Recent evidence from larger studies has, however, strengthened the case for adjuvant radiotherapy as a means to improve locoregional control and survival. Despite this, many patients still experience relapse and die. Research aimed at improving outcome such as a randomized trial incorporating the addition of chemotherapy to adjuvant radiotherapy is currently in progress in Australia and New Zealand. Ongoing research also includes the development of a proposed new staging system and investigating the role of molecular factors such as the epidermal growth factor receptor. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] XPC branch-point sequence mutations disrupt U2 snRNP binding, resulting in abnormal pre-mRNA splicing in xeroderma pigmentosum patients,HUMAN MUTATION, Issue 2 2010Sikandar G. Khan Abstract Mutations in two branch-point sequences (BPS) in intron 3 of the XPC DNA repair gene affect pre-mRNA splicing in association with xeroderma pigmentosum (XP) with many skin cancers (XP101TMA) or no skin cancer (XP72TMA), respectively. To investigate the mechanism of these abnormalities we now report that transfection of minigenes with these mutations revealed abnormal XPC pre-mRNA splicing that mimicked pre-mRNA splicing in the patients' cells. DNA oligonucleotide-directed RNase H digestion demonstrated that mutations in these BPS disrupt U2 snRNP,BPS interaction. XP101TMA cells had no detectable XPC protein but XP72TMA had 29% of normal levels. A small amount of XPC protein was detected at sites of localized ultraviolet (UV)-damaged DNA in XP72TMA cells which then recruited other nucleotide excision repair (NER) proteins. In contrast, XP101TMA cells had no detectable recruitment of XPC or other NER proteins. Post-UV survival and photoproduct assays revealed greater reduction in DNA repair in XP101TMA cells than in XP72TMA. Thus mutations in XPC BPS resulted in disruption of U2 snRNP-BPS interaction leading to abnormal pre-mRNA splicing and reduced XPC protein. At the cellular level these changes were associated with features of reduced DNA repair including diminished NER protein recruitment, reduced post-UV survival and impaired photoproduct removal. Hum Mutat 30:1,9, 2009. Published 2009 Wiley-Liss, Inc. [source] Familial clustering of cancer at human papillomavirus-associated sites according to the Swedish Family-Cancer DatabaseINTERNATIONAL JOURNAL OF CANCER, Issue 8 2008Shehnaz K. Hussain Abstract Familial aggregation of cervical cancer has been demonstrated previously, however aggregation of other human papillomavirus-associated anogenital, upper aerodigestive tract and skin cancers has not been fully characterized. The Swedish Family-Cancer Database, which contains reliable data on cancer incidence and nuclear family linkages for all residents of Sweden between 1958 and 2004, was used to calculate standardized incidence ratios (SIR) and 95% confidence intervals for offspring site-specific cancer risks according to site-specific cancer in sibling and parental probands. Offspring cancer risk was significantly increased when either a sibling or parent was affected at the same site for penile squamous cell carcinoma (SCC, SIR = 7.54), cervical adenocarcinoma (AC, SIR = 2.31), vulvar SCC (SIR = 2.27), skin SCC (SIR = 2.14), rectal AC (SIR = 1.86), in situ cervical SCC (SIR = 1.80), invasive cervical SCC (SIR = 1.77) and upper aerodigestive tract SCC (SIR = 1.57). Significant aggregation on the order of 2-fold between anogenital cancers at different sites or histologies was also observed. In situ cervical SCC risk in offspring was strongly influenced by siblings affected with oropharyngeal SCC (SIR = 3.17) and tonsillar SCC (SIR = 1.84). Familial skin SCC was largely unassociated with anogenital or upper aerodigestive tract cancer risk in offspring. These data suggest that common host factors exist among individuals affected with anogenital and upper aerodigestive tract cancers. © 2007 Wiley-Liss, Inc. [source] The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic reviewINTERNATIONAL JOURNAL OF CANCER, Issue 5 2007Article first published online: 27 NOV 200 Abstract Exposure to solar ultraviolet (UV) radiation is a known cause of skin cancer. Sunbed use represents an increasingly frequent source of artificial UV exposure in light-skinned populations. To assess the available evidence of the association between sunbed use and cutaneous malignant melanoma (melanoma) and other skin cancers, a systematic review of the literature till March 2006 on epidemiological and biological studies on sunbed use was performed in Pubmed, ISI Web of Science, Embase, Pascal, Cochrane library, Lilacs and Medcarib. Search for keywords in the title and in the abstract was done systematically and supplemented by manual searches. Only case,control, cohort or cross-sectional studies were selected. Data were abstracted by means of a standardized data-collection protocol. Based on 19 informative studies, ever-use of sunbeds was positively associated with melanoma (summary relative risk, 1.15; 95% CI, 1.00,1.31), although there was no consistent evidence of a dose,response relationship. First exposure to sunbeds before 35 years of age significantly increased the risk of melanoma, based on 7 informative studies (summary relative risk, 1.75; 95% CI, 1.35,2.26). The summary relative risk of 3 studies of squamous cell carcinoma showed an increased risk. For basal cell carcinoma, the studies did not support an association. The evidence does not support a protective effect of the use of sunbeds against damage to the skin from subsequent sun exposure. Young adults should be discouraged from using indoor tanning equipment and restricted access to sunbeds by minors should be strongly considered. © 2006 Wiley-Liss, Inc. [source] Effect of NSAIDs on the recurrence of nonmelanoma skin cancerINTERNATIONAL JOURNAL OF CANCER, Issue 3 2006Maria V. Grau Experimental studies have consistently shown a protective effect of nonsteroidal antiinflammatory drugs (NSAIDs) against nonmelanoma skin cancers (NMSC). However, little human epidemiological research has been done in this regard. We used data from the Skin Cancer Chemoprevention Study to explore the association of NSAID use and with the risk of basal-cell carcinoma (BCC) and squamous-cell carcinoma (SCC). 1,805 subjects with a recent history of NMSC were randomized to placebo or 50 mg of daily ,-carotene. Participants were asked about their use of over-the-counter and prescription medications at baseline and every 4 months during the trial. Skin follow-up examinations were scheduled annually with a study dermatologist; confirmed lesions were the endpoints in the study. We used a risk set approach to the analysis of grouped times survival data and unconditional logistic regression to compute odds ratios [ORs] for various exposures to NSAIDs. The use of NSAIDs was reported in over 50% of questionnaires. For BCC, NSAIDs exhibited a weak protective effect in crude analyses, which attenuated markedly after adjustment. For SCC, the use of NSAIDs in the year previous to diagnosis reduced the odds by almost 30% (adjusted OR= 0.71, 95% CI 0.48,1.04). When we accounted for frequency of use, results for BCC were not striking, and there were inconsistent suggestions of an inverse association with SCC. There were some indications of a modest, nonsignificant reduction on the number of BCCs and SCCs with NSAID use. Our data suggest a weak and inconsistent chemopreventive effect of NSAIDs on BCC and SCC. © 2006 Wiley-Liss, Inc. [source] Skin cancer trends in northern JordanINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2006Abdel K. Omari MD Background, The Jordan Cancer Registry was established in 1996, since which time all cases of cancer have been reported and registered. We have used this registry to perform the first analysis of skin cancer in northern Jordan and to compare our findings with those of published reports from other regions. Methods, All histopathologically proven cases of skin cancer, reported during the years 1997 through 2001, were reviewed. Information regarding tumor type, age, gender, and anatomical location was collected. Results, A total of 272 cases of malignant skin tumors were diagnosed between the years 1997 and 2001. Basal cell carcinoma (BCC) was the commonest type, representing 52.9% of all skin cancers. Females were more frequently affected than males, with age-adjusted incidence rates of 23.3 and 19.7 per 100,000 of population, respectively. Squamous cell carcinoma (SCC) comprised 26.4% of the total, its age-adjusted incidence rate per 100,000 of population being 14.2 for males and 6.18 for females. the incidence rate increased in males and decreased in females during the study period. The incidence of both BCC and SCC increased with age. The head and neck region was the commonest site affected by both types of cancer. Malignant melanoma (MM) comprised 11.39% of all skin cancer cases, with a female to male ratio of 1.2 : 1. The median age at onset for female patients was 49 years while that for males was 70 years, and the commonest site affected was the lower limbs, followed by the trunk. Conclusions, In Jordan, sun-related skin cancers have relatively low incidences and a rather stable pattern, compared with other areas with similar climate and skin phenotypes. [source] UVB phototherapy and skin cancer risk: a review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2005Ernest Lee MD Background, UVB phototherapy is a common treatment modality for psoriasis and other skin diseases. Although UVB has been in use for many decades, many clinicians are hesitant to use this type of phototherapy because of concern over increasing the skin cancer risk. Over the past 20 years, numerous studies have been published examining this issue, but a consensus or analysis of the skin cancer risk is required for the dermatologist to make an educated risk,benefit analysis. Objective, To assess the risk of skin cancer associated with UVB phototherapy. Methods, All prospective or retrospective studies were identified in MEDLINE from 1966 to June 2002. Bibliographies were searched to identify any additional studies examining this issue. All studies that attempted to quantify or qualify any additional skin cancer risk from UVB phototherapy were included. Study selection was performed by two independent reviewers. Results, Eleven studies (10 of which concerned psoriasis patients), involving approximately 3400 participants, were included. Of note, three of the studies involved the same cohort: members of the 16-center US Psoralen plus UVA (PUVA) Follow-up Study. Other than the most recent Finnish study, all studies eventually showed no increased skin cancer risk with UVB phototherapy. One of the PUVA cohort studies examined genital skin cancers, and found an increased rate of genital tumors associated with UVB phototherapy, although this study has not been duplicated. Conclusion, The evidence suggests that UVB phototherapy remains a very safe treatment modality. [source] Mycosis fungoides associated with malignant melanoma and dysplastic nevus syndromeINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2003J. A. Pielop MD Background The increased risk of second malignancies, including nonmelanoma skin cancers, in cutaneous T-cell lymphoma (CTCL) patients has been well documented. However, relatively few studies of malignant melanoma in CTCL patients have been reported. Methods A database of 250 CTCL patients registered over a 3-year period was searched to identify patients with diagnoses of both mycosis fungoides (MF) and malignant melanoma. Results We identified six cases of MF associated with malignant melanoma and one associated with dysplastic nevus syndrome, which is a marker of increased risk of melanoma. In four patients, melanoma was diagnosed along with or before MF. In the remaining two patients, MF was diagnosed prior to melanoma, although dysplastic nevi were noted at the time MF was diagnosed. These two patients received treatment for their MF (one with topical nitrogen mustard and another with radiation therapy and nitrogen mustard) prior to the histologic confirmation of melanoma. Six patients had early stages of MF (IA or IB), while one patient presented with simultaneous erythrodermic mycosis fungoides involving the lymph nodes as well as melanoma metastatic to the lymph nodes from an unknown primary. Conclusion There is an elevated prevalence of malignant melanoma in MF patients compared to the general US population (P < 0.00001) with a relative risk of 15.3 for observing malignant melanoma in MF patients (95% confidence interval 7.0,33.8). Possible pathologic links between the two diagnoses include effects of mycosis fungoides therapies, immunosuppression secondary to mycosis fungoides, and genetic alterations in the p16 tumor suppressor protein. [source] Diseases caused by human papillomaviruses (HPV)JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 5 2009Alessandra Handisurya Summary Human papillomaviruses (HPV) are non-enveloped tumor viruses with a double stranded DNA approximately 8 kilobases in length. The viral genome is enclosed by a spherical capsid with icosahedral symmetry and a diameter of about 55 nm. More than 100 HPV types have been identified. They infect the squamous epithelia of skin and mucosa and usually cause benign papillomas or warts. Persistent infection with high-risk oncogenic HPV causes all cervical cancers, most anal cancers, and a subset of vulvar, vaginal, penile and oropha-ryngeal cancers. In recent years cutaneous beta-HPV types have been associated with the pathogenesis of non-melanoma skin cancers. Two prophylactic HPV vaccines based on virus-like particles (VLP) are licensed. These are up to 100% effective in preventing HPV 16 and HPV 18 infections and associated genital lesions in women, who have not been previously infected with these types. One vaccine also prevents genital warts caused by HPV 6 and HPV 11. [source] Nucleolar organizer region staining patterns in paraffin-embedded tissue cells from human skin cancersJOURNAL OF CUTANEOUS PATHOLOGY, Issue 5 2005Rosana F. Romão-Corrêa Background:, Increased number of nucleoli (nucleolar organizer regions, NORs) with abnormal shapes and sizes, including small dots, has been used as prognostic tools to evaluate tumor proliferation levels and troublesome borderline lesions. In this study, NOR patterns of skin cancers were performed in the search of a valuable prognostic method to complement other histological procedures. Methods:, Paraffin-embedded tumor tissue was obtained from basal and squamous cell carcinomas, cutaneous malignant melanoma, premalignant lesions, and Skmel-28 human melanoma cells. Slices were dewaxed and AgNOR stained. The patterns were scored and submitted for statistical analyses. Results:, All types of cancer cells showed variable numbers of abnormally shaped nucleoli and dot-like structures. Only tumor cells presented four or more nucleoli, with or without dots, while 85% of the normal cells had one single NOR without dots. Most data were statistically significant when compared to normal cells. As a whole, squamous cell carcinoma and malignant melanoma tumor cells had less NOR alterations than basal cell carcinoma (BCC) tumor types. Conclusions:, Changes in the number and shape of nucleoli present in malignant cells could be attributed to increased levels on rDNA transcription on cancer cells, besides abnormal remodeling of chromatin, which could disrupt proper nucleoli association. Increased genetic alterations on malignant basal cells could contribute to impair invasive and migration abilities of BCC tumors. [source] Atypical Response of Xeroderma Pigmentosum to 5-Fluorouracil: A Histopathological Image Analysis Study Reveals New Insight into EtiopathogenesisJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005S.A. Centurion Xeroderma pigmentosum (XP) is a recessively inherited genodermatosis associated with extreme sun sensitivity, defective repair of several types of sunlight induced adducts in cellular DNA, and numerous, early-onset skin cancers. The dry, rough skin corresponds to progressive cytologic atypia and loss of polarity in the underlying epidermis. Associated with these changes are immune deficiencies against ultraviolet radiation-induced skin cancer. 5-Fluorouracil (5-FU) is a DNA synthesis antimetabolite used against several types of cancers. Applied topically in normal subjects it is associated with moderate to severe inflammation in areas where actinic keratoses have arisen followed by ablation of the actinic keratoses which is dependent on the inflammation. We applied 5-FU to the sun-exposed skin of two patients with XP, a 14 year-old light complected black male and a 14 year-old Caucasian female. No inflammation was observed, but marked improvement in the clinical presentation of the skin was seen, as well as an absence of new malignancies. This change was confirmed histopathologically and correlated with normalization of polarity and cytologic changes in the epidermal cells. These histologic findings were quantitated using computerized image analysis. These results may be due to activation of alternative DNA repair pathways in these nucleotide excision repair deficient cells. [source] Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinomaJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2005MJ Veness Summary Non-melanoma cutaneous cancers occur at an epidemic rate in Australia. With an ageing population, more Australians will develop these cancers and at an increasing rate. In the majority of cases local treatment is highly curative. However, a subset of the population will be diagnosed with a high-risk cutaneous squamous cell carcinoma. These can be defined as patients at risk of having subclinical metastases to regional lymph nodes based on unfavourable primary lesion features (including inadequately excised and recurrent lesions), patients with metastatic squamous cell carcinoma to regional lymph nodes, and squamous cell carcinoma in immunosuppressed patients. The mortality and morbidity associated with high-risk cutaneous squamous cell carcinoma is usually as a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Radiotherapy has an essential role in treating these patients and in many cases the addition of adjuvant radiotherapy may be life saving. It is therefore important that all clinicians treating skin cancers have an understanding and awareness of the optimal approach to these patients. The aim of this article is to present treatment recommendations based on an overview of the current published literature. [source] |