The profile of skin cancer patients at Dr Pirngadi Hospital Medan: A retrospective study

Progress in Dermatology: Cutaneous Oncology in Organ Transplant Recipients: Meeting the Challenge of Squamous Cell Carcinoma

Squamous cell carcinoma: Could it be the most common skin cancer?

The Mitochondrial DNA Common Deletion Is Present in Most Basal and Squamous Cell Carcinoma Samples Isolated by Laser Capture Microdissection but Generally at Reduced Rather than Increased Levels

Skin cancers are the most common type of cancer. Nonmelanoma skin cancers (NMSCs) are more common than melanoma. Although the mortality rate is low, cancer word can be frightening for patients. Surgery is the main treatment. As skin cancers are most commonly located on the face, undesirable cosmetic results can occur as a result of treatments or due to primary disease. Therefore, the quality of life of patients could be affected. To determine the effect of surgical treatment on quality of life of the patients with facial NMSC using the Dermatology Life Quality Index (DLQI) at baseline and 3 months after surgery. We aimed to see if there was any improvement in quality of life scores after surgery, and to identify factors affecting quality of life. A total of 255 patients; 174 basal cell carcinoma (BCC) (68.2%) and 81 squamous cell carcinoma (SCC) (31.8%) were included in our study. All participants completed DLQI at baseline and 3 months after surgery. The mean total DLQI scores were 6.37 ± 6.28 in patients with BCC, and 6.35 ± 6.16 in patients with SCC. The mean total DLQI scores were 3.96 ± 5.14 in patients with BCC (P < .001), and 4.49 ± 5.24 in patients with SCC (P < .001) 3 months after surgery. In patients with primary skin cancer, all subscale scores and total DLQI scores were worse than the recurrent skin cancer group in both BCC and SCC at baseline. According to the treatment modalities, total DLQI scores and all subscales were worse in the graft group in BCC and SCC patients at baseline. Interestingly, the sex and the type of skin cancer did not affect quality of life, but tumor localization ([auricula OR: 6.45 [95% CI: 1.28-37.47] and eyelid OR:0.20 [95% CI: 0.04-0.96]) treatment procedure ([flap procedure OR: 7.90 [95% CI: 2.64-23.62] and graft procedure OR: 5.47 [95% CI: 1.60-18.71]) and, primary tumor OR:3.86 (95% CI: 1.01-14.78) were significant. The quality of life of skin cancer patients was affected by tumor localization, treatment procedure, primary, or recurrent tumor. The quality of life showed a significant improvement in patients with facial NMSC after surgical treatment. However, the type of NMSC seems to have no effect on the quality of life.

Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial

e20044 Background: Multiple myeloma (MM) patients (pts) have shown a higher risk of developing other cancers, although the type, time course, and relationship to MM treatment of these cancers are less clear. In this study, we determined the risk of specific skin cancer (CA) types among MM patients and its relationship to onset of MM and treatment. Methods: MM pts and unrelated age, sex, and race-matched companions (controls) seen at a MM clinic were enrolled in a retrospective cohort study. Information regarding baseline characteristics of MM and history of skin CA was obtained from medical records. Overall skin CA prevalence and types were compared between groups; among MM patients, the occurrence of skin CA was analyzed relative to date of diagnosis and treatment regimens, with stratification according to treatment duration. Results: We enrolled 205 MM pts and 201 controls with 27.3% and 14.9% demonstrating skin CA, respectively (p &lt; 0.001). Specific types of skin CA included 60 and 37 basal cell carcinomas (BCC), 50 and 17 squamous cell carcinomas (SCC), and 9 and 5 melanomas in the MM pts and controls, respectively. The standardized incidence ratios (SIR) were SCC: 2.88 (p&lt; 0.001), BCC: 1.59 (p&lt;0.001), and melanoma: 1.76 (p = 0.074). SCC SIR was elevated (p&lt;0.001) across each yearly time point from 10 years prior to MM diagnosis through 10 years subsequent to MM diagnosis. BCC SIR was elevated (p &lt;0.002) from 7 through 10 years following MM diagnosis. The SIR markedly increased over time following the diagnosis of MM for both SCC and BCC. Relative risk (RR) was determined for pts treated with bortezomib, immunomodulatory agents, alkylating agents, glucocorticoids, and anthracyclines. There was no significant increase in RR overall or for any specific type of skin CA in relationship to the type or duration of MM treatment. Conclusions: MM pts show an increased risk of skin CA (there was no increase in melanoma incidence), including SCC and BCC. SCC occurred before and following the diagnosis of MM whereas BCC followed the diagnosis of MM. The post-MM diagnosis increase in skin CA was not related to specific drugs used to treat MM.

e14646 Background: Non-melanoma skin cancer (NMSC) is the most common form of human cancer. Aminolevulinic acid photodynamic therapy (ALA PDT) is a safe and effective treatment for NMSC precursors. It is unknown if ALA PDT treatment will affect incidence of NMSC in high risk patients (pts). Methods: A retrospective study was undertaken using a Veteran Affairs Boston Health Care System Medical Record Database. Study population included immunocompetent pts with history of NMSC, multiple actinic keratosis (AKs), and moderate to severe dermatoheliosis (DH). Study pts received a single application of 20 % ALA to the face or scalp following by exposure to blue light at 10 J/cm2. Differences in incidence of NMSC two years prior and two years after ALA PDT were tested using the Wilcoxon rank sum test. Data were analyzed by the median and interquartile range (IQR). Results: 43 Caucasian males (range 59- 87 yrs), 37 (87%) had history of NMSC on the face or scalp, 32 (78%) had basal cell carcinoma (BCC), 11 (22%) squamous cell carcinoma (SCC), 100% of patients had multiple (&gt;4) AKs prior to treatment and 23 (75% ) had moderate to severe DH determined by Griffiths scale. Prior to ALA-PDT 74 NMSC's were documented: 40 (54%) BCC and 34 (46%) SCC. 46 NMSC's were documented following ALA-PDT: 22 (48%) BCC and 24 (52%) SCC. Prior to ALA-PDT, the frequency of BCC averaged 2 [IQR 1 to 3, max=4], and the frequency of SCC averaged 1 [IQR 1 to 1, max=3]. Following ALA-PDT, the occurrence of BCC averaged 1 [IQR 0 to 1, max=5], and that of SCC averaged 1 [IQR 0 to 2, max= 4]. The difference between BCC frequency before and after ALA-PDT treatment shown a significant reduction in BCC incidence (P = 0.0018). No such differences were observed between the frequency of SCC before and after ALA-PDT (P=0.6230) Conclusions: A single ALA-PDT treatment to the face or scalp in high risk patients significantly reduces the incidence of BCC, the incidence of SCC was not reduced. The potential role of ALA PDT as a NMSC chemopreventive modality warrants further investigation in larger samples with an alternative treatment protocols. No significant financial relationships to disclose.

British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014.

Though the immune system plays a crucial role in skin cancer development, associations between immune-related diseases and skin cancer have not been well studied in racial and ethnic minorities. The goal of this cross-sectional study was to assess the relationship between various immune-related diseases and basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and cutaneous malignant melanoma (MM) diagnoses within the diverse “All of Us” Research Program cohort. It included 307,451 adult participants with electronic health record (EHR) data enrolled from 2017-2023. Participant EHRs were used to determine immune-related diseases and skin cancer diagnoses. Multivariate logistic regression analyses were adjusted for demographic characteristics, lifestyle factors such as smoking history, in addition to health insurance status, educational attainment, history of photosensitivity, history of organ transplant, as well as UV exposure at residence. R v4.0.5 was utilized to conduct the analysis. 8,107 participants with BCC, 4,102 with SCC and 2,461 with MM were identified. Personal history of any immune-related disease was significantly associated with all skin cancer types (odds ratio and 95% confidence intervals -- BCC: 1.27 [1.20-1.33]; SCC:1.38 [1.29-1.49]; MM: 1.55 [1.42-1.69]). Rheumatoid arthritis, hypothyroidism, type I diabetes, Crohn’s disease, and ulcerative colitis were each associated with the three skin cancer types. Multiple sclerosis, Sjogren’s syndrome, hyperthyroidism, dermatomyositis/polymyositis, vitiligo, and psoriasis were associated with at least one skin cancer. Systemic lupus, scleroderma, alopecia areata, and atopic dermatitis were not associated with any skin cancer. In non-White participants alone (n=133,144; 43.3%), history of any immune-related disease was similarly significantly associated with all three skin cancer types. These findings suggest that the history of several immune-related diseases is associated with skin cancer, including among racial/ethnic minorities, and thus increased skin cancer surveillance in these patient populations may be indicated. Citation Format: Erica M. Lin, Sara Ragi, Rachel Lim, Shirley Lin, Isabelle Moseley, Abrar Qureshi, Eunyoung Cho. Immune-related diseases and skin cancer in a racially and ethnically diverse US-based population [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A023.

Ultraviolet (UV) radiation is a major cause of nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Due to its demographics and geographic location, Florida's population is at increased risk of NMSC. While historical epidemiology suggests BCC has a significantly greater incidence than SCC, a 2012 study in South Florida reported a reverse in this ratio, with significantly higher SCC rates, warranting further investigation. A South Florida dermatology database was analyzed for confirmed NMSC biopsy results from 2024. Lesions were categorized into BCC (superficial and nonsuperficial subtypes) and SCC (in situ SCC [isSCC] and invasive subtypes). Among 856 NMSC lesions, 247 (28.9%) were BCC and 609 (71.1%) were SCC. Subtypes included 54 superficial BCC (6.3%), 193 nonsuperficial BCC (22.5%), 268 isSCC (31.3%), and 341 invasive SCC (39.8%). These results align with earlier findings, contradicting the belief that BCC is the most common NMSC. SCC subtypes represented more than 70% of cases, suggesting a shift in incidence patterns. This trend may be linked to the early use of UV-B protection-dominant sunscreens, which offer less protection against UV-A, a significant factor in the development of SCC. Additionally, treating SCC-suspicious lesions as actinic keratoses in favor of biopsy for BCC-suspicious lesions may have contributed to prior findings. Our findings challenge traditional epidemiologic teachings, showing a higher incidence of SCC than BCC. These trends may reflect historical photoprotection and/or changing biopsy practices.

Skin cancer diagnosis and surgical management in general practice

IntroductionKeratinocyte carcinomas (KCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are common skin malignancies with a growing incidence in Poland.AimThe aim is to generate a face map involving topography and frequency of KCs in particular anatomical areas.Material and methodsA group of 649 patients with 786 head skin cancers treated at the Department of Plastic, Reconstructive, and Aesthetic Surgery (Lodz, Poland) were enrolled in 2017–2024. The following variables were analysed: sex, age, type of skin cancer, BCC subtype, SCC grading, and anatomical location of the lesions.ResultsFacial skin cancers were located primarily in the nasal (n = 205, 26.1%), orbital (n = 175, 22.3%) and cheek area (n = 154, 19.6%). BCC was the most common skin cancer (n = 664, 84.5%), and the nodular subtype was dominant (n = 503 cases, 75.8%). SCC was diagnosed in 111 (14.1%) cases, and grade 1 was the most frequent (n = 42, 37.8%). SCC was significantly more frequent than BCC in the auricular, cheek and scalp area. BCC predominated significantly over SCC in the nasal and orbital area. The lower eyelid was the most frequently affected orbital subregion (63.4% of BCCs and 72.7% of SCCs).ConclusionsBCC is the most common skin cancer on the face. Among facial KCs, BCC is more frequent in nasal and periorbital areas, while SCC has a predilection for auricular and scalp regions. These findings underscore the importance of the anatomical site in the clinical assessment and diagnosis of skin cancers.

Every year, millions of people climb in various states of undress into warm, glowing tanning beds, where during a typical 2- to 15-minute session they’ll absorb a controlled dose of ultraviolet (UV) radiation at an intensity up to two to three times stronger than the sunlight striking the equator at noon. The tanning industry has grown rapidly since the 1980s,1 rising to an estimated 28 million users in the United States.2 This rise has been accompanied by an increase in diagnoses of skin cancer. The reasons behind the rising skin cancer diagnoses remain open to debate. Some experts attribute the rise to more frequent skin cancer screening, whereas others blame environmental and behavioral risk factors, particularly changes in UV exposure. In this latter context, UV-emitting tanning beds—classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC)3—have come under growing scrutiny. People tan to look healthy, but looks can be deceiving; UV radiation causes all three types of skin cancer. Melanoma, a tumor of the cells that produce the skin pigment melanin, is the rarest but deadliest type, accounting for 75% of skin cancer deaths worldwide.4 According to the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program, melanoma incidence among U.S. whites (who develop the disease more often than other races) rose from 8.7 cases per 100,000 people in 1975 to 28 cases per 100,000 in 2009.5 Most of that increase occurred in older men, who rarely tan indoors. But a closer look at the age-stratified SEER data reveals that melanoma rates among white girls and women aged 15–39 rose by 3.6% per year between 1992 and 2006, compared with a 2% increase per year among boys and men of the same ages.6 Although they’re not tracked by SEER, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC)—the other two types of skin cancer—also appear to be on the rise, according to regional studies from the United States and Europe. A recent study by Anne Marie Skellett, a consulting dermatologist at Norfolk and Norwich University Hospital, reveals that BCC diagnoses among people under age 30 in the United Kingdom jumped 145% between 1981 and 2006.7 Statistics such as these have prompted 33 U.S. states and some municipalities to ban or restrict indoor tanning among children under age 18.8 California’s ban, signed into law in October 2011, was the first,9 followed by Vermont in April 201210 and the city of Chicago the following June.11 Other states have introduced legislation to limit indoor tanning among minors.8 Melanoma in the United States Scanning electron micrograph of a melanoma cell magnified 8,000 times Mary Brady, an associate professor of surgery at Weill Medical College in New York and the author of an editorial on indoor tanning that appeared in the May 2012 issue of the Journal of Clinical Oncology,12 says the bans make sense. “We legislate against smoking in kids less than 18, and that sends a strong message that there’s something wrong with it,” she says. “We need to send the same message on indoor tanning.” But the bans have drawn a backlash from the tanning bed industry, whose representatives say they’ve been unfairly and incorrectly singled out. John Overstreet, executive director at the Indoor Tanning Association in Washington, DC, describes the evidence linking indoor tanning to skin cancer as speculation and advocacy science reported by the media as fact. He points out that UV light triggers skin cells to produce vitamin D, which may have cancer-protective effects. “It’s frustrating,” he says. “There’s no doubt that repeated overexposure to UV or burning can cause skin problems, but you also have to look at the health benefits, and that issue always gets lost.”

Diuretics and skin cancer

Incidence and Implications of Skin Cancers in Cancercare Manitoba Chronic Lymphocytic Leukemia (CLL) Clinic Patients