Carcinoma Research Articles

Experimental and molecular docking investigation of anticancer activity of new mixed-ligand Schiff base complexes against human colorectal (HCT116), lung (A549) and breast (MCF7) carcinoma cell lines

New mixed-ligand Cu(II) complexes, [Cu(SB)L1–3]ClO4, that contain a tridentate NN'O type unsymmetrical Schiff-base main ligand (SB) and a heterocyclic co-ligand (L) (py in (1), bpy in (2) and phen in (3)) were synthesized and characterized. The SB is the product of 1:1 condensation between 1,3-propanediamine with 2‑hydroxy-4-methoxybenzaldehyde, which was formed during the template synthesis of complex (1). Complexes (2) and (3) were obtained by the exchange of monodentate py with bidentate bpy or phen, respectively. The crystal structure of (2) was obtained by single-crystal x-ray crystallography (SCXRC). From the crystal structure, (2) is pentacoordinated with square-based pyramidal geometry around Cu(II). The anticancer activity of the complexes was studied against three human carcinoma cell lines. All the complexes showed a potent cytotoxic effect on the Human colorectal (HCT116), lung (A549) and breast (MCF7) cancerous cells that exert their cytotoxicity in a dose and time dependent manner. Among these complexes, (2) had the highest cytotoxicity that made it a promising candidate for developing new anticancer drugs. The IC50 values for (2) were 4.16, 4.97 and 7.82 μM against A549, MCF7 and HCT116, respectively, after 48 h of incubation. The IC50 values order were (2)<(1)<(3) in each cell line. Molecular docking studies were also performed on A549 (PDB ID: 4zxt), HCT116 (PDB ID: 3ruk) and MCF-7 (PDB ID: 4zvm) human carcinoma cells' proteins. Based on the estimated free binding energy (EFBE) good correlation was observed with the obtained experimental data.

Novel bis pyrimidine-pyrazolone and pyridinyl-4,5-dihydropyrimido[2,1[1]-c,1,2,4]triazepine utilized ultrasonic energy, anti-proliferative activity, docking simulation, and theoretical investigation

Eco-friendly synthesis of novel bis heterocyclic compounds containing pyridine derivatives utilized green tools such as ultrasonication energy. Moreover, the nucleophilic substitution of bis pyrimidine-2-thiol derivatives with hydrazine hydrate in glacial acetic acid in order to form the corresponding bis(hydrazinyl-6-(pyridin-yl)pyrimidin-4-yl) derivatives 3a-c in excellent yield. Furthermore, the latter obtained hydrazinyl pyrimidine derivatives 3a-c can easily be attacked with ethylacetoactate to give bis dihydro-3H-pyrazol-3-one derivatives 5a-c, while the reactivity of acetyl acetone in glacial acetic acid using ultrasonic energy affords the dihydropyrimido[2,1-c][1,2,4]triazepin-9-yl)-5-methyl-1H-1,2,3-triazol-1-yl)benzene derivatives 7a-c, and these compounds were elucidated utilized spectrum analysis. These obtained compounds were exhibited as having antitumor activity against MCF-7 breast and A-549 carcinoma cell lines via neutral red uptake assays, and bis compounds 5c and 7cshowed excellent activity comparable to the doxorubicin drug. Moreover, these biological evaluations were confirmed through molecular docking simulation with PDBID: 4hdq and PDBID:2ito, which showed the least binding affinity with -11.641 and -13.646 kcal/mol, respectively. Also, the theoretical calculation of these bis heterocycles was optimized through the DFT/B3LYP/6-31(G) basis set, which identified their physical descriptors and showed the stability of these bis compounds, confirmed the experimental work with FMO, ESP, and MEP.

Cryosurgery vs. curettage for intraepidermal carcinoma: a randomized controlled trial.

Cryosurgery is a common destructive treatment method for intraepidermal carcinoma (IEC) above the knee. Curettage alone is a simple, non-aggressive, and inexpensive treatment method commonly used on benign skin lesions. However, only one study has assessed curettage for treatment of IEC. We aimed to (1) compare the effectiveness of cryosurgery (standard method) to curettage (experimental method) for treatment of IEC in regard to overall clearance rates at 1-year follow-up, and (2) investigate whether wound healing times differed between the treatment groups. In this randomized and controlled, non-inferiority trial, adult patients with one or more IEC with a diameter of 5-20 mm, located above the knee and suitable for destructive treatment were recruited from Sahlgrenska University Hospital (Gothenburg, Sweden). Lesions were randomized to treatment with either cryosurgery or curettage. Wound healing was assessed by a nurse after 4-6 weeks and through self-report forms. Overall clearance was assessed by a dermatologist after one year. In total, 183 lesions in 147 patients were included, with 93 lesions randomized to cryosurgery and 90 to curettage. Eighty-eight (94.6%) of the lesions in the cryosurgery group and 71 (78.9%) in the curettage group showed an overall clearance at the 1-year follow-up visit (P=0.002). The non-inferiority analysis was inconclusive. Curettage resulted in both shorter self-reported wound healing times (mean time 3.1 vs 4.8 weeks, P<0.001) and a larger proportion of healed wounds after 4-6 weeks (P<0.001). Cryosurgery and curettage both result in high clearance rates for treatment of IEC, but cryosurgery is significantly more effective. On the other hand, curettage may result in shorter wound healing times.

Association of Proliferative Indices With Various Grades of Breast Carcinoma.

Various grades of breast carcinoma and proliferative indices used as nuclear protein Ki-67 and argyrophilic nucleolar organizer regions (AgNOR) are being compared to each other. In this observational cross-sectional investigation, 42 breast biopsies from questionable breast areas were collected and preserved in formalin and paraffin before the tissue blocks were made. A thorough medical history regarding the breast tumor and thorough physical examination results were recorded. Two sections were produced, one stained with an immunohistochemical marker called Ki-67 and the other with a unique stain called AgNOR. Grade I in Nottingham was found to be highest in subjects with Ki-67 1%, grade II in subjects with Ki-67 1-10%, and grade III in subjects with Ki-67>10%. Therefore, a higher Ki-67 score and a higher Nottingham grade were more closely associated. The mean AgNOR score was determined to be highest in Nottingham grade III and lowest in Nottingham grade I. In contrast to grade I and grade II of carcinoma (CA) breast, where there was no statistically significant association between Ki-67 and AgNOR, grade III of CA breast showed a statistically significant link between Ki-67 and AgNOR. Proliferation has been identified as a distinctive feature of cancer and as a key factor in the prognosis of the disease.

MAP4K4 regulates forces at cell-cell and cell-matrix adhesions to promote collective cell migration.

Collective cell migration is not only important for development and tissue homeostasis but can also promote cancer metastasis. To migrate collectively, cells need to coordinate cellular extensions and retractions, adhesion sites dynamics, and forces generation and transmission. Nevertheless, the regulatory mechanisms coordinating these processes remain elusive. Using A431 carcinoma cells, we identify the kinase MAP4K4 as a central regulator of collective migration. We show that MAP4K4 inactivation blocks the migration of clusters, whereas its overexpression decreases cluster cohesion. MAP4K4 regulates protrusion and retraction dynamics, remodels the actomyosin cytoskeleton, and controls the stability of both cell-cell and cell-substrate adhesion. MAP4K4 promotes focal adhesion disassembly through the phosphorylation of the actin and plasma membrane crosslinker moesin but disassembles adherens junctions through a moesin-independent mechanism. By analyzing traction and intercellular forces, we found that MAP4K4 loss of function leads to a tensional disequilibrium throughout the cell cluster, increasing the traction forces and the tension loading at the cell-cell adhesions. Together, our results indicate that MAP4K4 activity is a key regulator of biomechanical forces at adhesion sites, promoting collective migration.

Merkel Cell Hyperplasia Versus Intraepidermal Merkel Cell Carcinoma: A Comparative Study of 2 Cases.

Intraepidermal Merkel cell hyperplasia and Merkel cell carcinoma represent 2 histologically similar-appearing diagnoses with significant differences regarding prognosis and management. We present 1 case of each diagnosis to highlight characteristic histopathologic and immunohistochemical features. Our case of Merkel cell hyperplasia was identified by its small intraepidermal nest of monomorphic cells without atypia or mitoses, which demonstrated cytoplasmic, rather than perinuclear dot, patterning on CK20 staining. This can be contrasted with our case of intraepidermal Merkel cell carcinoma, which, despite a lack of dermal extension, demonstrated large nests of pleomorphic cells with frequent mitoses and apoptoses. The diagnosis was further confirmed by immunohistochemistry because CK20 staining showed classic perinuclear dot patterning. By presenting both diagnoses in parallel, this comparison aims to underscore crucial histopathologic and immunohistochemical similarities and differences.

The utility of p63, CK7, and CAM5.2 staining in differentiating pagetoid intraepidermal carcinomas.

Extramammary Paget disease (EMPD), pagetoid squamous cell carcinoma in situ (PSCCIS), and Paget disease of the breast (PD) are intraepidermal carcinomas with overlapping histopathologic features. CK7 and CAM5.2 stains are frequently utilized to distinguish PSCCIS from EMPD and PD. However, some cases of PSCCIS can stain positively for CAM5.2 and CK7, indicating a potential pitfall with these stains. p63 has been shown to distinguish PSCCIS from EMPD. We assessed p63 staining in PD and compared it to p63 staining of PSCCIS and EMPD. A retrospective search for 15 examples each of PSCCIS, EMPD, and PD with remaining tissue in the paraffin block was performed. The diagnosis was confirmed by a board-certified dermatopathologist and immunostaining for p63, CK7, and CAM5.2 was performed. Staining >55% was scored as positive. Staining <55% was scored as negative and an approximate percentage of positive cells was recorded. Diffuse nuclear expression for p63 was detected in 100% (15/15) of PSCCIS cases, 0% (0/15) of PD cases, and 0% (0/15) of EMPD cases. CK7 and CAM5.2 stains were positive in 100% of PD. CAM5.2 was positive in 100% of EMPD and CK7 was positive in 93% of EMPD. CAM5.2 was positive in 0% of PSCCIS biopsy specimens, but partial staining was seen in 20%. CK7 was positive in 13%, but partial staining was seen in 47%. p63 immunostaining is a highly sensitive and specific method for differentiating between PSCCIS and PD or EMPD. While CAM5.2 and CK7 are also useful ancillary stains in this differential diagnosis, false-positive and false-negative staining occurs with these two markers.

Intralesional photodynamic therapy induces apoptosis in basal cell carcinoma and Bowen's disease through caspase 3 and granzyme B.

Photodynamic therapy (PDT) is used to treat cutaneous cancers. It may induce cell death through direct and indirect means, including apoptosis, inflammation and certain immune mechanisms, with the depth of penetration as a potential modifying factor. To examine the pathways of apoptosis in the intralesional PDT of basal cell carcinoma (BCC) and intraepidermal squamous cell carcinoma (Bowen's disease). Sixteen patients with superficial or nodular BCC and Bowen's disease were treated with intralesional aminolevulinic acid-PDT. Biopsies were taken at baseline and 24 h post-PDT, and sections were examined by immunohistochemistry for the expression of markers of apoptosis, such as caspase 3, involved in the intrinsic apoptotic pathway, granzyme B, a caspase-independent apoptotic mediator, and the proapoptotic markers BAX and BAK. Apoptotic cells stained with TUNEL showed statistically significant staining at 24 h post PDT (p < 0.01 in both BCC and Bowen's lesions). Caspase 3 (p < 0.01 in BCC and p < 0.05 in Bowen's) and granzyme B (p < 0.01 in BCC and p < 0.01 in Bowen's) were significantly increased at 24 h post-PDT. BAX expression was apparently increased compared to baseline in Bowen's lesions at 24 h post-PDT, whereas Bak was upregulated both in BCC and Bowen's disease at baseline and at 24 h post-PDT. Intralesional PDT induces apoptosis in BCC and Bowen's disease via common and alternative apoptotic pathways involving granzyme B. Proapoptotic factors Bak in both BCC and Bowen and Bax in Bowen's disease appear to increase by intralesional PDT at 24 h.

Blue Light Inhibits Proliferation of Metastatic Cancer Cells by Regulating Translational Initiation: A Synergistic Property with Anticancer Drugs.

The aim of this study was to examine the inhibitory effect of blue light (BL) on the proliferation of metastatic cancer cells and synergistic properties with chemo-drugs. BL significantly inhibited the proliferation of B cell lymphoma (A20 and RAMOS) cells in a dose-dependent manner. Anti-proliferative effect of BL irradiation was identified to be associated with the inhibition of proliferating-cell nuclear antigen expression and cell cycle by decreasing S-phase cells. Consistent with its inhibitory effects, BL irradiation at 20 J/cm2 daily for 10 days inhibited metastasis of cancer cells which were distributed and invaded to other organs including bone marrow, liver, kidney, etc., and induced paraplegia, thereby leading to an increased survival rate of tumor-bearing mice. Anti-proliferative activity of BL was expanded in solid tumor cells including pancreatic carcinoma (Mia PaCa-2, PANC-1), lung carcinoma A549 and colorectal carcinoma HCT116 cells. Additionally, combination with chemo-drugs such as 5-FU and gemcitabine resulted in an increase in the anti-proliferative activity after BL irradiation accompanied by regulating mRNA translational process via inhibition of p70S6K, 4EBP-1 and eIF4E phosphorylation during cellular proliferation. These results indicate the anti-metastatic and photo-biogoverning abilities of BL irradiation as a potent therapeutic potential for repressing the progression of tumor cells.

Meme Karsinomlarında ER, PR, c-erbB2, Ki67, E-Cadherin Ekspresyonları, Nottingham Histolojik Grade ve Bazı Klinik Parametreler Arasındaki İlişkilerin Değerlendirilmesi

Objective: In this study, it was aimed to evaluate the relationships between Estrogen receptor (ER), Progesterone receptor (PR), c-erbB2 (HER2), Ki67, E-Cadherin expressions, Nottingham histological grade and some clinical parameters in breast carcinomas. Materials and Methods: A total of 74 patients diagnosed with breast carcinoma (CA) in our pathology department between 2018-2019 were included in this study. Immunohistochemical preparations stained with ER, PR, HER2, Ki67 and E-Cadherin were evaluated and analyzed retrospectively. For ER and PR, ≥1% expression was considered as positive staining, and &amp;lt;1% was considered as negative staining. HER2 expression was scored as 0, 1, 2 and 3. Ki67 proliferation index was considered as low (&amp;lt;10%), intermediate (10-20%) and high risk (&amp;gt;20%). The data were analyzed with chi-square test. Results: HER2 score showed a statistically significant change according to ER status (p=0.010). HER2 score also showed a statistically significant change according to PR status (p=0.004). There was a significant correlation between Ki67 and histological stage (p&amp;lt;0.001). Conclusions: Detection of high Ki67 index in breast carcinomas is poor prognostic. Detection of ER and PR expression and no expression of HER2 are good prognostic indicators. Preanalytical and analytical processes should be followed meticulously by pathologists.

Reversible Increase in Resistance of A-431 Carcinoma Cells to TRAIL-Induced Apoptosis in Confluent Cultures Corresponds to a Decrease in Expression of DR4 and DR5 Receptors

Reversible Increase in Resistance of A-431 Carcinoma Cells to TRAIL-Induced Apoptosis in Confluent Cultures Corresponds to a Decrease in Expression of DR4 and DR5 Receptors

Reversible Increase in Resistance of A-431 Carcinoma Cells to TRAIL-Induced Apoptosis in Confluent Cultures Corresponds to a Decrease in Expression of DR4 and DR5 Receptors

Reversible Increase in Resistance of A-431 Carcinoma Cells to TRAIL-Induced Apoptosis in Confluent Cultures Corresponds to a Decrease in Expression of DR4 and DR5 Receptors

Dermoscopic Findings in Intraepidermal Carcinoma: an Interobserver Agreement Study.

A wide range of descriptive terms have been used for dermoscopic findings in intraepidermal carcinoma (IEC) and the clinical diagnostic accuracy of IEC can be challenging. Furthermore, dermoscopic findings in IEC have only rarely been evaluated in fair-skinned populations. To measure the interobserver agreement between dermatologists for dermoscopic findings in IEC. Furthermore, to describe the frequency of these findings in a predominantly fair-skinned population. One hundred dermoscopic images of histopathologically verified IECs were collected. The 11 most common dermoscopic findings described in previous studies were re-defined in a new terminology in a pre-study consensus meeting. Images were assessed by eight experienced international dermoscopists. The frequency of findings and the interobserver agreement was analyzed. Scales (83%), dotted/glomerular vessels (77%), pinkish-white areas (73%) and hemorrhage (46%) were the most commonly present dermoscopic findings. Pigmented structures were found in 32% and shiny white structures (follicular or stromal) in 54% of the IEC. Vascular structures (vessels and/or hemorrhage) could be seen in 89% of the lesions. Overall, the interobserver agreement for the respective dermoscopic findings was poor to moderate, with the highest kappa values noted for scales (0.55) and hemorrhage (0.54) and the lowest for pinkish-white areas (0.015). Our results confirm those of previous studies on dermoscopy in IEC, including the frequency of pigmented structures despite the fair-skinned population. The interobserver agreement was relatively low. The proposed new terminology and our findings can hopefully serve as a guideline for researchers, teachers and students on how to identify IEC.

Expression status of MLH1 and MSH2 mismatch repair proteins in colorectal carcinoma

Abstract Background Colorectal carcinoma (CRC) is a main cause of morbidity and mortality worldwide. Lynch syndrome or hereditary nonpolyposis colorectal carcinoma is a cancer syndrome that accounts for 5–10% of cases of CRCs, and it is caused by a germline mutation in one or more of mismatch repair (MMR) genes, that is, MutL homolog 1 (MLH1), MutS homolog 2 (MSH2), MSH6, PMS1 homolog (PMS2), and epithelial cellular adhesion molecule. Nearly 90% of cases have mutations in either MLH1 or MSH2 gene. Aim To study the immunohistochemistry of MLH1 and MSH2 MMR proteins in CRC and to study the association of abnormal MMR protein expression with clinicopathological parameters. Patients and methods This study included 48 cases of consecutive colectomy specimens submitted to the Pathology Department of Al-Azhar University hospitals and some private laboratories. The patients’ age ranged between 22 and 81 years (median, 53 years), and 35 (72.9%) cases were male and 13 (27.1%) cases were females. Results Among the 48 studied CRC cases, 11 (22.9%) cases were MMR deficient, whereas 37 (77.1%) cases were MMR proficient. MMR defects owing to germline mutations of MSH2 were eight (72.7%) cases of the MMR deficient and that due to the functional missense mutation or hypermethylation of MLH1 were three (27.3%) cases. Conclusions Immunohistochemistry for MLH1 and MSH2 is a rapid, reliable, effective, and relatively inexpensive method to detect MMR deficiency in CRC tumors. The patterns of expression of MMR protein demonstrated distinct associations with right-sided mucinous colon carcinoma and high tumor grade, which may be valuable for prognosis and clinical treatment of CRCs.

Clinicopathological Profile of Patients with Bronchogenic Carcinoma at a Tertiary Care Center in Western India

Background: Bronchogenic carcinoma is the most common malignancy all over the globe in terms of incidence and mortality, especially in males. Its increasing incidence in nonsmokers and females is also an important concern. Objectives: The objective of this study was to study various demographic, clinical, radiological, and histopathological features of patients with confirmed diagnosis of lung cancer. Patients and Methods: Patients with confirmed histopathological diagnosis of bronchogenic carcinoma attending a tertiary care center in western India were included in the study. Results: A total of 50 patients were studied. Of 50, 45 were male and 5 were female. Average age of the patient was 59.92 years. Forty-six (92%) patients were current or ex-smokers, whereas only 4 patients were never-smokers. Cough (90%) followed by chest pain (62%) was the presenting symptom. Soft-tissue density mass lesion was the most common radiographic finding. Adenocarcinoma (36%) followed closely by squamous cell carcinoma (32%) was the diagnosed histological subtype. Of 50, 9 (18%) patients had evidence of distant metastasis at the time of diagnosis. Conclusions: This study concludes that adenocarcinoma was the most common subtype even in smokers. A high index of suspicion and prompt investigations in a patient with respiratory symptoms should be employed to diagnose patients at an early stage.

Argenteolides A and B, Glycosylated Polyketide-Peptide Hybrid Macrolides from an Actinomycete Streptomyces argenteolus.

Two novel glycosylated polyketide-peptide hybrid macrolides, argenteolides A (1) and B (2), were isolated from an actinomycete Streptomyces argenteolus. Argenteolide A (1) contains a unique 5/5/5 tricyclic system in a 20-membered macrocycle. Their structures were elucidated by extensive spectroscopic analysis, and their stereochemical configurations were established through the application of chemical derivatization, J-based configuration analysis, DP4+ calculation, and electronic circular dichroism calculation. The analysis of the genome sequence revealed a plausible biosynthesis mechanism, and isotope-labeled feeding studies suggested their biogenetic origins. Argenteolides A and B exhibited moderate cytotoxicities against A549, p388, and Hela human carcinoma cell lines as well as antibacterial activities against Staphylococcus aureus and Escherichia coli ATCC25922.

Co-delivery of docetaxel and p53 gene from cationic nanoparticles based on poly (l-lactide) and low-molecular-weight polyethyleneimine (PEA)

Recent findings revealed that low-concentration paclitaxel(DTX) could enhance cytotoxicity by upregulating p53 expression in lung cancer cell lines. So, co-delivery of DTX and RFP-p53 gene with PEA nanoparticles (NPs) was studied. The prepared DTX loaded PEA NPs (PEA/DTX) were characterized by particle size distribution, morphology, zeta potential, and crystallography and cytotoxicity. Results showed that the PEA/DTX NPs had a mall particle size (≤100 nm), moderate zeta potential (≥40 mV) and drug loading of 9.0%, DTX was released from PEA/DTX NPs in an extended period in vitro. More important, agarose gel electrophoresis showed that PEA/DTX cationic NPs were able to completely bind RFP-p53 gene with mean particles size and zeta potential. Studies on cellular uptake of (PEA/DTX)/RFP-p53 NPs demonstrated that both drug and gene were effectively taken up by A549 tumor cells. It was found that intravenous injection of (PEA/DTX)/RFP-p53 NPs efficiently inhibited growth of subcutaneous A549 carcinoma in vivo (p < 0.05) and was significantly less side effect than that of mice treated with the other groups. Therefore, the (PEA/DTX)/RFP-p53 NPs might be a promising candidate for A549 cancer therapy.

The Accuracy of MRI in the Local Staging of Endometrial Cancer: An Experience From a Tertiary Care Oncology Institute in Pakistan.

Objective Our objective is to assess the diagnostic accuracy of contrast-enhanced magnetic resonance imaging (MRI) in identifying the depth of myometrial invasion and cervical stromal involvement in endometrial carcinoma (EC) along with nodal status and its correlation with surgical and histopathological (HP) findings. Materials and methods We performed a retrospective study on female patients at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Patients with endometrial carcinoma (CA) were searched from the electronic record system, and a total of 188 patients fulfilling the study criteria were selected. All the patients were evaluated using a 1.5T MRI and underwent a hysterectomy. The outcome of preoperative MRI was correlated withhistopathology results, keeping pathologyas the gold standard. Results A total of 188 patients were included in the study, with a mean age of 56.67 ± 12.47 years. Of the patients, 72 (38.3%)were diagnosed with stage 1a. The second common stage was1b, seen in 43 (22.9%) patients. It was found that the staging of endometrial CA on MRI and HP were significantly correlated for myometrial invasion (stage 1a and 1b), cervical stromal involvement (stage 2b), serosal and adnexal (stage 3a), vaginal(stage 3b), and nodal (stage 3c) involvement as shown by their p-values of <0.01. However, in cases of parametrial invasion (stage 3b), bladderinvolvement, and rectal involvement (stage 4), MRI showed decreased sensitivity as shown by their p-values of 0.833, 0.87, and 0.9, respectively. Conclusion Preoperative MRI can predict local disease and low-risk patients accurately, thereby helping in proper surgical planning and avoiding more extensive surgery such as lymphadenectomy in these patients.

Knowledge and awareness about Bowen's disease among dental students.

The study aimed to assess the awareness and knowledge about Bowen's disease among dental students. Bowen disease is an infrequent skin disorder and is also referred to as squamous cell carcinoma in situ. It is a noninvasive form of intraepidermal squamous cell carcinoma with flat or slightly raised lesions. An online survey was conducted among 300 dental students between the age group of 18-30 years in the Chennai district based on Bowen's disease. This is the best approach to data collection due to the large population of the city of Chennai and is also appropriate in the current situation where people need to avoid gatherings and close contact. About 78.21% were BDS students and 21.79% were MDS students. In the age group of 10-20 years, 8.97% responded heard about Bowen disease and 3.85% responded not heard. Within the 21-30 years age group, 44.02% responded that Bowen disease is invasive and 20.09% responded noninvasive. Studies showed that the exact occurrence of Bowen's disease is not known. It is found to be more common in men than in women. To conclude, about 65% of participants were aware of Bowen's disease. Nevertheless, patients with Bowen's disease seem to be at an abnormal risk of internal malignancies, and they need to be educated about the various treatments available to prevent the cause as soon as possible.

Pigmented Macules on the Head and Neck: A Systematic Review of Dermoscopy Features.

Differentiating early melanoma from other flat pigmented lesions on the head and neck is challenging both clinically and dermoscopically, partly due to the wide differential diagnosis and the lack of specific diagnostic algorithms. To review publications covering the dermoscopic features of pigmented macules on the head and neck. Embase and PubMed (Medline) database from January 2015 to January 2021 were searched using a four-step search. Keywords used were dermoscopy/dermatoscopy or epiluminescence microscopy, lentigo maligna, lentigo maligna melanoma, lichen-planus-like-keratosis, solar lentigo, seborrheic keratosis, pigmented actinic keratosis (PAK), pigmented Bowen disease (pBD), pigmented intraepidermal carcinoma (pIEC) and head and neck. The commonest reported dermoscopic features of facial melanoma were irregular dots, atypical dots/globules, asymmetric pigmented follicular openings, rhomboid gray/black structures, increased vascular network, brown globules/dots and a pattern of circles. Pseudopods, radial streaming, blue white veil, irregular blotches, scar-like depigmentation and atypical pigment network were recorded in low frequencies. For PAK, pBD and pIEC perifollicular erythema, white/yellow surface scale, linear wavy vessels around hair follicles, hair follicular openings surrounded by a white halo, evident follicles or follicular or keratotic plugs, rosette sign and sharply demarcated borders were the salient features. Further studies are needed to determine the dermoscopic criteria for pigmented melanocytic and non-melanocytic lesions on the head and neck. Furthermore, there is a gap in the knowledge of site-specific dermoscopic features on specific sites, namely ears, nose, cheeks, scalp and neck which will also benefit from further studies.