Cases Of Basal Cell Carcinoma Research Articles

Cutaneous Superficial Basal Cell Carcinomais a Basal Cell Carcinoma In Situ: Electron Microscopy of a Case Series of Basal Cell Carcinomas.

Basal cell carcinoma (BCC) is the most common skin cancer. Skin cancers may present either as a non-invasive tumor or an invasive malignancy. The terminology of carcinoma in situ is used when the tumor is either just limited to epidermis or not present as single cells or nests in the dermis. However, currently the terminology superficial BCC is inappropriately used instead of BCC in situ when the skin cancer is limited to epidermis. In this study we compare the pathologic changes of superficial, nodular, and infiltrative BCCs using electron microscopy to identify the ultrastructural characteristics and validate the previously proposed terminology. Three cases of BCC (superficial BCC, nodular BCC, and infiltrative BCC) diagnosed by dermatopathologists at our institute were selected for review. Paraffin block tissues from these cases were sent for electron microscopy studies which demonstrated disruption of basal lamina in both nodular and infiltrative type of BCC, while it remains intact in BCC superficial type after extensive examination. Therefore, similar to other in situ skin cancers, there is no invasion of the neoplasm in superficial BCC into the dermis. Hence, the older term superficial BCC should be appropriately replaced with the newer terminology BCC in situ.

Carcinogenic risk in patients treated with UVA-1 phototherapy: A 5-year retrospective study.

UVA-1 phototherapy was first used to treat atopic dermatitis and afterwards to several other skin diseases. The contribution of UVA-1 in human photocarcinogenesis, skin photoaging, immune suppression, and hyperpigmentation is now well established. The actual contribution of UVA-1 radiation to the development of malignant melanoma (MM) in humans cannot be excluded. The aim of the study is to evaluate the risk of developing skin cancers (non-melanoma skin cancers (NMSCs) and MM) in patients treated with UVA-1 phototherapy with a 5-year dermatological follow-up. We conducted a retrospective cohort study with 31 patients with morphea and atopic dermatitis treated with medium dose UVA-1 phototherapy (34 J/cm2). All enrolled patients underwent an oncologic prevention visit annually with a 5-year follow-up with clinical evaluation of the entire skin surface. During the 5-year follow-up, we recorded a case of basal cell carcinoma (BCC) in the cervical region and one case of MM on the back (pT1a). In both cases, the patients were female and affected by morphea. The Glogau 3 group is prevalent (42%), which is consistent with moderate to severe aging; the data appear to be compatible with the age. This study attests that medium-dose UVA-1 phototherapy does not increase the risk of developing skin tumors and that UVA-1 phototherapy is not a worsening factor of facial photoaging. The main limitation of the study is the small sample size, avoiding to obtain statistically significant values. It was not possible to analyze individually the actual daily sun exposure during the 5-year observation period and to correlate it in terms of time and tumor development. Further studies with large sample sizes will be needed to confirm our data. Our study reaffirms how the dermatological examination performed annually is essential in the follow-up of patients undergoing this type of therapy.

Fragile hands: targeting nonmelanoma skin cancer on older hands using 595nm pulsed dye laser.

The mainstay of treatment for nonmelanoma skin cancer (NMSC) on thin skin remains surgical, but procedures on older hands may be complicated by skin fragility and dermal atrophy. Used without cooling, 595nm (nm) pulsed dye laser (PDL) has the capability of destroying NMSC through nonspecific thermal necrosis. The purpose of this study was to understand recurrence of NMSC on dorsal hands of older patients after one or two treatments using 595nm PDL. A retrospective chart review identified 147 cases of NMSC located on the dorsal hands treated with 595nm PDL. Cases of basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) were included. All patients received one to two treatments with PDL. The primary outcome was the recurrence of carcinoma. Among NMSC cases treated with PDL, recurrence occurred in 12 patients (8.2%). No cases of BCC recurred during the study period. Recurrence of SCC was 4.7% for SCC in situ and 10.4% recurrence for invasive SCC (p = 0.34). Among 71 patients treated once, recurrence occurred in 10 patients (14.1%), and among 76 cases treated twice, recurrence occurred in 2 patients (2.6%, p = 0.01). Two treatments of PDL for NMSC on the dorsal hands of older patients was well tolerated, had low recurrence, and seemed more effective than one treatment.

Basal cell carcinoma at the pinna

Basal cell carcinoma (BCC) is the most common type of non melanoma cutaneous malignancy BCC usually present on sun exposed area such as nose, mandibular, periocular region. A review of the literature revealed only a few reports of BCC on the auricle or conchal bowl. Objectives were to report a case of BCC of right pinna. A 62 year old man presented to ENT OPD with a painless blackish lesion in the right pinna appreciated since 6 months and progressively increased to the present size. On local examination of the pinna a blackish plaque with irregular margins was appreciated in the cocha, helical crus and incisura. It was soft to firm in consistency and tenderness absent. Wide excision of the lesion with healthy margin done under local anesthesia. Histopathology of excised specimen confirmed the lesion as BCC. BCC of pinna is an uncommon external ear pathology which should be kept as a differential diagnosis of lesions of the pinna by the otorhinolaryngologist.

Abstract 7310: Dietary feeding of silibinin effectively protects against UVB-induced basal cell carcinoma

Abstract Exposure to UVB radiation causes various malignancies, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). BCC is the most prevalent skin cancer type worldwide; ~3.6 million cases of BCC are diagnosed annually in the USA. Silibinin (SB) is a naturally occurring flavonolignan that is present in milk thistle seeds. It has been shown to effectively reduce BCC occurrence upon UVB radiation exposure, in both pre- and post-treatment studies, when applied topically. However, SB efficacy, when fed in diet, against UVB-induced BCC formation and growth has not been reported. We addressed this question employing Ptch+/- mice, where animals were divided into three groups. Group 1: control group, mice were fed adjusted vitamin diet (AIN-76A; TD94096) with no UVB exposure. Group 2: UVB group, mice were fed pellet control diet (semi-purified, modified AIN-76A) and exposed to UVB (240 mJ/cm2) 3 times/week (Mon, Wed, Fri). Group 3: SB group, mice were fed 1% SB (w/w)-supplemented diet and exposed to UVB similar to that in Group 2. This protocol was followed for 26 weeks; thereafter, animals were sacrificed at 14 weeks and 26 weeks post-UVB initiation, and skin samples were harvested and analyzed for BCC formation. β-galactosidase staining showed the development of BCC lesions at 26 weeks in the UVB group; however, SB-fed group had both lesser number of BCC lesions and decreased area covered by BCCs as compared to the UVB group. Non-UVB exposed control group had no BCC lesions. To address if SB feeding starts exerting its efficacy earlier than 26 weeks, we selected the early efficacy timepoint for transcriptomics analysis to determine the mechanism of SB efficacy. Skin RNA samples from the 14-week time point (n=4/group; RIN≥7; DV200>85%) were subjected to library preparation (550 ng of total RNA; Zymo-Seq RiboFree Total RNA Library Kit), ribosomal RNA-depletion RNA sequencing (80 million paired-end reads/sample), and data processing. About 16,000 unique genes were identified, of which ~65% were protein-coding genes. The samples within each group were highly correlated (mean>0.99; Pearson’s correlation). The UVB cluster was sequestered away from the other groups, indicating that the SB diet effectively mitigated the effects of UVB exposure, even at the transcriptome level. Additionally, gene ontology and pathway enrichment analysis (Ingenuity Pathway Analysis, Qiagen) of differentially expressed genes (p<0.05; fold change≤2) showed UVB-induced aberration and SB-associated enrichment in mitotic prometaphase, metaphase, and anaphase pathways, RHO GTPase signaling, and cell cycle regulation; the top functional network found to be dysregulated was lipid metabolism. Taken together, these results highlight the potential of dietary SB intake (apart from topical SB) to be an effective modality against UVB-induced BCC formation and growth and identify molecular targets that are plausibly involved in SB efficacy. Citation Format: Sandeep Paudel, Neha Mishra, Komal Raina, Chapla Agarwal, Rajesh Agarwal. Dietary feeding of silibinin effectively protects against UVB-induced basal cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7310.

Viscum Album Lipophilic Extract in Actinic Keratosis, Cutaneous Squamous Cell Carcinoma, and Basal Cell Carcinoma: A Retrospective Case Series

Introduction: Cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) belong to the group of keratinocyte carcinomas (KC). Actinic keratosis (AK) is a precursor lesion of cSCC. The incidences of cSCC, BCC, and AK are currently strongly increasing. Different standard therapies exist for these conditions but are not always applicable or successful. Hydrophilic Viscum album extracts have been used in anthroposophic cancer therapy since 1917. Viscum album lipophilic extract (VALE) is prepared by means of supercritical CO2 extraction. This retrospective case series assessed the safety and clinical effects of a topical application of 10% VALE in individual cases of cSCC, BCC, and AK. Methods: For this retrospective case series, a positive vote was obtained from the Ethics Committee of the University of Witten/Herdecke (No. 146/2020). Eligible patients signed a declaration of consent prior to inclusion in the study. The main outcome parameters were the clinical response to treatment with VALE and adverse drug reactions. Risk factors, concomitant therapies and diseases, further diagnostic and therapeutic information were documented where available. Data analysis was performed on the level of patients and of individual lesions. Results: The study population consisted of 55 patients with 74 skin lesions. Individual case analysis accompanied by photographic documentation revealed typical and promising treatment courses. Clinical response rates (complete + partial remissions) for individual lesions were 78% for cSCC, 70% for BCC, and 71% for AK. Complete remission rates for individual lesions were 56% for cSCC, 35% for BCC, and 15% for AK. In cSCC and BCC, shorter times to best clinical response were observed. Adverse drug reactions were reported in 5 patients including erythema and inflammatory reactions of mostly moderate severity that resolved completely. In one case, therapy was temporarily paused, in four cases it was continued without interruption. Discussion/Conclusion: The results of this study suggest that VALE is a safe and tolerable extract under whose application complete and partial remissions of KC could be observed. To improve and assess the efficacy of VALE, prospective investigations are necessary.

Advanced Periocular Basal Cell Carcinoma with Orbital Invasion: Update on Management and Treatment Advances.

Basal cell carcinoma (BCC) is the most frequent malignant periocular tumor. It is associated with exposure to ultraviolet radiation, and its incidence is gradually increasing. It may occasionally display more aggressive behavior and result in orbital or intracranial invasion. Mortality from periocular BBC with orbital invasion is very low, but the associated morbidity can be significant, from disfigurement to blindness. Traditionally, these cases have been treated with orbital exenteration or with radiotherapy (RT), but in recent years, hedgehog pathway inhibitors (HPIs) have emerged, are effective in more serious cases, and are used primarily or combined with surgery, changing our perspective on the management of these patients. We studied 24 cases of periocular BCC with orbital invasion, some primary and others recurrent, which were treated between 2011 and 2021 in the same hospital. All patients had clinical or radiological evidence of orbital invasion. Orbital exenteration was performed on 9/24 of the patients (1 received vismodegib after surgery), and 12/24 were treated, surgically preserving the eyeball, with 3 of them receiving adjuvant vismodegib. Three of the twenty-four patients were treated exclusively with vismodegib (Erivedge®, Genentech). One patient died due to poor tumor evolution, but the rest evolved favorably and they have had no recurrences. Vismodegib was generally well tolerated, except for in one patient who discontinued treatment due to the side effects. In advanced BBC with orbital invasion, mutilating surgical treatments such as exenteration or potentially vision-threatening treatments such as RT remain as options. In recent years, however, very promising new medical therapies have emerged, such as HPI, which can be used effectively instead of surgery or in combination with it, preserving the eye and vision, which implies a new approach to treatment.

Assessment of Standard Surgical Excision Efficacy and Analysis of Recurrence-Associated Factors in 343 Cases of Nasal Basal Cell Carcinoma: A Single-Center Retrospective Study.

In Caucasians, basal cell carcinoma, the predominant non-melanoma skin cancer type, poses challenges for surgeons due to anatomical and aesthetic concerns, particularly when located on the nose. The study aimed to evaluate tumor distribution, size, morphological subtypes, surgical outcomes, radicality levels, and their correlation with recurrence rates. A retrospective analysis encompassed 343 cases of nasal skin cancer over a four-year period from 1 January 2019 to 31 December 2022. The research cohort comprised 252 female and 91 male participants, averaging 75.2 years old. Tumors were most found on the left sidewall of the nose (25.4%) and the dorsum (24.8%). The infiltrative morphological subtype was predominant (70.8%). Standard surgical excision with fasciocutaneous plastic was the preferred surgical procedure. Radical excision, defined by the absence of tumor cells in a resection margin, was accomplished in 79.0% of lesions, whereas 16.9% demonstrated incomplete excision, signifying the presence of tumor cells in the resection margin. Non-radically excised tumors exhibited a significantly higher recurrence rate (24.1%) compared to those with radical excision (6.3%). In nasal reconstruction, diverse surgical techniques are essential for precise adaptation based on factors like tumor characteristics and patient needs. Despite surgeons' careful adherence to excision margin guidelines, the possibility of non-radical outcome cannot be eliminated.

Impact of the COVID-19 Pandemic on the Diagnosis and Management of Non-Melanoma Skin Cancer in the Head and Neck Region: A Retrospective Cohort Study.

The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital "Le Scotte" in Siena, Italy, the research includes 111 patients treated from 2018 to 2021. The study aims to understand how pandemic-related healthcare changes affected NMSC treatment, focusing on differences in diagnosis and management before and during the pandemic. Methods involved retrospective analysis of patient demographics, clinical characteristics, lesion details, and treatment modalities, using Jamovi software (version 1.6) for statistical analysis. Results revealed the scalp as the most common NMSC site, with Squamous Cell Carcinoma (SCC) being the predominant histotype. A significant rise in Basal Cell Carcinoma (BCC) cases and a reduction in surgery duration were noted during the pandemic. The shift to local anesthesia was more pronounced, reflecting the necessity to adapt to healthcare limitations. Despite the disruptions caused by the pandemic, there was no significant drop in NMSC cases, which is attributed to the noticeable nature of head and neck lesions. In conclusion, this study highlights that the COVID-19 pandemic significantly influenced surgical practices in NMSC management, emphasizing the need for effective healthcare strategies that balance quality patient care with public health safety measures.

Full Thickness Skin Graft Procedure for Basal Cell Carcinoma : A Case Report

Introduction : To present a case of basal cell carcinoma (BCC) of the right upper eyelid using a full thickness skin graft (FTSG) procedure
 Case Illustration : 69 year old woman with the main complaint of a lump on the upper right eye that has been getting bigger and bleeding more and more since 4 years ago. Examination revealed a tumor measuring 22mm x 12mm x 5mm, smooth surface of pearl-like nodules, talengectiasis, madarosis, palpebral retraction towards the medial canthus. The patient works as a farmer. Wide excision of the tumor and FTSG procedure was performed from the right infraclavicular area, histopathological results of basal cell carcinoma tumor.
 Discussion : BCC accounts for 90% of malignant eyelid tumors. The biggest risk factor for BCC is UV exposure. BCC rarely metastasizes but orbital invasion occurs in approximately 2%. This patient underwent an FTSG procedure. The graft was taken from the infraclavicular area. One of the key factors for graft success is revascularization of the graft area.
 Conclusion : FTSG procedure for BCC can give good results. The risk after the procedure is sometimes difficult to predict so that it can become difficult in graft attachment and even failure in attachment to the excision area can occur. This patient was under close observation due to a hematoma under the graft skin.

Challenges in Diagnosing and Initial Treatment of Advanced Eyelid Basal Cell Carcinoma in Rural Area: A Case Report

Introduction : Basal cell carcinoma (BCC) is the most common non-melanoma eyelid cancer with a high risk of recurrence. This case report discusses the management of extensive BCC in a rural setting with limited resources.
 Case Illustration : A 62-year-old Timorese female, presented to the hospital with a mass on the left periocular region. It appeared as a mole in the lower left eyelid and extended to the surrounding tissues over nine years. As a farmer, she was frequently sun-exposed. A blackish mass was found at the left orbit, buccal, and entire nose (8 x 7.5 cm) with an ulcerated surface and attached firmly. The right eye had bedside visual acuity >6/60, with palpebral edema, free eye movement, hyperemia nasal conjunctiva, and transparent cornea. The left eye is difficult to examine. Two submandibular lymphadenopathies were palpated. A Head CT scan showed a suspected malignant soft tissue mass with irregular thickening of soft tissue with ill-defined borders. Histopathology examination revealed a nodulocystic type of basal cell carcinoma.
 Discussion : Locally advanced BCC cases need a multidisciplinary approach. In a limited resources setting, the treatment highlights are histological diagnosis, complete surgical excision, and exenteration with margin control. From a broader perspective, the role of primary health care in educating and revering for early treatment is paramount.
 Conclusion : Prevention and early treatment are the most important factors in managing locally advanced BCC.

Study of facial reconstruction in basal cell carcinoma

Head and neck reconstruction presents unique challenges as the defects of this region are often difficult to conceal and the demands on the surgeon’s reconstructive skills are greater than they are elsewhere in the body where cosmesis may be less vital and function less specialized. Reconstruction depends on the size as well as the location of the defect. Smaller defects created after excision can be covered by local flaps, however larger defects require a combination of flaps such as rotation, transposition, and cheek advancement. Defects located over and beyond the hairline can be covered by skin grafting as well. We have taken 10 such cases of basal cell carcinoma and explained the various surgical procedures performed on the patients. In 4 of the patients, defect was covered via grafting and in the remaining 6 patients, a combination of forehead flap and cheek advancement flap was done. All the cases have shown excellent functional as well as cosmetic result.

Recurrence rates of periocular basal cell carcinoma following intra-operative en-face frozen section margin controlled excision.

To report the margin control process and rate of recurrence of periocular basal cell carcinomas (BCCs) managed by en-face, frozen section margin controlled (FSC), excision by a single surgeon with a 3-year follow-up. A retrospective analysis of all histopathologically proven cases of periocular BCC who underwent surgical excision with intra-operative, en-face, FSC, excision by a single surgeon from 2015 to 2019 was performed. Patients with less than 3-year follow-up were offered a virtual appointment to determine possible recurrence. A total of 88 BCC excisions from 86 patients were reviewed. Minimum 3-year follow-up data is available for 73 patients. The most common location and histological subtype was the lower eyelid and nodular BCC, respectively (47% and 83% of cases). Primary BCC (pBCC) comprised 98% (86/88) of cases and recurrent BCC (rBCC) comprised 2% (2/88) of cases. Negative frozen section margins were achieved in 93% (82/88) of excisions on the day of surgery. The overall recurrence rate during this time was 1.4% (1/73) at minimum 3years. Periocular BCC can be managed effectively by en-face, FSC, excision, with a high cure rate and low recurrence rate comparable to alternative excision techniques such as Moh's micrographic surgery. Advantages of en-face excision include same-day excision and reconstruction and reduced theatre time. Primary nodular BCCs with clear margins can be considered for early discharge with advice to self-monitor.

Exposome and basal cell carcinoma: a multicenter case-control study.

While ultraviolet radiation (UVR) present in sunlight is recognized as the main etiological agent of skin cancer, the most frequent form of which is basal cell carcinoma (BCC), other exposome factors like pollution, diet, and lifestyle may also contribute. This study aimed to investigate the association of BCC and exposome-related factors in the Spanish population. BCC cases (n = 119) and controls (n = 127) with no history of skin cancer were recruited between April 2020 and August 2022 by 13 dermatologists throughout Spain in this prospective multicenter case-control study. The BCC group had a higher proportion of outdoor workers, more years of UVR exposure, and a greater consumption of drugs (statins, ASA, hydrochlorothiazide, ACE inhibitors and omeprazole), P < 0.05. Avoidance of sun exposure was the most used photoprotection measure in both groups. The use of hats or caps was higher in the BCC group (P = 0.01). The solar protection factor (SPF) used 15 years previously was higher in the control group (P = 0.04). The control group had a higher daily screen time (P < 0.001), and practiced more relaxation activities (P = 0.03). Higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with BCC (P < 0.05). Statistical significance for all the aforementioned variables was maintained in the multivariate analysis (P < 0.05). The study found a significant association between BCC and multiple exposome-related factors in addition to chronic sunexposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers, promoting sun-safe behaviors and stress-reducing activities, and also adequate skin photoprotection in patients on certain medications associated with increased BCC risk.

MOHS MICROGRAPHIC SURGERY FOR BASAL CELL CARCINOMA: A REVIEW OF TREATMENT RESULTS

Objectives: To evaluate the results of Mohs Micrography Surgery (MMS) in the treatment of basal cell carcinoma (BCC). Materials and methods: We used the database of PUBMED and EMBASE to evaluate the results of MMS in treatment of BCC. Results: Nine studies with the total number of 5845 BCC cases were included in this review, the follow-up time varied from 12 to 42 months. The overall cumulative probabilities of recurrence after MMS were 2.4%. The cumulative probability of recurrence for the primary BCC group and the recurrent BCC group was 2.9% and 7.2%, respectively. In the recurrent BCC group, the cumulative probability of recurrence after MMS was lower than after standard surgical excision (SSE) (3.9% vs 13.5%, p &lt; 0.05). In MMS group, 52% of patients required one round of excision to achieve complete removal of BCC, 34% needed two rounds and 14% needed three rounds. The size of final skin defect after MMS was 1.34 times larger than that of the primary tumor (p &lt; 0.05). Conclusion: MMS is superior to SSE in BCC treatment, with lower recurrence rate and better normal skin-sparing. Therefore, MMS is strongly recommended for surgical treatment of BCC, especially in high-risk BCC. Received 28 June 2023Revised 26 September 2023Accepted 29 November 2023

Algorithm for the reconstruction of the parotid region: a single institution experience

ObjectiveThis study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap reconstruction of soft tissue for postoperative defects.Materials and methodsA retrospective review was conducted on 11 cases of soft tissue flap reconstruction for postoperative defects following the resection of malignant tumors in the parotid region. Statistical analysis was performed based on clinical data.ResultsAmong the 11 cases of malignant tumors in the parotid region, there were 2 cases of secretory carcinoma (SC) of the salivary gland, 2 cases of squamous cell carcinoma (SCC), 2 cases of carcinosarcoma, 1 case of mucoepidermoid carcinoma (MEC), 1 case of epithelial-myoepithelial carcinoma (EMC), 1 case of salivary duct carcinoma (SDC), 1 case of basal cell carcinoma (BCC), and 1 case of osteosarcoma. Among these cases, 4 were initial diagnoses and 7 were recurrent tumors. The defect repairs involved: 8 cases with anterolateral thigh free flap (ALTF), 2 cases with pectoralis major muscle flaps, and 1 case with forearm flap. The size of the flaps ranged from approximately 1 cm × 3 cm to 7 cm × 15 cm. The recipient vessels included: 4 cases with the facial artery, 4 cases with the superior thyroid artery, and 1 case with the external carotid artery. The ratio of recipient vein anastomosis was: 57% for branches of the internal jugular vein, 29% for the facial vein, and 14% for the external jugular vein. Among the 8 cases that underwent neck lymph node dissection, one case showed lymph node metastasis on pathological examination. In the initial diagnosis cases, 2 cases received postoperative radiotherapy, and 1 case received 125I seed implantation therapeutic treatment after experiencing two recurrences. Postoperative follow-up revealed that 2 cases underwent reoperation due to local tumor recurrence, and there were 2 cases lost to follow-up. The survival outcomes after treatment included: one case of distant metastasis and one case of death from non-cancerous diseases.ConclusionImmediate soft tissue flap reconstruction is an important and valuable option to address postoperative defects in patients afflicted with malignant tumors in the parotid region.

Multi-ancestry genome-wide meta-analysis identifies novel basal cell carcinoma loci and shared genetic effects with squamous cell carcinoma

Basal cell carcinoma (BCC) is one of the most common malignancies worldwide, yet its genetic determinants are incompletely defined. We perform a European ancestry genome-wide association (GWA) meta-analysis and a Hispanic/Latino ancestry GWA meta-analysis and meta-analyze both in a multi-ancestry GWAS meta-analysis of BCC, totaling 50,531 BCC cases and 762,234 controls from four cohorts (GERA, Mass-General Brigham Biobank, UK Biobank, and 23andMe research cohort). Here we identify 122 BCC-associated loci, of which 36 were novel, and subsequently fine-mapped these associations. We also identify an association of the well-known pigment gene SLC45A2 as well as associations at RCC2 and CLPTM1L with BCC in Hispanic/Latinos. We examine these BCC loci for association with cutaneous squamous cell carcinoma (cSCC) in 16,407 SCC cases and 762,486 controls of European ancestry, and 33 SNPs show evidence of association. Our study findings provide important insights into the genetic basis of BCC and cSCC susceptibility.

Metastatic basal cell carcinoma on the neck of an elderly man

Skin cancer will affect 1 in 5 Americans by age 70 and is most common in White patients. Basal cell carcinoma (BCC) is the most common type of skin cancer, constituting roughly 80% of nonmelanoma cutaneous skin cancers with ~3.5 million cases annually. BCC is routinely treated with cutaneous excision and/or topical medications, with high cure rates for both. Despite its prevalence, BCC rarely metastasizes. In this report, we describe a case of metastatic BCC on the right neck of an elderly man. This highlights the importance of routine skin exams and rapid assessment of palpable lymphadenopathy in patients with a history of nonmelanoma skin cancer.

Pigmented basal cell carcinoma in an old man treated with surgical excision and flap reconstruction: a case report

Background: Basal cell carcinoma (BCC) stands as the prevailing form of malignancy, and its prevalence is on the rise. While BCC carries a minimal risk of mortality, it can induce notable morbidity, chiefly due to localized damage. The incidence of BCC increases significantly after the age of 40 years, especially in women who are caused by exposure to ultraviolet (UV) rays. There are a variety of surgical and non-surgical treatments for BCC. In general, surgical methods are used more frequently because of their higher cure rates. We are reporting a case of pigmented basal cell carcinoma in an old Asian man who was treated with surgical excision with wound reconstruction using flap surgery. Case Report: A 70-year-old man sought consultation at the Dermatology and Venereology outpatient clinic of Dr. Soetomo Regional Public Hospital. His main complaint was a wound on his forehead from two years ago. Initially, it appeared as a small lump with skin color. Over time, the lump got bigger and then turned into a wound that got wider. He also felt pain and itchy on the wound. For the past year, the wound had become easily bleeding. Dermatological examination revealed an ulcer with a clean base, not sharply marginated, asymmetry, and a size of 1,8 x 1,6 cm, with a rolled-up margin and an elevated edge. There was a translucent hyperpigmented nodule on the edges and a sign of bleeding in the center of the ulcer. A dermoscopy examination showed a blue-gray ovoid nest, shiny white structureless area, arborizing vessels, and ulceration. Histopathological results from both biopsies showed the proliferation of anaplastic basal cells was a monotonous rounded nucleus, coarse chromatin, several prominent nuclei, and narrow cytoplasm to moderately that partially contained melanin. The patient was diagnosed with Pigmented BCC. The treatment plan was to use surgical excision with advancement flap reconstruction. Postoperative lesions showed improvement and healed after three weeks post-surgery. Conclusion: The management of BCC is determined based on the anatomical location and histological features. Widely used therapeutic approaches such as standard excision surgery or other invasive methods are significant therapeutic options.

Advancements in Basal Cell Carcinoma Diagnosis: Non-Invasive Imaging and Multimodal Approach.

(1) Background: The aim of this study was to correlate the diagnostic criteria described in dermatoscopy, ultrasonography (US), ex vivo confocal microscopy, and histology to the most common subtypes of basal cell carcinoma (BCC). (2) Methods: We conducted a prospective study including 46 BCC cases, which were analyzed with dermatoscopy using the Delta 30 dermatoscope and Vidix 4.0 videodermoscope, with US using a high-resolution 20 MHz linear probe, with confocal microscopy, along with histopathological analysis. (3) Results: This study categorized BCC by histological subtype, with nodular being the most common (84.8%) and various other subtypes represented. US measurements of tumor thickness correlated strongly with the histopathological depth of invasion index (DI). Dermatoscopy analysis revealed significant associations between specific features and BCC subtypes. The DI was directly related to arborized vessels but inversely related to short, fine telangiectasias, maple-leaf-like areas, and spoke-wheel areas. The presence of ulceration was directly related to the DI. Confocal microscopy images exhibited several characteristics, including fluorescence, nuclear crowding, peripheral palisading, clefting, increased nuclear-cytoplasmic (N/C) ratio, and a "cauliflower-like" appearance. (4) Conclusion: The advanced detection of BCC through imagistic techniques like dermatoscopy, confocal microscopy, and ultrasound improves the diagnosis and may offer valuable insights for treatment in the future by evaluating lesion characteristics.