Presence Of Basal Cell Carcinoma Research Articles

Real-Life Data on the Management of Incompletely Excised Basal Cell Carcinoma

Background: The histopathologic presence of basal cell carcinoma (BCC) cells at one or more margins of the specimen after surgical excision is considered suggestive of incomplete tumor clearance. The management of incompletely excised BCC might vary in different clinical scenarios from re-excision to application of other treatments or even watchful waiting. Objective: The aims of the study were to report the real-life management of incompletely excised BCC in a tertiary referral center and compare the recurrence rates according to the selected management modality. Methods: A retrospective study was conducted at a tertiary Dermatology Center in Northern Greece. Our electronic database was scanned over a 5-year period to retrieve all BCCs with available histopathologic assay reporting at least one involved margin (lateral or deep). The included patients were divided into 3 groups according to the selected management after incomplete excision: group 1 included those who underwent immediate re-excision (n = 26), group 2 those who were followed up without any additional therapy (n = 40), and group 3 those who were treated with adjuvant/complementary non-surgical treatment (n = 18). Finally, we recorded the presence or absence of residual tumor in the new histopathologic report of those tumors that were selected to be re-excised (group 1). The primary outcome was the appearance of clinical tumor recurrence. Results: Of 1,689 BCCs recorded in our database, 84 met the inclusion criteria and were included in the analysis. Re-excision had been selected in 26 of 84 patients (group 1), watchful waiting in 40 (group 2), and non-surgical treatments in 18 (group 3). The histopathologic reports of the 26 tumors of group 1 that were re-excised revealed residual tumor in 14 (53.8%) cases. Overall, a clinical recurrence occurred in 14 of 84 patients (16.7%) after a mean follow-up of 17 months. The median time to recurrence was 14 months. Of 40 patients without any treatment, recurrence developed in 10 (25%), while only 2 of 18 patients treated with non-surgical treatments recurred (11.1%). Conclusions: Our study suggests that positive histopathologic margins after BCC excision result in a clinical recurrence only in a proportion of patients. This percentage is higher when no further treatment is applied and lower when the area is re-excised or treated with imiquimod alone or combined with cryotherapy.

Correlations between antimicrobial peptides and spectrophotometric skin color parameters in patients with basal cell carcinoma

BackgroundAntimicrobial peptides (AMPs) are active molecules in the human innate immune system, that participate in host defense and regulate the inflammation process. Previous reports have confirmed that antimicrobial peptides play a critical role in carcinogenesis.ObjectiveThe present study aimed to evaluate the correlations between plasma concentrations of AMPs and spectrophotometric parameters of skin color in patients with basal cell carcinoma and compare the results with those of healthy controls.MethodsThe plasma concentrations of cathelicidin and beta-defensin-2 in 100 patients (50 with skin cancer and 50 healthy control subjects) were measured, and skin color parameters were tested using a DermaSpectrophotometer.ResultsIn patients with basal cell carcinoma, the concentrations of cathelicidin and beta-defensin-2 were significantly higher than those in healthy controls. In healthy control patients, when erythema increases, the levels of cathelicidin and beta-defensin-2 also increase. The direction of the relationship is opposite in people with basal cell carcinoma—the concentration of antimicrobial peptides decreases and the level of erythema increases.ConclusionA significantly higher level of plasma concentrations of cathelicidin and HBD-2 are correspondent to the presence of basal cell carcinoma. Skin cancer modifies the relationship between intensity of skin erythema and the levels of cathelicidin and HBD-2. This can be related to inadequate immunological response in patients with skin cancers. New direction of research may be pioneered in searching for cytokine or mast cells disorders.

Elevated serum levels of cathelicidin and β-defensin 2 are associated with basal cell carcinoma.

Antimicrobial peptides (AMPs) are one of the primary mechanisms used by the skin in the early stages of immune defense. AMPs have a broad antibacterial activity and also show antifungal and antiviral attributes. Various studies have also shown that levels of antimicrobial peptides change with the development of neoplasia. The aim of this paper is to assess the associations between the presence of basal cell carcinoma (BCC) and the plasma concentrations of cathelicidin and β-defensins (HBD1-3). We examined 108 patients (56 women, 52 men). The BCC group consisted of 49 patients with mean age 69.8 ±12.3 and the control group consisted of 59 participants with mean age 62.1 ±11.1. A statistical analysis of data was performed. The median serum concentration of cathelicidin was almost 3 times higher and the median concentration of HBD-2 more than 6 times higher in BCC patients than in the control group (p < 0.001). The logistic regression model revealed in univariate analysis that patients who had a detected cathelicidin level above ~1500 pg/ml had 9.9× higher likelihood of having BCC identified in the histopathology in comparison with the control group. In patients who had a HBD-2 level above ~1.2 ng/ml the OR of having BCC identified in the histopathology was 12.6 (p < 0.001). Elevated concentrations of cathelicidin and β-defensin 2 are associated with the presence of basal cell carcinoma. Additionally, the specificity of cathelicidin and β-defensin 2 in detecting basal cell carcinoma is high. However, it should be remembered that these factors are not specific only to this condition and further studies are needed.

A deep learning algorithm to detect the presence of basal cell carcinoma on Mohs micrographic surgery frozen sections

To the Editor: Nonmelanoma skin cancer represents the most common cancer in the United States with more than 5.4 million cases annually, of which 8 in 10 are basal cell carcinomas (BCCs).1 Mohs micrographic surgery (MMS) treats BCCs by providing margin control. The process of accurate and complete interpretation of frozen section slides would benefit from the presence of a second reader. We seek to apply deep learning to MMS by developing an algorithm to aid the surgeon in detecting BCC on frozen sections.

Qral and maxillofacial perspective of gorlin-goliz syndrome: A clinical case series of three patients

Gorlin-Goltz syndrome is an autosomal dominant inherited syndrome. It is also known as hereditary cutaneo-mandibular polyonocosis, multiple nevoid basal cell epithelioma-jaw cysts or bifid rib syndrome. Clinical criteria required for the diagnosis of Gorlin-Goltz syndrome includes a positive family history of the syndrome, presence of basal cell carcinomas, jaw cysts, and palmoplantar pits. The aim is to present the diagnosis, clinical features, and management of Gorlin-Goltz syndrome. Presented here is case series of three males suffering from Gorlin-Goltzsyndrome, their clinical manifestations and management. In conclusion, oral and maxillofacial manifestations of GorlinGotz syndrome play an important role in the diagnosis, initiate early preventive treatment and provide genetic advice, hence a thoroughknowledge of the clinical management is important. Early diagnosis and management of Gorlin-Goltz syndrome are important to avoid complications associated with thesyndrome.

Gorlin-Goltz Syndrome - A Rare Cause of Recurrent Jaw Pain in a Young Child

Gorlin-Goltz syndrome is an infrequent multisystem disease. At least two major criteria or one major and two minor criteria must be present to make the diagnosis. However, the most important criteria are the presence of basal cell carcinomas, odontogenic keratocysts, palmar and/or plantar pits, and ectopic calcification of falx cerebri. It is necessary to identify the syndrome early due to its predisposition to cancer. An early diagnosis can be made using a multi-disciplinary approach. We report a rare case of an 11-year-old boy with this syndrome with an additional unusual finding of gynaecomastia.

Automated identification of basal cell carcinoma by polarization-sensitive optical coherence tomography.

We report an automated classifier to detect the presence of basal cell carcinoma in images of mouse skin tissue samples acquired by polarization-sensitive optical coherence tomography (PS-OCT). The sensitivity and specificity of the classifier based on combined information of the scattering intensity and birefringence properties of the samples are significantly higher than when intensity or birefringence information are used alone. The combined information offers a sensitivity of 94.4% and specificity of 92.5%, compared to 78.2% and 82.2% for intensity-only information and 85.5% and 87.9% for birefringence-only information. These results demonstrate that analysis of the combination of complementary optical information obtained by PS-OCT has great potential for accurate skin cancer diagnosis.

Rhinophyma et carcinomes cutanés associés : à propos d’un cas et revue de la littérature

Rhinophyma, final stage of rosacea is considered as benign pathology. We present the case of a patient with basal cell carcinoma diagnosed on rhinophyma. The removal of all cutaneous nasal unit and its analysis has diagnosed the presence of three basal cell carcinomas and two in situ squamous cell carcinomas. Reconstruction was performed by full-thickness skin graft. The literature reports a few cases of association between rhinophyma and skin cancers but none ever reported the simultaneous presence of basal cell carcinoma and squamous cell carcinomas. The low number of articles does not reveal statistically significant relationship between rhinophyma and skin cancer, which would consider the rhinophyma as a risk factor. Monitoring of these patients should be as rigorous as possible and surgical care requires histologic analysis not to omit the presence of cancerous lesions.

Mast cells in photodamaged skin: what is their role in skin cancer?

In this review, changes that we have observed in the prevalence of mast cells in human sun-exposed skin, and their potential immunoregulatory role, are discussed. More specifically, in a study of Australian volunteers, the prevalence of dermal mast cells was increased in back-of-hand skin, anecdotally the most sun-exposed site of the body, but not in skin from buttock, inner arm or shoulder. By histological analysis of back-of-hand skin, there was a significant correlation between dermal mast cell prevalence and elastin content suggesting increased mast cell prevalence with photodamage. We hypothesised that these mast cells were immunomodulatory upon activation by sun exposure. However, no link was found between dermal mast cell prevalence in hand skin and the presence of basal cell carcinomas. Finally, we discuss other roles for increased numbers of mast cells in UV-exposed photodamaged skin.

手掌の点状陥凹に基底細胞上皮腫を伴った基底細胞母斑症候群の１例

We reported a case of basal cell nevus syndrome (BCNS) . A 12-year old boy visited us for the examination of numerous skin pits on the palms. He showed hypertelorism, mandibular cyst, calcification of the falx, and mental retardation. Clinical diagnosis of BCNS was made by these findings. Examination of other family members did not reveal palmar pits or any other signs of BCNS. Skin biopsy from the palmar pits showed reduced thickness of the stratum corneum and the presence of basal cell carcinoma in the dermis.Chromosome-analysis of peripheral leukocytes revealed the deletion of 9q21.3-22.1. His parents did not show any abnormalities in chromosome-analysis. Very few cases of BCNS have been reported that have basal cell carcinoma on the palms. [Skin Cancer (Japan) 2000; 15: 27-30]