Management Of Skin Cancer Research Articles

Editorial for “Latest Advances in Diagnosis and Management of Skin Cancer”

The rising global incidence of skin cancer has established this disease as a critical public health issue [...]

Nurse-Led Models of Service Delivery for Skin Cancer Detection: A Systematic Review.

To consolidate evidence on nurse-led models for skin cancer detection by focusing on their roles, comparing their effectiveness to physician-led care and highlighting any value-added benefits. Systematic review methodology with narrative synthesis. MEDLINE Complete, PubMed, Embase, CINAHL Complete, ScienceDirect, Scopus, BNI, LILACS, PsycINFO, Trip Medical Database, ERIC, EThOS, CDSR, WoS, Google Scholar, ClinicalTrials.gov, ICTRP, CENTRAL and the website 'Getting It Right First Time'. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies between January 1992 and September 2024 were evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. The search encompassed both peer-reviewed and grey literature; however, no grey literature met the inclusion criteria. Of the 6680 records screened, six studies met the inclusion criteria, involving 3325 patients across England, New Zealand and the United States. These studies focused on nurse-led models of care for skin cancer, assessing outcomes such as diagnostic accuracy, treatment effectiveness, cost savings, waiting times, access to care and patient satisfaction. While none directly compared nurse-led to dermatologist-led models, one study demonstrated comparable diagnostic accuracy between nurses and ophthalmologists. Nurse-led models were shown to effectively substitute for or complement physician-led care, though only one study was authored by a nurse consultant, highlighting a gap in nursing-led research. Service users favoured community-based, nurse-led care for its accessibility, convenience and cost-effectiveness, with health education noted as an added benefit in one study. Nurse-led models demonstrate potential for high diagnostic accuracy in skin cancer, effective treatment delivery and enhanced patient education on skin self-examination. While role delineation remains a challenge, nurses play a critical role in supporting dermatologists in addressing the increasing referral demands associated with skin cancer care. The systematic review protocol (registration number: CRD42023448950) was developed in collaboration with a patient representative with lived experience of melanoma, alongside academic experts in dermatology nursing and specialist; dermatology clinicians. A patient representative with lived experience of melanoma contributed to the review protocol. Training and Competency Development: Completing nationally recognised dermatology nursing qualifications beyond the Advanced Clinical Practice pathway and practical training to extend assessment, diagnostic and treatment skills are essential for autonomous practice in dermatology. Specific skills in nurse-led skin cancer care are vital to ensure clinical competency. Dermatology Nurse Consultant Training Programme: Policies should prioritise nationally recognised Advanced Nurse Practitioner to Dermatology Nurse Consultant Training Programmes focusing on assessment, diagnostic and treatment skills. A structured, portfolio-based approach to training is crucial for achieving competency and enabling autonomous practice in dermatology, supporting the delivery of high-quality care. Support for Community-Based Care: Policy-level support for community-based care is critical, particularly in rural or underserved regions. These models reduce patient travel, improve timely care access and provide training opportunities for rural clinicians, offering a viable alternative to hospital-based services. Standardising Nurse-Led Models: Developing national or international guidelines is essential for scaling nurse-led models. Standardisation allows these models to adapt to the specific needs of local services while maintaining high standards of care. Delivering Comprehensive Care: Nurse-led models show promise in delivering standard care comparable to physician-led services for specific components of the skin cancer care pathway. They also provide value-added care benefits, such as tailored patient education, enhancing outcomes and satisfaction. Nurse-led models demonstrate diagnostic accuracy in identifying skin lesions, including skin cancer, while contributing to treatment, patient education and follow-up care. Despite their growing role in skin cancer management, greater dissemination and publication of their outcomes are needed to inform clinical practice. This review highlights the importance of standardising nurse-led approaches into scalable frameworks to support dermatologists, enhance patient outcomes and ensure consistent care standards in skin cancer. Further evaluation is required to assess their efficiency, cost-effectiveness and implementation across diverse healthcare settings.

Using the power of artificial intelligence to improve the diagnosis and management of nonmelanoma skin cancer

Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most prevalent type of skin cancer. While generally less aggressive than melanoma, early detection and treatment are crucial to prevent the complications. Artificial intelligence (AI) systems show promise in enhancing the accuracy, efficiency, and accessibility of NMSC diagnosis and management. These systems can facilitate early interventions, reduce unnecessary procedures, and promote collaboration among healthcare providers. Despite AI algorithms demonstrating moderate-to-high performance in diagnosing NMSC, several challenges remain. Ensuring the robustness, explainability, and generalizability of these models is vital. Collaborative efforts focusing on data diversity, image quality standards, and ethical considerations are necessary to address these issues. Building patient trust is also essential for the successful implementation of AI in the clinical settings. AI algorithms may outperform experts in controlled environments but can fall short in the real-world clinical applications, indicating a need for more prospective studies to evaluate their effectiveness in the practical scenarios. Continued research and development are essential to fully realize AI’s potential in improving NMSC diagnosis and management by overcoming the existing challenges and conducting comprehensive studies.

Comparison of Keratinocyte Cancer Tumour and Defect Sizes Treated by Mohs Micrographic Surgery: Sydney Versus Outside Metropolitan Sydney.

Australia and New Zealand face the world's highest skin cancer rates, with non-metropolitan regions bearing a greater burden. Mohs micrographic surgery (MMS) is the gold-standard treatment for keratinocyte cancers (KCs) due to high cure rates and tissue-sparing benefits. This study evaluates whether Outside Metropolitan Sydney (OMS) patients present with larger tumours and defects than Sydney Metropolitan Area (SMA) patients. This retrospective study examined MMS cases at The Skin Hospital in 2017. Patients were divided into Sydney Metropolitan Area (SMA) and Outside Metropolitan Sydney (OMS), with OMS sub-grouped into Non-Sydney Metropolitan (NSM) and Regional, Rural and Remote (RRR). Tumour and defect sizes were compared between OMS, SMA, and RRR and NSM, with additional exploratory analyses assessing surgical outcomes and tumour characteristics. Of 2073 patients undergoing MMS, 1870 basal cell carcinomas and 203 squamous cell carcinomas were included. Tumours and defects were significantly larger in OMS patients (median tumour size: 0.8 cm2, defect size: 2.1 cm2) compared to SMA patients (median tumour size: 0.7 cm2, defect size: 1.8 cm2). No correlation was found between distance travelled and tumour or defect size. SMA patients also had greater flap and primary closures than OMS. Subgroup analysis of RRR and NSM showed no significant difference in tumour or defect sizes. Patients from OMS presented with larger KCs, suggesting barriers to earlier access to specialised care. This highlights geographic disparities in skin cancer management outside major cities in Australia in the context of MMS, emphasising the need for improved access and dermatological workforce distribution.

Enhancing Melanoma Diagnosis through the Integration of Artificial Intelligence: Identifying Gaps and Future Research Directions

Melanoma (Skin cancer) remains a significant global health challenge because of its increasing incidence and economic impact. Despite advances in diagnostics and treatment, significant research gaps hinder effective management. This study aims to identify and illuminate these gaps, providing a comprehensive overview of current skin cancer research in technology integration perspective. The focus is on integrating advanced diagnostic technologies, such as electrical impedance spectroscopy and multispectral imaging, into clinical practice to improve early detection. The study also explores the potential of nanotechnology for targeted treatment and addresses challenges like drug resistance and the economic burden of treatment. This research aims to develop effective and personalized skin cancer treatments by incorporating patient perspectives and validating AI technologies. The goal is to advance skin cancer management, improve patient outcomes, and reduce the global burden of the disease.

Clinical Approaches for the Management of Skin Cancer: A Review of Current Progress in Diagnosis, Treatment, and Prognosis for Patients with Melanoma.

Melanoma represents a significant public health challenge due to its increasing incidence and potential for metastasis. This review will explore the current clinical approaches to the management of melanoma, focusing on advancements in diagnosis, treatment, and prognosis. Methods for early detection and accurate staging have been enhanced by new diagnostic strategies. Treatment modalities have expanded beyond traditional surgical excision to include targeted therapy and immunotherapy. Prognostic assessment has benefited from the development of novel biomarkers and genetic profiling. This review will highlight the progress made in the multidisciplinary management of melanoma, underscoring the importance of continuous research to improve patient outcomes.

5-Fluorouracil- and Sesamol-Loaded Transliposomal Gel for Skin Cancer: In Vitro, Ex Vivo, and Dermatokinetic Evaluation.

This study explores a novel approach to managing skin conditions through a combination therapy utilizing a phospholipid-enriched edge activator-based nanoformulation. 5-Fluorouracil (5-FU)- and sesamol (SES)-loaded transliposomes (FS-TL) were developed using a thin film hydration method and optimized using Box-Behnken Design. FS-TL characterization indicated a vesicle size of 165.6 ± 1.1 nm, polydispersity index of 0.28 ± 0.01, and a zeta potential of -33.17 ± 0.9 mV, and the percent entrapment efficiencies for 5-FU and SES were found to be 63.16 ± 1.07% and 75.60 ± 3.68%, respectively. The drug loading percents for 5-FU and SES were found to be 5.87 ± 0.099% and 7.03 ± 0.34%, respectively. The morphological studies exhibit the distinctive spherical shape of the nanoformulation. The in vitro drug release demonstrated sustained release with 82.52 ± 1.2% and 86.28 ± 1.3% releases for 5-FU and SES, respectively. The ex vivo skin permeation exhibited 81.04 ± 2.1% and 78.03 ± 1.7% for 5-FU and SES. Confocal laser microscopy scanning (CLSM) revealed a deeper formulation penetration (30.0 μm) of excised mice skin membranes than for a standard rhodamine solution (10.0 μm). The dermatokinetic investigation revealed that FS-TL gel has significantly higher concentrations of 5-FU and SES (p < 0.001). The efficacy of FS-TL (p < 0.05) in eradicating the A431 melanoma cell line was satisfactory. These findings suggest the potential of FS-TL formulation over conventional approaches in skin cancer management.

Recent Advances in Cutaneous Carcinoma Therapy Through Integrated Use of Immunotherapy and Nanotechnology.

Skin cancer is one of the most lethal cancers today, posing significant challenges to public health and potentially impacting global health and economic stability. Due to its high rate of incidence, innovative and effective treatments are crucial. Among these, immunothera-peutic approaches have emerged as transformative, offering new hope by harnessing the body's immune system to target and eliminate cancerous cells. Immunotherapy has changed the treatment landscape for skin cancer, providing options such as checkpoint inhibitors and adoptive cell transfer therapies that specifically enhance immune activity against tumors. De-spite these advancements, the broader adoption of immunotherapeutic modalities is challeng-ing due to concerns about their toxicity and variable efficacy. The side effects, such as im-mune-related adverse events, can be severe and sometimes limit their use. In response to these challenges, nanotechnology in cancer treatment has gained significant attention. Nanotechnol-ogy-based approaches show promise in improving the delivery and effectiveness of cancer therapies, particularly for skin cancer immunotherapy. Nanoparticles can deliver therapeutic agents directly to tumors, minimizing systemic toxicity and enhancing treatment precision. These strategies also boost the immune system's ability to target cancer cells while overcom-ing the limitations of current immunotherapies. This review explores various anticancer thera-peutic approaches for managing skin cancer, focusing on immunotherapy and its challenges. It highlights how integrating nanotechnology with cancer immunotherapy offers a promising av-enue for enhancing treatment efficacy and safety. The review also provides an overview of re-cent advancements in skin cancer treatment, showcasing how these innovative strategies are paving the way for more effective and less toxic therapeutic options in combating one of the deadliest cancers.

Immunosuppression and Mohs surgery: Navigating risks in high-stakes skin cancer management.

Immunosuppression and Mohs surgery: Navigating risks in high-stakes skin cancer management.

Review Understanding of the many Facets of Cancer and the Management of Skin Cancer

Cancer is a complex disorder characterized by the unregulated proliferation of cells that have the potential to invade other regions of the body. It stems from genetic alterations in various cell types, resulting in tumor formation. These growths are classified as benign (noncancerous) or malignant (cancerous). Unlike benign tumors, which typically remain localized, malignant tumors can spread, infiltrate nearby tissues, and establish secondary growth in organs far from the original site. The treatment approach depends on the specific type and progression of cancer, encompassing options such as surgical intervention, radiation-based therapies, drug-based treatments, immune system-boosting techniques, and therapies targeting particular cellular mechanisms. Skin cancer is a common occurrence among various cancer types, especially in populations with lighter skin tones. Skin cancer is a prevalent form of cancer, particularly in the Caucasian population. The most common skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. BCCs, which arise from the basal layer of the epidermis, are often treated with surgery, topical therapies, or cryotherapy depending on their risk and location. Mohs micrographic surgery is effective for high-risk or recurrent BCCs, whereas topical treatments such as 5-fluorouracil and imiquimod are used for superficial BCCs. Early diagnosis through biopsy and various imaging techniques is crucial for effective management. Advances in treatment, including targeted therapies and improved surgical techniques, continue to enhance patient outcomes and reduce recurrence rates. Understanding these diverse aspects of cancer and skin cancer will help devise effective treatment strategies and improve patient prognosis.

Elevating Therapeutic Penetration: Innovations in Drug Delivery for Enhanced Permeation and Skin Cancer Management.

Skin cancer stands as a challenging global health concern, necessitating innovative approaches to cure deficiencies within traditional therapeutic modalities. While conventional drug delivery methods through injection or oral administration have long prevailed, the emergence of topical drug administration presents a compelling alternative. The skin, aside from offering a swift and painless procedure, serves as a reservoir, maintaining drug efficacy over extended durations. This comprehensive review seeks to shed light on the potential of nanotechnology as a promising avenue for efficacious cancer treatment, with a particular emphasis on skin cancer. Additionally, it underscores the transdermal approach as a viable strategy for addressing various types of cancer. This work also explores into the delivery of peptides and proteins along with in-depth explanations of different delivery systems currently under investigation for localized skin cancer treatment. Furthermore, the review discusses the formidable challenges that must be surmounted before these innovations can find their way into clinical practice, offering a roadmap for future research and therapeutic development.

Current Management of Non-melanoma Skin Cancers

Current Management of Non-melanoma Skin Cancers

A Study of Skin Cancer Knowledge, Attitudes, and Preventive Practices Among Healthcare Professionals and the General Population in Pakistan: Insights for Healthcare Interventions and Policy Development.

Background: Skin cancer is a major global health issue that can be life-threatening. The current study explores the knowledge, attitudes, and practices of healthcare professionals and the general population regarding skin cancer. Method: A cross-sectional study was conducted between January and June 2023 in Lahore, the second-largest city in Pakistan. A total of 407 respondents from the general population and 230 healthcare professionals were recruited using a convenient and snowball sampling technique, respectively. Data were collected using questionnaires and statistical analysis, including chi-square tests, and bivariate logistic regression was performed using SPSS Version 20. Result: In the overall population, 46.4% identified as male, 45.0% as female, and 8.6% chose not to disclose their gender. Significantly differing levels of skin cancer knowledge were observed between genders, with males reporting a higher knowledge (36.4%, crude odds ratio = 1.413, p < 0.001) compared to females (32.9%). In addition, females displayed a more positive attitude (crude odds ratio = 1.874, p < 0.001) and practice (crude odds ratio = 1.401, p < 0.05) toward skin cancer prevention. Furthermore, younger age groups exhibited greater knowledge, attitudes, and practices regarding skin cancer. Education and employment status also have a direct influence on skin cancer knowledge and practices. Moreover, in the current study, healthcare professionals comprised 61.3% physicians, 16.5% nurses, and 22.2% pharmacists. Among these, 37.3% of physicians, 11.3% of nurses, and 12.6% of pharmacists demonstrated the ability to identify common signs and symptoms of skin cancer in a patient (p < 0.001). Furthermore, 44% of physicians regarded regular skin cancer screenings as "very important" (p < 0.01). In addition, 27.4% of physicians and 8.7% of pharmacists exhibited a positive attitude toward regular screening of at-risk patients (p < 0.05). Conclusion: The current study highlights gender and age disparities in skin cancer knowledge and prevention among the general population, emphasizing the need for targeted public health interventions to enhance knowledge and proactive practices. In addition, among healthcare professionals, it reveals variations in knowledge levels, emphasizing the importance of tailored education initiatives to promote consistent skin cancer prevention and management practices within the healthcare community.

Fabrication and In Vivo Evaluation of In Situ pH-Sensitive Hydrogel of Sonidegib-Invasomes via Intratumoral Delivery for Basal Cell Skin Cancer Management.

Basal cell skin cancer (BCSC) develops when skin cells proliferate uncontrollably. Sonidegib (SDB) is a therapeutic option for the treatment of BCSC by inhibiting hedgehog signaling. The problems with SDB's low solubility, poor bioavailability, resistance, poor targeting, and first-pass action make it less effective when taken orally. This investigation set out to design an intratumoral in situ pH-sensitive hydrogel of SDB-invasomes (IPHS-INV) that can effectively treat BCSC by improving SDB's bioavailability, sustainability, targeting, and efficacy while also reducing its resistance and undesirable side effects. Numerous S-INV formulations were developed using Box-Behnken Design Expert and tested before settling on the optimum S-INV formulation. An experimental 7, 12-dimethylbenzanthracene (DMBA) carcinoma rat model was used for in vivo studies of the IPHS-INV formulation after it was combined with chitosan. Phospholipids (1.72% w/w), cholesterol (0.15% w/w), ethanol (1% v/v), and cineole (1.5% v/v) were shown to be the optimal components in the SDB-invasome formulation. The IPHS-INV formulation outperformed the permeation and bioavailability of free SDB by 7.14 and 6 times, respectively, and sustained its release by 57.41%. The IPHS-INV formulation showed a decrease in tumor volume of 99.05% and a reduction of hypercellular tumors, indicating its anti-cancer activity. The intratumoral IPHS-INV formulation maintained a higher concentration of SDB in tumors, indicating its targeting activity. These findings support the use of the intratumoral IPHS-INV formulation as an effective strategy for the treatment of BCSC.

Wheatgrass (Triticum aestivum Linn) : A review of its traditional uses, phytochemistry and pharmacology for the management of skin cancer

Wheatgrass (Triticum aestivum Linn) : A review of its traditional uses, phytochemistry and pharmacology for the management of skin cancer

Unlocking the potential: integrating phytoconstituents and nanotechnology in skin cancer therapy- A comprehensive review.

Skin carcinoma, which includes basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma, is influenced by various factors such as genetic predisposition, chemical exposures, immune system imbalances, and ultraviolet (UV)radiation. This review delves into the mechanisms behind the development of these cancers, exploring the therapeutic potential of microbial, plant derived compounds and nanoparticles in advancing skin cancer treatments. Special attention is given to the cytotoxic effects of anti-neoplastic agents from microbial sources on different cancer cell lines, particularly melanoma. Additionally, the review highlights the role of phytochemicals- such as quercetin, resveratrol, and curcumin alongside vitamins, terpenoids, and sulforaphane, in management of skin cancers through mechanisms like apoptosis induction and cell cycle regulation. Recent advancements in nanotechnology-based drug delivery systems, including NP and microemulsion formulations, are also discussed for their enhanced ability to specifically target cancer cells. The diverse roles of NPs in skin cancer therapy, especially in terms of targeted drug delivery and immune modulation, are reviewed. These innovative NPs formulations have showed improved skin penetration and tumor-specific delivery, reduced systemic toxicity and enhanced therapeutic effectiveness.

National Trends in Healthcare Expenditures for the Management of Skin Cancer in the United States.

Malignant melanoma and keratinocyte carcinomas account for a substantial proportion of healthcare expenditures in the United States. To estimate trends in the economic burden of skin cancer in the United States between 1996 and 2016. The Disease Expenditure Project and Global Burden of Disease databases were used to estimate annual total costs and population-standardized rates of change for skin cancer-related healthcare spending. Skin cancer expenditures totaled $23.4 billion in 2016, of which $1.4 billion (95% CI: $1.3-$1.6 billion) was melanoma-related and $22 billion (95% CI: $18-$28 billion) was keratinocyte carcinoma-related. Most spending on skin cancer management occurred in ambulatory care settings [60.7% (95% CI: 57.7%-64.3%) for melanoma and 87.8% (95% CI: 87.2%-88.2%) for keratinocyte carcinoma]. Pharmaceutical costs for melanoma have increased since 2010 to $365 million (95% CI: $327-$416 million), which represents 26.1% (95% CI: 22.6%-29.3%) of total melanoma expenditure. Skin cancer management in the United States is costly. Expenditures have increased substantially since 1996 without signs of plateauing in recent years.

Exploring the Multifaceted Potential of Kigelia africana: Journey from Ethnomedicine to Cosmeceutical

Since ancient times, Indian Balam Kheera or Kigelia africana sausage trees have been utilized to heal a variety of human afflictions. Ethnobotanists have documented the traditional uses of K. africana, which include the management of skin conditions, cancer, and gynaecological problems. Scientists have been interested in assessing the bioactivity of plant components of K. africana. Numerous researchers have been most interested in its fruit and leaves due to their diverse pharmacological properties. K. africana has been used to develop items that are sold commercially, yet many of them lack complete standardization. It is necessary to carry out additional research, extract novel bioactive phytochemicals, standardize K. africana products, and scientifically confirm other traditional applications of K. africana; despite numerous efforts by researchers to do so, many of these claims remain unsupported. The purpose of this review was to draw attention to Kigelia africana's undiscovered cosmetic potential.

Clinical Utility of a Digital Dermoscopy Image-Based Artificial Intelligence Device in the Diagnosis and Management of Skin Cancer by Dermatologists.

Patients with skin lesions suspicious for skin cancer or atypical melanocytic nevi of uncertain malignant potential often present to dermatologists, who may have variable dermoscopy triage clinical experience. To evaluate the clinical utility of a digital dermoscopy image-based artificial intelligence algorithm (DDI-AI device) on the diagnosis and management of skin cancers by dermatologists. Thirty-six United States board-certified dermatologists evaluated 50 clinical images and 50 digital dermoscopy images of the same skin lesions (25 malignant and 25 benign), first without and then with knowledge of the DDI-AI device output. Participants indicated whether they thought the lesion was likely benign (unremarkable) or malignant (suspicious). The management sensitivity of dermatologists using the DDI-AI device was 91.1%, compared to 84.3% with DDI, and 70.0% with clinical images. The management specificity was 71.0%, compared to 68.4% and 64.9%, respectively. The diagnostic sensitivity of dermatologists using the DDI-AI device was 86.1%, compared to 78.8% with DDI, and 63.4% with clinical images. Diagnostic specificity using the DDI-AI device increased to 80.7%, compared to 75.9% and 73.6%, respectively. The use of the DDI-AI device may quickly, safely, and effectively improve dermoscopy performance, skin cancer diagnosis, and management when used by dermatologists, independent of training and experience.

Keratinocyte Carcinoma: Canadian Landscape and an Evidence-based Approach to Follow-up

Dermatologists play a vital role in the early detection, prevention and effective management of skin cancer in patients with a prior history of the disease. Regular monitoring and timely interventions greatly enhance the overall prognosis and quality of life for patients with skin cancer. Dermatologists possess the requisite expertise to accurately diagnose and oversee the management of cutaneous skin cancers. Skin cancer screening via total body skin exam (TBSE) is often considered one of the safest, easiest, and most cost-effective tests in medicine. Despite dermatologists’ ability to offer such invaluable care for this patient population, offering routine skin checks for all patients with a prior history of skin cancer becomes exceptionally challenging given the high demand for dermatology care across Canada. It is important for dermatologists to maximize the efficiency of care during TBSEs by adhering to evidence-based guidelines when determining the frequency and duration of follow-up. These guidelines also provide a solid foundation for discussions with patients regarding the rationale for discharge back to their primary care provider.