Skin Cancer Research Articles

ACGAN: adaptive conditional generative adversarial network architecture predicting skin lesion using collaboration of transfer learning models

Skin cancer has become a serious disease which has the potential to scale up if it is not identified earlier. It is imperative to detect and give treatment to skin cancer promptly. Diagnosing skin cancer manually takes a lot of time and it is costly, and the probability of false diagnosis has increased due to the outstanding resemblances among various skin lesions. Enhancing the classification of multi-class lesions of skin needs the development of investigative systems which should be automated. Data augmentation with GANs and Adaptive Conditional Generative Adversarial Network strategies improves performance. The performance is tested using balanced and unbalanced datasets. Using a proper process of augmentation of data, the suggested system attains a 94% accuracy for the VGG16, 93% for the ResNet50 and 94.25% for ResNet101. The process of collaboration of all such methods improves accuracy further to 95%. In summary, the novelty of the work lies in its holistic approach to automated skin lesion classification, incorporating advanced deep learning models, novel data augmentation techniques and comprehensive performance evaluation on real-world datasets. These contributions collectively advance the field of computer-aided diagnosis for the detection of skin cancer and treatment.

The Impact of Psoriasis Treatments on the Risk of Skin Cancer: A Narrative Review.

Several studies have described increased risk ratios of certain types of malignancies in patients with severe psoriasis. Among these, the lymphoproliferative disorders, including non-Hodgkin's lymphoma, cutaneous T-cell lymphoma and non-melanoma skin cancer, have been described most frequently. In addition to traditional cancer risk factors, some psoriasis treatments may also be implicated as potential carcinogens. The aim of this study was to perform a review of current literature on the association between psoriasis, the therapies against this disease and skin cancer, focusing on both epidemiology and the potential mechanism involved. Some psoriasis treatments, such as psoralen and ultraviolet A (PUVA) therapy and cyclosporine, have been associated with increased risk of skin cancer. Variable data have been reported for anti-tumour necrosis factor (TNF) drugs, whereas other class of biologics, like anti-IL17 and IL23, as well as ustekinumab, seem not to be related to skin cancer risk, such as the case of currently available small molecules.

Use of Hydrochlorothiazide in the United States Following Label Update About Skin Cancer Risk.

On August 20, 2020, the United States (U.S.) Food and Drug Administration (FDA) issued a Drug Safety Communication (DSC) along with labeling updates to inform the public about a small increased risk of non-melanoma skin cancer (NMSC) associated with hydrochlorothiazide (HCTZ) use. This study aims to assess whether the DSC impacted HCTZ use in the U.S. We conducted a trend analysis in the Sentinel Distributed Database using national healthcare administrative data from January 2017 to November 2022. We identified two cohorts each month: An overall cohort of all enrollees and a skin cancer cohort of those with a history of NMSC. For each cohort, we plotted the monthly proportion of patients receiving HCTZ-containing products among those receiving any thiazide diuretics. We performed interrupted time series analyses to quantify the impact of the DSC on these monthly proportions. Secondary analyses were conducted on the proportion of HCTZ users among patients receiving any antihypertensives. In the overall cohort, the DSC was only associated with a statistically significant but clinically negligible trend change of monthly HCTZ proportion within this cohort (0.018%; 95% CI, 0.012%-0.025%). Similar results were observed in the skin cancer cohort. The secondary analysis found no significant level change or trend change in the monthly proportion of HCTZ use among antihypertensive users. We did not observe significant changes in HCTZ use following the DSC about its NMSC risk, among the overall population and those with a history of NMSC. Our findings were in accordance with the DSC recommendation.

Alpha-1 antitrypsin deficiency associated with increased risks of skin cancer, leukemia, and hepatic cancer: A nationwide cohort study.

α1-Antitrypsin deficiency is characterized by elevated elastase activity and excessive elastin degradation, which may impact cancer development and progression. We tested the hypothesis that individuals with α1-antitrypsin deficiency have increased susceptibility to cancer in the Danish population. In a nationwide nested study, we identified 2702 individuals with α1-antitrypsin deficiency and 26,750 control subjects without α1-antitrypsin deficiency matched on age, sex, and municipality. We recorded admissions due to cancer as outcomes during a median follow-up of 62 years. Individuals with α1-antitrypsin deficiency versus control subjects had an increased hazard of skin cancer (2.18, 95%CI: 1.81-2.63), leukemia (1.76, 1.12-2.79), liver cancer (3.91, 2.23-6.85), and cancer overall (1.25, 1.13-1.38). Corresponding hazard ratios when the entire Danish population was used as control group were 3.02 (2.55-3.58), 1.83 (1.19-2.81), 4.46 (2.74-7.28), and 1.45 (1.31-1.59). When the analysis was stratified according to comorbidities, the hazard for skin cancer was higher in those with chronic obstructive pulmonary disease (COPD) (3.59, 2.60-4.95) and skin disease (2.93, 2.19-3.92) but remained elevated in those without any of these diseases. Hazards for skin cancer in individuals with α1-antitrypsin deficiency were similar when stratified by liver cirrhosis and ischemic heart disease (ps for interaction: ≥0.76). Hazards for liver cancer in individuals with α1-antitrypsin deficiency versus control subjects were similar when stratified according to liver cirrhosis, COPD, skin disease, and ischemic heart disease (ps for interaction: ≥0.13). Individuals with α1-antitrypsin deficiency have increased risks of skin cancer, leukemia, and liver cancer in the Danish population.

Clinical Significance Unveiled: Understanding the Meaning of FACE-Q Skin Cancer Scores for Improved Patient Care.

The FACE-Q Skin Cancer Module is a Patient-Reported Outcome Measure (PROM) utilized to assess outcomes following facial skin cancer resection. However, the lack of Minimal Important Difference (MID) estimates hinders the interpretability of the PROM scores. This study established MID estimates for the four outcome scales from the FACE-Q Skin Cancer Module using distribution-based methods. A prospective cohort study at four hospitals in the United States, enrolled participants who underwent Mohs Micrographic Surgery (MMS) for facial skin cancer between April 2020 and April 2022. Participants completed the Satisfaction with Facial Appearance, Appearance-related Psychosocial Distress, Cancer Worry, and Appraisal of Scars scales at four time points: pre-operatively, 2-week, 6-month, and 1-year post-surgery. A total of 990 patients participated in the study, with completion rates of 98.4% for the pre-operative assessment, 70.8% at 2weeks, 59.3% at 6months, and 60.4% at 1year. MID estimates, calculated using 0.2 standard deviation and 0.2 standardized response mean, were determined for the four scales. The mean MID estimates, based on a Rasch transformed score ranging from 0 to 100, were 5 for the Appraisal of Scars scale and 4 for the remaining three scales. This multicenter study provides valuable MID estimates for the FACE-Q Skin Cancer Module, specifically for the MMS patient population, enabling clinicians and researchers to better interpret scores, determine appropriate sample sizes, and apply the findings in clinical care.

Bicubic regression analysis a novel approach for estimation of physicochemical properties of skin cancer drugs through degree based entropy

Skin cancer poses a significant risk to the healthcare system worldwide and is projected to increase substantially over the next two decades, particularly if not detected in its early stages. The primary aim of this study is to construct a quantitative structure-property relationship (QSPR) by correlating calculated entropies with topological indices and specific physical-chemical properties of pharmaceuticals, in order to enhance their usefulness. The bicubic regression model is constructed through degree-based topological entropies to perform the QSPR analysis for the prediction of physiochemical properties like polar surface area, complexity, molar refractivity, boiling point, and polarity of skin cancer drugs. It is also examined that degree-based entropies provide best-fit models for skin cancer physiochemical properties. We inspected five physio-chemical properties of these anticancer drugs and found this methodology suitable for predicting best-fit approximations regarding R2 value. It is expected that this approach will be very favourable to examining problems related to mathematical chemistry.

Assessing the Concordance of Clinical and Pathological Diagnoses in Basal Cell Carcinoma Among the Iranian Population: A Cross-Sectional Analysis of 229 Cases.

Nonmelanoma skin cancer (NMSC) is the most prevalent malignancy globally, with basal cell carcinoma (BCC) being the most common type. This study aims to evaluate the concordance between clinical and pathological diagnoses of BCC, emphasizing the importance of early detection. In this cross-sectional study, we conducted a retrospective review of clinical and pathological records for 229 patients diagnosed with BCC between 2020 and 2024. The analysis focused on gender, age, lesion location, and diagnostic accuracy. Among the 229 patients, 193 were men (84.3%), and 131 (57.2%) had recorded clinical diagnoses. The mean age of diagnosed patients was 67.72 years. Lesions were primarily located on the scalp (29.5%), face (26.4%), and nose (13.9%). Of the pathological evaluations, 184 cases (80.3%) confirmed BCC, while 45 cases had alternative diagnoses. Notably, 94.6% of clinically diagnosed patients were suspected to have BCC by their physicians. A significant portion of cases (42%) lacked prior clinical diagnoses, reflecting a potential gap in education among nondermatologists regarding BCC recognition. The study found high concordance between clinical and pathological diagnoses of BCC, underscoring the need for improved clinical assessment skills among healthcare providers. Collaboration with dermatologists is essential for accurate diagnosis and improved patient outcomes. Enhanced training in recognizing BCC symptoms is recommended to address the identified gaps in clinical suspicion.

Transcriptomic analysis of genes associated with vitamin D receptor signalling reveals differences between skin cancers.

Vitamin D activates the vitamin D receptor (VDR), which dimerizes preferentially with the retinoid X receptor-α (RXRα). This heterodimer connects with genetic elements responsive to vitamin D, inhibiting or stimulating gene activity. We performed Nanostring® analysis of VDR/RXRα to compare the mRNA expression of this heterodimer and their correlated transcriptomes in non-melanoma skin cancer (basal cell carcinomas (BCC) and squamous cell carcinomas (SCC)) and melanocytic lesions (intradermal nevi (IN), and melanomas (MM)) with control skin. To evaluate VDR, RXRα and other 22 correlated genes in BCC, SCC, IN and MM, paraffin samples had their transcriptomes analysed using Nanostring®, a platform that allows multiple mRNA analyses. There were 46 samples, including 11 BCC, 10 SCC, 10 IN, 12 MM and 3 pools of control skins. Most mRNAs differed between the lesion groups and the control group. BCC and SCC NCOR2 were upregulated; in MM and IN, RXRγ was higher than in the control group. TP53, FOXO3 and MED1 showed a significant difference when we compared the BCC group to the SCC group. Melanoma and intradermal nevi differed only in AhR. VDR and RXRα were lower than the control in all groups. The panel shows a clear difference between the non-melanocytic cancers and, on the other hand, a slight difference between the melanocytic lesions. The study of vitamin D's influence through its receptor and RXRα is an exciting issue for understanding the importance of this pathway, and the present study can impact the prevention and treatment strategies, mainly in non-melanocytic tumours.

Human papillomaviruses in hand squamous cell carcinomas from Chilean patients

IntroductionCutaneous squamous cell carcinoma (SCC) accounts for 20% of all skin cancers and its incidence continues to increase globally. It represents 75% of non-melanoma skin cancer (NMSC) mortality. Risk factors include ultraviolet radiation (UVR) exposure, advanced age, chemical exposure, fair skin types, and immunosuppression. While most human papillomavirus (HPV) infections are associated with the development of warts, a subgroup is potentially implicated in the development of cutaneous SCC. The prevalence of alpha, beta, and gamma-HPV in Chilean patients with hand SCCs has not been previously addressed. The objective of this study was to evaluate the presence of HPV and genotyping in hand SCC from Chilean patients.Materials and methodsAn observational, cross-sectional, descriptive study was conducted. Alpha (α), beta (β) and gamma (γ)-HPV detection was performed by conventional polymerase chain reaction (PCR) in paraffin-embedded tissue samples from 52 patients diagnosed with hand SCC from Santiago, Chile. HPV genotyping was carried out via direct amplicon sequencing by Sanger method.ResultsThe most frequent carcinoma site was the dorsum of the hands (52.5%). α-HPV was not detected in these specimens, whereas β-HPV and γ-HPV were detected in 25% of the analyzed samples. The most frequent genotypes found were β-HPV 100 (38%) and γ-HPV 178 (15%). Additionally, γ-HPV 101, 162, HPV-mSK_016, HPV-mSK_083, HPV-mSK_213 and HPV-mSK249nr genotypes were detected, none of which had been previously described in cutaneous SCC.Conclusionβ-HPV and γ-HPV are detectable in 25% of hand SCCs from Chilean patients. It is important to conduct prospective studies to better elucidate the role of these viruses in the development of this disease.

Cost Analysis of Sunscreens Targeted Towards Skin of Color.

Skin cancer most commonly affects fair-skinned individuals1; however, it can appear in individuals of all skin tones. Photoprotective behaviors such as applying sunscreen should be practiced by all individuals regardless of skin tone. Herein, the authors discuss the cost and protection of popular sunscreens targeted towards patients with darker skin or skin of color (SOC), and suggest important considerations providers should take into account when advising about sunscreen recommendations for patients with skin of color. J Drugs Dermatol. 2024;23(11):e181-e182. doi:10.36849/JDD.8710e.

A Patient-Relevant Measurement Strategy to Assess Clinical Benefit of Novel Therapies for Non-metastatic Cutaneous Squamous Cell Carcinoma.

Although cutaneous squamous cell carcinoma (CSCC) is the second most common type of skin cancer, research describing the patient experience is limited. This study sought to create a conceptual model of non-metastatic disease, to assess patient-reported outcome (PRO) instruments commonly used in CSCC against this model, and to develop a patient-relevant measurement strategy for evaluating the benefit of new therapies. Researchers conducted a literature review, a review of patient blogs, and interviews with dermatologists to draft the conceptual model. A total of 22 patients with CSCC participated in 60-min phone interviews, which were subsequently transcribed, coded, and analyzed; the conceptual model was thenupdated. PRO instruments used in CSCC were assessed for content validity on the basis of this. The CSCC patient experience includes physical symptoms, psychological impacts, and behavior changes. Existing PRO instruments were assessed against the conceptual model using targeted subdomains considered to be relevant for assessing clinical benefit. Four modules of the FACE-Q® Skin Cancer instrument, plus de novo items developed for concepts not assessed by the FACE-Q® [lesion symptoms, negative treatment effects (including symptomatic), and experience of care], provide the best coverage for the concepts of interest hypothesized to show the benefit of novel treatments. This research provides a comprehensive understanding of the experience of patients with non-metastatic CSCC, and the effects of its treatment. It also identifies unmet needs in a subgroup of patients reporting negative treatment experiences. Further cognitive debriefing and psychometric analysis of de novo items are warranted for applications in clinical research.

Analysis of registered clinical trials in Italy regarding dermatology (2003-2022): a cross-sectional study on historical trend and prospects for industry investments.

This cross-sectional analysis intends to evaluate trend and outlook of industry clinical research in Italy regarding dermatology and its prospects for the next few years. A computerized search of ClinicalTrial.gov database was carried out considering the 20-year period 2003-2022 using the following string: "Skin Diseases OR Skin cancer OR Skin Neoplasms OR Skin Infection OR Skin Lesion OR Skin Ulcer OR Skin Laxity OR Skin toxicity OR Dermatologic Complication OR Skin abnormalities". During the last 20 years 690 Industry Clinical Trials (IndCTs) were conducted in Italy regarding dermatological investigations, almost entirely funded by non-Italian pharmaceutical companies, involving 4497 centers, and recruiting an average of 13.0 subjects per site. The number of controlled and randomized studies has grown quite regularly and in the last 5 years they represented 79.6% of IndCTs initiated. Countries most frequently sharing with Italy international protocols were Spain (75.0%), Germany (71.8%), France (68.5%), the USA (67.4%), and the UK (54.8%). These data point to a historical involvement of Italy in dermatology IndCTs lower than in the major European countries. However, the war in Ukraine has deprived IndCTs of the contribution of Russia, Ukraine, and Belarus, meaning a mean of about 40 new IndCTs per year in a population of 200 million inhabitants. In contrast, many indicators point to Italy as a country with potential in dermatology wider than used in the past: an efficient health care system accessible to any citizen or resident, 4.6 million dermatological interventions per year, low density of IndCTs concerning dermatology, good production of scientific papers in indexed medical journals, relatively low cost of services and labour and geopolitical stability. The European Clinical Trials Information System's (CTIS), mandatory for the EU member states since early 2023 allows common, simplified, and harmonized regulatory procedures over the life cycle of clinical trials in Europe (EMA, 2023) and plays in favor of Italy's greater competitiveness in clinical research.

MobileNet-V2: An Enhanced Skin Disease Classification by Attention and Multi-Scale Features.

The increasing prevalence of skin diseases necessitates accurate and efficient diagnostic tools. This research introduces a novel skin disease classification model leveraging advanced deep learning techniques. The proposed architecture combines the MobileNet-V2 backbone, Squeeze-and-Excitation (SE) blocks, Atrous Spatial Pyramid Pooling (ASPP), and a Channel Attention Mechanism. The model was trained on four diverse datasets such as PH2 dataset, Skin Cancer MNIST: HAM10000 dataset, DermNet. dataset, and Skin Cancer ISIC dataset. Data preprocessing techniques, including image resizing, and normalization, played a crucial role in optimizing model performance. In this paper, the MobileNet-V2 backbone is implemented to extract hierarchical features from the preprocessed dermoscopic images. The multi-scale contextual information is fused by the ASPP model for generating a feature map. The attention mechanisms contributed significantly, enhancing the extraction ability of inter-channel relationships and multi-scale contextual information for enhancing the discriminative power of the features. Finally, the output feature map is converted into probability distribution through the softmax function. The proposed model outperformed several baseline models, including traditional machine learning approaches, emphasizing its superiority in skin disease classification with 98.6% overall accuracy. Its competitive performance with state-of-the-art methods positions it as a valuable tool for assisting dermatologists in early classification. The study also identified limitations and suggested avenues for future research, emphasizing the model's potential for practical implementation in the field of dermatology.

The caretaker-reversible Tarsorrhaphy

PurposeTo present a modification of the reversible tarsorrhaphy that can be opened and reclosed as necessary by caretakers and the patient.MethodsRetrospective case series of patients who underwent the reversible tarsorrhaphy.Materials included intravenous (IV) tubing as bolsters and 4–0 polypropylene suture. The 4–0 suture is first passed through and through one end of IV tubing approximately 20 mm in length. Starting on the lateral upper lid and approximately 4 mm above the lash line, the suture is placed through the skin and into the tarsus. The suture exits through the eyelid gray line. These steps through the eyelid are repeated in the opposite direction. An air knot is tied above the upper eyelid near the base of IV tubing. A second air knot can be tied higher to provide a handle easily allowing the caretaker to close the eyelid.ResultsIncluded were 13 patients (ages 21–95-yeas), indications included lagophthalmos secondary to cicatricial changes from burns (2), keratouveitis (1), neurogenic palsy (3), neurotrophic ulcer (6), and cicatricial changes from skin cancer (1). There were no reported difficulties in maintaining the tarsorrhaphy by either family members or healthcare providers. The first tarsorrhaphy for each patient lasted between 3–19 weeks, with an average of 8 weeks. All were well tolerated.ConclusionsThe caretaker-reversible tarsorrhaphy can be used as a temporizing measure. The technique balances the need for ocular protection with the need for examination/treatment by health care professionals and, equally importantly, the patients and caretakers.

[Translated article] RF- Relationship Between Porokeratosis and Skin Cancer

[Translated article] RF- Relationship Between Porokeratosis and Skin Cancer

Melanoma as a detection-dependent cancer: proxy measures of screening and surveillance associated with 3-year incidence of detection procedures for skin cancer in a national prospective study

Abstract Background Increased levels of skin detection activities are suspected of driving recent rapid increases in melanoma incidence. While ecological studies report rising rates of skin biopsies in many industrialised populations, few studies have accessed individual-level clinical data to test the hypothesis that people exposed to skin screening and surveillance go on to experience higher levels of biopsies and excisions, and higher incidence of melanoma. Objective To measure the incidence rates of detection events and melanoma diagnoses in a national cohort during follow-up, stratified according to screening or surveillance activities in the index year. Methods We conducted a prospective cohort study of 10,674,200 men and women using linked data from Australia’s universal health insurance scheme (2011-2016). Participants who underwent biopsies or who were diagnosed in skin cancer in 2011/2012 were excluded. We then defined participants as surveilled, screened, or unscreened for skin cancer based on medical claims occurring in 2013. We compared rates of biopsies, excisions for suspected melanoma, and excisions for histologically confirmed melanoma during follow-up (2014-2016). Results After adjusting for socio-demographic factors, screened people were significantly more likely than unscreened people to undergo skin biopsies (RR 2.59, 95% CI 2.56-2.63), excisions for suspected melanoma (RR 2.57, 95%CI 2.53-2.60), and excisions for confirmed melanoma (hazard ratio 3.32, 95% CI 3.24-3.40) during follow-up. Similarly elevated rates of subsequent diagnostic events were observed for the surveilled group. Importantly, rates of detection and rates of melanoma remained elevated in each of the subsequent years of follow-up among those who were screened or surveilled in the index year. Conclusions People undergoing skin screening or surveillance subsequently experience higher rates of diagnostic scrutiny and higher rates of melanoma.

Immunotherapy at the end of life.

188 Background: It is well established in the literature that cancer treatment administered at the end of life (EOL) does not improve either quality of life or survival rates. Patients undergoing systemic cancer treatments at near the EOL often have reduced access to hospice services and an increased likelihood of acute medical interventions, including emergency department visits, intensive care unit admissions, and in-hospital deaths. The development of immune checkpoint inhibitors (ICIs) has revolutionized cancer care over the past decade, demonstrating the ability to extend progression-free survival and overall survival in patients with various cancers. Furthermore, ICIs may represent a promising therapeutic option for adults with impaired performance status (PS) due to their relatively favorable side-effect profile when compared to conventional chemotherapy. While numerous studies have examined chemotherapy at the end of life, research specifically focusing on the administration of immunotherapy during this period is scarce. Methods: We conducted a retrospective chart review using the electronic medical record database at Scripps clinic focusing on cancer patients undergoing immunotherapy who passed away between June 1, 2017, and August 30, 2023, comprising a cohort of 641 individuals. Our investigation was designed to provide a retrospective overview of patient characteristics and outcomes, with a specific emphasis on factors at EOL. Results: The most prevalent tumor types were lung (34%), GI (21%), skin (13%), GU (12.6%) and others (19.4%). On average, no patients received immunotherapy in the last 30 days of their lives. Among the different cancer types, breast cancer patients had the longest interval between last treatment and death, averaging 259 days. This was followed by patients with head and neck cancer (207 days), skin cancer (199 days), genitourinary (GU) cancers (177 days), lung cancer (140 days), gynecological (GYN) cancers (135 days), and gastrointestinal (GI) cancers (134 days). 19 patients died from immune-related adverse events (IrAEs). These patients had the shortest interval between their last treatment and death, with a mean of 34 days. This was followed by those who died due to cancer progression, with an average interval of 148 days. Conclusions: The decision to administer anticancer therapies near the EOL is increasingly complex. Oncologists must carefully discuss immunotherapy with patients, monitor for IrAEs, and consider discontinuing treatment if there is disease progression, worsening PS or after two years of treatment.

MIDC: Medical image dataset cleaning framework based on deep learning

Deep learning technology is widely used in the field of medical imaging. Among them, Convolutional Neural Networks (CNNs) are the most widely used, and the quality of the dataset is crucial for the training of CNN diagnostic models, as mislabeled data can easily affect the accuracy of the diagnostic models. However, due to medical specialization, it is difficult for non-professional physicians to judge mislabeled medical image data. In this paper, we proposed a new framework named medical image dataset cleaning (MIDC), whose main contribution is to improve the quality of public datasets by automatically cleaning up mislabeled data. The main innovations of MIDC are: firstly, the framework innovatively utilizes multiple public datasets of the same disease, relying on different CNNs to automatically recognize images and remove mislabeled data to complete the data cleaning process. This process does not rely on annotations from professional physicians and does not require additional datasets with more reliable labels; Secondly, a novel grading rule is designed to divide the datasets into high-accuracy datasets and low-accuracy datasets, based on which the data cleaning process can be performed; Thirdly, a novel data cleaning module based on CNN is designed to identify and clean low-accuracy datasets by using high-accuracy datasets. In the experiments, the validity of the proposed framework was verified by using four kinds of datasets diabetic retinal, viral pneumonia, breast tumor, and skin cancer, with results showing an increase in the average diagnostic accuracy from 71.18 % to 85.13 %, 82.50 %to 93.79 %, 85.59 %to 93.45 %, and 84.55 %to 94.21 %, respectively. The proposed data cleaning framework MIDC could better help physicians diagnose diseases based on the dataset with mislabeled data.

New Formulations of Acyclothymidine Dinucleosides Reduce Damaging Effects of Ultraviolet Radiation in an Ex Vivo Skin Model.

The greatest risk factor for skin cancer is exposure to ultraviolet (UV) rays of the sun. Among the three types of solar radiation (UVA, UVB, UVC), UVB rays are most commonly associated with skin cancer. UVB exposure promotes the formation of cyclobutane pyrimidine dimers (CPDs) in the DNA of cells in the epidermal skin layers, which can lead to mutations as DNA repair machinery attempts to repair the damage. These mutations can lead directly to skin carcinogenesis. Previous studies in animal and in human ex vivo skin models have shown that topical application of acyclothymidine dinucleosides protects DNA from UV-induced damage by preventing the formation of CPDs and helps initiate repair through the activation of DNA repair enzymes. Here we review the biological evidence leading to the development and formulation of ProteXidineTM (Topix Pharmaceuticals, Inc., Amityville, NY), as a UV protective agent for topical human application. We also provide clinical data pertaining to four ProteXidineTM formulations (test materials 1-4) tested for their abilities to reduce CPDs in an ex vivo human skin tissue model. J Drugs Dermatol. 2024;23(11):953-956. doi:10.36849/JDD.8420.

Carcinoma Erysipeloides, A Case-report and Review of the Sixty-nine Cases in the Literature

Carcinoma erysipeloides (CE) is a rare form of cutaneous metastasis appearing similar to erysipelas or cellulitis. Due to its rarity, little is known about CE. We here initially reported a case of CE secondary to rectal carcinoma and then reviewed the literature and analyzed the basic characteristics of the cases reported previously. Sixty-nine patients(including our case) with CE were identified. The mean age of diagnosis with CE was 60±15 yr(min:25 yr, max:91 yr), and 69.6% of the patients were female. Breast cancer, skin cancer, and gastroesophageal cancer were the three most commonly seen malignancies presented with CE(52.2 %, 11.6 %, and 10.1 %, respectively). Adenocarcinoma(81.2 %) was the primary histological subtype of the cases. While CE was the first presentation of the disease in 20.3% of patients, it was associated with recurrence or disease progression in 69.7 %. The median time from the first presentation of the disease to the diagnosis of CE was two years. More than half of the patients(55.1 %) have received local dermatological treatment with another differential diagnosis before diagnosis of CE. Only 21.7 % of the patients responded to the treatment, and median survival after diagnosis of CE was 4 months(min:0 mo, max:24 mo). CE has a poor prognosis and is most common in individuals with breast cancer and adenocarcinoma. Patients generally receive local dermatological treatments with different diagnoses. CE should be considered in the differential diagnosis, especially in the presence of erysipelas/cellulitis-like lesions in patients with a history of malignancy or who do not respond to local treatments.