Cisplatin combination chemotherapy in squamous cell carcinoma and adenoid cystic carcinoma of the skin

Seven patients with skin cancers, six with squamous cell carcinoma (SCC) and one with adenoid cystic carcinoma, were treated with cisplatin in combination with vindesine or adriamycin. Partial response was observed in three patients with squamous cell carcinomas: two cases with metastatic lung lesions and one with a primary skin lesion and lymph node metastasis. Two of the responding SCC had been resistant to previous chemotherapy, including peplomycin and mitomycin C. Multiple metastatic lesions of adenoid cystic carcinoma of the skin completely regressed after two courses of the combination chemotherapy with cisplatin and adriamycin. This report showed that cisplatin combination chemotherapy may be useful for the treatment of cutaneous squamous cell carcinoma, which is resistant to peplomycin, and adenoid cystic carcinoma of the skin.     

Basal cell carcinoma of the vulva

Basal cell carcinoma (BCC), the most common human malignancy, accounting for 75% of all non-melanoma skin cancer, is uncommon on unexposed skin such as the perianal and genital regions. We describe a woman with BCC of the vulva treated with local resection. All margins of excision were free of disease. The patient recovered without complication and there have been no recurrences after 2 years of follow-up. Approximately 200 cases of BCC on perianal and genital skin have been reported in the literature. Although the aetiology of vulvar BCC is not known, early diagnosis is important. Because BCC in these sites sometimes seems innocuous, biopsy of all suspect lesions is advisable.     

Declining mortality rates for nonmelanoma skin cancers in West Germany, 1968-99

BACKGROUND: Mortality analyses based on routine death certification provide a rough guide to the magnitude of nonmelanoma skin cancer (NMSC) mortality. OBJECTIVES: To examine time trends in NMSC mortality over a 32-year period for the territory of West Germany which included a population of about 66 million people. METHODS: We analysed the NMSC skin cancer mortality data (1968-99) from the former West Germany including West Berlin. We calculated the age-specific and age-standardized mortality rates (World Standard Population) and used a Poisson regression to estimate the underlying age, cohort and period effects. RESULTS: The age-standardized mortality rate decreased from 0.56 per 100,000 in 1968 to 0.24 per 100,000 in 1999 among men and from 0.42 per 100,000 in 1968 to 0.11 per 100,000 in 1999 among women. The estimated annual percentage decrease of the age-standardized NMSC skin cancer mortality rate was -2.3%[95% confidence interval (CI) -2.6 to -1.9] among men and -3.5% (95% CI -4.0 to -3.1) among women during the period 1968-99. This decline is mainly due to a rate decrease in people aged 80 years or more. The change in NMSC skin cancer mortality rates was best explained by age, cohort and period effects. CONCLUSIONS: The NMSC mortality in West Germany showed a continuous decrease from 1968 to 1999. The favourable mortality decline by birth cohort in the most recent birth cohort is an indicator of a likely decline in mortality in the future.     

Basal cell carcinoma of the scrotum

An 80-year-old man with a 7 year history of a slowly enlarging, asymptomatic scrotal nodule is presented. He had a negative history for sexually transmitted disease, trauma to the area, radiotherapy and chemical or arsenic exposure. The lesion was excised with a margin of 0.8 cm of normal skin. Examination of the specimen revealed a basal cell carcinoma.     

Mutational analysis of CDKN2A genes in patients with squamous cell carcinoma of the skin

BACKGROUND: Nonmelanoma skin cancers [squamous cell carcinomas (SCC) and basal cell carcinomas (BCC)] are the most common neoplasias of the Caucasian population. OBJECTIVES: The purpose of our study was to determine the involvement of CDKN2A genes in the development of sporadic nonmelanoma skin cancer in Greek patients. PATIENTS AND METHODS: Allelic imbalance analysis was performed in 22 SCC and five Bowen's disease specimens. Mutational analysis was performed on exons 1alpha, 1beta and 2 of the CDKN2A locus in 22 SCC, five Bowen's disease and 39 BCC specimens. Exon 1alpha was additionally screened in 28 BCC specimens to complete the mutational analysis of a previous study. RESULTS: Overall, 52% (14 of 27) of the SCC and Bowen's disease specimens exhibited loss of heterozygosity (LOH) in at least one microsatellite marker, whereas, only two of 27 (7%) exhibited microsatellite instability. LOH in 9p appears to be equally involved in both BCC and SCC tumours. Exons 1alpha, 1beta and 2 of the CDKN2A locus were screened for mutations. A Val28Gly substitution in exon 1alpha and a CCC-->TTT (Ala57Val and Arg58Ter) substitution in exon 2, resulting in a change in the amino acid sequence, are reported for the first time in two SCCs, the latter being indicative of a combination of an ultraviolet (UV) radiation-induced mutation and a point mutation. A previously described polymorphism of CDKN2A, the gene for p16INK4a, Ala148Thr, was also detected in an allelic frequency of 3.72%. No mutation was found in any of the five Bowen's disease specimens, or in exon 1beta of CDKN2A, also the gene for p14ARF. CONCLUSIONS: Mutations and the high incidence of 9p LOH detected in our SCC samples imply that inactivation of CDKN2A genes, via allelic loss and/or mutation (probably UV-induced) may play a significant role in nonmelanoma skin cancer development, particularly in the more aggressive SCC type.     

Basal cell carcinoma of the skin: whole genome screening by comparative genome hybridization revisited

Basal cell carcinoma (BCC) of the skin is considered to be the most common malignancy in people of European ancestry. It is often not clinically aggressive and has been regarded as genetically stable. However, histopathologic subtypes of BCC differ in their ability to invade surrounding tissues and recur. The aim of this work was to present a comprehensive study of chromosomal imbalances of cutaneous BCC and to correlate the findings with their histopathologic and clinical features. In all, 101 tumor samples were classified according to the current microscopic classification of BCC and then analyzed by comparative genomic hybridization (CGH). Over 60% of BCC were found to carry chromosomal imbalances – partial or whole chromosome gains and losses. Different subtypes of BCC presented common chromosomal alterations. No single chromosomal imbalance was found to be characteristic of a particular subtype of BCC, although the frequency of some chromosomal changes differed from one group to the other. The significance of chromosome 2 gains as a phenomenon that does not coexist with the losses in 9q is discussed.     

皮肤基底细胞癌和皮肤鳞状细胞癌270例回顾性分析

 目的:总结我院皮肤基底细胞癌(BCC)和皮肤鳞状细胞癌(SCC)临床与组织病理资料,以期提高BCC与SCC的诊断率。方法：回顾性分析2014年1月1日-2018年12月31日间我院皮肤科门诊经组织病理切片确诊的170例BCC与100例SCC患者的临床与病理资料。结果：BCC与SCC年度发病整体均呈逐渐上升趋势。BCC、SCC男女患病比例分别为0.8∶1、1∶1，好发部位均为曝光部位(头面颈部和四肢)，临床诊断与组织病理诊断符合率分别为62.4%与30.0%。临床诊断上，BCC易与脂溢性角化病(SK)、色素痣混淆；SCC易与BCC、鲍温病、光线性角化病(AK)混淆。结论：BCC和SCC为临床常见的非黑素性皮肤肿瘤，但易误诊和漏诊。临床医生对于可疑病灶应尽早行皮损组织病理检查。     

皮肤鳞状细胞癌整体可视化动物模型实验研究

目的:建立整体可视化皮肤癌的模型,以期实时动态观察药物与肿瘤体积、血清指数等指标的量效关系,为研究皮肤癌临床治疗提供一种更好的动物模型.方法:利用pEGFP-N1表达质粒转染皮肤鳞状细胞癌(以下简称鳞癌)SCL-1细胞,经筛选后建立稳定表达绿色荧光蛋白(EGFP)的皮肤鳞癌细胞株pEGFP-SCL-1.细胞悬液接种于裸鼠皮下,借助整体荧光成像系统实时监测细胞在接种部位生长情况.结果:皮肤鳞癌细胞pEGFP-SCL-1稳定、高效表达EGFP,裸鼠皮下注射部位种植成瘤,1周左右肿瘤向周围组织浸润;常规组织病理学检查验证了可视化模型的可靠性.结论:利用稳定转染的皮肤鳞癌pEGFP-SCL-1细胞,在注射部位种植建立整体可视化皮肤鳞癌,为研究皮肤癌治疗提供有效的阶段性监测的实验模型.     

Malignant skin cancers in the Finnish Twin Cohort: a population-based study, 1976-97

BACKGROUND: Both hereditary and environmental factors are implicated in the aetiology of cutaneous neoplasms. Studies of twins make it possible to estimate the contribution of inherited genes to the development of disease. OBJECTIVE: To assess the importance of hereditary and environmental factors (including physical environment and lifestyles) in malignant melanoma and malignant nonmelanoma of the skin. METHODS: The Finnish Twin Cohort, comprising 25 882 adult like-sexed twins with established zygosity, was linked with the Finnish Cancer Registry to identify malignant skin cancers in a prospective follow-up from 1976 to 1997. Standardized incidence ratios were computed based on national rates. RESULTS: Sixty twins were diagnosed with melanoma and 49 twins with nonmelanoma during the follow-up. The risks of these cancers did not differ from the risk in the population at large. There was only one pair where both twins had a malignant skin cancer (dizygotic male twins both with squamous cell carcinoma). CONCLUSIONS: The near-total lack of concordance for skin cancer in twin pairs suggests that environmental and not hereditary effects are most important in the causation of malignant skin cancers in a white population with low levels of sun exposure.     

Squamous cell carcinoma in situ of the skin: history, presentation, biology and treatment

Squamous cell carcinoma in situ (SCCIS) of the skin is a problem commonly dealt with by dermatologists. The classic presentation, originally described by Bowen, is easily recognized, but presentation on some anatomical surfaces may be associated with less than typical features. Major aetiological factors for this disease are UV light, human papillomavirus infection and immunosuppression. The natural course of SCCIS is usually prolonged, with treatment being appropriate, but not urgent. The choice of therapy requires consideration of the location of the lesion, and a desire for a high cure rate without causing loss of form, function or cosmesis. The immunomodulatory agent imiquimod has offered a significant advance for the topical treatment of SCCIS. Our improved understanding of the underlying biology of SCCIS permits us to make rational choices of treatment. In the future we may be able to determine which of these lesions may progress to invasive disease, and help us select the most effective therapy.     

Tretinoin and the prevention of keratinocyte carcinoma (Basal and squamous cell carcinoma of the skin): a veterans affairs randomized chemoprevention trial

Keratinocyte carcinoma (KC) is the most common cancer in the United States, with no proven means for prevention other than systemic retinoids, which have significant toxicity, and sunscreen. Topical tretinoin has been used for KC chemoprevention, although this use is unproven. Hence, we conducted the randomized Veterans Affairs Topical Tretinoin Chemoprevention Trial of high-dose topical tretinoin for KC prevention. We randomized 1,131 patients to topical 0.1% tretinoin or a matching vehicle control for 1.5-5.5 years. The primary outcomes were time to development of new basal cell carcinoma (BCC) and new invasive squamous cell carcinoma (SCC) on the face or ears. The effects were not significant (P=0.3 for BCC and P=0.4 for SCC). The proportions of the tretinoin and control groups who developed a BCC at 5 years were 53 and 54% and an invasive SCC at 5 years were 28 and 31%. These differences (95% confidence intervals) were: for BCC, 1.0% (-6.5, 8.6%); for SCC, 3.6% (-3.1, 10.3%). No differences were observed in any cancer-related end points or in actinic keratosis counts. The only quality of life difference was worse symptoms in the tretinoin group at 12 months after randomization. This trial in high-risk patients demonstrates that high-dose topical tretinoin is ineffective at reducing risk of KCs.     

Survivin及p63蛋白在鳞状细胞癌皮损中的表达及其意义

目的：研究皮肤鳞癌组织中Survivin蛋白和p63蛋白的表达及其意义：方法：采用免疫组化法检测60例皮肤鳞癌组织中Survivin蛋白和p63蛋白的表达，探讨两者与鳞癌组织分化程度的关系。结果：Survivin蛋白在皮肤鳞癌组织中阳性表达率为73．3％，其表达越强，组织分化程度越低。p63在高分化鳞癌中呈环状分布于癌巢周围，低分化鳞癌中阳性细胞增多，分布紊乱，其表达在癌的不同分化中差异有显著性。结论：皮肤鳞癌中Survivin蛋白的表达与分化程度有密切关系，它的高表达提示肿瘤预后不良，也可能成为治疗皮肤鳞癌的重要新靶点。p63过度表达的癌细胞是获得了更具增殖、侵袭和间变能力的细胞。     

Basal cell carcinoma of the vulva: a report of four cases

Four cases of vulval basal cell carcinoma were identified in multiparous females aged 46-78 years. Symptoms included discomfort and pruritus ranging from 6 weeks to 4 years in duration. Such symptoms occurred in the context of a pink vulval plaque. The non-specific symptoms, in the context of the particular anatomical site, led to late presentation. Subsequent treatment in all cases involved wide local excision following incisional biopsy. No recurrence has been documented after a minimum follow-up period of 12 months.