Dermoscopy in Epidermodysplasia Verruciformis

BACKGROUND: Epidermodysplasia verruciformis (EV) is a rare autosomal recessive genodermatosis characterized by an impairment of cellular immunity. It clinically manifests as widespread, long-lasting, pityriasis versicolor-like macules and flat, wart-like papules, usually occurring in early childhood. There is a risk of development of multiple skin cancers in the third decade, primarily in sun-exposed skin. EV-associated human papillomaviruses have been implicated in a number of cutaneous lesions in non-EV populations, such as seborrheic keratoses or psoriasis. They have also been implicated in the development of nonmelanoma skin cancer, especially in immunosuppressed patients. Patients affected with EV are not able to eliminate oncogenic viruses within lesions, leading to a malignant transformation. OBJECTIVE: To describe the dermoscopic characteristics of EV cutaneous tumors by performing histopathologic correlation. METHODS AND MATERIALS: Cutaneous lesions and tumors from two patients affected by EV were included. Clinical and dermoscopic images were obtained and excision with ulterior histopathology was performed in all suspicious tumors and characteristic lesions. RESULTS: Dermoscopy and histology of pityiriasis versicolor-like macules, wart-like papules, seborrheic keratosis-like tumors, psoriasis-like plaques, collision tumors, and Bowen in situ carcinoma are described. CONCLUSIONS: Dermoscopy in EV tumors correlated with histopathologic findings and improved the differential diagnosis of tumors in this disease.     

Aggressive Squamous Cell Carcinoma Originating as a Marjolin's Ulcer

Background. Marjolin's ulcer is an epidermoid carcinoma arising in a scar or chronic wound and can have an aggressive course.
Objective. To present a case of squamous cell carcinoma arising in a burn scar with resulting metastases and to discuss Marjolin's ulcer.
Results. The patient continued to have further metastatic disease despite aggressive surgical treatment.
Conclusion. In following patients with chronic ulcers and wounds, it is important to evaluate any changes immediately with biopsies and further imaging studies if indicated in order to treat effectively. Even aggressive surgical intervention will sometimes be inadequate in treating these tumors.     

Maintenance Versus Reduction of Immunosuppression in Renal Transplant Recipients With Aggressive Squamous Cell Carcinoma

Background. There has been a significant increase in skin cancers in transplant patients in recent years. Transplant recipients are also more likely to develop skin cancers that are locally invasive with the potential to metastasize early.
Objectives. This study aimed to determine the effect of significantly reducing or stopping immunosuppressive therapy on prognosis of aggressive squamous cell carcinomas (SCC) in renal transplant recipients (RTRs).
Patients/methods. Retrospective study of nine patients with aggressive SCC identified two groups, one whose immunosuppressive therapy was not altered and the other who had their therapy stopped or significantly reduced.
Results. Aggressive SCC all occurred on the head and neck, with five of the primary tumors originating from the ear. Using a Wilcoxon-Breslow test to compare equality of survivor functions, reducing or stopping immunosuppression was associated with the prolongation of metastatic disease-free survival period (p=0.023).
Conclusions. This nonrandomized pilot study suggests that reduction of immunosuppression in RTRs with aggressive SCC may improve prognosis compared to patients whose immunosuppression is unchanged. Allograft function may continue despite significant reduction of immunosuppression.     

Prognostic Significance of CD151 Expression in Esophageal Squamous Cell Carcinoma with Aggressive Cell Proliferation and Invasiveness

Background

CD151 is a member of the tetraspanins and has recently been reported as a promoter of the malignant progression of cancer. The purpose of this study was to clarify the clinicopathological outcome and prognostic significance of the immunohistochemical expression of CD151 in esophageal squamous cell carcinoma (ESCC).

Methods

We evaluated the significance of CD151 expression by immunohistochemistry in 138 surgically resected ESCC and the association of CD151 expression with clinicopathological features.

Results

Seventy-five (51.7%) ESCC showed a positive expression of CD151, which indicated a significant association with tumor depth (P = 0.004), lymph node metastasis (P = 0.002), distant metastasis (P = 0.025), and lymphatic invasion (P = 0.046), as well as the Ki-67 labeling index (P = 0.011). The 5-year survival rate of ESCC patients with CD151-positive expression was significantly lower than with CD151-negative expression (positive, 43.1%; negative, 63.8%; P = 0.003). Multivariate analysis showed that positive CD151 expression was not an independent factor for poor survival (P = 0.096).

Conclusions

CD151 expression is associated with tumor proliferation and invasiveness in ESCC.     

Periocular Squamous Cell Carcinoma

BACKGROUND We present a case report of periocular squamous cell carcinoma and a review of the literature with emphasis on early diagnosis, proper follow-up and management, reconstructive options, and new immunomodulatory therapies.
OBJECTIVE The objective is to guide the dermatologist and the dermatologic surgeon in proper management and continued care of patients with periocular squamous cell carcinoma in light of its propensity for perineural involvement and regional lymphatic metastases.
MATERIALS AND METHODS A MEDLINE, Ovid, and PubMed search was conducted for recent relevant articles pertaining to "periocular,""periorbital,""squamous cell" carcinoma, and their "surgery""treatment" modalities.
CONCLUSIONS Periocular squamous cell carcinoma is an aggressive tumor, characterized by perineural involvement and an overall rate of regional lymph node metastases reported to range from 10% to as high as 20% to 25%. Increased vigilance must be undertaken when treating these high-risk tumors. Mohs micrographic surgery or excision with frozen section analysis is the standard of care for periocular squamous cell carcinoma. Multiple options exist for the reconstruction of the postoperative defect that allow for excellent function and cosmesis. Finally, research into new immunomodulators will hopefully lead to an increased understanding of the aggressive nature of periocular squamous cell carcinoma and potential aid in the treatment of the tumor.     

Aggressive Cutaneous Squamous Cell Carcinoma Associated with Prolonged Voriconazole Therapy in a Renal Transplant Patient

A 69-year-old man, with a history of end-stage renal disease due to polyarteritis nodosa, followed by invasive pulmonary aspergillosis secondary to cyclophosphamide and corticosteroids, received a renal transplant 2 years ago under prophylactic treatment with voriconazole. Because of the severity of the aspergillosis, it was decided to continue voriconazole for a prolonged period. Eighteen months after transplantation, the patient developed a severe facial phototoxic reaction. A few months later, he developed multiple actinic keratoses and a large, rapidly expanding, poorly differentiated squamous cell carcinoma (SCC) with perineural invasion and metastatic lymph nodes, necessitating radical surgery and radiotherapy. Voriconazole therapy has been suggested to be involved in the development of multi-focal invasive SCC when complicated by a phototoxic reaction. Therefore, an alternative antifungal prophylaxis regimen (for instance with posaconazole) should be considered when evaluating patients for solid organ transplantation who are at high risk for the development of cutaneous malignancies.     

Aggressive and Neglected Basal Cell Carcinoma

Background. Basal cell carcinoma (BCC) is the most common cutaneous malignancy and usually has a benign coarse. Rarely, examples of aggressive and neglected types of this tumor are seen.
Objective. To present an interesting and dramatic example of how some people neglect their tumors and how devastating the sequelae can be.
Methods. We report a 58-year-old man with an extensive BCC and signs of cranial nerve involvement.
Results. The patient had a large, infected ulcer on his scalp. He also had skull bone destruction, osteomyelitis, mastoiditis, cranial nerve paralysis, and radiographic features of the skull base and upper cervical soft tissue involvement. Pathologic studies revealed an infiltrating form of BCC.
Conclusions. If left untreated and neglected, as in this case, BCC can become inoperable and complicated.
ALI ASILIAN, MD, AND BANAFSHE TAMIZIFAR, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.     

Squamous Cell Carcinoma in an Ileal Conduit

We report a patient with squamous cell carcinoma that developed at the ureteroileal anastomosis and extended into the ileal conduit 11 years after a radical cystectomy for transitional cell carcinoma of the bladder. To our knowledge, this is the first report to document the development of a squamous cell carcinoma in an ileal conduit after a radical procedure for bladder cancer.     

Hidradenitis Suppurativa and Squamous Cell Carcinoma

BACKGROUND: Hidradenitis suppurativa is a recurrent, chronic inflammatory disease with complications such as abscesses and sinus tract formations, fistulization, and scarring. Squamous cell carcinoma is rare, and is the most serious complication. OBJECTIVE: To present the evolution of squamous cell carcinoma in long-term hidradenitis suppurativa. METHODS: Case report and literature review. CONCLUSION: Many conservative therapies have no or minimal effect in perineal hidradenitis suppurativa. Therefore surgical excision must be considered in the early stages of the disease at this region to prevent further complications.     

Significance of Intramural Metastasis in Patients with Esophageal Squamous Cell Carcinoma: An Indicator of Aggressive Cancer Behavior

World Journal of Surgery - Intramural metastasis (IM) is occasionally noted in patients with esophageal squamous cell carcinoma (ESCC). However, few recent studies have investigated the...     

Squamous Cell Carcinoma Arising in a Leishmania Scar

BACKGROUND: The appearance of squamous cell carcinoma (SCC) in chronic scar lesions of various etiologies has been reported. Here we present a case of SCC developing in a Leishmania scar after 59 years. OBSERVATIONS: An Iranian female presented with a SCC that arose when she was 3 years of age in a scar that was secondary to cutaneous Leishmania. CONCLUSIONS: SCC should be included as a rare but late sequela of cutaneous Leishmania.     

Incidentally-Discovered Squamous Cell Carcinoma after Endoscopic Sphincterotomy

The association between the development of bladder cancer and chronic bladder irritation is well established in the literature. Chronic urinary tract irritation can be the result of bacterial infections, foreign bodies, trauma of repeated catheterization, neurogenic bladder, urolithiasis, or chronic bladder outlet obstruction, all which have been implicated in the pathogenesis of non-bilharzial squamous cell carcinoma of the bladder (SCC). With many of the aforementioned factors present in patients with spinal cord injury, several retrospective studies have demonstrated a 16–28 fold increased relative risk of bladder cancer, with SCC accounting for 10 times more cases of bladder cancer compared to the general population. In this report, we present the case of incidentally-discovered SCC of the bladder found within sphincter/prostate chips of a patient with neurogenic bladder due to spinal cord injury n clean intermittent catheterization ho underwent sphincterotomy with negative cystoscopic findings.Key Words: Bladder cancer, Catheterization complication, Cystoscopy, Spinal cord injury, Squamous cell carcinoma     

皮肤鳞状细胞癌的研究进展

皮肤鳞状细胞癌是黑素瘤之外导致皮肤肿瘤患者死亡的首要病因。皮肤鳞状细胞癌的发病机制至今尚不明确,限制了相关分子靶向治疗的发展。目前,临床上对该病的治疗仍以手术治疗为主,辅以放射治疗等其他手段。本文结合文献对其相关研究进展进行综述。