Journal of Skin Cancer最新文献

Background: Locally advanced basal cell carcinoma represents a therapeutic challenge, especially if already exposed to hedgehog (Hh) pathway inhibitor (HPI) therapy. Effectiveness after switching to another HPI still requires exploration.

Methods: This observational, descriptive study retrospectively evaluates the clinical outcomes of sonidegib in patients with vismodegib-treated locally advanced basal cell carcinoma in a real-world, multicenter cohort across nine centers. Twelve patients with histologically aggressive locally advanced basal cell carcinoma previously exposed to vismodegib for at least 3 months were analyzed. Each received sonidegib at a standard dosage. Treatment response was assessed clinically according to tumor size changes and classified as complete response (100% decrease), partial response (at least 50% decrease), stable disease (up to 20% increase or less than 50% decrease), or disease progression (at least 20% increase). Adverse events (AEs) were documented.

Results: Two patients achieved complete clinical response, nine demonstrated partial response, and one exhibited disease progression. Disease control was achieved in 11 of the 12 patients (91.7%). No novel AEs have been documented, and they were managed through dose adjustments or temporary interruptions.

Conclusion: These findings suggest that sonidegib could still show efficacy and may still serve as a viable second-line option after prior Hh pathway suspension.

Introduction: Mycosis fungoides (MF) is the most common form of cutaneous T cell lymphoma. Given that MF is a rare disease, evidence regarding its impact on sleep and quality of life is limited; however, our study aims to evaluate this aspect.

Patients and methods: In this case-control study, 72 patients with MF were enrolled in the case group, and 72 matched healthy individuals were enrolled in the control group. Data regarding sleep disturbances were collected and analyzed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires. Poor sleep quality was defined as a score > 5.

Results: The control and case groups had median scores of 5.12 ± 2.57 and 10.22 ± 3.75 by PSQI and 6.39 ± 4.86 and 16.28 ± 6.99 by ISI, respectively. Multiple logistic regression revealed a significant association between the study group and the prevalence of poor sleep quality, as measured by both the PSQI (p < 0.0001) and the ISI (p < 0.0001). However, age, sex, marital status, pruritus, disease stage and onset, and lesion locations were not found to be associated with poor sleep quality.

Discussions: Both the severity and prevalence of sleep disorders were significantly higher in the patients compared to a matched healthy population. Due to the profound impact of sleep on quality of life and considering the high prevalence of sleep disorders in patients with MF, evaluating a patient's sleep quality could improve their quality of life. Therefore, professional treatment can be administered if sleep disorders are observed or suspected.

Cutaneous melanoma (CM) remains a rapidly rising malignancy, with metastatic disease still carrying a limited 5-year survival. Immune checkpoint inhibitors (ICIs) have changed the treatment landscape, yet only a fraction of patients achieves durable benefit. Easily obtainable blood-based biomarkers are, therefore, needed to guide patient selection and prognostication. Eosinophilic granulocytes have emerged as potential modulators of antitumor immunity. In this systematic review and meta-analysis, we adhered to PRISMA guidelines and searched PubMed, Cochrane Library, and Scopus for studies published from 2011 onward that evaluated baseline peripheral eosinophil counts (absolute or percentage) as predictors of overall survival (OS) in advanced (stage III/IV) melanoma patients treated with ICI. Six cohort studies totaling 4.243 patients met inclusion criteria, each reporting hazard ratios (HRs) and 95% confidence intervals (CIs) in multivariable analyses for high versus low baseline eosinophil groups. Study quality was high (Newcastle-Ottawa Scale ≥ 7 stars), though selection biases were noted across all cohorts. A random-effects meta-analysis (DerSimonian-Laird method) initially yielded a pooled HR of 0.69 (95% CI: 0.36-1.30) for high versus low eosinophil counts, but heterogeneity was substantial (I ² = 77.8%, p < 0.001). Through Baujat and leave-one-out diagnostics, one study was identified as an influential outlier; its exclusion reduced heterogeneity down to 33.3% (p=0.20). Reanalysis of the remaining five studies (n = 4.158) demonstrated a significant survival advantage for patients with elevated baseline eosinophils (HR: 0.51 and 95% CI: 0.39-0.66; p < 0.001). Funnel plot symmetry and a nonsignificant Egger's test (p=0.27) indicated no evidence of publication bias. These findings support baseline peripheral eosinophil count as a cost-effective, readily available biomarker associated with improved OS under ICI therapy in advanced melanoma. However, prospective studies with standardized eosinophil thresholds, comprehensive covariate adjustment, and integrated mechanistic analyses are warranted to validate and operationalize this marker for patient stratification in clinical practice.

This study utilized molecular docking techniques to investigate the potential of phytochemical compounds in Houttuynia cordata Thunb. extract as inhibitors of the oncogenic MAPK signaling pathway in melanoma. The docking results revealed that several phytochemical compounds exhibited favorable binding interactions with the BRAF^V600E, MEK, and ERK ATP-binding site. A total of 16 compounds have high affinity (binding energies < -9 kcal/mol) for BRAF^V600E, 13 compounds for MEK-1, 6 compounds for MEK-2, 18 compounds for ERK-1, and 10 compounds for ERK-2. Hesperidin exhibited the lowest binding energy to BRAF^V600E (-10.216 kcal/mol) and ERK-2 (-10.336 kcal/mol). Quercitrin has the lowest binding energy against MEK-1 (-9.963 kcal/mol), 3-hydroxy-β-sitost-5-en-7-one demonstrated the lowest binding energy to ERK-1 (-10.495 kcal/mol), and rutin was best against MEK-2 with a calculated binding energy value of -9.963 kcal/mol. The binding modes of these compounds are compared with the known inhibitors of the oncoprotein targets that showed similar interactions to key amino acid residues indicating their inhibitory potential and are suggested as promising candidates for melanoma treatment.

Objective: This study aims to evaluate the diagnostic efficacy of dermoscopy for cutaneous squamous cell carcinoma (cSCC).

Methods: A retrospective analysis was conducted on skin lesions diagnosed as cSCC via histopathology at the Department of Dermatology, Pingdu District, The Affiliated Hospital of Qingdao University, between January 2021 and August 2024 (case group). Lesions suspected of cSCC but ultimately diagnosed as other conditions served as the control group. The study compared disease progression and dermoscopic features between the two groups through chi-square test and logistic regression analysis, using histopathological results as the diagnostic reference standard.

Results: The case group consisted of 41 lesions, while the control group comprised 18 lesions diagnosed with conditions including actinic keratosis, basal cell carcinoma, and keratoacanthoma. The clinical misdiagnosis rate was approximately 30.5%. Notably, a disease duration of less than 2 years (28/41, 68.29%), the presence of white circles (21/41, 51.22%) and blood spots (35/41, 85.37%), and a total of ≥ 5 dermoscopic features (19/41, 46.34%) were significantly more prevalent in the case group compared to the control group (both p < 0.05). Among these, a disease duration of less than 2 years, along with the presence of white circles and blood spots, demonstrated statistical significance in differentiating cSCC from other conditions (both p < 0.05).

Conclusions: For patients with clinically suspected cSCC, a disease duration of less than 2 years and dermoscopic observation of white circles and blood spots provide substantial diagnostic value.

Introduction: Mycosis fungoides (MF) represents the most prevalent form of cutaneous lymphoma, characterized by diverse histopathological patterns. However, recent comprehensive studies systematically evaluating the spectrum of histopathological patterns and changes associated with MF in patients within Iran are notably lacking.

Method: This cross-sectional descriptive study analyzed 64 skin biopsy slides diagnosed with MF, archived from 2013 to 2023 at Al-Zahra Hospital and a private dermatopathology laboratory in Isfahan, Iran. Inclusion criteria included all slides with complete demographic data and a confirmed MF diagnosis. Patterns and finding of these slides were analyzed according to age, gender, and biopsy site. Data analysis was performed using SPSS Version 26.0, with significance set at p < 0.05.

Results: The study included 31 females and 33 males, with a mean age of 44.64 ± 14.91 years. The most common biopsy site was the trunk (45.31%). The predominant histopathologic patterns observed were psoriasiform (33 cases), lichenoid (14 cases), and spongiotic (10 cases), with universal epidermotropism across all slides. Parakeratosis and cytological atypia were found in 37 and 31 cases, respectively. Notably, eosinophils were more frequent in males (p=0.016), and cytological atypia were significantly more common in males than females (p=0.044). Mild dermal infiltrate was the most prevalent, particularly in the 35-42 and 43-56 age groups, with a significant age-related variation (p=0.041).

Conclusion: This study reveals that psoriasiform, lichenoid, and spongiotic patterns are the most common in MF, with epidermotropism present in all cases. Age and gender significantly influence certain features, but overall, histopathological patterns showed no significant variation by biopsy location or age group.

Hispanic and Latino melanoma patients face significant disparities in patient outcomes and survival rates due to challenges in melanoma care, including later-stage diagnoses, disproportionate financial burdens, and cultural differences. Healthcare insurance status is an important contributing factor to these disparities, with uninsured Hispanic patients being more likely to delay seeking medical attention and face higher out-of-pocket costs. Socioeconomic factors, including lower income levels, limited education, and occupations that may increase UV exposure exacerbate these disparities. Additional factors such as inadequate patient education, language barriers, and inadequate health education campaigns also limit melanoma awareness, prevention, and healthcare access in Hispanic populations. Consequently, there is an urgent need for culturally tailored interventions, such as community-based, targeted health campaigns and enhanced, culturally sensitive provider training to better address these disparities and improve melanoma outcomes in Hispanic and Latino populations.

Background: Corticotropin-releasing hormone (CRH) regulates immunological and cellular processes. Recently, CRH is expressed in skin cancers, where its expression appears to correlate with the degree of malignancy. Objective: This study correlates CRH expression in melanoma metastases with patient survival and compares the intensity of CRH expression in melanoma to that in less aggressive skin cancer entities. Methods: Tissue microarrays with cores from 94 melanomas and 40 melanocytic nevi and 51 slides from 41 basal cell carcinomas (BCCs) and 10 squamous cell carcinomas (SCCs) were immunohistochemically stained for CRH. The intensity of CRH expression in melanoma metastases was stratified by sex and correlated with patient survival. Furthermore, proliferation and apoptosis were assessed in CRH-stimulated A431 cells using enzyme-linked immunosorbent assays and an apoptosis detection kit. Results: The intensity of CRH expression was higher in primary melanomas than in melanocytic nevi. Higher CRH expression was also found in melanoma metastases from women compared to men. However, higher CRH expression was correlated with reduced overall survival only in men. Compared to melanoma, BCCs and SCCs showed weaker CRH expression, which was in line with the finding that in vitro, CRH stimulation of the A431 cells reduced their proliferative activity. Conclusion: CRH does not necessarily correlate with the degree of malignancy, as semimalignant cancers such as BCC show higher levels of CRH expression than SCCs. In melanoma, CRH expression in metastases may be an important prognostic factor for overall survival in men, which needs further evaluation.

The incidence of nonmelanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), is increasing globally, driven by factors such as chronic UV exposure, climate change, and aging populations. This comprehensive retrospective cohort study examined 1252 patients treated for NMSCs at the Plastic Surgery Unit of the University of Messina, Italy, from 2012 to 2023. The study aimed to assess demographic characteristics, histological types, lesion attributes, recurrence rates, and geographical variations in NMSC incidence. Beyond confirming global epidemiological trends, this study highlights clinically relevant factors influencing tumor presentation, including environmental risk exposure, lesion recurrence, and histological aggressiveness. Data were collected on patient demographics, tumor location, histological subtype, lesion diameter, presence of ulceration, recurrence, and differentiation grade. Statistical analysis was conducted using R software (Version 4.2.0). Findings demonstrated that patients residing in coastal areas had a significantly higher incidence of NMSCs, reinforcing the role of exposure and environmental pollutants in carcinogenesis. These findings align with global trends and highlight the urgent need for early diagnosis, targeted dermatological surveillance, and public health interventions to mitigate the rising burden of NMSCs. The study underscores the necessity of enhanced sun protection awareness, integration of dermatological screenings in primary care settings, and improved treatment protocols to reduce recurrence and morbidity.

Background: Cutaneous squamous cell carcinoma (CSCC) is the second most prevalent form of skin cancer globally. However, its incidence is rising relative to basal cell carcinoma (BCC) in countries such as Australia and the United States. In South Africa, where the population is exposed to numerous CSCC risk factors, including high ultraviolet radiation levels and a high burden of immunosuppression, there remains a notable paucity of scientific literature characterising the disease within this context. Aims: To describe the clinical, histopathological and risk profile characteristics of CSCC in a South African cohort to identify patterns that can inform local clinical practice and guide future research priorities. Methods: A retrospective data analysis of patients seen at Tygerberg Academic Hospital between 1 September 2019 and 31 August 2020 was conducted. Demographic and clinical data were extracted from medical records. Two study evaluators used predetermined criteria to review the histopathological features in skin biopsies. Risk stratification of lesions followed the guidelines of the National Comprehensive Cancer Network. Results: Over one year, 113 CSCCs were diagnosed in 83 patients. Participants were primarily Fitzpatrick skin phototype I (65.1%) and male (60.2%), with a median age of 73 years and a male-to-female ratio of 1.51:1. The BCC-to-CSCC incidence ratio was 1.71:1. Most lesions had been present for over 6 months (87.6%) and were located on the head and neck (59.3%). Punch biopsies diagnosed 62.8% of lesions. Histologically, 63.7% were well differentiated, and 40.7% were invasive. Conventional CSCCs comprised 75.2% of lesions; 5.3% were the high-risk acantholytic subtype. A high recurrence risk was found in 77.0% of lesions. Conclusion: This study highlights the heterogeneous nature of CSCC in South Africa and underscores the need for prospective, context-specific research to enhance prevention, early detection and management efforts nationwide.