Journal of Skin Cancer最新文献

Introduction: Nevus sebaceous (NS) is a rare congenital hamartoma that may cause some concerns for parents. Benign skin tumors can develop in NS, although malignant transformations have occasionally been documented. This study aimed to investigate the histopathological characteristics of NS lesions in relation to sex, age, location, type, and any associated superimposed tumors. Methods: This retrospective cross-sectional study was conducted on the histopathologic reports of 60 patients with NS who were referred to our center between 2010 and 2022. Information, including sex, age, location of the lesion, and histopathological features of the NS lesion, was recorded. Results: The mean age of the patients was 24.52 ± 12.19 years, and 65.0% of the patients (39 cases) were men. Most of the lesions were observed on the scalp and face. Benign and malignant neoplasms were observed in 5% and 10% of patients, respectively. All the cases of malignant tumors (six cases) were identified as basal cell carcinoma, and three cases were benign tumors of syringocystadenoma papilliferum. Demodex infestation and apocrine gland dilatation were observed in 56.7% and 23.3% of patients, respectively. Benign neoplasms were significantly more frequent in women (p=0.039). In addition, malignant neoplasms were significantly more prevalent among patients aged ≥ 25 years (p=0.001). The frequencies of acanthosis and focal parakeratosis were higher in the scalp, and sebaceous hyperplasia was more common in the face (p < 0.05). Conclusion: Our study revealed that malignant tumors were more common than benign lesions in patients with NS. Benign neoplasms were more frequent in women. Malignant neoplasms were detected in patients aged more than 25 years.

Background: Ultraviolet (UV) radiation from the sun is a major risk factor for skin cancers. Nonetheless, many individuals in western countries tan outdoors. This study aimed to identify types of tanners and their reasons for outdoor tanning based on a Q methodology study. Methods: A heterogeneous sample of 25 participants aged 19-61 years was recruited and interviewed using the Q sort method. The participants ranked 37 reasons for outdoor tanning according to their subjectively perceived importance in a predetermined grid. Data were analyzed using an inverted factor analysis technique developed specifically for Q methodology. The transcripts of the postsort interviews were used to better understand the quantitative findings. Results: Three groups (factors) of tanners were identified based on 22 of the 25 participants. While enhancement of attractiveness was a major reason for outdoor tanning in the middle-aged group, the youngest and the oldest groups had a stronger focus on relaxation, well-being, and mental health. All three groups stated that vitamin D production was an important factor for tanning outdoors. Discussion: These findings suggest that people may have different reasons for exposing themselves to harmful UV radiation, but that there is a pattern most participants in our study could be assigned to. Especially the finding that all groups tanned outdoors to meet their vitamin D needs seems to be a starting point for future research and skin cancer prevention.

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.

Cutaneous T-cell lymphomas (CTCLs) are a type of non-Hodgkin lymphoma that usually involves the skin. It has different subtypes including mycosis fungoides (MFs), Sézary syndrome (SS), primary cutaneous anaplastic large lymphoma (PC-ALCL), lymphomatoid papulosis (LyP), and subcutaneous panniculitis-like T-cell lymphoma (SPTCL). There are several reports of incidence, relapse, or progression of CTCLs by using specific drugs. We aim to identify drug- and vaccine-induced CTCL characteristics. A systematic search was conducted using MeSH terms/keywords: CTCL and drug-induced or drug-associated or vaccine-associated or vaccine induced through PubMed/Medline, Scopus, Web of Science, and Embase until May 10, 2024. Out of 14,031 papers, 60 articles were included, involving 71 patients with a mean age of 53.5 ± 17 years. Among them, 52.1% were male. Medications were categorized into four groups: conventional, biologics, small molecules, and vaccines. The most frequently reported medications in the first group were fingolimod (n = 8) and methotrexate (n = 7). Infliximab (n = 6) and etanercept (n = 5) were the most commonly reported biologics. Pfizer-BioNTech (n = 11) vaccine and JAK inhibitors (n = 3) were the most reported vaccine and small molecules. LyP (n = 17) was the most frequently reported type of CTCL, followed by PC-ALCL (n = 13), MF (n = 11), SS (n = 8), and SPTCL (n = 8). The most common underlying conditions were rheumatoid arthritis (n = 15) and multiple sclerosis (n = 10). Twenty patients (28%) experienced disease regression after discontinuing the drug, with a mean ± SD of 8.6 ± 8.8 weeks. In 14 patients (20%), chemotherapy and/or radiotherapy were initiated. Six patients passed away after being diagnosed with CTCL: two because of CTCL recurrence and four because of other complications. It is important recognizing CTCL as a possible, although rare, adverse effect of certain drugs and vaccines, and taking a history of vaccinations, especially COVID-19 vaccines, and immunosuppressive drugs such as fingolimod, TNF-a inhibitors, and methotrexate.

Acral melanoma (AM) is the most common type of melanoma arising in people with skin of color. AM is often diagnosed late and associated with poor outcomes. Melanoma outcomes are also impacted by socioeconomic status. Although uncommon, AM is a public health concern in South Africa because of its epidemiology and association with health access issues, which predispose to late diagnosis. South African patients are managed based on staging systems and treatment guidelines developed for other populations. This cohort study aimed to determine the survival outcomes in a cohort of South African AM patients and how these were associated with demographic, clinical, pathological, and management data. The study included patients diagnosed at a referral hospital between 1 January 2010 and 31 December 2021. Analysis occurred in 2022 and 2023. The main outcomes of interest were survival time in months (overall and progression-free, OS and PFS). Survival outcomes were analyzed using Kaplan-Meier survival curves. Survival probabilities were compared between subgroups using log-rank tests. Univariate and multivariable analyses were performed using the Cox proportional hazards models to assess factors associated with survival. Ninety-one patients were included in the analysis. After a median follow-up of 28 months (range: 0-151 months), 48 patients (52.7%) had died. The 3- and 5-year survival rates for the entire cohort were 64.8% and 56.0% respectively. Notably, the OS and PFS were not affected by the population group (p value = 0.628, not significant). The examination of OS and PFS by the clinical stage group demonstrated proportional hazard. Although SLNB comprised a small group, the results appear to be prognostically valid, specifically for OS. The results indicate that the AJCC eighth edition staging is broadly applicable to AM in this population; however, a rigorous comparison was not possible. SLNB appears to be prognostically valid. No difference in survival outcomes by population group was shown.

Point mutations at codon 600 of the BRAF oncogene are the most common alterations in cutaneous melanoma (CM). Assessment of BRAF status allows to personalize patient management, though the affordability of molecular testing is limited in some countries. This study aimed to develop a model for predicting alteration in BRAF based on routinely available clinical and histological data. Methods: For identifying the key factors associated with point mutations in BRAF, 2041 patients with CM were recruited in the study. The presence of BRAF mutations was an endpoint. The variables included demographic data (gender and age), anatomic location, stage, histological subtype, number of mitosis, and also such features as ulceration, Clark level, Breslow thickness, infiltration by lymphocytes, invasiveness, regression, microsatellites, and association with nevi. Results: A relatively high rate of BRAF mutation was revealed in the Ukrainian cohort of patients with CM. BRAF-mutant melanoma was associated with younger age and location of nonsun-exposed skin. Besides, sex-specific differences were found between CM of various anatomic distributions and the frequency of distinct BRAF mutation subtypes. A minimal set of variables linked to BRAF mutations, defined by the genetic input selection algorithm, included patient age, primary tumor location, histological type, lymphovascular invasion, ulceration, and association with nevi. To encounter nonlinear links, neural network modeling was applied resulting in a multilayer perceptron (MLP) with one hidden layer. Its architecture included four neurons with a logistic activation function. The AUROCMLP6 of the MLP model comprised 0.79 (95% CІ: 0.74-0.84). Under the optimal threshold, the model demonstrated the following parameters: sensitivity: 89.4% (95% CІ: 84.5%-93.1%), specificity: 50.7% (95% CІ: 42.2%-59.1%), positive predictive value: 73.1% (95% CІ: 69.6%-76.3%), and negative predictive value: 76.0% (95% CІ: 67.6%-82.8%). The developed MLP model enables the prediction of the mutation in BRAF oncogene in CM, alleviating decisions on personalized management of patients with CM. In conclusion, the developed MLP model, which relies on the assessment of 6 variables, can predict the BRAF mutation status in patients with CM, supporting decisions on patient management.

Skin cancer is the most common cancer worldwide. According to the Skin Cancer Foundation, Mohs micrographic surgery (MMS) is considered the most effective technique for treating nonmelanoma skin cancer (NMSC). Recurrence rate after MMS for treating NMSC ranges from 1.4% to 3.2% for primary tumors and 2.4%-6% for recurrent tumors. The aim of the study was to report data from a tertiary care center in Lebanon providing MMS to patients with NMSC. Retrospective cohort study was conducted through chart review of 94 patients at the Lebanese American University Medical Center (LAUMC-RH) with a total of 115 cases of MMS identified. The study showed that most cases were males (72; 63%), and 77% were aged > 60 years (88). The average tumor size was 1.6 cm. Recurrence rate was zero in primary tumors and 0.9% in recurrent tumors. With respect to age, bivariate analysis showed that cases of males over 60 years of age were more significantly associated with undergoing Mohs surgery (69% vs. 31%; p=0.012). With respect to maximum tumor diameter (MTD) > 1 cm, male gender was associated with a higher MTD when compared to females (74% vs. 26%; p=0.02). Also, Area L was associated with a larger MTD when compared to areas H and M, respectively (90% vs. 61.1% vs. 37.7%; p=0.01). Multivariate analysis of MTD showed that tumors with MTD > 1 cm were significantly associated with male gender, presence in low- or middle-risk areas and being a recurrent tumor. This study shows that MMS is adequate for the treatment of NMSC at our center with minimal complications (< 1%) and recurrence (< 1%).

Objective: The primary aims of the study were to (1) explore the association of skin cancer and four ultraviolet radiation (UVR) indicators (sunbed use, healthcare data on diagnosed melanocytic nevi (MN) and actinic keratosis (AK), and latitude of birthplace), and (2) find factors other than UVR that could explain the increasing trend in incidence of skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and cutaneous malignant melanoma (CMM).

Methods: This population-based cohort study used self-reported questionnaire data from the Stockholm Public Health Cohort, encompassing 103 questions, merged with data from Swedish national registers. The study population included almost 35,000 Swedish-born people aged 30-66 years in 2014. Binomial logistic regression was employed for analysis. A forward stepwise regression was applied to select significant risk factors among all the factors included. We tentatively tested >30 variables separately for any relationship with each of the three skin cancers. A 5% level of significance was applied. Melanoma in situ and SCC in situ were excluded.

Results: The four UVR-related factors (sunbed use, being diagnosed with AK or MN, birthplace latitude) had a significant association with at least one of the three skin cancers that remained after adjustment including behavioural, social, hereditary, and medical factors. Sunbed use >10 times before age 30 years was related to all three skin cancers; SCC adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) 1.12-2.47, CMM (aOR 1.57, 95% CI 1.11-2.22), and the clearest dose-response association with BCC (aOR 1.74, 95% CI 1.46-2.06). None of the examined lifestyle factors, except physical activity, had any significant associations with UVR indicators or skin cancer.

Conclusion: We did not find any preventable explanatory cause other than UVR exposure for the increasing incidence of skin cancers. This result remained when adjusting for an array of possible confounders including behavioural, social, hereditary, and medical factors.

Melanoma in challenging anatomical locations such as the face, acral surfaces, and mucosal areas presents unique hurdles for surgical excision. This review examines alternative nonsurgical treatment modalities in the context of these complexities, addressing the gaps in current guidelines and the varied efficacy of existing therapies. A comprehensive literature search was conducted using PubMed, Embase, and Web of Science databases. The review focuses on peer-reviewed articles discussing nonsurgical treatment options for melanoma in complex anatomical locations. Articles were screened by three independent researchers, ensuring a broad analysis of topical agents, immunotherapies, radiotherapies, and targeted therapies. The review highlights significant advancements in localized treatments such as imiquimod and intralesional therapy with talimogene laherparepvec (T-VEC), which show promise in managing nonexcisable melanomas. BRAF and MEK inhibitors, as well as checkpoint inhibitors targeting CTLA-4 and PD-1/PD-L1 pathways, demonstrate improved survival rates but pose challenges with resistance and systemic side effects. Radiotherapy serves as an adjunctive strategy due to melanoma's inherent radioresistant properties. Despite advancements, there is a notable absence of comprehensive, evidence-based protocols to guide the treatment of melanoma in these critical areas. This paper underscores the need for standardized treatment guidelines that account for the efficacy, side effects, and psychosocial impacts of therapies. Future research should focus on refining existing treatments and exploring innovative modalities to enhance patient outcomes in the management of nonexcisable melanomas. Comprehensive guidelines and long-term efficacy studies are essential to optimize care and improve the quality of life for patients afflicted with melanoma in challenging anatomical locations.

This cross-sectional study assessed the knowledge, attitude, and practices (KAP) regarding skin cancer among dermatology clinic patients, medical students, and general practitioners (GPs) in Tehran, Iran. The researchers collected data using a validated questionnaire administered online, measuring KAP on scales of 0-31, 0-16, and 0-28, respectively, with scores above 16, 8, and 14 indicating "good" levels. Of 2243 participants (mean age 28 years), 59.4% had good knowledge, 19.8% had good attitudes, 31.8% had good practices, and 29.8% had good overall KAP. Medical students/GPs scored higher on knowledge and attitudes, while patients scored better on practices. Knowledge, attitudes, and practices were positively correlated in professionals but inversely correlated in patients. The findings suggest that while knowledge was moderate, attitudes and behaviors remained poor, particularly among patients. Immediate interventions are needed to improve attitudes and prevention practices, as public health initiatives must focus on positively influencing both to translate knowledge into meaningful action and find the reasons why good knowledge may not always lead to good practice. These findings underline the need for targeted interventions to bridge the gap between knowledge and preventive behaviors, to effectively reduce the burden of skin cancer in the population.