Usefulness of ultrasonography in determining the surgical excision margin in non-melanocytic skin cancer

The number of tumor-infiltrating macrophages was estimated in 43 patients with skin cancer, including 18 cases of squamous cell and 25 cases of basal cell carcinoma. Macrophages were identified in cell cultures by 2 assays, namely phagocytosis and resistance to detachment by trypsin. The average percentage of adherent cells for the 2 groups of skin tumors was 4.5 ± 2.6 and 10.2 ± 5.2, respectively, and the difference was statistically significant. Follow-up studies after surgical excision of the primary neoplasm showed a relatively low macrophage content in 2 of the 4 cases in which local recurrences occurred. Preliminary functional studies suggested that soluble factors may be released by neoplastic cells, accounting for the inhibitory effect of tumor cell supernatants on macrophage Chemotaxis in vitro.

Download Full-text

Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: A Research Protocol (Preprint)

10.2196/preprints.9296 ◽

2017 ◽

Author(s):

Naomi D Herz ◽

Anastasia Chalkidou ◽

Fiona Reid ◽

Stephen Keevil ◽

Andrew Coleman ◽

...

Keyword(s):

Skin Cancer ◽

Confocal Microscopy ◽

Surgical Excision ◽

Reflectance Confocal Microscopy ◽

Lentigo Maligna ◽

Recurrence Rates ◽

Skin Cancer Screening ◽

Lentigo Maligna Melanoma ◽

Excision Margins ◽

The Uk

UNSTRUCTURED Skin cancer is the most common type of cancer in the UK, with over 100,000 cases diagnosed each year. Melanoma is a type of skin cancer that can develop from a mole. However, moles that are suspicious histologically are often difficult to diagnose clinically by eye, even for experts working in specialist skin cancer screening clinics. In the UK, 350,000 patients per year are referred to hospital clinics with suspicious moles, and approximately half undergo a biopsy to identify the 5-10% who require further treatment. If cancer cannot be ruled out clinically and on the basis of biopsy results, the lesion is surgically removed. One type of pre-cancerous mole, called lentigo maligna, is particularly challenging to treat. It develops insidiously, can become large, and is difficult to assess when it transforms into a lentigo maligna melanoma. It is also difficult to identify the margins by eye or with the aid of a dermatoscope. This results in high excision rates. Excision is often incomplete despite large areas of tissue removal (5 mm around tumour’s visible margin), and there are high recurrence rates even when the lesion is considered successfully removed. Reflectance confocal microscopy is an imaging technique that can supplement dermoscopy in identifying if a clinically suspicious mole is malignant and can better assess lentigo maligna margins. It allows clinicians to see the skin lesion in greater detail than dermoscopy and therefore better guide more accurate diagnoses. This prospective study will examine patients with suspicious moles and lentigo maligna to determine whether confocal microscopy can both reduce the number of unnecessary biopsies of moles and more accurately guide the surgical excision margins of lentigo maligna.

Download Full-text

Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management

Frontiers in Oncology ◽

10.3389/fonc.2021.689789 ◽

2021 ◽

Vol 11 ◽

Author(s):

Emmanuele Venanzi Rullo ◽

Maria Grazia Maimone ◽

Francesco Fiorica ◽

Manuela Ceccarelli ◽

Claudio Guarneri ◽

...

Keyword(s):

Skin Cancer ◽

Early Stage ◽

Treatment Options ◽

Case Series ◽

Surgical Excision ◽

People Living With Hiv ◽

Skin Cancers ◽

Ablative Techniques ◽

Living With Hiv ◽

Melanoma Skin

Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.

Download Full-text