Cutaneous Cryptococcosis Mimicking Basal Cell Carcinoma in a Patient with AIDS

1998 ◽  
Vol 3 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Rosemarie Ingleton ◽  
Evelyn Koestenblatt ◽  
Philip Don ◽  
Howard Levy ◽  
Wojciech Szaniawski ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Systemic Disease ◽  
Immune Deficiency Syndrome ◽  
Skin Lesions ◽  
Deficiency Syndrome ◽  
Cutaneous Manifestations ◽  
Systemic Involvement ◽  
Cutaneous Cryptococcosis

Background: Cryptococcosis is an opportunistic infection caused by the encapsulated yeast Cryptococcus neoformans. This ubiquitous organism has emerged as a frequent finding in immunosuppressed patients, especially those with underlying malignancies, organ transplants, and the acquired immune deficiency syndrome (AIDS). Cutaneous manifestations of cryptococcosis occur in 10 to 15% of patients having systemic involvement. These skin lesions may simulate a variety of different disease entities. Methods: A case of crytococcosis mimicking a basal cell carcinoma is the subject of a case report presentation. Results: A case of cutaneous cryptococcosis mimicking basal cell carcinoma occurred in a patient with AIDS, who did not appear to have dissemination, but was treated aggressively to stem possible occult systemic disease. Conclusion: Cutaneous crytococcosis may mimic other dermatologic disorders.

scholarly journals Optical Coherence Tomography of Peri-Ocular Skin Cancers: An Optical Biopsy

2020 ◽  
pp. 1-9
Author(s):  
Sabrina Bergeron ◽  
Bryan Arthurs ◽  
Debra-Meghan Sanft ◽  
Christina Mastromonaco ◽  
Miguel N. Burnier Jr.
Keyword(s):  
Squamous Cell Carcinoma ◽  
Optical Coherence Tomography ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Basal Cell ◽  
Skin Lesions ◽  
Sebaceous Carcinoma ◽  
Optical Coherence ◽  
Oct Imaging

<b><i>Introduction:</i></b> Optical coherence tomography (OCT) imaging has been used as a diagnostic tool for retinal disease for several years, and OCT apparatuses are becoming increasingly powerful. However, OCT has yet to reach its full potential in ophthalmology clinics. Alike retinal layers, it has been shown that OCT is able to generate cross-sectional images of the skin and allows visualization of skin lesions in a histopathology-like manner. <b><i>Objective:</i></b> We aim to validate OCT as an imaging modality for peri-ocular skin cancer. Through a series of cases, we highlight findings for 3 common eyelid malignancies: basal cell carcinoma, squamous cell carcinoma and sebaceous carcinoma. We propose an OCT image-based signature for basal cell carcinoma. <b><i>Methods:</i></b> This is a prospective study. Fifty-eight lesions suspicious of malignancy from 57 patients were subjected to OCT imaging prior to the surgical excision of the lesion. OCT images were analysed and scored according to previously identified OCT features. Eight representative examples are presented, highlighting the OCT patterns for each malignancy side by side to its corresponding histopathological sections. <b><i>Results:</i></b> Out of the 58 lesions analysed, 53 were malignant. A loss of the dermal-epidermal junction is observed in all malignant lesions. A strong link is observed between the presence of subepithelial hyporeflective nests on OCT and the diagnosis of basal cell carcinoma (present in 83% of cases). Conversely, lesions of epithelial origin such as squamous cell carcinoma are most often represented on OCT by acanthosis. Two supplementary cases, one basal cell carcinoma and one sebaceous carcinoma, are provided to illustrate how OCT imaging is a valuable tool in cases where clinical observations may be unusual. <b><i>Conclusions:</i></b> We provide evidence supporting the use of OCT for the evaluation of peri-ocular cancers. OCT enables visualization of the skin layers in vivo, before biopsy. Our results show that certain OCT features can contribute to include or exclude a diagnosis of basal cell carcinoma. By integrating this non-invasive imaging methodology into the routine assessment of peri-ocular skin lesions, especially in health care centres where access to specialists is limited, OCT imaging can increase clinical precision, reduce delays in patient referral and enhance patient care.

scholarly journals Mice with a Targeted Mutation of Patched2 Are Viable but Develop Alopecia and Epidermal Hyperplasia

2006 ◽  
Vol 26 (17) ◽  
pp. 6609-6622 ◽  
Author(s):  
Erica Nieuwenhuis ◽  
Jun Motoyama ◽  
Paul C. Barnfield ◽  
Yoshiaki Yoshikawa ◽  
Xiaoyun Zhang ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Genetic Disorder ◽  
Skin Lesions ◽  
Hair Follicles ◽  
Limb Bud ◽  
Epidermal Hyperplasia ◽  
Phenotypic Analysis ◽  
Developmental Abnormalities

ABSTRACT Hedgehog (Hh) signaling plays pivotal roles in tissue patterning and development in Drosophila melanogaster and vertebrates. The Patched1 (Ptc1) gene, encoding the Hh receptor, is mutated in nevoid basal cell carcinoma syndrome, a human genetic disorder associated with developmental abnormalities and increased incidences of basal cell carcinoma (BCC) and medulloblastoma (MB). Ptc1 mutations also occur in sporadic forms of BCC and MB. Mutational studies with mice have verified that Ptc1 is a tumor suppressor. We previously identified a second mammalian Patched gene, Ptc2, and demonstrated its distinct expression pattern during embryogenesis, suggesting a unique role in development. Most notably, Ptc2 is expressed in an overlapping pattern with Shh in the epidermal compartment of developing hair follicles and is highly expressed in the developing limb bud, cerebellum, and testis. Here, we describe the generation and phenotypic analysis of Ptc2 tm1/tm1 mice. Our molecular analysis suggests that Ptc2 tm1 likely represents a hypomorphic allele. Despite the dynamic expression of Ptc2 during embryogenesis, Ptc2 tm1/tm1 mice are viable, fertile, and apparently normal. Interestingly, adult Ptc2 tm1/tm1 male animals develop skin lesions consisting of alopecia, ulceration, and epidermal hyperplasia. While functional compensation by Ptc1 might account for the lack of a strong mutant phenotype in Ptc2-deficient mice, our results suggest that normal Ptc2 function is required for adult skin homeostasis.

Diagnosing Basal Cell Carcinoma by Dermatoscopy

1998 ◽  
Vol 3 (2) ◽  
pp. 62-67 ◽  
Author(s):  
David M. Carroll ◽  
Elizabeth M. Billingsley ◽  
Klaus F. Helm
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Blood Vessels ◽  
Basal Cell ◽  
Skin Surface ◽  
Skin Lesions ◽  
Noninvasive Technique ◽  
Cutaneous Malignancy ◽  
Basal Cell Carcinomas ◽  
Pigmented Skin Lesions

Background: Dermatoscopy (DS) has been used primarily to evaluate pigmented skin lesions. Little information is available on DS findings of basal cell carcinoma (BCC). Dermatoscopy is a noninvasive technique that allows visualization of cutaneous features from the skin surface to the papillary dermis. Basal cell carcinoma, the most common cutaneous malignancy, is traditionally diagnosed clinically and confirmed with biopsy. Objective: To determine the dermatoscopic features of non-pigmented basal cell carcinomas. Methods: The dermatoscopic findings of 27 lesions that clinically were suspicious for BCC were analyzed. Results: Of these 27 clinically suspect lesions, the biopsies revealed BCC in 20 specimens and squamous cell carcinoma (SCC) in two specimens. Twenty of these 22 specimens had dermatoscopic findings of BCC: diffusely distributed, branching blood vessels, asymmetric, and narrow blood vessels distributed deeper in the dermis, or a milky-red corona with superficial wide blood vessels. One nodular BCC in our study showed no distinct findings. Conclusions: Many BCCs have characteristic DS findings; however, dermatoscopic examination of some tumours will not demonstrate any known characteristic findings. As such, the DS criteria we propose for BCC are best utilized as an adjunctive study of clinical impressions. Biopsy remains the definitive diagnostic tool.

scholarly journals Cutaneous Cryptococcosis Mimicking Basal Cell Carcinoma in a Patient with Sézary Syndrome

2012 ◽  
Vol 92 (3) ◽  
pp. 286-287 ◽  
Author(s):  
D Töröcsik ◽  
L Gergely ◽  
I Veres ◽  
É Remenyik ◽  
Á Bégány
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Sézary Syndrome ◽  
Sezary Syndrome ◽  
Cutaneous Cryptococcosis

A Review of Topical Imiquimod in the Management of Basal Cell Carcinoma, Actinic Keratoses, and Other Skin Lesions

2009 ◽  
Vol 1 ◽  
pp. CMT.S1969
Author(s):  
Jubin Ryu ◽  
F. Clarissa Yang
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Antiviral Agents ◽  
Nucleoside Analogs ◽  
Skin Lesions ◽  
Off Label ◽  
Trade Name ◽  
Superficial Basal Cell Carcinoma ◽  
External Genital Warts

Imiquimod (trade name Aldara™) is a small molecule of the imidazoquinoline family, a group of nucleoside analogs that were first synthesized as potential antiviral agents. It has since been discovered to activate both innate and adaptive immunity, as well as apoptosis. Clinically, it has been approved for three indications thus far: external genital warts, actinic keratosis, and superficial basal cell carcinoma. In addition to these applications, a number of off-label uses have been reported in the literature. In this review, we summarize and discuss the literature describing imiquimod's mechanism of action, its approved and off-label clinical uses, and its safety and tolerability.

scholarly journals The Safety and Effectiveness of Elastic Scattering Spectroscopy and Machine Learning in the Evaluation of Skin Lesions for Cancer

Iproceedings ◽  
10.2196/35441 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35441
Author(s):  
Cristiane Benvenuto-Andrade ◽  
A Cognetta ◽  
D Manolakos
Keyword(s):  
Squamous Cell Carcinoma ◽  
Elastic Scattering ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Basal Cell ◽  
Predictive Value ◽  
Prevalence Rate ◽  
Skin Lesions ◽  
Elastic Scattering Spectroscopy

Background Elastic scattering spectroscopy (ESS) is an optical biopsy technique that can distinguish between a normal and abnormal tissue in vivo without the need to remove it. The handheld device measures ESS spectra of skin lesions and classifies lesions as either malignant or benign with an output of “Investigate Further” or “Monitor,” respectively, with positive results accompanied by a spectral score output from 1 to 10, indicating how similar the lesion is to the malignant lesions the device was trained on. The algorithm was trained and validated with over 11,000 spectral scans from over 3500 skin lesions. Objective The purpose of this study was to evaluate the safety and effectiveness of the handheld ESS device in detecting the most common types of skin cancer. Methods A prospective, single-arm, investigator-blinded, multicenter study conducted at 4 investigational sites in the United States was performed. Patients who presented with skin lesions suggestive of melanoma, basal cell carcinoma, squamous cell carcinoma, and other highly atypical lesions were evaluated with the handheld ESS device. A validation performance analysis was performed with 553 lesions from 350 subjects with algorithm version 2.0. An independent test set of 281 lesions was selected and used to evaluate device performance in the detection of melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Statistical analyses included overall effectiveness analyses for sensitivity and specificity as well as subgroup analyses for lesion diagnoses. Results The overall sensitivity of the device was 92.3% (95% CI: 87.1 to 95.5%). The sensitivity for subgroups of lesions was 95% (95% CI 75.1% to 99.9%) for melanomas, 94.4% (95% CI 86.3% to 98.4%) for BCCs, and 92.5% (95% CI 83.4% to 97.5%) for SCCs. The overall device specificity was 36.6% (95% CI 29.3% to 44.6%). There was no statistically significant difference between the dermatologist performance and the ESS device (P=.2520). The specificity of the device was highest for benign melanocytic nevi (62.5%) and seborrheic keratoses (78.2%). The overall positive predictive value (PPV) was 59.8%, and the negative predictive value (NPV) was 81.9% with the study’s malignancy prevalence rate of 51%. For a prevalence rate of 5%, the PPV was estimated to be 7.1%, and the NPV was estimated to be 98.9%. For a prevalence rate of 7%, the PPV was estimated to be 9.8%, and the NPV was estimated to be 98.4%. For a prevalence rate of 15%, the PPV was estimated to be 20.3%, and the NPV was 96.4%. Conclusions The handheld ESS device has a high sensitivity for the detection of melanoma, BCC, and SCC. Coupled with clinical exam findings, this device can aid physicians in detecting a variety of skin malignancies. The device output can aid teledermatology evaluations by helping frontline providers determine which lesions to share for teledermatologist evaluation as well as potentially benefitting teledermatologists’ virtual evaluation, especially in instances of suboptimal photo quality. Acknowledgments This study was sponsored by Dermasensor Inc. Conflicts of Interest None declared.

Tumours of the skin

2020 ◽  
pp. 5732-5742
Author(s):  
Edel O’Toole
Keyword(s):  
Skin Cancer ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Ultraviolet Light ◽  
Basal Cell ◽  
Light Exposure ◽  
Human Cancer ◽  
Skin Lesions ◽  
Gorlin’S Syndrome ◽  
Gorlin's Syndrome

A variety of tumours, both benign and malignant, are found in skin. Benign skin lesions, such as seborrhoeic keratoses and skin tags, are often just a cosmetic nuisance, but some benign skin lesions can be a component of diseases with serious medical consequences (e.g. neurofibromatosis or LEOPARD syndrome). Skin cancer is the most common human cancer and its incidence continues to increase. It most commonly affects older, fair-skinned individuals who have had either acute intermittent exposure to ultraviolet light or chronic ultraviolet light exposure. Organ transplant recipients have a 200-fold increased risk of squamous cell carcinoma. About 2% of patients who develop skin cancer have a genetic predisposition, for example, Gorlin’s syndrome in basal cell carcinoma and familial melanoma syndromes in malignant melanoma. Mutations in the PTCH gene cause Gorlin’s syndrome, and loss of heterozygosity at that locus is also present in most sporadic basal cell carcinoma.

LIGHT-INDUCED FLUORESCENCE SPECTROSCOPY AND OPTICAL COHERENCE TOMOGRAPHY OF BASAL CELL CARCINOMA

2009 ◽  
Vol 02 (03) ◽  
pp. 261-268 ◽  
Author(s):  
EKATERINA BORISOVA ◽  
ELFRIDA CARSTEA ◽  
LUMINITA CRISTESCU ◽  
ELMIRA PAVLOVA ◽  
NIKOLAY HADJIOLOV ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Skin Cancer ◽  
Basal Cell Carcinoma ◽  
Fluorescence Spectroscopy ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Normal Skin ◽  
Biological Tissues ◽  
Skin Lesions ◽  
Optical Coherence

Many up-to-date optical techniques have been developed and applied recently in clinical practice for obtaining qualitatively and quantitatively new data from the investigated lesions. Due to their high sensitivity in detection of small changes, these techniques are widely used for detection of early changes in biological tissues. Light-induced fluorescence spectroscopy (LIFS) is one of the most promising techniques for early detection of cutaneous neoplasia. Increasing number of recent publications have suggested that optical coherence tomography (OCT) also has potential for non-invasive diagnosis of skin cancer. This recent work is a part of clinical trial procedure for introduction of LIFS technique into the common medical practice in National Oncological Medical Center in Bulgaria for diagnosis of non-melanoma skin cancer. We focus our attention here on basal cell carcinoma lesions and their specific features revealed by LIFS and OCT analysis. In this paper we prove the efficiency of using the combined LIFS-OCT method in skin lesions studies by integrating the complimentary qualities of each particular technique. For LIFS measurements several excitation sources, each emitting at 365, 385 and 405 nm maxima are applied. An associated microspectrometer detects in vivo the fluorescence signals from human skin. The main spectral features of the lesions and normal skin are discussed and their possible origins are indicated. OCT images are used to evaluate the lesion thickness, structure and severity stage, when possible. The obtained results could be used to develop a more complete picture of optical properties of these widely spread skin disorders. At the same time, our studies show that the combined LIFS-OCT method could be introduced in clinical algorithms for early tumor detection and differentiation between normal/benign/malignant skin lesions.

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