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The diagnosis of basal cell carcinoma (BCC) in dark phototypes can be a challenging task due to the lack of relevant clues and its variable presentation. In this regard, there is growing evidence that dermoscopy may benefit the recognition of BCC even for skin of color (SoC). The objective of this review is to provide an up-to-date overview on clinical and dermoscopic patterns of BCC in SoC, also comparing such findings with those of the main clinical mimickers reported in the literature. A comprehensive search of the literature through the PubMed electronic database was carried out in order to identify papers describing the clinical and dermoscopic features of BCC in dark phototypes (IV–VI). By finding macroscopic clinical presentations of BCCs in SoC patients and any possible clinical mimickers considered in the retrieved papers, we built a differential diagnosis list and analyzed the dermoscopic findings of such conditions to facilitate the diagnosis of BCC. BCC in darker skin may present as pigmented nodular lesions, pigmented patches or plaques, ulcers, erythematous nodular lesions, erythematous plaques or patches, or scar-like lesions, depending on its subtype and body site. The differential diagnosis for BCC in patients with SoC includes squamous cell carcinoma, melanoma, nevi, adnexal tumors and sebaceous keratosis. Additionally, it differs from that of Caucasians, as it also includes lesions less common in fair skin, such as dermatosis papulosa nigra, melanotrichoblastoma, and pigmented dermatofibrosarcoma protuberans, and excludes conditions like actinic keratosis and keratoacanthoma, which rarely appear in darker skin. The resulting differences also include infectious diseases such as deep cutaneous mycosis and inflammatory dermatoses. The most prevalent differentiating dermoscopic feature for BCC includes blue, black and gray dots, though arborizing vessels still remain the predominant BCC feature, even in dark phototypes. Diagnostic approach to BCC in dark-skinned patients varies due to the prevalence of dermoscopy findings associated with hyperpigmented structures. Clinicians should be aware of such points of differentiation for a proper management of this tumor in SoC. [ABSTRACT FROM AUTHOR]

Background: Skin cancer shows geographic and ethnic variation. New Zealand—with a predominantly fair-skinned populations, high UV indices and outdoor lifestyles—has high rates of skin cancer. However, population prevalence data is lacking. This study aimed to determine the demographics and socioeconomic disease trends of non-melanoma skin cancer prevalence in New Zealand from a large targeted-screening study. Methods: A targeted screening programme was conducted among 32,839 individuals, Fitzpatrick Skin Types I to IV in Auckland, New Zealand during the 2008–2022 period. This data was analyzed retrospectively. Linear regression models were used to assess statistical trends of skin cancer prevalence over time, along with associated factors that included demographics, disease trends and overall prevalence. Results: A total of 32,839 individuals were screened and 11,625 skin cancers were detected. 16,784 individuals were females who had 4,378 skin cancers. 16,055 individuals were males who had 5,777 skin cancers. 54 males and 65 females had multiple skin cancers. The article presents detailed descriptions of tumour types and subtypes detected, age groups, demographic and socioeconomic information. regarding the non-melanoma skin cancers detected. Conclusion: Overall men have more non-melanoma skin cancer (NMSC) than females; however females develop more BCC on the lips. BCC is three times more common in the 31-50 age group, whereas SCC are significantly more prevalent after age 80. Prevalence of BCC has not changed over the 15-year timeframe of the study but SCC has increased. Older ages and higher incomes are associated with higher rates of NMSC in New Zealand. [ABSTRACT FROM AUTHOR]

Objective: To present a case of reconstruction of a full-thickness lower eyelid defect.Case report: Male patient Y. aged 71 years was admitted to the Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation) with the diagnosis: cancer of skin of the lateral canthus of the left eye, T1N0M0, stage I, clinical group II. According to the medical history, the neoplasm was self-detected 5 years ago. Histology findings revealed micronodular basal cell carcinoma.After a general clinical examination, the patient underwent surgery to remove the neoplasm of the lower eyelid skin and lateral canthus and reconstruct the defect using a lateral infraorbital fat pad flap, local tissues, and a free autologous cartilage graft. The configuration of the soft tissues of the eyelid was restored. Soft tissue edema was not observed. The functional state of the lacrimal apparatus was fully preserved. The esthetics of the soft tissue was rehabilitated.Conclusions: Reconstruction in such esthetically significant area as the middle third of the face is associated with special requirements for graft formation and positioning. A gentle and functionally justified method for restoring the parameters of the tarsal plate, conjunctival sac, and lower eyelid skin ensures complete rehabilitation of patients and improves their quality of life.

Abstract Background Following the pivotal phase II trial BOLT, the Hedgehog (Hh) inhibitor sonidegib was approved in the EU to treat locally advanced basal cell carcinoma (laBCC) in patients not amenable to surgery or radiotherapy. We report safety data from the interim analysis of the real-world NISSO study. Methods NISSO is an ongoing non-interventional, multinational, post-authorization safety study (NCT04066504). Patients with laBCC are treated with sonidegib 200 mg orally once daily and followed for 3 years. Dose modifications were allowed according to the local prescribing information. Results Between May 6, 2019, and March 15, 2022, 321 patients with laBCC were enrolled at 46 European sites (data cut-off: June 22, 2023). Treatment was discontinued in 241 (75.1%) patients, with the main reasons being the patient/guardian decision (n = 69, 28.6%), treatment success (n = 40, 16.6%) and the physician decision (n = 35, 14.5%). The median duration of sonidegib exposure was 8.8 months (4.4–13.7 months). Overall, 284 (88.5%) patients had ≥ one treatment-emergent adverse event (TEAE). Most TEAEs were ≤ grade 2 and the most common were muscle spasms (n = 141; 43.9%), dysgeusia (n = 119; 37.1%), and alopecia (n = 97; 30.2%). After 3 months of treatment, the cumulative rates of muscle spasms, dysgeusia, and alopecia were 21.8%, 16.2%, and 3.7%, respectively. TEAEs led to treatment discontinuation in 59 (18.4%) patients, while 149 (46.4%) patients had at least one TEAE leading to dose reduction or interruption. Serious drug-related TEAEs were reported in 13 (4.1%) patients. Conclusions These results confirm the safety profile previously observed. Most patients experienced the onset of common TEAEs after 3 months of treatment, and the cumulative incidence of most common TEAEs was 10–20% lower compared to the BOLT study, except for dysgeusia and fatigue that had a similar incidence. The percentage of patients experiencing TEAEs requiring interruption or dose reduction was similar to the BOLT study, while the proportion of patients with TEAE leading to discontinuation of sonidegib was lower. This study demonstrates that the tolerability of sonidegib is manageable in routine clinical practice. Trial registration. NCT04066504.

Abstract Background Identifying modifiable risk factors is essential for the prevention of skin cancer; however, establishing causality can be challenging in conventional epidemiological studies. This study aimed to determine the causal associations of potentially modifiable risk factors with skin cancer using Mendelian randomization (MR). Methods Genetic instruments for 53 risk factors, including socioeconomic status, dietary and lifestyle factors, anthropometric measures, medication use, and comorbidities, were identified from previous genome-wide association studies. Two-sample MR analyses were performed using summary statistics for three major types of skin cancer: melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Findings were verified using multiple MR methods under different assumptions and replication datasets. Results Genetic liability to sunburn occasions, actinic keratosis, and prior skin cancers was associated with a higher risk of all three types of skin cancer, whereas genetic liability to vitiligo was associated with a lower risk. For specific skin cancer types, genetically predicted higher nevus counts and occupational class were associated with an increased risk of melanoma. Genetic liability to rheumatoid arthritis, type 2 diabetes, and increased physical activity were associated with a lower risk of BCC. Genetically predicated body mass index showed a negative association with BCC, and a positive association with SCC. Conclusions Our study reaffirmed several previously established risk factors and identified novel potential risk factors for skin cancer. Further work is needed to unravel the biological pathways in different skin cancer types and translate our findings to inform public health policies.

Backgroundobjective: Post-oncological nasal reconstruction presents both aesthetic and functional challenges. While established methods exist for quantitatively evaluating functional results following surgery, equivalent systems for assessing aesthetic outcomes are lacking. Three-dimensional (3D) photogrammetry, already used in maxillofacial and orthodontic surgery for aesthetic evaluation, overcomes some limitations of traditional methods like direct anthropometry. However, its applicability in oncological facial reconstruction has not yet been explored. In our study, we applied the 3dMDtrio™ system for the quantitative analysis of line and surface modifications following nasal reconstruction. Methods: We conducted a prospective observational study enrolling patients with skin neoplasms located on the nose undergoing surgical excision and reconstruction. Using the 3dMDtrio™ system, we measured the dimensions and projections of nasal surfaces and the positions of specific landmarks before and after surgery. The surface measurements were then correlated with aesthetic evaluations performed by three plastic surgeons, not involved in the procedure, using a 5-point Likert scale. Results: We included 33 patients with a mean age of 71 years, ranging from 40 to 94. We obtained complete documentation of all postoperative measurements for 21 patients. We observed significant changes in the positions of the landmarks post-surgery, limited to the right ala and nasion. The average nasal surface area was 4674.41 mm2 ± 477.24 mm2 before surgery and 4667.95 mm2 ± 474.12 mm2 after surgery, with no significant discrepancies. The evaluation using the Likert scale revealed an average score of 3.04 ± 0.48, with a significant negative correlation to the measured surface changes. Conclusion: Our findings suggest that 3D photogrammetry can be considered a valid method for objectively assessing volumetric changes associated with post-oncological nasal reconstructive surgery.

Abstract Basal cell carcinoma (BCC) is the most frequent malignant tumour worldwide and incidences are rising rapidly. BCC grow locally, but can invade surrounding tissues. Little is known concerning their impact on the health-related quality of life (HrQoL), and limited available data reports contradicting results. Measuring HrQoL in BCC patients should be done using disease-specific questionnaires such as the Basal and Squamous cell carcinoma Quality of Life (BaSQoL) questionnaire. The aim of this study was to assess the BCC-related HrQoL by examining all relevant patient, tumour and treatment characteristics to identify the main factors for the BCC-related impact. Specific attention for older BCC patients wass brought forward because of the often complex decisions in this subgroup. Patients ≥ 18 years with a history of BCC were asked to fill in the BaSQoL questionnaire, consisting of 5 subdomains. Multivariable analyses were done using a generalized additive model (GAM) because of the need for incorporation of non-linear functions. The study obtained approval of the Ethics Committee of the Ghent University Hospital (EC/2019/1352). Informed consent was obtained from all subjects. All experiments were performed in accordance with relevant guidelines and regulations. Four hundred patients with a median age of 66 were enrolled. Mean BaSQoL subscores were 0.78 (SD 0.63) for ‘behaviour’, 1.01 (SD 0.73) for ‘diagnosis&treatment’, 0.90 (SD 0.73) for ‘worries’, 0.40 (SD 0.63) for ‘appearance’ and 1.20 (SD 0.75) for ‘other people’, illustrating the low to moderate impact of BCC on the HrQoL. A GAM with subsequent ANOVA testing was done for all relevant variables. In 4 out of 5 BaSQoL subdomains ‘age’ showed a significant correlation (‘behaviour’ p = 0.007; ‘diagnosis&treatment’ p = 0.026; ‘worries’ p = 0.003; ‘appearance’ p = 0.008). Lower BaSQoL scores were seen in older patients, meaning less BCC-impact on their HrQoL. There was a clear non-linear correlation between BaSQoL scores and age, illustrating that the impact of BCC on the HrQoL shows a rapid decrease starting around the age of 70. This study is the first to illustrate the relation between the BCC-related HrQoL and the age of patients with the use of a disease-specific HrQoL instrument. We found a lower BaSQoL score in older adults, with a specific age group of interest starting around the age of 70–75. This is an argument for a potential wait-and-see strategy for BCC in these patients.

Background and Design: The aim of this study is to enhance the diagnosis and treatment of basal cell carcinoma (BCC) by comparing clinical, dermoscopic, and pathological features. Materials and Methods: This retrospective study included patients from the dermatology clinic between 2012 and 2015 with 111 BCC lesions. Results: The average age for aggressive-type BCC patients was higher. Aggressive-type BCCs were more common on the face. Dermoscopic, gray-blue ovoid nests were more common on the trunk. Pigmented dots were less common on the face, while globules were more frequent on the scalp. Small erosions were more prevalent on the extremities, while shiny white-red structureless areas were more common on the trunk and extremities. Dot vessels were more prevalent on the scalp. Vascular features were more common on the face, whereas pigmented characteristics were less common. Other dermoscopic features were more common on the face and trunk. Arborizing vessels, ulcerations, white crystals, and hairpin vessels were more common in nodular lesions. Other dermoscopic features were more prevalent in nodular lesions. Mixed-type BCCs had more gray-blue ovoid nests and globules, while single-type BCCs had more small erosions. Vascular features were more common in mixed-type BCCs. Ulceration was more common in aggressive BCCs, while small erosions were more prevalent in nonaggressive BCCs. Histopathologically, pigmented BCCs were more common on the scalp and trunk than on the face. Superficial BCCs were more common in trunks and flat lesions. Adenoid BCC was more prevalent in nodular lesions. Scalp mixed-type BCCs were more common and aggressive. Mixed-type BCCs had a higher number of subtypes, including pigmented, infiltrative, adenoid, micronodular, and solid BCCs. Cystic degeneration was more common in mixed-type BCCs. Conclusion: Clinical-pathological correlations and dermoscopic findings improve our understanding of BCC, aiding in accurate diagnosis and management.

Objective: Some histological basal cell carcinoma (BCC) types demonstrate more aggressive behavior than others. They are known as high-risk BCC and are more challenging in therapy, contrary to indolent (low-risk) BCC types. Identifying novel protein markers to predict aggressiveness and potential therapeutic targets in challenging cases is recommended. GATA3 is a transcription factor critical for epithelial and lymphocytic differentiation. This study investigated the immunohistochemical expression of GATA3 in indolent and aggressive BCC and its association with BCL2 expression. Material and Methods: Retrospectively collected indolent and aggressive BCC groups (24 cases each) were immunohistochemically stained with anti-GATA3 and BCL2 antibodies. The mean expression score (by area percentage) and TIL counts were determined and compared using ImageJ analysis. Stromal tumor-infiltrating lymphocytes (TIL) were counted per high-power field (HPF) on hematoxylin and eosin (H&E) staining. Results: GATA3 and BCL2 expressions were significantly higher in the indolent group than in the aggressive group. GATA3 expression significantly correlated with BCL2 score and TIL counts. Higher GATA3 expression was significantly associated with a more indolent BCC histological type, higher BCL2 expression, and higher TIL count. Conclusion: GATA3 is a possible target for immunomodulation experiments to improve BCC immunotherapy outcomes.

Abstract Background The incidence of skin cancers in transplant recipients is known to have increased compared to the general population. Risk factors include age at the time of transplantation, duration and dose of immunosuppressive medication. Research data on the incidence of skin cancer precursors in transplant recipients is limited. Objectives We aimed to investigate the incidence of skin cancers and their precursors and the factors influencing their development in Finnish liver transplant recipients. Methods We recruited 140 volunteers who were over 18 years old at the time of the study and had been transplanted at least 5 years before. Patients were examined by a dermatologist between 2012 and 2016 and, if necessary, followed up based on cutaneous findings. All patients in the study were followed up until May 2021 or until the death of the patient, based on medical records. Results The study found an increased incidence of nonmelanoma skin cancers (NMSCs), especially of squamous cell carcinoma, in liver transplantation (LT) recipients compared to the general Finnish population (squamous cell carcinoma SIR 21.2, basal cell carcinoma SIR 7.6). Precursors of squamous cell carcinoma were found in 43 patients (30.7%) after transplantation. The study found no statistically significant difference between the drugs used for immunosuppression. Conclusions Our data showed an increased risk of NMSCs in LT recipients. After LT, patients are at significant risk of SCC and its precursors may be found even in almost third of patients in 17.5 years follow‐up. Given this information, it is considered important to monitor LTRs with adequate frequency to treat precursors as early as possible before the development of SCC.

Abstract Background Rates of keratinocyte carcinoma (KC) across Europe are impacted by population demographics and geography. Regional differences in KC occurrence exist, but few European studies investigate incidences of specific subtypes in the secondary healthcare sector on a national level. Objectives To determine geographical differences in incidence rate and lifetime risk of KC subtypes across Denmark, including nodular and superficial basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and the KC precursor, Bowen's disease (BD), identified in office‐based dermatological practice. Methods Based on a nationwide registry (The Danish Skin Cancer Registry), all patients in Denmark's five regions with a histologically‐ or clinically verified KC or BD registered in a state‐funded office‐based dermatology practice between 2013 and 2022 were included. Trends in national‐ and region‐specific age and sex standardised tumour incidence rates (STIR) were calculated. Further, national lifetime risk of each tumour subtype was estimated. Results Between 2013 and 2022, the combined STIR for KC/BD rose 172% nationally from 180 to 489 per 100,000 person‐years (PY). This increase reflected rising rates of nodular BCC, SCC, and BD, while superficial BCC incidence was relatively stable. Regional differences in STIR for combined KC/BD were observed, with the Capital Region and North Jutland generally demonstrating higher rates than Zealand, Southern‐ and Central Denmark (e.g., North Jutland vs. Southern Denmark: 714 vs. 405/100,000PY). While the estimated lifetime risk of developing at least one KC or BD tumour was 21.8%, risk varied with tumour subtype, resulting in subtype‐specific risks of 16.4%, 5.1%, 1.9% and 1.3% for nodular BCC, superficial BCC, SCC, and BD, respectively. Conclusions In Denmark's secondary dermatological care sector, incidence of nodular BCC, SCC and BD continues to rise with an overall lifetime risk nearing 22%. While KC incidence is increasing in Denmark, the study detected differences in geographical trends and rate increases of specific tumour subtypes.

Abstract Basal cell carcinoma (BCC), which frequently occurs in sun‐exposed areas of the head and neck region, is the most common cutaneous malignancy but the least studied with radiologic imaging techniques. This article outlines the case of a 65‐year‐old male with a pigmented BCC of the right shoulder discovered on positron emission tomography‐computed tomography (PET/CT). The lesion was initially suspected as a melanoma. However, the histopathological features showed a tumor of basaloid cells. PET/CT is an excellent technique for the detection of hypermetabolic tumors, such as melanoma, squamous cell and Merkel cell carcinomas, in lymph nodes and distant organs. The usefulness of PET is limited for slowly growing tumors, such as BCC. However, PET/CT can be useful for the detection of distant metastasis in locally advanced BCC as well as in the follow‐up of locally advanced BCC on Hedgehog inhibitors.

Background: Tattooing is a widespread practice and has increased in popularity over time. Many lesions have been described in relation to tattoos, including malignant tumors. Objectives: The primary goal of this review is to determine whether the frequency of published cases of skin cancers within tattoos has been increasing over time. Methods: Our review is in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and reporting criteria. The databases MEDLINE via PubMed, Embase via Elsevier, and Scopus via Elsevier were searched from inception to February 23, 2023. No data or publication date limits were imposed. Results: Our review identified 160 cases of cutaneous tumors arising within tattoos. An increase in published cases over time was observed. Most reported tumors developed within red tattoo pigment (36.9%), with the largest contribution by squamous cell carcinoma and keratoacanthoma lesions. Limitations: There was a lack of consistency of information in published case reports which limited the scope of our analysis. Small sample size was also a limitation of this review. Conclusions: With the increased popularity of tattoos, it is helpful to continue reporting cases of cutaneous malignancies within tattoos. Awareness of the frequency and severity of tumors within tattoos may be communicated to the public.

Background Basal cell carcinoma (BCC) is the most common type of nonmelanoma skin cancer. Typically, resection requires a safety margin of ≥4 mm. When removing tumor cells, achieving complete excision with minimal safety margins and reconstructing the defect to preserve the original appearance are important. In this study, we used a 3-mm resection margin to confirm recurrence and re-resection rates.

Background: Impact of Merkel cell polyomavirus (MCPyV) associated Merkel cell carcinoma (MCC) has not been assessed in the Icelandic population, nor in a whole population elsewhere. Objectives: The primary objective was to assess trends in the incidence of MCC in Iceland and the association with MCPyV. Secondary objectives aimed to analyze MCC outcomes. Methods: In this retrospective cohort study, patients diagnosed with MCC between 1981 and 2021 were identified from the Icelandic Cancer Registry. Patients were separated into 2 groups based on MCPyV immunochemistry staining. Age-standardized incidence was calculated and Joinpoint analysis was used to assess incidence trends. A Cox proportional hazards model was used to assess survival differences between the 2 groups. Results: Overall incidence of MCC increased from 0.015 to 0.26 per 100,000 persons, though the incidence of MCPyV positive cases recently decreased while negative cases increased. MCPyV negative tumors were associated with sun exposure (P

Cysteamine (CA) induces duodenal ulcers in rodents (Selye and Szabo, Nature 244:458–459, 1973). Cysteine (Cys), a precursor for the formation of CA (via catabolism of coenzyme A), does not cause lesions in the duodenum (Szabo et al., J Pharmacol Exp Ther 223:68–76, 1982). CA also has antimutagenic and anticancer pharmacology (Fujisawa et al., PLoS ONE 7, 2012; Lee, Adv Pharmacol Pharm Sci 2023:2419444, 2023). We propose a mechanism of CA-induced cell death dependent on oxygen and CA dioxygenase (ADO) that can explain the 50-year-old mystery as to why CA is, but Cys is not, ulcerogenic. Those cells expressing coenzyme A-catabolizing enzymes are subject to a unique type of oxygen- and enzyme-bound-Fe2+-dependent death, type II ferroptosis. [ABSTRACT FROM AUTHOR]

Background: Squamous cell carcinoma (SCC) is one of the most commonly diagnosed neoplastic disorders in reptiles. Recently, however, it has been demonstrated that basal cell carcinomas (BCCs) are frequently misclassified as SCCs. Several histological SCC and BCC variants have been characterised and their classification may allow the establishment of appropriate prognosis estimation and treatment approaches. Hypothesis/Objectives: To describe the clinical features and surgical outcomes of SCCs and BCCs diagnosed between 2010 and 2022 in reptiles. Animals: Thirty‐three captive reptiles (21 squamates and 12 chelonians). Materials and Methods: Detailed clinical history, including staging and surgical outcomes, were performed. Statistical analysis assessed significant factors using Prism (v8.2.1). Results: While SCC was predominantly diagnosed in lizards, BCC was most commonly diagnosed in chelonians, and both neoplasms mainly occurred in adult to aged, male individuals. Although the gross pathological findings were highly comparable between SCC and BCC, considerable variation could be seen according to the primary location (oral, cutaneous or epidermis of the shell). Humane euthanasia or noncurative intent surgeries were performed in a minority of the cases. Curative intent surgeries were successful in 19 of 27 cases during a 1‐ to 7‐year follow‐up period, yet recurrence was seen in 8 cases. The results of this study allowed the identification of significant high‐risk prognostic factors for SCC and BCC in reptiles. Conclusions and Clinical Relevance: This study contributes to predicting the clinical behaviour and prognosis of distinct SCC and BCC histological variants, and selecting the most appropriate treatment protocol. [ABSTRACT FROM AUTHOR]

Background: One of the hereditary syndromes associated with multiple early‐onset basal cell carcinomas (BCCs) is basal cell nevus syndrome (BCNS), of which a minority is caused by germline SUFU mutations. Germline SUFU mutations show a spectrum of phenotypes, of which multiple hereditary infundibulocystic basal cell carcinoma syndrome (MHIBCC) is one. Patients with MHIBCC develop multiple basaloid skin tumors from middle age onwards. Methods: Three patients presenting with an MHIBCC phenotype were tested for a germline SUFU mutation. Skin biopsies were assessed by two dermatopathologists. Results: Our study adds three new pathogenic SUFU variants, including a mosaic, to the current literature. Literature suggests a spectrum of phenotypes of patients carrying the same SUFU mutation, which ranges from the MHIBCC phenotype, to BCNS, to patients that develop life‐threatening brain tumors. This last risk is significantly higher in germline SUFU mutation carriers when compared to BCNS patients carrying germline PTCH1 mutations. Conclusions: Germline SUFU mutation carriers should be recognized as a distinct group of patients carrying specific health risks, independent of meeting the BCNS criteria. Phenotypic prediction based on the specific SUFU mutation seems unfeasible. It is of utmost importance that the less apparent MHIBCC phenotype is recognized, to provide (second generation) germline SUFU mutation carriers appropriate healthcare. [ABSTRACT FROM AUTHOR]

Several studies have been published describing development of cutaneous malignancy after vismodegib therapy; no systematic review has been conducted to interpret these data. Our objective was to systemically review reported cases of same-site or different-site cutaneous malignancy after smoothened inhibitor (SMOi) therapy for primary basal cell carcinoma (BCC). PubMed, CINAHL, and Scopus were systematically searched January 1, 2012 – March 28, 2024. Inclusion criteria: primary BCC, SMOi therapy, and biopsy-proven secondary malignancy. Exclusion criteria: non-human subjects. Bias was assessed using Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Twenty-three cases describing same-site secondary malignancy were included. Average patient age was 67.2 years, mean treatment time 8.4 months, and average latency period to secondary malignancy development of 10.2 months. Five cases describing different-site secondary cutaneous malignancies were included. Mean patient age was 80.4 years, mean treatment time 2.9 months, and mean latency period 4.5 months. Twenty-seven cases were associated with vismodegib, while one case described vismodegib then sonidegib therapy. Pathologies included squamous cell carcinoma, BCC, basosquamous carcinoma, and malignant melanoma. The mechanism(s) by which same-site and different-site secondary malignancy occur are not known; mechanisms may differ depending on location type and secondary tumor type. We discuss multiple mechanistic hypotheses including pharmacologic selective pressure leading to hedgehog pathway mutant cells and activation of pro-growth signaling, and potential protective effect of hedgehog inhibition from melanoma given reports of rapid growth after SMOi discontinuation. This study is limited by the small number of reported cases. Additional research is needed to investigate these hypotheses. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is a slowly progressive, locally aggressive and rarely metastasizing cancer, and although its mortality is low, its morbidity and cost of disease are high. While BCC is more common, cutaneous malignant melanoma (CMM) is significant due to its higher mortality rate. These patients can be treated, but recurrence, metastasis and mortality may occur in such patients. Various environmental, phenotypic and genotypic factors, especially ultraviolet (UV) radiations, play a role in the etiology of BCC and CMM. Histopathological examination continues to be the “gold standard” in their diagnosis. Spexin (SPX) and DARS2 are newly discovered proteins linked to many diseases, including cancer. These proteins may have an effect on the development and expression of skin cancers such as BCC and CMM. In this study, we evaluated the potential of SPX and DARS2 expressions as immunohistochemical biomarkers in the differential diagnosis of BCC and CMM. This study was conducted retrospectively using samples taken from the pathology laboratory. A total of 180 patient samples were used. The control group consisted of healthy skin tissues of the patients, and the other groups consisted of BCC and CMM tissues of the same patients. Tissue samples of all three groups were evaluated immunohistochemically with SPX and DARS2. The immunoreactivity of SPX was found to be higher in BCC and CMM tissue samples than in healthy skin tissues in the control group. DARS2 immunoreactivity was found to be higher in CMM tissues compared to the other two groups, and statistically significant in BCC tissues when compared with healthy control group tissues. SPX can be used as an immunohistochemical biomarker in the diagnosis of BCC and CMM. Since DARS2 expression is statistically more significant in CMM tissues than in BCC tissues, it can be used in differential diagnosis. [ABSTRACT FROM AUTHOR]

Keratinocyte carcinoma is the most common form of cancer in the United States. Often treated by surgical excision, electrodessication and curettage, or Mohs surgery, treatment can frequently leave patients with a scar and can be time consuming and inconvenient for both patients and healthcare providers. Utilizing non-ablative fractional laser therapy followed by tirbanibulin ointment, we treated 30 basal and/or squamous cell carcinomas on 23 patients over the age of 50 with varying skin types. Multiple areas of the face and body, and carcinomas at differing stages, were treated. We maximized the depth of penetration of the fractional laser by using bulk heating methods while simultaneously optimizing cosmetic results. This is an ongoing study as we continue to track the progress of our participants. Thus far, no clinical or histological recurrence of carcinoma has been found in any of the treated sites. [ABSTRACT FROM AUTHOR]

There is a paucity of information on racial and ethnic disparities relating to barriers to care in healthcare access and utilization in patients with cutaneous malignancies. We conducted a cross-sectional analysis of adults with melanoma, basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) in the National Institutes of Health (NIH) All of Us Research Program collected between May 2018 and July 2022. Participants included adults (aged 18 or older) with cutaneous malignancy who completed the Health Care Access and Utilization survey. We identified 5,817 adults who were diagnosed with BCC (67%), cSCC (28.9%), and melanoma (23.9%). Non-Hispanic Black (NHB) and Hispanic patients were more likely than non-Hispanic White (NHW) patients to delay a primary care visit due to cost (p = 0.005 and p = 0.015, respectively). NHB patients were also more likely to delay care due to lack of transportation (p < 0.001). NHB and Hispanic patients were more likely to place importance on seeing a provider from the same background (NHB p < 0.002; Hispanic p = 0.002) and also were more likely to report never being able to see such a provider (NHB p < 0.001; Hispanic p = 0.002). Medicaid/Medicare patients, non-college graduates, and those with lower incomes also faced increased barriers to care, including delays due to cost and transportation issues. People of color with cutaneous malignancies are more likely to delay care in seeing primary care providers due to cost or transportation issues. This study provides important insights on disproportionate healthcare usage among racial/ethnic groups that may help mitigate healthcare disparities. [ABSTRACT FROM AUTHOR]

Childhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established. Identify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS. KC were identified among Childhood Cancer Survivor Study participants, a cohort of 5-year cancer survivors diagnosed <21 years of age between 1970 and 1999 in North America. Cumulative incidence was estimated and multivariable models assessed relative rates of KC associated with survivor and treatment characteristics. Among 25,658 participants, 1446 developed 5363 KC (93.5% basal cell carcinoma, 6.7% squamous cell carcinoma; mean age 37.0 years (range 7.3-67.4), mean latency 25.7 years; 95.3% White and 88.4% with radiotherapy). Mean lesion count was 3.7 with 26.1% experiencing ≥4. Radiotherapy imparted a 4.5-fold increase in the rate of any KC and 9.4-fold increase in the rate of ≥4 KC. Allogeneic and autologous hematopoietic cell transplant were associated with a 3.4- and 2.3-fold increased rate of KC, respectively. Participant self-reporting of some data including race without skin phototype and past medical history may have impacted analysis. The burden of KC in CCS remains high, but predictable risk factors should guide screening. [ABSTRACT FROM AUTHOR]

Residual tumor is not always clinically apparent following biopsy of cutaneous carcinomas, which may prompt patients to question the need for definitive treatment. We investigated the percentage of cases in which residual tumor was histologically present at the time of Mohs micrographic surgery (MMS) for basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) and investigated factors associated with residual tumor. We examined 483 MMS cases performed for biopsy-proven BCC (n = 287) and SCC (n = 196) between October 2022 and April 2023. Single-stage MMS specimens were step-sectioned en face to exhaust the block. Univariate and multivariable logistic regression models were created. Residual tumor was identified in 83.3% of BCC and 66.8% of SCC at the time of MMS (P =.01). In patients clinically appearing tumor-free following biopsy, residual histologic tumor was identified in 68.2% of BCC and 41.5% of SCC. Residual tumor was significantly more likely in men (P =.04), high-risk sites (P =.002), smaller biopsy sizes (P =.0003), and larger preoperative sizes (P <.0001). Single center, retrospective cohort. The majority of patients with BCC and SCC have residual histologic tumor at the time of MMS, oftentimes even when tumor is not clinically apparent. Multiple factors impact the presence/absence of residual tumor. [ABSTRACT FROM AUTHOR]

Image-guided superficial radiation therapy (IGSRT) combines superficial radiation therapy (SRT) with full dermal visualization (FDV) via high-resolution dermal ultrasound (HRDUS) for the treatment of non-melanoma skin cancer (NMSC). The gold standard for IGSRT delivery includes a comprehensive cancer care model with support for dermatologists from a multidisciplinary team. When delivered in this model, IGSRT can achieve cure rates of 99% for treatment of NMSC. This paper focuses on the benefits of HRDUS used in conjunction with SRT for NMSC. Medical records from 7 dermatology clinics of 883 patients with 1507 cases of NMSC treated with IGSRT between 2017 and 2018 were retrospectively reviewed. In total, 92% of the NMSC lesions showed daily depth fluctuations, 60.32% of lesions did not require changes during therapy, and nearly 40% of lesions required at least one compensatory change during therapy. In total, 83% of NMSC lesions were labeled as high risk based on the 2024 NCCN guidelines. Increasing and decreasing tumor depth measurements during IGSRT inform dermatologists when adaptive changes in energy (kV), TDF, and dose will result in more efficacy and less toxicity, respectively.

A 62-year-old man presented with a slowly growing, painless lesion on his face. This eventually led to a progressive left-eye vision lesion, and the patient was subsequently diagnosed with advanced basal cell carcinoma (BCC). Of note, BCC involving cranial nerves is extremely rare, making this case unique and important to highlight. Standard treatment options for BCC involve surgery, radiation, or platinum-based chemotherapy. However, targeted therapies such as sonidegib and vismodegib – sonic hedgehog pathway inhibitors – have emerged that have been approved for treating BCC, as have anti-PD1 immunotherapies, such as cemiplimab, with their success likely based on the high tumor mutational burden seen in some of these tumors. Epidermal growth factor receptor (EGFR) inhibitors also serve a role in treating this condition as well. Molecular studies on metastatic/advanced BCC and other rare malignancies may inform treatment therapeutic decisions.

The incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) is constantly increasing, becoming a significant health problem. CTLA-4 is a critical immune checkpoint, and it has been suggested that a variant of variable-number tandem repeat in the 3’-UTR of its gene, known as (AT)n, may be associated with a higher susceptibility to some cancers; however, little is known about genetic variants of the CTLA-4 gene in NMSC. To establish the association of this genetic variant in the CTLA-4 gene with the susceptibility of NMSC carcinogenesis in the Western Mexican population, samples from 150 BCC patients, 150 SCC patients, and 150 healthy individuals as the reference group (RG) were analyzed by endpoint PCR, followed by electrophoresis to genotype the samples. We found that the short-repeat 104/104 bp genotype may be a risk factor for BBC carcinogens (OR = 2.92, p = 0.03), whereas the long-repeat 106/106 bp genotype may be a protective factor for both BCC (OR = 0.13, p = 0.01) and SCC (OR = 0.32, p = 0.01) susceptibility. Our results show that in the Western Mexican population, long-repeat (AT)n variants in the CTLA-4 gene are associated with a protective factor in BCC and SCC. In contrast, short repeats are associated with a risk factor.

Objective To investigate the efficacy and safety of Sonidegib for basal cell carcinoma. Methods Clinical data and skin histology were analyzed in a patient with ulcerated brown plaque on the nasal dorsum. After the diagnosis of basal cell carcinoma, patient was orally given a Hedgehog pathway inhibitor, Sonidegib. Results The patient was diagnosed with basal cell carcinoma. After the treatment with Sonidegib, the skin lesions became flat and ulcers were healed, without the development of new ulcers. Prior to the treatment, patient's liver and muscle enzymes were normal. Following one-week treatment with Sonidegib, the patient experienced muscle weakness, loss of appetite, vomiting, fatigue, and drowsiness, with an EGOG level of 3. After 4 weeks of treatment, the liver enzymes and serum CK were 2.5 times over normal levels. Sonidegib was discontinued at week 6 due to his intolerance of side effects. Then the patient was given the Mohs surgery and skin grafting. Conclusions Sonidegib can induce liver damage and musculoskeletal reactions. Adverse reactions should be dynamically monitored in clinical use of this drug. If the tumor is large or direct surgical removal may cause severe trauma, neoadjuvant therapy can be beneficial. In clinic, drugs can be intermittently administered according to patients' tolerance to improve tolerance and adherence.

Abstract Background Skin cancer shows geographic and ethnic variation. New Zealand—with a predominantly fair-skinned populations, high UV indices and outdoor lifestyles—has high rates of skin cancer. However, population prevalence data is lacking. This study aimed to determine the demographics and socioeconomic disease trends of non-melanoma skin cancer prevalence in New Zealand from a large targeted-screening study. Methods A targeted screening programme was conducted among 32,839 individuals, Fitzpatrick Skin Types I to IV in Auckland, New Zealand during the 2008–2022 period. This data was analyzed retrospectively. Linear regression models were used to assess statistical trends of skin cancer prevalence over time, along with associated factors that included demographics, disease trends and overall prevalence. Results A total of 32,839 individuals were screened and 11,625 skin cancers were detected. 16,784 individuals were females who had 4,378 skin cancers. 16,055 individuals were males who had 5,777 skin cancers. 54 males and 65 females had multiple skin cancers. The article presents detailed descriptions of tumour types and subtypes detected, age groups, demographic and socioeconomic information. regarding the non-melanoma skin cancers detected. Conclusion Overall men have more non-melanoma skin cancer (NMSC) than females; however females develop more BCC on the lips. BCC is three times more common in the 31-50 age group, whereas SCC are significantly more prevalent after age 80. Prevalence of BCC has not changed over the 15-year timeframe of the study but SCC has increased. Older ages and higher incomes are associated with higher rates of NMSC in New Zealand.

Background: Basal cell carcinoma (BCC) cases exhibit variations in tumour number, location, and growth patterns. While some patients develop only one BCC, approximately one-third of patients later develop one or more additional lesions. Aims: The aim of the study was to identify risk factors for further BCC lesions in patients with different phenotypic presentations. Materials and Methods: We retrospectively evaluated 1052 histopathologically diagnosed tumours of 861 patients, who were divided into four phenotypic presentation groups according to tumour number at initial diagnosis and during follow-up. Age, sex, tumour characteristics, surgical margins, re-excision and residual tumour rates were compared. Univariate and multivariate logistic regression analyses were performed to determine risk factors for multiple tumour development. Results: There were 723 patients in the single presentation phenotype 1 (SPP1) group, 19 in the SPP-more group, 114 in the multiple presentation phenotype (MPP)-cluster initial group, and five patients in the MPP-cluster later group. Male sex was more common in the MPP-cluster later group (P = 0.028). The mean age was lower in the SPP1 and SPP-more groups (P = 0.002). Ear involvement was more common in the MPP-cluster later group (P < 0.05). Superficial and basosquamous subtypes were more common in the SPP-more and MPP-cluster later groups (P < 0.05). Re-excision and residual tumour rates were lowest in the SPP1 group (P < 0.05). Age over 69 years, male sex, and periorbital or upper extremity location were significant risk factors for multiple tumour development (P < 0.05). Limitations: The limitations of our study include the inability to evaluate environmental risk factors, phenotypic and ethnic characteristics, and the short follow-up period for newly added patients. Conclusions: Predicting different phenotypic presentations by taking the age, gender, and tumour characteristics (localization, histopathological subtype) of the patients into account may allow new tumours to be detected at an early stage.

Introduction: Basal cell carcinoma (BCC) is treated with local surgery or noninvasive treatment modalities. If a BCC remains untreated, it can develop into a locally advanced BCC or a metastatic BCC. Case Presentation: Here we report in detail the management of three complex advanced BCC (aBCC) after treatment failure with vismodegib. On all tumors, next generation DNA sequencing in the Center for Personalized Cancer Treatment-02 (CPCT-02) study was performed; subsequently, patients were included in the Drug Rediscovery Protocol (DRUP) trial, in which treatment was started with commercially available targeted anticancer drugs based on the molecular tumor profile. All patients showed partial response or stable disease following treatment with second line PD-1 inhibitors with an average duration of response of 12.3 months. Discussion/Conclusion: Immunotherapy can be a treatment option for aBCC resistant to hedgehog pathway inhibitor treatment. However, despite the high tumor mutational burden of aBCCs, immunotherapy does not always lead to a long response. Rechallenge or combining treatment of hedgehog inhibitors and PD-1 inhibitors by parallel or alternating cycles may be a strategy to lengthen the treatment response.

Introduction: Grenz ray therapy popular in dermatology decades ago causes multiple and recalcitrant skin cancer in the treated field many years later. The treatment of choice is surgical excision, but limitations especially disfiguring scarring are a major challenge. We introduce 20 MHz high-intensity focused ultrasound (HIFU) as a new therapy overcoming the limitations of excisional surgery. Case Presentation: A 66-year-old female, who in the 1980s had received several grenz ray treatments of the scalp, developed multiple basal cell carcinomas in the field. She had over 30 excisional surgeries including Mohs surgery in the past with many local complications but, nevertheless, recurrent cancers. HIFU treatments applied to eight basal cell carcinomas and two precancerous lesions resulted in complete clearing at 12-month control, but one recurrence after 15 months. Conclusion: The HIFU treatment is convenient, with very few complications, and applicable to field eradication of skin premalignancies and malignancies. HIFU may fill out a hitherto unmet need of both preventive and curative treatment with better long-term control of patients with recalcitrant skin cancer after grenz ray given in the past. HIFU is a new potentially important therapeutic modality in skin oncology, combining curative treatment, field eradication, and prevention in one procedure through treatment of lesions in different states of progression.

In fair-skinned populations worldwide, skin cancer is a serious public health threat. A significant percentage of all reported occupational diseases fall back on skin cancer. Over the past few decades, there has been a rise in the frequency of skin cancer diagnoses among outdoor workers. The main cause of non-melanoma skin cancer is solar ultraviolet radiation (UVR), which is also the most common occupational carcinogenic exposure in terms of the number of exposed workers (i.e., outdoor workers). Sun protection—and concomitantly the prevention of occupational skin cancer—is a component of workplace safety. The risks of solar UVR exposure at work are often disregarded in practice, despite the recent recognition of the need for measures to support outdoor workers’ sun protection behavior. It is anticipated that occupational dermatology will become increasingly focused on sun safety in the coming decades. To handle current hurdles in a sustainable manner, the full range of preventive measures should be utilized. Existing strategies for the prevention of occupational skin cancer might be evolved and enriched by new (educational) concepts, methods, and/or technologies. In this, not only components of general prevention and individual prevention but also setting-based prevention and behavior-based prevention might be freshly thought through.

A 74-year-old woman in good general health presented with a 5-year history of progressive hair loss over several years, interpreted as female androgenetic alopecia (AGA), and was treated with topical 5% Minoxidil without improvement. The patient’s relevant medical history revealed infiltrating, triple-negative apocrine carcinoma of the right breast four years before, treated by quadrantectomy, radiation, lymphadenectomy and chemotherapy, with no recurrence at the last follow-up. On examination, there was an asymptomatic 15 × 15 cm firm and whitish area of scarring alopecia on the central scalp. Dermoscopy revealed multiple arborizing vessels and many telangiectasia. The clinical considerations included mainly cutaneous metastasis of breast carcinoma (alopecia neoplastica), pseudopelade of Broque and morpheaform basal cell carcinoma (BCC). A histopathologic examination revealed characteristic changes of morpheaform BCC with basaloid islands and cords of atypical basaloid cells diffusely infiltrating the dermis, embedded in a sclerotic and hypervascularized stroma. Secondary alopecia neoplastica due to morpheaform BCC on the scalp is an exceedingly rare entity, possessing subtle clinical features that may mimic both scarring and non-scarring alopecia. Delayed recognition may contribute to aggressive behavior and extensive local destruction. Treatment with hedgehog inhibitors in locally advanced BCC of the scalp, both in adjuvant and neoadjuvant modalities, is promising.

Abstract Background Basal cell carcinoma (BCC) is the most common form of skin cancer, typically developing in sun‐exposed areas such as the face. Surgery is the treatment of choice, with a overall good prognosis. However, some scars can be unsightly or bothersome, and some tumours are too large or badly located to be eligible for surgery. Plasmonic photothermal therapy is presented here as an alternative treatment. Our team has developed green gold nanoparticles that have demonstrated their efficacy in inducing hyperthermia in the tumour‐microenvironment when combined with near‐infrared laser (NIR laser). Objectives The aim of this study is to demonstrate the effectiveness of gold nanoparticles combined with laser treatment against BCC. Methods In vitro, BCC cells were exposed to gold nanoparticles, both with and without laser treatment, to study the effects of this therapy on skin cells. Subsequently, mice bearing BCC were treated with photothermal therapy to assess tumour growth. Results Gold nanoparticles were found to be nontoxic to the cell line, and photothermal therapy induced apoptosis. In vivo studies showed complete regression of tumours without unsightly scarring and no recurrence after 40 days. Conclusions Plasmonic photothermal therapy using gold nanoparticles proved its efficacy in the destruction of BCC.

Abstract Background Autofluorescence (AF)‐Raman spectroscopy is a technology that can detect tumour tissue in surgically excised skin specimens. The technique does not require tissue fixation, staining, labelling or sectioning, and provides quantitative diagnosis maps within 30 min. Objectives To explore the clinical application of AF‐Raman microscopy to detect residual basal cell carcinoma (BCC) positive margins in ex vivo skin specimens excised during real‐time Mohs surgery. To investigate the ability to analyse skin specimens from different parts of the head‐and‐neck areas and detect nodular, infiltrative and superficial BCC. Methods Fifty Mohs tissue layers (50 patients) were investigated: 27 split samples (two halves) and 23 full‐face samples. The AF‐Raman results were compared to frozen section histology, carried out intraoperatively by the Mohs surgeon and postoperatively by dermatopathologists. The latter was used as the standard of reference. Results The AF‐Raman analysis was completed within the target time of 30 min and was able to detect all subtypes of BCC. For the split specimens, the AF‐Raman analysis covered 97% of the specimen surface area and detected eight out of nine BCC positive layers (similar to Mohs surgeons). For the full‐face specimens, poorer contact between tissue and cassette coverslip led to lower coverage of the specimen surface area (92%), decreasing the detection rate (four out of six positives for BCC). Conclusions These preliminary results, in particular for the split specimens, demonstrate the feasibility of AF‐Raman microscopy for rapid assessment of Mohs layers for BCC presence. However, for full‐face specimens, further work is required to improve the contact between the tissue and the coverslip to increase sensitivity.

Abstract Background Optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) can yield improved diagnostic accuracy of nonmelanoma skin cancer (NMSC) in comparison with dermoscopy alone. Objectives The aim of this study was to compare the diagnostic performance of OCT and RCM together and individually with that of dermoscopy. Methods Patients with lesions suspicious for NMSC were randomized into two groups in a prospective, single‐centre study. In the intervention group (IG), every lesion was examined with dermoscopy, OCT and RCM, while in the control group (CG), every lesion was examined with dermoscopy alone. Results A total of 365 lesions of 250 patients (105 female, 145 male) were included in the study. A total of 208 basal cell carcinomas (BCCs), 65 squamous cell carcinomas (SCCs) and 31 SCCs in situ were examined histologically. The IG involved significantly fewer biopsies than the CG (14 vs. 27, p = 0.029) and required fewer additional inpatient stays due to positive biopsy results (2 vs. 12, p = 0.001). For the diagnosis of BCC, diagnostic accuracy was 81% with dermoscopy, 84% with OCT, 83% with RCM and 85% with the combination of OCT and RCM (OCT/RCM). The diagnostic accuracy of OCT for BCC subtypes was as follows: superficial, 89%; nodular, 79%; sclerodermiform, 82%; and nodular‐cystic BCC, 75%. For the diagnosis of SCC, diagnostic accuracy was 85% with dermoscopy, 87% with OCT, 89% with RCM and 87% with OCT/RCM. For the diagnosis of in situ SCC, diagnostic accuracy was 87% with dermoscopy, 89% with OCT, 89% with RCM and 91% with OCT/RCM. Conclusions Diagnostic accuracy increased with OCT and RCM and was even higher when both methods were used together. OCT and RCM could facilitate optimization of lesion management by reducing the number of punch biopsies and reducing additional inpatient stays due to positive biopsy results.

We present a case of a 49-year-old man with a giant basal cell carcinoma of the back, with metastases in the lungs, liver, mediastinum and both adrenal glands. Neoadjuvant vismodegib was administered, after which wide local resection of the tumour was performed. There have been no signs of local recurrence.

This article discusses a feasibility study on the use of mobile teledermoscopy for monitoring high-risk melanoma patients. The study involved 75 patients from two Australian tertiary centers who used a portable teledermoscope compatible with their mobile phones. The study found that mobile teledermoscopy was effective in detecting skin cancers, with the potential to fast-track 37% of visits for concerning lesions. Participants aged ≤40 years and those with tertiary education provided more reliable transmissions. The study also noted a small additional cost to the healthcare system. The authors of a letter to the editor discuss the study and suggest that mobile teledermoscopy can be used to support conventional practice for high-risk patients under certain criteria. The study was supported by the NHMRC Centre of Research Excellence in Melanoma and the Melanoma Institute of Australia. [Extracted from the article]

Introduction: This study explores the impact of the COVID-19 pandemic on the diagnosis of basal cell carcinoma (BCC) in Lower Silesia, Poland, comparing pre-pandemic, pandemic, and post-pandemic periods. It investigates how different medical facilities adapted to the pandemic's challenges and the subsequent implications for cancer diagnosis. Methods: Data from histopathology and cytology laboratories were analyzed, focusing on BCC diagnoses from 2018 to 2022. This study included various medical centers categorized by size and source of implementation. Statistical analyses were conducted to compare diagnoses before, during, and after the pandemic. Results: During the initial wave of the pandemic, there was a significant reduction in newly diagnosed BCC cases, followed by a surge post-pandemic. Larger medical centers adapted more effectively, while district hospitals faced challenges. Private practices maintained stable diagnosis rates. The increase in diagnoses post-pandemic suggests a backlog of undiagnosed cases during the pandemic. Discussion: Challenges in accessing healthcare during the pandemic led to delayed cancer diagnoses. Larger medical centers were better equipped to handle the crisis, while district hospitals struggled. Private practices maintained stability, possibly due to pre-scheduled appointments. Recommendations include public education on symptom recognition and standardizing histopathological evaluation protocols. Conclusions: Despite data limitations, this study provides valuable insights into the pandemic's impact on cancer diagnosis, highlighting the need for proactive measures in future health crises to ensure timely detection and treatment of cancer cases. [ABSTRACT FROM AUTHOR]

Keratinocytes are major cellular components of the skin and are strongly involved in its homeostasis. Oncogenic events, starting mainly from excessive sun exposure, lead to the dysregulation of their proliferation and differentiation programs and promote the initiation and progression of non-melanoma skin cancers (NMSCs). Primary melanomas, which originate from melanocytes, initiate and develop in close interaction with keratinocytes, whose role in melanoma initiation, progression, and immune escape is currently being explored. Recent studies highlighted, in particular, unexpected modes of communication between melanocytic cells and keratinocytes, which may be of interest as sources of new biomarkers in melanomagenesis or potential therapeutic targets. This review aims at reporting the various contributions of keratinocytes in skin basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma, with a greater focus on the latter in order to highlight some recent breakthrough findings. The readers are referred to recent reviews when contextual information is needed. [ABSTRACT FROM AUTHOR]

Background: There is evidence from observational studies that skin microbiota is linked to skin cancers. Nevertheless, the causal association between skin microbiota and skin cancers is yet to be fully clarified. Methods: A bidirectional two-sample Mendelian randomization (MR) was performed to determine the causal relationship between skin microbiota and skin cancers. A total of 294 skin microbial taxa were identified from the first genome-wide association study across three skin microenvironments of two German population cohorts. Summary data of three skin cancers (malignant melanoma, squamous cell carcinoma, and basal cell carcinoma) were obtained from the FinnGen consortium. Moreover, sensitivity analysis examined horizontal pleiotropy and heterogeneity, and microenvironmentbased meta-analysis confirmed the reliability of the results. Results: We identified 65 nominal causalities and 5 strong causal associations between skin microbiota and skin cancers. Among them, the class Bacilli revealed a bidirectional positive relationship with malignant melanoma. The class Betaproteobacteria and class Gammaproteobacteria demonstrated a causal association with an elevated risk of malignant melanoma and basal cell carcinoma, respectively. In the reverse MR analysis, malignant melanoma was associated with a lower abundance of phylum Bacteroidetes. There were no indications of significant heterogeneity in instrumental variables or evidence of horizontal pleiotropy. Conclusion: Our MR analysis indicated bidirectional causal associations between skin microbiota and skin cancers, and had the potential to offer novel perspectives on the mechanistic of microbiota-facilitated carcinogenesis. [ABSTRACT FROM AUTHOR]