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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]

Cutaneous squamous cell carcinoma (cSCC) is the second-most-prevalent malignancy in humans. A delayed diagnosis of cSCC leads to heightened invasiveness and positive surgical margins. Bowen's disease (BD) represents an early form of cSCC and presents as a small erythematous, photo-distributed, psoriasiform plaque. Although certain dermoscopy features in BD are quite characteristic, histopathology remains the gold standard for diagnosis and provides a severity-scoring system that assists in guiding appropriate treatment strategies. The classification of precancerous lesions of the vulva and penis has undergone multifarious transformations due to variations in clinical and histopathological characteristics. Presently, erythroplasia of Queyrat is categorized as a clinical variant of penile intraepithelial neoplasia (PeIN). The diagnoses of vulvar intraepithelial neoplasia (VIN) and PeIN present significant challenges and typically necessitate one or more biopsies, potentially guided by dermoscopy. Aceto-white testing demonstrates a notably high negative predictive value for genital precancerous lesions. Histopathological examination represents the gold-standard diagnosis in VIN and PeIN, while p16 and p53 immunostainings alongside HPV testing provide crucial diagnostic clues. The histopathologic features, degree of differentiation, and associations with lichen planus, lichen sclerosus, and HPV guide the selection of conservative treatments or surgical excision. [ABSTRACT FROM AUTHOR]

Background The relationship between human papillomavirus (HPV) and Bowen disease (BD) is not fully understood. Objectives To investigate the differences in HPV detection rates in BD samples across various body regions and analyse the expression patterns of p53, p16 and Ki-67 in relation to HPV presence. Methods Tissue samples from patients diagnosed with BD, confirmed through histopathology, were retrospectively collected. Next-generation sequencing was used for HPV DNA detection. Immunohistochemistry (IHC) for p16, p53 and Ki-67 was performed. Results Out of 109 patients with BD, 21 (19.3%) were HPV-positive. All identified types were α-HPVs, with HPV-16 being the most common. The HPV detection rate was significantly higher in the pelvic (9/13, 69%, P < 0.001) and digital (5/10, 50%, P = 0.02) areas compared with those in the other regions. HPV presence was significantly correlated with p53 negativity (P = 0.002), the p53 'non-overexpression' IHC pattern (P < 0.001) and p16–p53 immunostain pattern discordance (P < 0.001). Conversely, there was no notable association between HPV presence and p16 positivity, the p16 IHC pattern or Ki-67 expression. Conclusions Our findings suggest the oncogenic role of sexually transmitted and genito-digitally transmitted α-HPVs in the pathogenesis of BD in pelvic and digital regions. Graphical Abstract Open in new tab Download slide [ABSTRACT FROM AUTHOR]

This article explores a rare case of blue discoloration in a nail tumor called onychomatricoma. The blue pigmentation was found to be caused by a fungal infection called pigmented onychomycosis. The article provides a detailed description of the clinical and histopathological features of the case, emphasizing the challenges in diagnosing and treating the tumor. It also discusses the rarity of blue chromonychia and the potential diagnostic value of nail clippings. The article aims to inform readers about the clinical features, diagnosis, and treatment of onychomatricoma, emphasizing the importance of accurate diagnosis and differentiation from other nail disorders. [Extracted from the article]

This article provides an overview of nail diseases and their management. It emphasizes the importance of recognizing and assessing changes in the nails, as they can indicate underlying systemic or localized diseases. The most common nail diseases seen in primary care include fungal infections, psoriasis, trauma, and melanonychia. Treatment can be challenging due to the anatomy of the nail and limited options available. The article also discusses various nail conditions, such as discoloration, thickening, thinning, pitting, pain, abnormal curvature, and grooves. It provides information on specific conditions like nail psoriasis, longitudinal melanonychia, Bowen's disease, myxoid pseudocysts, onychopapilloma, malalignment, and chronic paronychia. Treatment options include physical therapies, surgery, and environmental management. Recognizing the clinical features and seeking appropriate treatment is crucial for timely diagnosis and improved outcomes. [Extracted from the article]

Introduction: Oral cavity squamous cell carcinoma (OSCC) occurs most frequently in patients >60 years old with a history of tobacco and alcohol use. Epidemiological studies describe increased incidence of OSCC in younger adults (<45 years). Despite its poor prognosis, knowledge of OSCC tumor microenvironment (TME) characteristics in younger adults is scarce and could help inform possible resistance to emerging treatment options. Methods: Patients with OSCC were evaluated using TCGA-HNSC (n=121) and a stage and subsite-matched institutional cohort (n=8) to identify differential gene expression focusing on the extracellular matrix (ECM) and epithelialmesenchymal transition (EMT) processes in younger (=45 years) vs. older adults (=60 years). NanoString nCounter analysis was performed using isolated total RNA from formalin-fixed paraffin-embedded (FFPE) tumor samples. Stained tumor slides from young and old OSCC patients were evaluated for CD8+ Tcell counts using immunohistochemistry. Results: Younger OSCC patients demonstrated significantly increased expression of ECM remodeling and EMT process genes, as well as TME immunosuppression. Gene set enrichment analyses demonstrated increased ECM pathways and concurrent decreased immune pathways in young relative to old patients. Transcripts per million of genetic markers involved in ECM remodeling including LAMB3, VCAN, S100A9, COL5A1, and ITGB2 were significantly increased in tumors of younger vs. older patients (adjusted p-value < 0.10). Young patient TMEs demonstrated a 2.5-fold reduction in CD8+ T-cells as compared to older patients (p < 0.05). Conclusion: Differential gene expression impacting ECM remodeling and TME immunosuppression may contribute to disease progression in younger adult OSCC and has implications on response to evolving treatment modalities, such as immune checkpoint inhibitor therapy. [ABSTRACT FROM AUTHOR]

A case of Bowen's disease of toe is reported. A 39-year-old woman presented with red asymptomatic lesion on the medial side of the left big toe for over a month. Topical treatment with glucocorticoid was not effective. A similar rash appeared on the same area 5 to 6 years ago, and was surgically removed. Clinical examination revealed a demarcated red plaque 1.5 cm×1.5 cm in diameter, with dark red crust in the center, on her big left toe. The histopathological examination of the skin lesion showed heteroplasia of the squamous epithelium in the epidermis. The diagnosis was Bowen's disease. Following removal of lesion with electrocauterization, 5-aminolevulinic acid photodynamic (ALA-PDT) was given 4 times. The lesion completely subsided with no recurrence during 1-year telephone follow-up.

A case of Bowen's disease of toe is reported・ A 39・year-old woman presented with red asymptomatic lesion on the medial side of the left big toe for over a month ・ Topical treatment with glucocorticoid was not effective ・ A similar rash appeared on the same area 5 to 6 years ago, and was surgically removed・ Clinical examination revealed a demarcated red plaque 1・ 5 cm X 1・ 5 cm in diameter, with dark red crust in the center, on her big left toe・ The histopathological examination of the skin lesion showed heteroplasia of the squamous epithelium in the epidermis・ The diagnosis was Bowen's disease・ Following removal of lesion with electrocauterization, 5-aminolevulinic acid photodynamic(ALA・PDT)wa$ given 4 times・ The lesion completely subsided with no recurrence during 1-year telephone follow・up. [ABSTRACT FROM AUTHOR]

This article discusses the use of voriconazole inhalation powder (VIP) as a novel therapeutic option for treating invasive pulmonary fungal infections in lung transplant recipients. The article presents two cases of lung transplant recipients who were successfully treated with VIP after experiencing complications and adverse effects from other antifungal treatments. VIP was administered via a handheld dry powder inhalation device and was well tolerated with no significant adverse effects or drug interactions. The authors suggest that VIP could be a valuable alternative for high-risk patient populations and may have potential applications in primary prophylaxis or adjunctive therapy. Further studies are needed to validate the clinical efficacy of VIP. [Extracted from the article]

This case report details the management of a 79-year-old male with recurrent methicillin-resistant Staphylococcus capitis bacteremia and endocarditis. The patient's clinical journey encompassed multiple hospital admissions, with challenges in managing endocarditis, pacemaker replacements, and potential cutaneous sources of infection. The treatment regimen included intravenous antibiotic therapy during hospitalization and suppressive antibiotic treatment upon discharge, alongside a decolonization strategy for his scalp lesions. [ABSTRACT FROM AUTHOR]

Objective: By presenting a case study on multiple instances of Bowen's disease and the consistent use of narrow‐band ultraviolet B (NB‐UVB) phototherapy over a three‐year period, our aim is to enhance the comprehension of domestic clinicians regarding the disease. Additionally, we seek to review existing literature, encouraging dermatologists to consider clinical secondary primary lesion diagnoses. Method: Our approach involves analyzing a diagnosed case of multiple Bowen's disease, examining clinical manifestations, histopathology, imaging results, and treatment methods related to NB‐UVB phototherapy. We aim to facilitate discussion and understanding through a comprehensive literature analysis. Results: An elderly male with a 30‐year history of psoriasis vulgaris initiated continuous NB‐UVB therapy three years ago. A year later, he developed red patches and plaques with distinct borders and scaly surfaces on his face, trunk, lower extremities, and scrotum. Histopathological examination confirmed Bowen's disease. Treatment involved liquid nitrogen cryotherapy, with no recurrence observed during the one‐year follow‐up. Conclusion: This case highlights that Bowen's disease, typically solitary, can manifest as multiple instances, especially in individuals with a history of psoriasis vulgaris. While NB‐UVB stands as the primary treatment for psoriasis vulgaris, caution is warranted due to the potential risk of skin tumor induction with prolonged high‐dose usage. Clinicians should be vigilant in monitoring and assessing the long‐term implications of such therapies. [ABSTRACT FROM AUTHOR]

Background: Basal differentiation in oral squamous cell carcinoma is usually detected at invasive sites. However, its significance as a prognostic value has been poorly investigated. Methods: COL17 was selected as a basal differentiation marker because of its stable expression in the basal‐like cells of oral squamous cell carcinoma. Sixty‐five cases of oral squamous cell carcinoma were subclassified into COL17‐high (30 cases) and ‐low (35 cases) types, and the prognostic value was analyzed by Cox regression analysis. In addition, the stem cell markers such as SOX2, KLF4, MYC as well as the stem cell‐related markers BMI1, EZH2, and YAP and its paralog TAZ, were immunohistochemically analyzed. Their prognostic values were investigated along with their COL17 status by Cox regression analysis. Results: No significant difference was observed between the COL17‐high and ‐low groups in the disease‐specific survival and recurrence‐free survival in oral squamous cell carcinoma. When the COL17‐high and ‐low categories were combined with the SOX2, KLF4, EZH2, or YAP/TAZ status in the basal layers, together with gender and age as covariates, the hazard ratios reached 3.3, 3.7, 2.8, and 3.1, respectively. In addition, multivariate analysis, including COL17, SOX2, and KLF4, with gender and age as covariates, showed a significantly poor prognosis for disease‐specific survival. Conclusion: Based on the relatively high hazard ratios, it is indicated that basal differentiation and the expression status of SOX2 and KLF4 in the basal layers are prognostic factors for oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Opinion statement: Skin tumors commonly seen in dermatology are involved in all layers of the skin and appendages. While biopsy of affected skin remains an essential method to confirm diagnosis and to predicate tumor prognosis, it has its limitations. Recently, photodynamic diagnosis (PDD) has demonstrated high sensitivity in detecting affected skin and mucosal tissues, providing valuable guidance for precision surgery to resect skin and mucosal tumors. In this review, we summarized the literatures concerning the applications of PDD in diagnostic process and treatment of skin and mucosal conditions such as actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Bowen's disease (BD) and extramammary Paget's disease (EMPD). The findings suggest that PDD holds substantial promise for expanding clinical applications and deserves further research exploration. [ABSTRACT FROM AUTHOR]

Purpose: Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin, which mainly occurs in the sun exposed sites of white patients over 65 years, with a higher recurrence and metastasis rate. Clinically, MCC overlapping Bowen’s disease (BD) is a very rare subtype of MCC. Few cases in the literature have been described and the management is not well defined. We summarize and update the epidemiology, clinical and histopathological features, metastasis characteristics, local recurrence rate and management of it by presenting two cases of MCC overlapping BD and reviewing the literature over the last 11 years. Design: We consulted databases from PubMed, ResearchGate and Google Scholar by MeSh “Merkel cell carcinoma” and “Bowen’s disease”, “Bowen disease” or “squamous cell carcinoma in situ”, from January 2013 to December 2023 and reviewed the literatures. We reported two additional cases. Results: Total 13 cases of MCC overlapping BD were retrospectively analyzed, in whom mainly in elderly women over 70 years, the skin lesions were primarily located on the faces, followed by the extremities and trunk. Most of them were asymptomatic, firm, dark red nodules arising on rapidly growing red or dark brown patches, or presenting as isolated nodules. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. All cases were confirmed by histopathology and immunohistochemistry. The most definitive treatment was extended local excision, but local recurrences were common. Of the 13 cases, 4 cases experienced local or distant metastasis. One suffered from an in-transit recurrence of MCC on the ipsilateral leg after local excision and lymph node dissection, whose metastasis completely subsided after avelumab treatment and without recurrence or metastasis during 6 months of follow-up. Conclusions: MCC overlapping BD is a very rare skin tumor mainly predisposed on the faces, with high misdiagnosis rate and recurrence rate. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. The acronym, AEIOUN, has been proposed to aid in clinical identification. Our reports and the literature review can provide a better awareness and management of it. [ABSTRACT FROM AUTHOR]

A study published in the journal Skin Research & Technology examines the use of a 3D hyperspectral imaging system and convolutional neural networks (CNN) for the diagnosis of skin lesions. The study involved 175 lesions from 73 patients and found that the novel imaging system showed promising diagnostic performance. The researchers compared the outcomes of the CNN analysis to traditional imaging methods and found that the HSI-CNN system achieved higher specificities and did not require expertise from the user. The study suggests that the HSI-CNN system has potential for skin cancer diagnosis in primary healthcare settings and may be a useful tool for specialists in ambiguous cases. However, further studies and comparisons with other imaging modalities are needed to validate the system's performance in clinical practice. [Extracted from the article]

Background: Due to the lack of a large series of benign and malignant vulvar lesions, the features of dermoscopy are not well established. Objective: The aim of our study was to describe the epidemiological profile and the clinical and dermoscopic characteristics that may indicate malignancy or benignity in vulvar hyperpigmentation. Materials and Methods: From June 2020 to June 2023, we conducted a retrospective, prospective study involving 42 patients with 59 pigmented lesions. Results: The parallel, homogeneous, and globular patterns were observed in benign lesions (nevi, lentigo, melanosis). The cerebriform pattern was observed in seborrheic keratosis and Bowen's disease (BD). In cases of BD, we also observed white, structureless areas, glomerular vessels, a homogeneous brownishgray area, and brown dots. Conclusion: Good clinico-dermoscopic correlation should guide the diagnosis and management of pigmented vulvar lesions. Dermoscopy may be helpful in distinguishing between a benign lesion and a malignant lesion, yet in cases of doubt, a biopsy may be necessary. [ABSTRACT FROM AUTHOR]

Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3–5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase. [ABSTRACT FROM AUTHOR]

Background: Bowen's disease (BD) is a precancerous in-situ squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for a successful outcome. Aim: This study aimed to the efficacy and safety of carbon dioxide (CO2) laser ablation followed by manual dermabrasion and intralesional 5-fluorouracil (IL 5-FU) injection as combination therapy for BD. Materials and Methods: This was a retrospective, observational study comprising 29 clinically and histopathologically diagnosed BD patients with no history of prior treatment. Demographic characteristics and clinical examination of the lesions and regional lymph nodes were retrieved. All patients were subjected to CO2 laser ablation followed by manual dermabrasion and IL 5-FU injection. Results: Mean age was 61.93 ± 9.31 years with male preponderance (62.1%). Trunk (48.3%) was the most frequently involved site. Mean tumor size was 40.8 ± 16.4 mm (range: 15–86 mm). All lesions healed with a cure rate of 96.6%. Complications seen in patients included atrophic scarring with persistent post-inflammatory hyperpigmentation in three patients (10.3%), secondary infection in two cases (6.9%), and hypertrophic scar with early keloid in one patient (3.4%). Recurrence was reported in one patient (3.4%). Limitation: The study was limited by retrospective study design, small sample size, and no comparison with standard therapy. Conclusion: Combination approach using carbon dioxide laser ablation followed by manual dermabrasion and IL 5-FU injection has been proved to be effective, efficient and safe with good functional, oncological and aesthetic outcomes in treating BD.

Simple Summary: Skin cancer is the most common cancer in transplant recipients; however, screening may reduce advanced disease. The study aimed to determine referral rates to screening, the incidence, and risk factors of skin cancer in a Danish liver transplant recipient cohort. Of the 246 recipients, 89% were referred to screening and 15.6% were diagnosed with skin cancer or preneoplastic lesions during the screening period. Basal cell carcinoma was the most common skin cancer type followed by squamous cell carcinoma. Actinic keratosis was the most common preneoplastic lesion, followed by Bowen's disease. The time since transplantation and actinic keratosis were identified as independent risk factors of skin cancer. The study determined the incidence and risk factors of skin cancer/preneoplastic lesions in liver transplant recipients enrolled in a screening program, while demonstrating a high screening referral rate. (1) Background: Skin cancer is the most common cancer in transplant recipients. Timely and regular screening may reduce advanced disease. The study aimed to determine referral rates to screening, the incidence, and risk factors of skin cancer in a Danish liver transplant recipient cohort. (2) Methods: All first-time liver transplant recipients, >18 years old, attending outpatient care between January 2018 and December 2021 were included. The referral rates and incidence of skin cancer/preneoplastic lesions were calculated. Risk factors were assessed using Cox regression analyses. (3) Results: Of the 246 included recipients, 219 (89.0%) were referred to screening, and 102 skin cancer/preneoplastic lesions were diagnosed in 32 (15.6%) recipients. The IR of any skin cancer/preneoplastic lesion was 103.2 per 1000 person-years. BCC was the most frequent skin cancer followed by SCC, IR: 51.3 vs. 27.1 per 1000 person-years, respectively. No cases of MM were observed. The IR of actinic keratosis and Bowen's Disease were 48.1 vs. 13.2 per 1000 person-years, respectively. Time since transplantation was independently associated with skin cancer/preneoplastic lesions, HR (95%CI) 2.81 (1.64–4.80). (4) Conclusions: The study determined the incidence and risk factors of skin cancer/preneoplastic lesions in liver transplant recipients enrolled in a screening program, while demonstrating a high screening referral rate. [ABSTRACT FROM AUTHOR]

Bowen's disease is a slowly progressive squamous cell carcinoma (SSC) in situ with high potential for malignant transformation. In this case, we describe a patient with multicentric Bowen's disease for the past 26 years, developing growths over his left buttock. The patient had a previous history of growth developing over his right thigh, and was diagnosed with metatypical basal cell carcinoma (BCC). The points that make this case noteworthy are recurrent cutaneous carcinomas over the multicentric generalized occurrence of in situ SCC of extragenital type, the rarity of the site, and the nature of its morphological presentation in the skin of color. [ABSTRACT FROM AUTHOR]

Background: Bowen's disease (BD) is a precancerous in-situ squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for a successful outcome. Aim: This study aimed to the efficacy and safety of carbon dioxide (CO2) laser ablation followed by manual dermabrasion and intralesional 5-fluorouracil (IL 5-FU) injection as combination therapy for BD. Materials and Methods: This was a retrospective, observational study comprising 29 clinically and histopathologically diagnosed BD patients with no history of prior treatment. Demographic characteristics and clinical examination of the lesions and regional lymph nodes were retrieved. All patients were subjected to CO2 laser ablation followed by manual dermabrasion and IL 5-FU injection. Results: Mean age was 61.93 ± 9.31 years with male preponderance (62.1%). Trunk (48.3%) was the most frequently involved site. Mean tumor size was 40.8 ± 16.4 mm (range: 15–86 mm). All lesions healed with a cure rate of 96.6%. Complications seen in patients included atrophic scarring with persistent post-inflammatory hyperpigmentation in three patients (10.3%), secondary infection in two cases (6.9%), and hypertrophic scar with early keloid in one patient (3.4%). Recurrence was reported in one patient (3.4%). Limitation: The study was limited by retrospective study design, small sample size, and no comparison with standard therapy. Conclusion: Combination approach using carbon dioxide laser ablation followed by manual dermabrasion and IL 5-FU injection has been proved to be effective, efficient and safe with good functional, oncological and aesthetic outcomes in treating BD. [ABSTRACT FROM AUTHOR]

Porokeratosis is a skin condition that involves the formation of plaques, characterized by a hyperkeratotic ridge with an atrophic center. There is a histological presence of a cornoid lamella, which is a parakeratotic column that traverses through the stratum corneum. The plaques are mostly benign but have the potential to become squamous cell carcinomas if left untreated. Porokeratosis lesions typically occur on the extremities, but they can develop anywhere. The occurrence of porokeratosis on the lip is exceedingly rare. We report three cases of porokeratosis on the lip. Each incidence was treated with cryotherapy, which was unsuccessful in two. One of these two patients did not elect for topical treatment and is being monitored for lesion changes. The second patient was successfully treated via shave biopsy. The third patient was lost to follow-up post-cryotherapy. [ABSTRACT FROM AUTHOR]

Precise assessment of facial lesions in photo-damaged skin could be challenging. A collision of benign, premalignant and malignant tumours is not uncommon. Selecting the biopsy site is fundamental for making a proper diagnosis. Therefore, biopsies should not be taken blindly but should be preceded by a detailed preliminary evaluation with dermoscopy, in particular. The article presents a case of a 78-year-old female patient, in whom dermoscopy-guided incisional biopsy of an irregular erythematous plaque led to the diagnosis of in situ squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

This comprehensive study delves into the intricate landscape surrounding the role of human papillomavirus (HPV) in extragenital keratinocyte skin tumors, specifically exploring Bowen's disease (BD) and in situ squamous-cell carcinoma (iSCC). Through a multifaceted examination, this research study elucidates the nuanced interplay of HPV, gender dynamics, anatomical site variations, and potential implications for the etiopathogenesis of these malignancies. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) are the most frequently occurring non-melanocytic skin cancers. The objective of our study is to present the pathophysiology of BCC and cSCC and its direct relationship with the histopathological diagnostics and the differential diagnostics of these types of cancer, based on the morphological characteristics, immunohistochemical profile, and genetic alterations. The qualitative study was based on emphasizing the morphological characteristics and immunohistochemistry profiles of BCC and cSCC and the differential diagnostics based on the tissue samples from the Clinical Pathology Department of Mures Clinical County Hospital between 2020 and 2022. We analyzed the histopathological appearances and immunohistochemical profiles of BCC and cSCC in comparison with those of Bowen disease, keratoacanthoma, hyperkeratotic squamous papilloma, metatypical carcinoma, pilomatricoma, trichoblastoma, Merkel cell carcinoma, pleomorphic dermal sarcoma (PDS), and melanoma. Our study showed the importance of the correct histopathological diagnosis, which has a direct impact on the appropriate treatment and outcome for each patient. The study highlighted the histopathological and morphological characteristics of NMSCs and the precursor lesions in HE and the immunohistochemical profile for lesions that may make the differential diagnosis difficult to establish. [ABSTRACT FROM AUTHOR]

Purpose: Oculoplastic surgeons excise and reconstruct eyelid tumors, although plastic surgeons have traditionally managed these cases. Current demand of this surgery is growing, and planning referral services is a health management necessity. This pilot study retrospectively reviewed same population eyelid specimens excised by both disciplines comparing data. Methods: Clinical and epidemiologic features of 1423 eyelid lesions biopsied between 2015- 2020 in Emek Medical Center (EMC), Israel were reviewed. Results: Among 1423 specimens, 1210 (85.0%) were benign and 213 (15.0%) were malignant/pre-malignant. Mean age at diagnosis was significantly higher in malignant tumors than in benign tumors (76 and 59 years respectively, p value < 0.001). The most common benign eyelid lesions were soft fibroma (20.1%), seborrheic keratosis (11.0%) and melanocytic nevus (10.3%). The most common malignant/pre-malignant eyelid tumors were basal cell carcinoma (BCC) (9.2%), actinic keratosis (2.6%) and Bowen's disease (1.9%). Ophthalmology removed 37 malignant/pre-malignant lesions (5.4%) out of 683 compared to plastics removing 142 malignant/pre-malignant lesions out of 740 (19.2%) specimens. Eyelid malignancy in the plastics department was significantly higher than in the ophthalmology department (p value < 0.001). 270 (70.0%) lesions caused by UV exposure were removed by plastics and 116 (30.0%) were removed by ophthalmology (p value < 0.001). Conclusions: Eyelid lesions in patients aged 76 or older are more likely to be malignant. Ophthalmology eyelid specimens in younger patients are more commonly benign and related to inflammation. Specimens from the plastics department are more commonly malignant, related to UV-exposure, and are from older patients. This difference may be due to a misconception that plastic surgeons have more eyelid cancer reconstruction experience than oculoplastic surgeons, or less awareness of the oculoplastic expertise available today. [ABSTRACT FROM AUTHOR]

Randomized controlled trials comparing the effectiveness of 5-fluorouracil cream, methylaminolevulinate photodynamic therapy (MAL-PDT) and surgical excision in patients with Bowen's disease are lacking. In this multicenter noninferiority trial, patients with a histologically proven Bowen's disease of 4-40 mm were randomly assigned to excision with 5 mm margin, 5% 5-fluorouracil cream twice daily for 4 weeks, or 2 sessions of MAL-PDT with 1 week interval. The primary outcome was the proportion of patients with sustained clearance at 12 months after treatment. A noninferiority margin of 22% was used. Between May 2019 and January 2021, 250 patients were randomized. The proportion of patients with sustained clearance was 97.4% (75/77) after excision, 85.7% (66/77) after 5-fluorouracil, and 82.1% (64/78) after MAL-PDT. Absolute differences were −11.7% (95% CI −18.9 to −4.5; P =.0049) for 5-fluorouracil versus excision and −15.4% (95% CI −23.1 to −7.6; P =.00078) for MAL-PDT versus excision. Both noninvasive treatments significantly more often led to good or excellent cosmetic outcome. Based on our predefined noninferiority margin of 22%, 5-fluorourcail is noninferior to excision and associated with better cosmetic outcome. For MAL-PDT noninferiority to excision cannot be concluded. Therefore, 5-fluorouracil should be preferred over excision and MAL-PDT in treatment of Bowen's disease. [ABSTRACT FROM AUTHOR]

Bowen's disease is a cutaneous squamous cell carcinoma in situ, a rare precancerous disease most frequently manifested by an erythematous, scaly crusted plaque on sun-exposed areas. We report on the case of an 83-year-old female, with an asymptomatic, erythematous scaly plaque, within an uncommon topographic setting, a peculiar localization that prompted a series of inquiries into multiple potential differential diagnoses. We also review the main treatment options, among which surgical extension, cryotherapy, topical agents, or photodynamic therapy are of paramount importance. [ABSTRACT FROM AUTHOR]

Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. This article describes the causes, epidemiology, and characteristics of suspicious premalignant squamous cell lesions so that clinicians can identify these lesions and refer patients for specialist treatment as appropriate. [ABSTRACT FROM AUTHOR]

Introduction: Studies focused on dermoscopic aspects of pigmented Bowen disease (pBD) in Latin American population are scarce and limited to only case reports or small series. Objectives: To report dermoscopic findings in a large series of 147 pBD diagnosed in Ibero-Latin American population. Methods: We conducted a multicentric, retrospective study on 147 histologically proven pBD under the auspices of the Dermoscopy Chapter of the Ibero-Latin American College of Dermatology. Results: The study population consisted of 77 females (52%) and 70 males (48%) with a mean age of 68.6 years. 70.1% of patients had skin phototype 3, 15.6% to skin phototype 2, and 14.3% to skin phototype 4. On clinical examination, near 60% of pBD were flat, 70% presented with scales, and 90% were asymmetric. Under dermoscopy, structureless hypopigmented areas, dots brown and pink color were the most frequently observed. Regarding specific dermoscopic clues to pBD, the most prevalent were structureless hypopigmented areas, vessels arranged in linear fashion at the periphery, and pigmented lines or pigmented dots distributed in a linear fashion. Clustered, coiled, and dotted vessels were observed in 55.8%, 45.6%, and 45.6% of the cases, respectively. Conclusions: We report a large series of cases of pBD in Latin American patients, with most patients being skin phototype 3 and 4. Distinctively in our study, the pigmented structures and the clues derived from the presence of melanin were much more frequent than in previous reports in fair skin.

This article discusses a case of a cutaneous horn arising from an underlying verrucous cyst. Cutaneous horns are hard, conical-shaped projections that can arise from various skin lesions, including benign, premalignant, and malignant ones. The patient in this case was a 60-year-old female who presented with a single hard projection on her forearm, which was found to be a cutaneous horn with an underlying verrucous cyst. The article provides a detailed description of the histopathological features and differential diagnoses of this rare condition. [Extracted from the article]

This article discusses a case of carcinoma in situ arising in a patient with Hailey-Hailey disease (HHD), a rare inherited blistering disorder. The patient presented with recurrent itchy lesions on the scrotum and groin folds, along with a growth on the scrotum associated with pus discharge and bleeding. The diagnosis of carcinoma in situ was confirmed through histopathological examination, and a wide local excision was performed. The article highlights the occurrence of this condition in HHD and discusses the possible factors contributing to the development of cutaneous malignancies in HHD. [Extracted from the article]

This article reports on a case study of a female patient from a Taiwanese family who carries a rare CARD14 mutation and has developed multiple skin cancers over a 15-year period. The patient had a history of psoriasis and received various treatments, including phototherapy and etanercept. Despite discontinuing these treatments, she continued to develop skin cancers. The article suggests that the CARD14 mutation, along with prior phototherapy and immunosuppression, may have contributed to the development of skin malignancies. The study highlights the potential higher risk of skin cancer in patients with CARD14-associated psoriasis. [Extracted from the article]

This article discusses two cases of patients with HIV who developed cutaneous squamous cell carcinomas (cSCCs) that tested positive for alpha (α)-papillomaviruses (HPVs). The patients had a history of recurrent cervical intraepithelial neoplasia (CIN) and persistent anogenital HPV infections. The study suggests that defective immunity towards α-HPVs may also occur in the skin and lead to cSCC. The detection of high-risk (HR)-HPVs in cSCC could indicate hypersusceptibility to HPV infection and may impact therapeutic strategies for cSCC. [Extracted from the article]

Background: Transcriptional repressor GATA binding 1 (TRPS1) is a transcription factor recently shown to play a role in the development of breast and liver cancer. Here, we evaluate TRPS1 immunoexpression in normal skin tissues and various cutaneous tumors. Methods: TRPS1 immunohistochemistry was performed in 109 cases of primary cutaneous tumors and 19 cases of metastatic carcinomas. TRPS1 expression was also evaluated in the normal skin tissues. Results: The normal epidermis was TRPS1−. In contrast, the eccrine apparatus, epithelial compartment of the hair follicles, hair papilla, sebaceous glands, and anogenital mammary‐like glands were TRPS1+. In primary cutaneous tumors, TRPS1 positivity varied in poroma (2/3), nodular hidradenoma (4/5), spiradenoma (4/4), cutaneous mixed tumor (5/5), trichilemmal cyst (7/8), proliferating trichilemmal tumor (1/3), pilomatricoma (9/9), sebaceoma (2/5), extramammary Paget disease (13/13), sebaceous carcinoma (2/2), actinic keratosis (3/10), Bowen disease (7/12), and squamous cell carcinoma (1/5) cases. All cases of seborrheic keratosis, basal cell carcinoma, Merkel cell carcinoma, and malignant melanoma were TRPS1−. All metastatic breast carcinoma cases (8/8) were highly positive for TRPS1, while all but one of the other metastatic tumor cases were TRPS1−. Conclusions: TRPS1 immunoexpression was observed in several skin appendages and cutaneous tumors. [ABSTRACT FROM AUTHOR]

Early cutaneous squamous cell carcinoma (cSCC) can be challenging to diagnose using clinical criteria as it could present similar to actinic keratosis (AK) or Bowen's disease (BD), precursors of cSCC. Currently, histopathological assessment of an invasive biopsy is the gold standard for diagnosis. A non‐invasive diagnostic approach would reduce patient and health system burden. Therefore, this study used non‐invasive sampling by tape‐stripping coupled with data‐independent acquisition mass spectrometry (DIA‐MS) proteomics to profile the proteome of histopathologically diagnosed AK, BD and cSCC, as well as matched normal samples. Proteomic data were analysed to identify proteins and biological functions that are significantly different between lesions. Additionally, a support vector machine (SVM) machine learning algorithm was used to assess the usefulness of proteomic data for the early diagnosis of cSCC. A total of 696 proteins were identified across the samples studied. A machine learning model constructed using the proteomic data classified premalignant (AK + BD) and malignant (cSCC) lesions at 77.5% accuracy. Differential abundance analysis identified 144 and 21 protein groups that were significantly changed in the cSCC, and BD samples compared to the normal skin, respectively (adj. p < 0.05). Changes in pivotal carcinogenic pathways such as LXR/RXR activation, production of reactive oxygen species, and Hippo signalling were observed that may explain the progression of cSCC from premalignant lesions. In summary, this study demonstrates that DIA‐MS analysis of tape‐stripped samples can identify non‐invasive protein biomarkers with the potential to be developed into a complementary diagnostic tool for early cSCC. [ABSTRACT FROM AUTHOR]

Background Bowen's disease (BD) is a squamous cell carcinoma in situ, commonly encountered in elderly population with an incidence reported as 15 cases per 100 000 people per year. It is considerably more common in Caucasian skin compared to skin of colour where it has not been studied extensively; the prevalence of BD in skin of colour is now known. Methods A retrospective study was conducted in the Department of Dermatology, Venereology & Leprology. Hospital records of patients who were seen in the clinic between September 2017 and September 2022 [N=228,194] were screened, records of patient who underwent biopsy were retrieved [N'=1431]; eight patients (n=8) with clinical diagnosis of BD, confirmed on histopathology were included in the study. Results The mean age of patients included was 60.37±6.9 years with equal male and female [M:F=1]. The only risk factor identified was prolonged sun exposure seen in half the patients. The mean duration of the lesions at time of presentation was 3.27±3.21 years. The most common site was trunk (62.5%) followed by lower limb (25%) and head & neck (12.5%). All, except one, had lesion over photo-protected sites. All patients presented with a well-defined plaque; morphological features included pigmentation (75%), scaling (75%), crusting (62.5%), erythema (25%) and ulceration (12.5%). The mean size of the lesion (plaque) at presentation was 5.50±3.02×5.71±2.81 cm2 Biopsy was characteristic in all cases; features seen were atypia (100%), loss of polarity (100%), acanthosis (87.5%), hyperkeratosis (87.5%), parakeratosis (87.5%), hyperchromatic nucleus (87.5%), pleomorphism (87.5%), dyskeratotic cells (87.5%), mitotic figures (87.5%), "Windblown appearance" (62.5%), pigment incontinence (62.5%) and dermal invasion (12.5%). The histological variants seen in our study were classical (62.5%), papillated (25%) and irregular (12.5%). Conclusion We present here our experience of BD seen at our tertiary centre; there are limited case series from India describing BD. More prospective and population-based studies are needed in the future to determine the burden of the disease among Indians. [ABSTRACT FROM AUTHOR]

Guiyun Zhang,1 Yufeng Lu,2 Bin Liu,3 Yanmei Wang,4 Wenyi Li,1 Yangchun Xu1 1Department of Dermatology, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China; 2Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130000, People’s Republic of China; 3Department of Breast Surgery, The Second Hospital of Jilin University, Changchun, 130041, People’s Republic of China; 4Department of Clinical Nutrition, Jilin Province People’s Hospital, Changchun, 130021, People’s Republic of ChinaCorrespondence: Yangchun Xu, Department of Dermatology, The Second Hospital of Jilin University, No. 218 Ziqiang Street, Nanguan District, Changchun, 130041, People’s Republic of China, Tel +86-431-8113-6244, Email xuyc@jlu.edu.cnIntroduction: Bowen’s disease (BD) commonly occurs in sites of chronic sunlight exposure such as head, neck and extremities. It rarely distributes on the nipple and areola.Case Presentation: A 59-year-old female presented with crusted plaque on the right breast for over 1 month. Physical examination found an asymptomatic plaque (5 cm × 5 cm) with irregular shape on the right breast. Histopathological examination suggested irregularly acanthotic epidermis and atypical epidermal cells. Dermis showed inflammatory cell infiltration. Immunohistochemical staining showed negative staining for cytokeratin 7 and cytokeratin 20, and positive staining for Ki67 (60%). The mass was excised and no recurrence occurred in the follow-up. Additionally, we reviewed the literature about BD of the breast and summarized the clinical manifestations, histological features, and treatment options.Conclusion: We reported a rare BD case involving nipple and areola. Wide local excision and complete nipple excision are effective for patients with BD of the nipple and areola.Keywords: Bowen’s disease, breast, nipple, case report

This article discusses a case of arsenical keratosis with unusual lung involvement. Arsenical keratosis is a skin condition characterized by hyperpigmentation and hypopigmentation, as well as yellowish hyperkeratotic papules and plaques. It is caused by long-term ingestion of arsenic above the safe limit. In this case, a 65-year-old male shopkeeper from West Bengal presented with multiple lesions on his palms and trunk. Further examination revealed lung involvement, and a diagnosis of arsenical keratosis with basal cell carcinoma and lung malignancy was made. The patient was referred for further treatment. The article emphasizes the importance of extensive evaluation in cases of chronic arsenic exposure to rule out internal organ involvement. [Extracted from the article]