Search

Copyright of Journal der Deutschen Dermatologischen Gesellschaft is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Photodynamic therapy (PDT) is internationally established as an approved treatment option for in situ forms of keratinocytic skin cancer (actinic keratoses, Bowen's disease, basal cell carcinoma). For these indications, there are standardized treatment protocols using narrow‐spectrum light sources or (artificial) daylight, the use of which is associated with successful healing, a low rate of lesion recurrence, and a very good cosmetic result. Daylight PDT is superior to conventional PDT in terms of significantly less pain and associated higher patient acceptance. Newer indications, for which no approval has yet been granted, but which nevertheless have sufficient evidence of efficacy according to the study situation, are inflammatory (lichen sclerosus, acne) and infectious dermatoses (viral warts, cutaneous leishmaniasis, atypical mycobacteriosis). In addition, PDT is increasingly being used in aesthetic dermatology with the aim of skin rejuvenation. [ABSTRACT FROM AUTHOR]

Bowen's disease (BD) is a relatively rare early‐stage squamous cell carcinoma in situ, most commonly affecting the middle‐aged and elderly, and occurring on the skin or mucous membranes of various parts of the body. Its onset is concealed, the course of the disease is chronic, and some patients have malignant tumors outside the skin; therefore, it is necessary to diagnose and evaluate the disease at an early stage. This study aimed to investigate the application of reflectance confocal microscopy (RCM) in the diagnosis of BD. We performed RCM imaging on the lesion site and underwent skin biopsy for histological diagnosis of 92 patients initially diagnosed with BD in clinic. A retrospective analysis of the RCM result as well as the histological examination revealed that after analyzing RCM images, out of 92 biopsy lesions, 61 were diagnosed with BD, of which 54 were consistent with RCM diagnosis. Among the 59 cases diagnosed with BD by RCM, 54 cases were consistent with the histological diagnosis. Afterwards, we analyzed the RCM characteristics in patients with BD verified by biopsy, and compared the RCM images of two different lesions, classic Bowen's disease and pigmented Bowen's disease, and further summarized the key points of BD under RCM. Finally, we focused on the differential characteristics between BD and other skin diseases in RCM. RCM is of great value in the diagnosis of BD. Research Highlights: A retrospective study of RCM and histological diagnosis in patients with clinical diagnosis of BD.Analyze the RCM characteristics of skin lesions verified by biopsy.RCM is of great value in the diagnosis and differentiation of BD. [ABSTRACT FROM AUTHOR]

Background: Malignant epithelial nail unit tumors pose significant diagnostic and therapeutic challenges due to their clinical presentation often mimicking benign conditions and due to the need to preserve as much nail unit function as possible during surgery. Early detection is crucial, even if none of these tumors represent a life-threatening disease. Objectives: This review focus on squamous cell carcinoma, verrucous carcinoma, eccrine porocarcinoma, onychocytic carcinoma, basal cell carcinoma, malignant onychopapilloma, malignant onycholemmal cyst and onycholemmal carcinoma. Methods: Existing literature on the aforementioned tumors has been revised and synthesized. Results: Clinical presentation, pathology, diagnostic procedures, risk factors and the challenges associated with surgical management have been described in detail. Conclusions: Malignant epithelial tumors of the nail unit require careful evaluation and management due to their complex presentation. Early detection and an informed surgical approach are essential to improve patient outcomes and minimize complications. [ABSTRACT FROM AUTHOR]

Nonmelanoma skin cancers (NMSC), comprising basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are typically encountered on photo‐exposed skin. Nevertheless, several cases of NMSC have been described in covered areas such as the genital region; furthermore, some of these lesions may express a variable degree of pigmentation. Due to the existence of mucosal melanoma, an accurate diagnosis is paramount. In this narrative review, we focused our attention on management and – in particular‐ diagnosis of pigmented NMSC (pNMSC) located in the genital region, emphasizing the features assessed by dermoscopy and reflectance confocal microscopy. As an implementation, we included data on pNMSC from the Dermatology Unit of the University of Campania Vanvitelli. BCC in the genital region represents only 1% of all BCC cases. It has been supposed that the mutation of patched 1 may lead to the development of BCC even without concomitant UV exposure. Pigmented variants on genitals have seldom been described. More prominent dermoscopic features seem to be blue‐gray ovoid nests and arborizing vessels associated with whitish structureless areas. SCC and Bowen's disease (BD) – a variant of in situ SCC – may be encountered in the genital area and are sometimes associated with human papillomavirus (HPV) infection. Pigmented SCC is very rare, and most of the literature is focused on pigmented BD (pBD), which is mainly characterized by gray‐brown dots in a linear fashion and glomerular vessels without evident scales. In conclusion, pNMSC is rarely encountered on genitals; evaluation with dermoscopy or other ancillary devices like RCM is important both to exclude benign lesions like seborrheic keratosis and lentigo and to rule out melanoma. [ABSTRACT FROM AUTHOR]

Mohs micrographic surgery is the gold standard for treating many types of skin cancer, particularly skin cancers of high-risk areas such as the face, genitalia, and digits, due to its tissue-sparing technique and low recurrence rates. The use of Mohs micrographic surgery for human papilloma virus-associated cutaneous malignancies has yet to be explored in a systematic review. The authors sought to assess outcomes including recurrence rates of Mohs micrographic surgery for human papilloma virus-associated cutaneous malignancies. PubMed was searched for the use of Mohs micrographic surgery in types of human papilloma virus-associated cutaneous malignancies. After application of exclusion and inclusion criteria, 33 articles were included. 700 cases from 33 studies were included. Overall recurrence rate following Mohs micrographic surgery was 39/478 (8.2%) at a mean follow-up time of 51.5 months. Recurrence rate for nail unit/digit squamous cell carcinoma was 10/103 (9.7%) at mean follow-up of 47.6 months. Recurrence rate for penile squamous cell carcinoma was 15/181 (8.3%) at mean follow-up of 45.9 months. Recurrence rate for Bowen's disease in extragenital areas was 11/189 (5.9%) at mean follow-up of 59.7 months. Patients overall reported satisfactory functional and cosmetic results. Mohs micrographic surgery demonstrates low recurrence rates and excellent functional and cosmetic outcomes in the treatment of human papilloma virus-associated cutaneous malignancies. [ABSTRACT FROM AUTHOR]

The editorial "Photodynamic Therapy 2.0" published in Biomedicines discusses the advancements and applications of photodynamic therapy (PDT) in treating various medical conditions, including oncological and non-oncological disorders. The article highlights recent studies on the benefits of PDT, such as wound healing, stress resistance, and extended lifespan in animal models. It also explores the efficacy of PDT in treating conditions like Bowen's disease, brain tumors, and nasopharyngeal carcinoma, emphasizing the potential for significant advancements in treatment. Additionally, the editorial presents research on innovative techniques and treatment targets that show promise for future development in the clinical field. [Extracted from the article]

Background Photodynamic therapy (PDT) has been strongly recommended as an excellent alternative treatment for Bowen disease (BD). However, reported data on 5-aminolaevulinic acid-mediated PDT (ALA-PDT) with red-light irradiation are limited and the long-term effectiveness remains to be determined, especially in dark-skinned populations. Objectives We aimed to review routine clinical practice in the field of BD treatment with ALA-PDT over an extended study period (2011–2021), calculate the overall clearance rate, and explore and evaluate factors that might affect the effectiveness of therapy in a real-world setting. Methods The medical records of patients with BD who received ALA-PDT with red-light irradiation between February 2011 and June 2021 were reviewed and summarized. Univariate and multivariate analyses of clinically relevant variables that may affect treatment outcomes were conducted to identify risk predictors. Results The overall clearance rate of 122 BD lesions was 89.3% with a median follow-up time of 36 months. The correlation between the effectiveness and fluorescence intensity of pre-PDT or PDT sessions was statistically significant after eliminating the interference of confounding factors. All recurrences occurred in the first 2 years following ALA-PDT. Conclusions ALA-PDT is an effective treatment for BD in patients with darker-coloured skin. Well-executed operations and effective pretreatment are the determinants of effectiveness. Fluorescence intensity of pre-PDT appeared to be a significant predictor of final effectiveness. In addition, 2 years of follow-up is necessary following ALA-PDT. [ABSTRACT FROM AUTHOR]

Background: Arsenical keratosis is a precancerous dermatosis which could be induced by long‐term exposure to arsenic poisoning. Arsenic is often added to traditional Chinese medicine in a non‐compliant manner to increase the effectiveness of psoriasis treatment, which is often the main cause of arsenic poisoning in Chinese patients with psoriasis. Objectives: We performed a systemic review of arsenic keratosis during the past 32 years to better understand the sources, treatment, and prognosis of arsenic keratosis in China. Methods: We searched Medline/PubMed, Embase, CNKI, and Wanfang databases for research studies published between 1992 and 2024. A total of 64 papers with 78 individual Chinese of arsenical keratosis were included in this analysis. Results: Of the patients included in the analysis, 92.21% of arsenic poisoning was due to iatrogenic factors: Chinese traditional medicine. Seventy‐six patients (98.70%) had skin manifestation of hyperkeratotic papules and plaques, 68 patients (88.31%) had hyperpigmentation, 43 cases (55.84%) had hypopigmentation, and only 4 had a clear indication of Mees' lines in nails. A total of 52.63% of patients presented with tumors, including squamous cell carcinoma, Bowen's disease, and basal cell carcinoma. For patients with tumors, 20 opted for surgery, 6 for radiotherapy, and 3 for PDT. All patients with only cutaneous tumors are currently well‐controlled. Death occurred in one patient with metastatic squamous cell carcinoma. Keratinizing papules improved significantly in 70.59% of patients treated with Acitretin Capsules. Conclusions: In this study, arsenic sources in Chinese patients were mainly from traditional Chinese medicine, and there were no reports of exposure to water sources or occupational sources in the past 32 years. Most of the patients showed keratinizing papules and pigmentation, and more than 1/2 of the patients showed skin tumors, mainly squamous cell carcinoma. The treatments of tumors are mainly surgical treatment, PDT and radiotherapy can also be selected. The improvement in keratinizing rash was greater than 70% with acitretin capsules. Patients with this disease should be regularly followed up for early detection and timely treatment of potential malignant tumors. [ABSTRACT FROM AUTHOR]

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 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]

Background/Objectives: Actinic keratoses (AK) are premalignant skin lesions caused by chronic sun exposure, topically managed by 5-fluorouracil (5-FU), diclofenac 3% gel, and imiquimod. Despite their effectiveness, long treatment duration and severe adverse local skin reactions have limited patient concordance. Calcipotriol has recently been used as a combination agent for existing topical AK treatments. A systematic review was performed to determine the clinical efficacy of 5-FU and calcipotriol for the treatment of AK, Bowen's disease, and squamous cell carcinoma (SCC). Methods: A systematic literature search was conducted on Medline, Embase, and Cochrane Library. Among the 84 records screened, 12 were retrieved for full-text review and 8 were included in the final analysis. Results: Among the 8 studies, there were 214 control patients and 288 patients who received the intervention. The combination 5% 5-FU with calcipotriol resulted in a significant reduction in the number of AKs on the face, scalp, right upper extremity, and left upper extremity for all sites at 8 weeks (P <.0001). No significant difference in SCC incidence was observed at 1 or 2 years, but there was a significant reduction observed at 3 years for SCC on face and scalp. No study assessed the combination for Bowen's disease. Conclusions: Combination 5% 5-FU with calcipotriol is an effective treatment for Aks; however, future trials may consider longer treatment and follow-up periods for the treatment and prevention of AK, SCC in situ, and SCC. [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]

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]

The article in Pediatric Dermatology presents a case of a 2-year-old girl with a brownish-black plaque on her right hand since birth, along with nail dystrophy. The diagnosis was congenital linear porokeratosis, a rare skin disorder characterized by aberrant keratinization. The article discusses the clinical presentation, differential diagnosis, histopathological findings, and treatment options for this condition, emphasizing the importance of careful observation due to the risk of malignancy associated with porokeratosis. [Extracted from the article]

The article explores the occurrence of nonmelanoma skin cancer (NMSC) in vitiligo patients using ruxolitinib cream, a topical Janus kinase (JAK) inhibitor. Six patients experienced NMSC events, primarily in White adults with predisposing risk factors, but most events were mild and not directly linked to the cream. The study did not establish a clear connection between ruxolitinib plasma concentrations and NMSC development, suggesting the need for additional research to confirm these findings. [Extracted from the article]

The article in the International Journal of Dermatology discusses the dermoscopic findings of periungual Bowen's disease (PBD) in a retrospective case series. The study reviewed cases of PBD seen at a regional nail clinic from 2010 to 2020 and identified common dermoscopic features such as scaling, pink-white amorphous areas, and a prominent edge. The research found that PBD can be challenging to diagnose, especially in cases with prominent keratinization, and highlighted the importance of dermoscopy in distinguishing PBD from other conditions. [Extracted from the article]

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]

Bowen’s disease is a form of non-invasive (in situ) squamous cell skin cancer localized in the non-genital area. Russian and European clinical guidelines include photodynamic therapy (PDT) in the standard of care for patients with Bowen’s disease. In the present review, the efficacy and safety profile of different PDT regimens for Bowen’s disease are analyzed according to the available literature data. PDT can be used to treat large Bowen’s disease lesions localized in areas of the body characterized by severe healing and in cases where surgery is not feasible. Analysis of the results of studies shows that PDT is superior in efficacy and cosmetic results to traditional local treatments such as 5-fluorouracil or cryotherapy. In all analyzed studies in patients with Bowen’s disease, PDT achieved a significant clinical effect. Complete regression of pathologic foci was achieved in 67-100% of patients. In studies evaluating the recurrence rate of Bowen’s disease after PDT, this value ranged from 2-28% with the range of 6-18% in most of the studies. Most often, 5-aminolevulinic acid and its methyl ester are used for PDT in Bowen’s disease. According to some researchers, aminolevulinic acid allows to achieve a more long-term positive clinical effect with a lower incidence of painful reactions during treatment

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]

Introduction: Large cell acanthoma is a rare, benign epidermal neoplasm of unknown aetiology. Because of the ongoing nosological debate, some authors regard it as a separate independent entity, while others classify it as a subtype of other conditions like lentigo, seborrheic keratosis, actinic keratosis, or even Bowen's disease. Large cell acanthomas are usually solitary lesions located within sun-exposed skin, well-demarcated from surrounding. The diagnosis is always based on histological examination. Objective: Presentation of the characteristic clinical, videodermatoscopic, and histopathological features of this rare neoplasm. Case report: The paper presents the case of a 76-year-old man who, for several years, had been observing a gradually spreading, yellow--brown lesion with a hyperkeratotic surface, located on the skin of his upper back. Based on histological examination, large cell acanthoma was diagnosed. Conclusions: Histological examination plays a crucial role in the differential diagnosis of atypical skin lesions, including large cell acanthoma. [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]

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]

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]

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]