Basal Cell Carcinoma News Headlines

An unusual presentation of merkel cell carcinoma of the eyelid.

Orbit. 2008;27(4):331-3

Authors: Saedon H, Hubbard A

Merkel cell carcinoma is a rare primary neuroendocrine tumor occurring on any part of the body. It usually presents as a firm, nontender, violaceous, or purple nodule located on areas of the body that have been exposed to sunlight. A 68-year-old female presented with a rapidly growing lesion on the left lower eyelid from 6 weeks. Examination showed a 4 cm diameter, exophytic, ovoid skin lesion of the left lower lid. Wide local excision of this lesion was followed by adjuvant chemotherapy. Histological examination of therapeutic frozen section of the lesion and the presence of neuroendocrine marker and cytokeratin markers established the diagnosis of Merkel Cell carcinoma. The follow-up at 8 months was uneventful. Merkel cell carcinoma can have an unusual presentation of a large, exophytic, oval lesion resembling a basal cell carcinoma. Merkel cell carcinoma has predilection for rapid spread; hence, in a case of lid lesions, a suspicion for this diagnosis should be kept in mind.

PMID: 18716977 [PubMed - in process]

Bioavailability of aminolaevulinic acid and methylaminolaevulinate in basal cell carcinomas: a perfusion study using microdialysis in vivo.

Br J Dermatol. 2008 Aug 19;

Authors: Sandberg C, Halldin CB, Ericson MB, Larkö O, Krogstad AL, Wennberg AM

Background Photodynamic therapy is becoming a popular treatment for superficial nonmelanoma precancerous and cancerous lesions, showing excellent cosmetic results. Nevertheless, the reported cure rates vary and the transdermal penetration of drugs has been discussed as a limiting factor, particularly for treatment of nodular basal cell carcinoma (BCC). Objectives To investigate the transdermal penetration of aminolaevulinic acid (ALA) and methylaminolaevulinate (MAL) in BCC in vivo using a microdialysis technique. The different prodrugs were compared and the effect of curettage was studied. Methods Twenty patients with 27 histologically verified BCCs (13 superficial, 14 nodular) were included. All lesions were located at the front of the body (head and face excluded). The first 10 patients included were treated with MAL (13 BCCs), and the following 10 patients with ALA (14 BCCs). A light curettage was performed on every second lesion (curettage, n = 13; noncurettage, n = 14). Microdialysis catheters were inserted into the tumours at tissue depths varying from 0.4 to 1.9 mm. Dialysates were collected at 15-30-min intervals for 4 h and the interstitial concentrations of MAL and ALA were determined using high-performance liquid chromatography. Results No significant difference in interstitial drug concentration was observed between lesions treated with ALA or MAL during the 4-h measurement period. However, for the lesions with deeper catheter locations, i.e. at or below 1 mm (n = 11), drug concentrations above the detection limit were obtained in only six lesions. All but one BCC with superficial catheter location, i.e. < 1 mm (n = 16), exhibited detectable drug concentration (P = 0.026). The interstitial peak concentrations were reached within 90 min in 23 of the 27 BCCs, but were not found to be correlated with the depth of the catheters. No difference was found when comparing superficial and nodular BCCs, and the effect of curettage was found to be negligible. Conclusions The results imply that there is no significant difference in transdermal penetration of ALA and MAL in tumour tissue. Detectable levels of drug were not obtained in almost 50% of the lesions where catheters were situated 1-1.9 mm in the lesion. Curettage was not found to affect the interstitial concentration, indicating that penetration of drug indeed might be a problem when treating BCCs thicker than 1 mm.

PMID: 18717673 [PubMed - as supplied by publisher]

Elevated frequency of p53 genetic mutations and AgNOR values in squamous cell carcinoma.

J Cutan Pathol. 2008 Aug 18;

Authors: Bukhari MH, Niazi S, Khaleel ME, Sharif MA, Ghani R, Mehmood MT, Tahseen M, Chaudhry NA, Hasan M

Background: Epidermal squamous cell carcinoma (SCC) is a common malignancy in Pakistan. We hypothesize that it is characterized by higher frequency of p53 genetic mutations and increased AgNOR values compared with squamous cell papilloma (SCP) and basal cell carcinoma (BCC). Experimental design: To test our hypothesis, 140 skin biopsies (including 20 normal skin, 20 SCP, 20 BCC and 80 SCC samples of various grades) were examined for p53 mutations using immunohistochemistry (IHC) and polymerase chain reaction (PCR). AgNOR staining was used for histological determination of AgNOR index. Results: Both markers were undetectable in normal skin and were low in SCP. They were upregulated in BCC and SCC. PCR experiments revealed p53 mutations in 70% and 96.25% of BCC and SCC, respectively. Higher AgNOR values were seen in SCC than in BCC (mean AgNOR count = 5.81 +/- 31 and 8.36 +/- 19; percentage of AgNOR was 43.5% and 53% in BCC and SCC, respectively). Finally, p53 IHC score was found to be related to the AgNOR index in the histological grading of BCC and SCC (r = +0.983, p < 0.0001). Conclusion: Our results suggest that a higher frequency of p53 genetic mutations and increased AgNOR values exist in SCC compared with BCC and SCP. 'Consequently, SCC patients may have poorer prognosis'.

PMID: 18715257 [PubMed - as supplied by publisher]

Complete remission of nodular basal cell carcinoma after combined treatment with photodynamic therapy and imiquimod 5% cream.

Dermatol Online J. 2008;14(2):25

Authors: Devirgiliis V, Panasiti V, Curzio M, Gobbi S, Rossi M, Roberti V, Calvieri S

PMID: 18700128 [PubMed - in process]

G-Protein-Coupled Receptor GPR49 is Up-regulated in Basal Cell Carcinoma and Promotes Cell Proliferation and Tumor Formation.

Am J Pathol. 2008 Aug 7;

Authors: Tanese K, Fukuma M, Yamada T, Mori T, Yoshikawa T, Watanabe W, Ishiko A, Amagai M, Nishikawa T, Sakamoto M

The significance of Hedgehog (HH) signaling in the development of basal cell carcinoma (BCC) has been established. Although several target genes of HH signaling have been described previously, their precise role in tumorigenesis and cell proliferation is not yet known. To identify genes responsible for tumor formation in BCC, we screened a DNA microarray database of human BCC cases; the orphan G-protein-coupled receptor GPR49 was found to be up-regulated in all cases. GPR49 is a novel gene reported to be a marker of follicular and other tissue stem cells. Using real-time quantitative RT-PCR analysis, significant expression of GPR49 mRNA was observed in 19 of 20 BCC cases (95%) compared with controls. Up-regulation of GPR49 was confirmed by in situ hybridization. Moreover, knockdown of mouse Gpr49 showed suppression of cell proliferation in a mouse BCC cell line, and overexpression of GPR49 in human immortalized keratinocyte HaCaT cells induced proliferation. Furthermore, HaCaT cells overexpressing GPR49 showed tumor formation when transplanted into immunodeficient mice. In addition, inhibition of the HH signaling pathway in a mouse BCC cell line down-regulated endogenous Gpr49, whereas activation of HH signaling in mouse NIH3T3 cells up-regulated endogenous GPR49. These results suggest that GPR49 is expressed downstream of HH signaling and promotes cell proliferation and tumor formation in cases of BCC.

PMID: 18688030 [PubMed - as supplied by publisher]

[Basal cell carcinoma.]

Presse Med. 2008 Aug 5;

Authors: Nseir A, Estève E

Basal cell carcinoma (BCC) accounts for 80% of skin cancers, and its frequency is increasing substantially and regularly. Its principal risk factor is sun exposure, especially strong and intermittent exposure causing phototrauma. BCC occurs most frequently on the head and neck. The most frequent clinical forms are nodular, superficial and sclerosing. Management guidelines were issued in 2004, according to the methodology of ANAES (the national agency of health care accreditation and evaluation (ANAES) at the request of the French Society of Dermatology. Histologic examination of BCC is almost always essential. Surgery remains the standard of treatment; other treatments must be considered as second-line choices. Clinical monitoring must be suggested to the patient after treatment, because of the risk of recurrence. A consultation at least once a year for at least 5 years and preferably for life is recommended.

PMID: 18687568 [PubMed - as supplied by publisher]