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Epithelial and fibroepithelial tumors
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
Apart from actinic keratoses plus squamous cell carcinoma, basal cell carcinoma is the most frequent malignant neoplasm of humans.253 Less than 25 cases have been described in the nail region.254,255 Commonly, basal cell carcinoma presents as a periungual eczema or chronic paronychia that may be associated with granulation tissue, erosion or ulceration, and pain.256–259 Jagged border was observed in superficial basal cell carcinoma.260 One case in a white patient presented as an acquired longitudinal melanonychia.261 Fingers are the most common localization, ten of them in the thumb,262 only seven basal cell carcinomas were observed in the ungual region of the toes.59,263–265 Multiple small periungual basal cell carcinomas were seen as pearl-like transparent papules in an 8-month-old baby266 and two more children267. The diagnostic delay ranges from 1 to 40 years.268 The treatment of choice is microscopically controlled surgery. The clinical differential diagnosis comprises trauma, onychomycosis, bacterial infection, eczema, chronic paronychia, pyogenic granuloma, squamous cell carcinoma, and amelanotic melanoma.
Topical therapy
Published in Graham Colver, Outcomes of Skin Surgery, 2008
Results for superficial basal cell carcinoma are around 90 % initial success but up to 10% of lesions recur over 3 years. Thin nodular lesions may respond in up to 90% of cases but recurrence is higher at around 14% at 4 years.
The Epidemiology of Skin Cancer
Published in Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk, Photodermatology, 2007
Variations in risk profiles have been proposed for both basal cell carcinoma and melanoma at different locations and with different clinicopathological variants. The frequency of superficial basal cell carcinoma appears to be higher in females and seen in younger patients as compared with nodular lesions. The latter occur mainly in the head/neck region while superficial lesions occur mainly on the trunk. Chronic sun exposure may be an etiologic factor for nodular lesions while intermittent sun exposure may play a role in superficial basal cell carcinoma (85,86). Similarly, heterogeneity of risk by anatomical site, suggesting multiple causal pathways, have been proposed for melanoma, with chronic sun exposure influencing the risk of melanoma of the head, and neck and intermittent sun exposure associated with a nevus-prone phenotype influencing the risk of melanoma elsewhere (87). However, limited data have been published on these issues.
A retrospective study comparing different injection approaches of 5-aminolevulinic acid in patients with non-melanoma skin cancer
Published in Journal of Dermatological Treatment, 2022
Weihong Zhao, Jun Wang, Ying Zhang, Baoyong Zheng
Younger age, superficial basal cell carcinoma, and Bowen’s disease were associated with no or partial treatment response or recurrence. The results of the study agreed with the results of a retrospective cohort studies (6,16), and prospective study (11) but not agreed with a retrospective study (17), and prospective studies (1,9). The possible reasons for such controversies are the use of the different treatment therapy and/or absence of a universal algorithm for assessment for no or partial response of treatment and non-melanoma skin cancer recurrence (18). Also, the maximum penetration depth for irradiation is 3 mm only (1). The plum-blossom needle can reach 3 mm11 and needle-free injection penetrates the epidermis and delivers 5-aminolevulinic acid intradermally (10). Bowen’s disease has a risk of invasive carcinoma (6). Aggressive growth of superficial basal cell carcinoma is frequently noted in younger patients in which there is an absence of retraction artifact (19). The skin of aged patients is more susceptible to penetrate 5-aminolevulinic acid than younger patients (6). Intralesional 5-aminolevulinic acid followed by irradiation with red light is effective for non-melanoma skin cancer patients of advanced age, squamous cell carcinoma, and Paget’s disease. Also, younger patients and patients with basal cell carcinoma and Bowen’s disease require comprehensive follow-up.