Non-Melanoma Skin Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
A biopsy or excision is required for Bowen’s disease or actinic keratosis if there is suspicion of an invasive component, suggested by induration followed by development of a nodular lesion with a keratotic surface, which may break down to an ulcer with an ill-defined margin. Clinicopathological variants of actinic keratosis include hypertrophic, atrophic, acantholytic, Bowenoid, and pigmented. They all show atypical keratinocyte proliferation (dyskeratoses) within the epidermis. Initially, dysplastic changes are confined to small foci in the epidermis in which there are aggregates of atypical pleomorphic keratinocytes at the basal layer. There may be hyperkeratosis and parakeratosis overlying the dysplastic keratinocytes in the epidermis. The atypical keratinocytes show loss of polarity, nuclear pleomorphism, disordered maturation, and increased numbers of mitotic figures.
Non-melanoma skin cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2014
A biopsy or excision is required for Bowen’s disease or actinic keratosis if there is suspicion of an invasive component suggested by induration followed by development of a nodular lesion with a keratotic surface, which may break down to an ulcer with an ill-defined margin. Clinicopathological variants of actinic keratosis include hypertrophic, atrophic, acantholytic, bowenoid and pigmented. They all show atypical keratinocyte proliferation (dyskeratoses) within the epidermis. Initially, dysplastic changes are confined to small foci in the epidermis in which there are aggregates of atypical pleomorphic keratinocytes at the basal layer. There may be hyperkeratosis and parakeratosis overlying the dysplastic keratinocytes in the epidermis. The atypical keratinocytes show loss of polarity, nuclear pleomorphism, disordered maturation and increased numbers of mitotic figures.
Restricted rule-outs
Caroline J Rodgers, Richard Harrington in Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Refer to the guidance at the beginning of the chapter on safe safety netting. Provision of written information can be really helpful here. For example, the British Association of Dermatologists has online patient information leaflets that can be downloaded and printed. You should advise the patient about the following: Diagnostic uncertainty: explain that all the current signs and symptoms point towards this lesion being a solar keratosis.Time course: explain that a solar keratosis can usually be successfully treated but if left untreated a small proportion of cases can progress to a skin cancer (SCC). This is usually clinically obvious, for example with the development of a nodule.When should the patient seek further help: advise that it is good to check the skin every couple of months for new lesions or changes to the skin. If the patient notices any changes, he should seek advice. The features that should prompt the patient to seek further advice from the GP should be explained (e.g. new, growing, itching, bleeding lesions and the ABCDE features for melanocytic lesions).Where to seek help: explain that the patient should initially return to his GP if he is concerned about a skin lesion.
Curcumin nanoparticles incorporated in PVA/collagen composite films promote wound healing
Published in Drug Delivery, 2020
QingQing Leng, Yue Li, XianLun Pang, BiQiong Wang, ZhouXue Wu, Yun Lu, Kang Xiong, Ling Zhao, Ping Zhou, ShaoZhi Fu
H&E staining images of the CPCF group on days 3, 6, 9, 12, and 15 shown in Figure 4(B) indicate a clear division between the epidermis and the dermis and in the appearance and distribution of hair follicles. On day 3, the local skin tissue appeared discontinuous with a large number of inflammatory cells with the presence of granulation tissue and partial fibroblasts. On day 6, there was a clear division between the epidermis and the dermis. Keratosis was visible at the edges of the epidermis. The skin in the wound area had been completely re-epithelialized, however, its structure was relatively loose. Several fibroblasts were seen in the dermis. On day 9, the epidermis resembled the normal skin dermis; fibroblasts that still showed a slightly disordered arrangement could be seen in the dermis. Additionally, blood vessels could also be seen. On day 12, the fibroblasts had arranged well and the epidermis was similar to that of the normal skin. On day 15, obvious hair follicles deep into the dermis were seen. The epidermis and the dermis appeared very similar to that of the normal skin.
Patient-reported outcomes in topical field treatment of actinic keratosis in Swedish and Danish patients
Published in Journal of Dermatological Treatment, 2018
Hanna Norrlid, Jenny M. Norlin, Heidi Holmstrup, Irena Malmberg, Karin Sartorius, Henrik Thormann, Gregor B. E. Jemec, Gunnel Ragnarson Tennvall
Actinic keratosis (AK) is a common skin condition caused by cumulative sun exposure (1). Diagnosis is based on histology of clinically suspect lesions, but various imaging technologies are being tested as diagnostic aids (2–6). Some AK lesions spontaneously regress (7), while a minority may progress to squamous cell carcinoma (SCC) (8–10). Single lesions most often appear as a consequence of field cancerization in a generally sun exposed area of the skin (2). AK prevalence has been estimated to between 1.4% and 25% of the population (11–14) and known risk factors are age, cumulative sun exposure, Fitzpatrick skin type and previous AK diagnosis (15,16). Current guidelines mostly recommend active treatment of AK, both to reduce symptoms and to lower the risk of developing SCC (17–19), although Danish guidelines accept “no treatment” as a valid treatment option (20).
Dietary Garcinol Arrests Pancreatic Cancer in p53 and K-ras Conditional Mutant Mouse Model
Published in Nutrition and Cancer, 2018
Nadia Saadat, Sarah Akhtar, Arvind Goja, Nurul H. Razalli, Andreea Geamanu, Doina David, Yimin Shen, Smiti Vaid Gupta
As Garcinol was administered through diet, we investigated the fore-stomach H&E slides for possible toxicity of dietary Garcinol. The mouse stomach consists of the fore stomach, the proximal and the nonglandular, keratinized stratified squamous epithelium part. The latter two-third glandular part of the stomach has cap cells, chief cells, and parietal cells for gastric secretions (20). The epithelium lining of the fore-stomach, mainly mucosal epithelium, gets irritated and hypertrophied with ingestion of toxic substances. Sometimes this is associated with keratosis and inflammation and can leads to severe complications if not addressed at earlier stages (22). Along with chemical irritants, insecticides, and drugs, some synthetic and naturally occurring anti-oxidants have shown fore stomach hyperplasia and toxic effects after oral administrations as early as in four weeks (23). No toxicity to Garcinol was observed after ingestion of our diet in mice. These findings support Garcinol as a suitable candidate for oral administration in clinical trials.
Related Knowledge Centers
- Actinic Keratosis
- Epidermis
- Keratin
- Keratinocyte
- Mucous Membrane
- Precancerous Condition
- Seborrheic Keratosis
- Chronic Scar Keratosis
- Hydrocarbon Keratosis
- Keratosis Pilaris