Epithelial and fibroepithelial tumors
Eckart Haneke in 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.
The Epidemiology of Skin Cancer
Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk in 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.
Notes on Genetic and Radiation Control of Senescence
Nate F. Cardarelli in The Thymus in Health and Senescence, 2019
Basal cell carcinoma arises from ultraviolet exposure. Immunosuppressed patients are more likely to develop it as compared with immunocompetent persons;313 UV promotion of tumor activity is through effecting the immune system.314 UV effects are greater on immature T cells, which are deficient in nucleotide excision repair capabilities, than on mature cells.315 The skin pigment melanin, serving as a free-radical trap, protects against UV damage to chromosomes.299,316,317 The density of melanin and other chromophores (such as urocanic acid) regulates the depth of UV skin penetration.299 Patients treated with ultraviolet radiation for various psoriatic conditions show an increased incidence of skin cancer.318 Acute and chronic exposure to UV also leads to alteration in the TH/TS cell ratios and decreased skin test reactivity.318
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
Nowadays incidences of skin cancer are increased in the world because of ultraviolet radiation, ozone depletion, and the other several factors (1). Consumption of caffeinated drinks reduces non-melanoma skin cancer in the Chinese population but the rate of non-melanoma skin cancer is highest in the Chinese population among the Asia-pacific because of Fitzpatrick skin types III (darker white skin) and IV (light brown skin) of the Chinese population (2). Most of the skin cancer is developed from the epidermis. From the basal cells and near the epidermis-dermis junction, the basal cell carcinoma (the non-melanoma skin cancer) is developed. It is the most common type of skin cancer. Also, from keratinocytes, the squamous cell carcinoma (the non-melanoma skin cancer) is developed which is the second most common skin cancer, and from the basal intercellular melanocytes, the melanoma skin cancer is developed and is the third most common skin cancer (3). The majority of the non-melanoma skin cancer are basal cell and squamous cell carcinomas in a ratio of approximately 4:1. Besides that, a wide variety of additional nonmelanoma skin tumors occurred from the other cells present in skin, for example, lymphocytes, Merkel cells, vascular endothelial cells, mesenchymal stromal cells, and cells forming the adnexal structures. These cancers are quite rare compared to basal cell and squamous cell carcinomas (4).
Basal cell carcinoma and malignant melanoma cutaneous collision tumor
Published in Baylor University Medical Center Proceedings, 2018
Reid Green, Meghan Woody, Anthony C. Soldano, Erin Madden
A 67-year-old man presented to his primary care physician with an ill-defined, variegated plaque on the right dorsal forearm. A biopsy was performed and microscopic examination demonstrated a pigmented basal cell carcinoma. The patient underwent wide excision, yielding a 4.0 × 1.2 × 0.6 cm tissue sample with negative margins. Histologically, nests of basaloid tumor cells were seen with peripheral palisading and focal architectural clefting between the tumor cells and adjacent fibromyxoid stroma. In addition, colonizing the basal cell carcinoma, there was an in situ melanoma composed of large, variably sized nests and single melanocytes. There was also an associated invasive component of melanoma composed of similarly atypical melanocytes (Figures 1a–1c). Immunohistochemical stains for S-100 protein, MART-1, and SOX10 highlighted the melanoma (Figure 1d). Immunohistochemical stains for high-molecular-weight cytokeratin and Ber-EP4 highlighted the basal cell carcinoma. The patient had a negative sentinel lymph node biopsy and has remained free of recurrence for 18 months.
Accidental discovery of metastasized basal cell carcinoma
Published in Acta Chirurgica Belgica, 2022
Hanne Verberght, Thomas Schok, Siebe Wouda, Frits Aarts
The patient was admitted to the internal medicine department and had a consultation with general surgery. A normocytic anemia caused by chronic illness and type 2 diabetes was newly discovered upon admission. Histopathological investigation of the biopsy specimens from the lesion confirmed the diagnosis of solid growing basal cell carcinoma. An additional CT scan (thorax/abdomen/pelvis) showed a pathological fracture of the sacrum, a lung lesion in the right lower lobe (20 mm), and two liver lesions (8 and 21 mm). Bone biopsies confirmed the suspicion of metastatic basal cell carcinoma (Figure 2). Solid growing BCC with liver, lung, and bone metastases was diagnosed. The histology images confirmed the diagnosis of BCC as BerEp4 and cytokeratin 7 immunohistology were positive. In this case, p40 was also positive, which may indicate the development of squamous cell carcinoma (SCC). However, in SCC, BerEp4 and cytokeratin 7 immunohistology are negative.
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