Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial

Background The use of sunscreens on the skin can prevent sunburn but whether long-term use can prevent skin cancer is not known. Also, there is evidence that oral betacarotene supplementation lowers skin-cancer rates in animals, but there is limited evidence of its effect in human beings. Methods In a community-based randomised trial with a 2 by 2 factorial design, individuals were assigned to four treatment groups: daily application of a sun protection factor 15-plus sunscreen to the head, neck, arms, and hands, and betacarotene supplementation (30 mg per day); sunscreen plus placebo tablets; betacarotene only; or placebo only. Participants were 1621 residents of Nambour in southeast Queensland, Australia. The endpoints after 4.5 years of follow-up were the incidence of basal-cell and squamous-cell carcinomas both in terms of people treated for newly diagnosed disease and in terms of the numbers of tumours that occurred. Analysis of the effect of sunscreen was based only on skin cancers that developed on sites of daily application. All analyses were by intention to treat. Findings 1383 participants underwent full shin examination by a dermatologist in the follow-up period. 250 of them developed 758 new skin cancers during the follow-up period. There were no significant differences in the incidence of first new shin cancers between groups randomly assigned daily sunscreen and no daily sunscreen (basal-cell carcinoma 2588 vs 2509 per 100 000; rate ratio 1.03 [95% CI 0.73-1.46]; squamous-cell carcinoma 876 vs 996 per 100 000; rate ratio 0.88 [0.50-1.56]). Similarly, there was no significant difference between the betacarotene and placebo groups in incidence of either cancer (basal-cell carcinoma 3954 vs 3806 per 100 000; 1.04 [0.73-1.27]; squamous-cell carcinoma 1508 vs 1146 per 100 000; 1.35 [0.84-2.19]). In terms of the number of tumours, there was no effect on incidence of basal-cell carcinoma by sunscreen use or by betacarotene but the incidence of squamous-cell carcinoma was significantly lower in the sunscreen group than in the no daily sunscreen group (1115 vs 1832 per 100 000; 0.61 [0.46-0.81]). Interpretation There was no harmful effect of daily use of sunscreen in this medium-term study. Cutaneous squamous-cell carcinoma, but not basal-cell carcinoma seems to be amenable to prevention through the routine use of sunscreen by adults for 4.5 years. There was no beneficial or harmful effect on the rates of either type of skin cancer, as a result of betacarotene supplementation.

RUNX3 protein is overexpressed in human basal cell carcinomas

Basal cell carcinomas (BCC), which are the most common form of skin malignancy, are invariably associated with the deregulation of the Sonic Hedgehog (Shh) signalling pathway. As such, BCC represent a unique model for the study of interactions of the Shh pathway with other genes and pathways. We constructed a tissue microarray (TMA) of 75 paired BCC and normal skin and analysed the expression of beta-catenin and RUNX3, nuclear effectors of the wingless-Int (Wnt) and bone morphogenetic protein/transforming growth factor-beta pathways, respectively. In line with previous reports, we observed varying subcellular expression pattern of beta-catenin in BCC, with 31 cases (41%) showing nuclear accumulation. In contrast, all the BCC cases tested by the TMA showed RUNX3 protein uniformly overexpressed in the nuclei of the cancer cells. Analysis by Western blotting and DNA sequencing indicates that the overexpressed protein is normal and full-length, containing no mutation in the coding region, implicating RUNX3 as an oncogene in certain human cancers. Our results indicate that although the deregulation of Wnt signalling could contribute to the pathogenesis of a subset of BCC, RUNX3 appears to be a universal downstream mediator of a constitutively active Shh pathway in BCC.

Aumento da incidência de carcinoma basocelular em hospital universitário: 1999 a 2009

A incidência do carcinoma basocelular vem aumentando em todos os países. Realizou-se estudo ecológico de 5169 laudos de carcinoma basocelular, da FMB-Unesp, entre janeiro/1999 e dezembro/2009. O incremento médio da incidência para o período foi de 90,6%, projetando-se um diagnóstico para cada 15 pacientes encaminhados à dermatologia. Tal tendência se manteve, mesmo quando indexada pelo número de laudos histopatológicos, movimento hospitalar, atendimentos da dermatologia e população de Botucatu.

Carcinoma basocelular da pálpebra: fatores relacionados com a recidiva tumoral

FUNDAMENTOS: O carcinoma basocelular (CBC) palpebral é o tumor maligno mais freqüente das pálpebras, sendo possível observar casos em que existe recidiva após a exérese tumoral. OBJETIVO: O objetivo deste estudo foi procurar reconhecer fatores relacionados com a recidiva do CBC palpebral. MÉTODOS: No período de 1998 a 2001 foram detectados, na Faculdade de Medicina de Botucatu/Unesp, 23 pacientes que apresentaram recidiva clínica de CBC palpebral. Foi realizada análise retrospectiva dos pacientes, analisando-se idade, sexo, história de exposição solar, localização do tumor na pálpebra, diagnóstico clínico, diagnóstico histológico, acometimento de bordas cirúrgicas e tempo de seguimento. RESULTADOS: em meio aos 23 pacientes analisados, não houve predominância de sexo, e a média de idade foi de 72,9 anos. Dos tumores localizados exclusivamente na pálpebra inferior, sobretudo no canto interno (74,0%), 34,7% eram do tipo sólido ulcerado, e a maioria (66,6%) apresentava margens cirúrgicas livres, quando da ressecção tumoral. CONCLUSÃO: A maioria das recidivas de CBC palpebral foi de tumores do tipo sólido e localizados no canto interno. Margens cirúrgicas livres não representam garantia de que a lesão não vá recidivar ou surgir de novo.

Frequência de ocorrência de carcinoma basocelular palpebral na região Centro-Oeste paulista e características dos portadores

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Immunohistochemical aspects of basal cell adenoma and canalicular adenoma of salivary glands

Basal cell adenoma is a benign epithelial neoplasm with a uniform histologic appearance dominated by basaloid cells. Those cells may be distributed in various arrangements as solid, trabecular, tubular and membranous. Canalicular adenoma is also a benign neoplasm composed by columnar cells arranged in branching and interconnecting cords of single or double cell thick rows. There is some disagreement among investigators about whether canalicular adenoma should be included within the basal cell adenoma histologic spectrum. In the present study we compared the expression of cytokeratins (CK), vimentin and muscle-specific actin, utilizing immunohistochemical technique, in three cases diagnosed as basal cell adenomas predominantly of the solid type, and three cases of canalicular adenomas. The results obtained showed a distinct immunoprofile for both neoplasms. Solid areas of basal cell adenomas did not stain for any of the tested antibodies; only when there was tubular differentiation, those structures expressed CKs 7, 8, 14, and 19 in luminal cells and vimentin in non-luminal cells. On the other hand, canalicular adenomas strongly expressed CKs 7 and 13. The panel of antibodies utilized supports the separation of the two entities. © 2001 Elsevier Science Ltd.

carcinoma basocelular com invasão orbitária

The purpose of this paper is to report a recidivate basal cell carcinoma of the eyelid with orbital invasion located in the inner canthus of the left eye. A 79 year old, male, Caucasian patient had a basal cell carcinoma removed from the left inner eyelid canthus 8 years ago and the edges of the resection were compromised by the lesion. The patient had recurrence of the lesion and orbital invasion. He was submitted to orbital exenteration and the ethmoid bone was removed too. The authors call attention to the necessity of correct diagnosis and followup to have success in the management of the patient.

Carcinoma basocelular múltiplo e metastático concomitante a sarcoma pleomórfico e metástatico em área de linfedema crônico - Relato de caso

Chronic lymphedema presents as interstitial fluid retention due to a failure in the lymphatic system drainage. The affected region becomes more vulnerable immunologically and predisposed to the onset of neoplasms. Basal Cell Carcinoma is the most common sort of neoplasm, nevertheless it rarely metastisizes. Sarcomas are malignant mesenchymal neoplasms, locally aggressive, which can spread. Here is reported an infrequent case of multiple basal cell carcinoma, synchronous to a poorly differentiated pleomorphic sarcoma, both spreading to lymph nodes and arising from tissue compromised by chronic lymphedema. © 2012 by Anais Brasileiros de Dermatologia.

Airway Basal Cell Vascular Endothelial Growth Factor-mediated Cross-Talk Regulates Endothelial Cell Dependent Growth Support of Human Airway Basal Cells

The human airway epithelium is a pseudostratified heterogenous layer comprised of cili-ated, secretory, intermediate and basal cells. As the stem/progenitor population of the airway epi-thelium, airway basal cells differentiate into ciliated and secretory cells to replenish the airway epithelium during physiological turnover and repair. Transcriptome analysis of airway basal cells revealed high expression of vascular endothelial growth factor A (VEGFA), a gene not typically associated with the function of this cell type. Using cultures of primary human airway basal cells, we demonstrate that basal cells express all of the 3 major isoforms of VEGFA (121, 165 and 189) but lack functional expression of the classical VEGFA receptors VEGFR1 and VEGFR2. The VEGFA is actively secreted by basal cells and while it appears to have no direct autocrine function on basal cell growth and proliferation, it functions in a paracrine manner to activate MAPK signaling cascades in endothelium via VEGFR2 dependent signaling pathways. Using a cytokine- and serum-free co-culture system of primary human airway basal cells and human endothelial cells revealed that basal cell secreted VEGFA activated endothelium to ex-press mediators that, in turn, stimulate and support basal cell proliferation and growth. These data demonstrate novel VEGFA mediated cross-talk between airway basal cells and endothe-lium, the purpose of which is to modulate endothelial activation and in turn stimulate and sustain basal cell growth.

Facial basal cell carcinomas recurring after photodynamic therapy: a retrospective analysis of histological subtypes

Photodynamic therapy (PDT) is an established treatment for basal cell carcinomas (BCCs). Although recurrences are sometime observed, their histological patterns have never been specifically studied or compared with the one of the initial tumor.