Non-melanoma skin cancer (NMSC), comprising basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), is the most common malignancy worldwide. The incidence of NMSC is increasing with 2–3 million new diagnoses per year globally. Australia, with chronic high ultraviolet (UV) exposure, has the highest incidence of NMSC in the world, with the majority of cSCCs (70–90 %) arising on the sun-exposed skin of the head and neck (HN) in older Caucasian males [1–4].

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/cncr.24208

Metastatic cutaneous squamous cell carcinoma of the head and neck: the Immunosuppression, Treatment, Extranodal spread, and Margin status (ITEM) prognostic score to predict outcome and the need to improve survival

FUNDAMENTO: O carcinoma basocelular e o câncer da pele mais comum, compreendendo 75% dos tumores epiteliais malignos. Localiza-se na face e acomete individuos brancos, acima de 40 anos de idade, com historia de exposicao repetitiva a luz solar. OBJETIVO: Descrever o carcinoma basocelular em suas variaveis epidemiologica, clinica e histopatologica. CASUISTICA: Realizou-se estudo transversal de 300 pacientes com carcinoma basocelular atendidos no Servico de Dermatologia do Hospital de Clinicas, no periodo de 1999 a 2003. Foram preenchidos protocolos com identificacao do paciente, historia de exposicao solar e caracterizacao do carcinoma basocelular. RESULTADOS: Foram identificadas 447 lesoes de carcinoma basocelular nos 300 pacientes estudados, cuja maioria era do sexo feminino (59,3%) e da raca branca (93%), com historia de exposicao solar (90,3%), apresentando lesao unica (74%), predominantemente facial (77% das lesoes). O tipo histopatologico mais frequente foi o nodular (46,3% das lesoes), com predominio do superficial no tronco. CONCLUSOES: Observou-se predominio do carcinoma basocelular no sexo feminino, demonstrando a tendencia atual desse tumor. A presenca de varios tumores sucessivos ou simultâneos em um mesmo paciente salienta a importância de exames periodicos nesses doentes. Nao se estabeleceu correlacao entre os tipos clinicos e histopatologicos. Confirmou-se que o tipo superficial e mais frequente no tronco.

http://www.scielo.br/pdf/abd/v81n2/en_v81n02a04.pdf

Carcinoma basocelular - Análise de 300 casos observados em Uberlândia - MG

ZAC is a zinc finger transcription factor that induces apoptosis and cell cycle arrest in various cell lines. The corresponding gene is maternally imprinted and localized on chromosome 6q24-q25, a region harboring an unidentified tumor suppressor gene for a variety of solid neoplasms. ZAC expression is lost or down-regulated in some breast, ovary, and pituitary tumors and in an in vitro model of ovary epithelial cell transformation. In the present study, we examined ZAC expression in normal skin and found a high expression level in basal keratinocytes and a lower, more heterogeneous, expression in the first suprabasal differentiating layers of epidermis. In vitro, ZAC was up-regulated following induction of keratinocyte differentiation. Conversely, ZAC expression triggered keratinocyte differentiation as indicated by induction of involucrin expression. Interestingly, we found a dramatic loss of ZAC expression in basal cell carcinoma, a neoplasm characterized by a relatively undifferentiated morphology. In contrast, ZAC expression was maintained in squamous cell carcinomas that retain the squamous differentiated phenotype. Altogether, these data suggest a role for ZAC at an early stage of keratinocyte differentiation and further support its role in carcinogenesis.

https://mcr.aacrjournals.org/content/molcanres/3/9/483.full.pdf

The Candidate Tumor Suppressor Gene ZAC Is Involved in Keratinocyte Differentiation and Its Expression Is Lost in Basal Cell Carcinomas

Mohs surgery for squamous cell carcinoma.

Nonmelanoma skin cancer (NMSC) is the most common malignancy encountered in the white population, andmore than amillion new cases are expected annually in the United States alone. Overall, 75% arise in the head and neck region, approximately 80% are basal cell carcinoma (BCC) and 20% are squamous cell carcinoma (SCC) cases. Nearly half of the patients are over the age of 65 and 25% have multiple lesions. The incidence of SCC increases more rapidly with age and cumulative sun exposure than does that of BCC, is far more common in the older age group, and is more common in men than in women. The incidence of NMSC is increasing and age at initial presentation is decreasing. Other than sun exposure, host factors, medical syndromes, and environmental exposure were reported to be associated with increased incidence of NMSC. Countries with fair-skinned populations and excess sun exposure, such as Australia and Israel (ranking 1 and 2, respectively, in the incidence of skin cancer) are particularly prone to this type of neoplasia, reaching what was described as epidemic proportions. Skin cancer is usually noted early even if not necessarily recognized as such, and often a prolonged period of time elapses before a definite diagnosis is reached. The median delay between occurrence of initial symptoms and presentation is reported to be 3 years. Many of the patients with skin lesions tend to try different remedies, some of which may favorably affect or alter the appearance of the lesions to an extent, and this may lead to further delay. Although the majority of NMSCs occur in sunexposed skin and thus appear in readily observed areas, a significant number of patients present with advanced invasive disease, not infrequently accompanied by regional metastases. This may be due to a multitude of reasons: lack of awareness of the significance of local recurrence by either physician or patient, late detection of recurrent or residual disease, lack of adequate follow-up, failure to associate a neck or parotid mass with a skin lesion, an abundance of other skin lesions, the availability of fluorouracil cream treatment, and, of course, denial. Also, proximity to structures such as the eye or ear may generate reluctance to Correspondence to: Y. P. Talmi

Problems in the current TNM staging of nonmelanoma skin cancer of the head and neck.

Nonmelanoma skin cancer is the most common cancer in the United States, and its incidence is increasing dramatically. Although mostly caused by sun exposure, less common causes are also discussed. Several types of basal cell carcinomas are described, as well as squamous cell carcinoma. While these carcinomas rarely cause death, they can be locally destructive, and removal can cause significant disfigurement and functional impairment. The value of early detection is emphasized.

Katz Mh

Papers

Nonmelanoma skin cancer.