Ingenol mebutate (IM) is approved for the treatment of actinic keratosis and induces cell death in precancerous lesions. The efficacy of IM in the treatment of genital warts was investigated in a therapy-refractory patient. The 74-year-old male was treated with IM gel for three consecutive days. Treatment course and efficacy were evaluated by clinical inspection and non-invasive diagnostics namely optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Within 24 to 48 hours IM induced a strong local inflammatory reaction. One week later a complete response was observed. OCT and RCM showed a strong reaction after treatment with erosions, swelling of cells, and a subepidermal dark band in representative lesions. IM has the advantage of a short treatment period in contrast to other topical treatments and shows a promising clinical outcome. Larger studies are needed to validate the data.
Aged ; Cell Death ; Condylomata Acuminata ; Humans ; Keratosis, Actinic ; Male ; Microscopy ; Microscopy, Confocal ; Tomography, Optical Coherence

BACKGROUND: The incidence of cutaneous malignant tumors and premalignant lesions has recently increased worldwide. However, studies investigating the incidence and clinical manifestations of cutaneous malignant tumors and premalignant lesions in Korea are rare, especially in southeastern Gyeonggi-do Province. OBJECTIVE: To analyze the recent trends in the incidence of cutaneous malignant tumors and premalignant lesions in southeastern Gyeonggi-do Province. METHODS: We retrospectively reviewed 451 cases of cutaneous malignant tumors and 455 cases of premalignant lesions from 2006 to 2016. RESULTS: The average annual incidence rates of cutaneous malignant tumors and premalignant lesions among the total number of outpatients was 0.84% and 0.85%, respectively, and both these rates increased significantly over time. Basal cell carcinoma was most commonly diagnosed cutaneous malignant tumor (50.8%), followed by squamous cell carcinoma (24.6%), malignant melanoma (8.2%), and metastatic carcinoma (5.1%). The most common premalignant lesion was actinic keratosis (60.0%). The mean age of the patients with cutaneous malignant tumors and premalignant lesions was 68.8 years and 70.8 years, respectively. The ratio of male to female patients was 1 : 1.19 for cutaneous malignant tumors and 1 : 2.01 for premalignant lesions. The face was the most common site for both cutaneous malignant tumors and premalignant lesions (at 71.9% and 75.8%, respectively). CONCLUSION: This retrospective study provided data about the incidence and clinical patterns of cutaneous malignant tumors and premalignant lesions among patients in southeastern Gyeonggi-do Province.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Gyeonggi-do* ; Humans ; Incidence ; Keratosis, Actinic ; Korea ; Male ; Melanoma ; Outpatients ; Retrospective Studies ; Statistics as Topic*

No abstract available.
Actins ; Keratosis, Actinic ; Prevalence

Psoriasis is an auto-immune skin disease, which is characterized by the excessive generation of plaques on the skin with typically a long-lasting red, itchy and scaly symptoms. Imiquimod, which has been used for the treatment of external genital warts, actinic keratosis, and superficial basal cell carcinoma, induced of psoriasis-like skin disorders with skin erythema and thickness in mice. In the present study, we tried to find the bioactive herbal extract against imiquimod-induced psoriasis-like skin disorder in mice. During the searching of the herbal extract with anti-psoriatic effect, the ethanolic extract of Cnidium officinale ameliorated imiquimodinduced psoriasis-like skin disorder in mice. The morphological evaluation, H&E staining and Psoriasis Area and Severity Index (PASI) score showed that ear and back thickness, and erythema induced by imiquimod were significantly reversed after the treatment of the cream of the ethanolic extract of C. officinale. The overexpressed myeloperoxidase (MPO) and keratin 6A levels were decreased by the treatment of C. officinale cream. Also, IFN-γ, c-fos and IκB-α mRNA levels, which are related to the progression of psoriasis, were reduced by C. officinale cream. Thus, the ethanolic extract of C. officinale ameliorated psoriasis-like skin disorder induced by imiquimod and might be the therapeutic agent for psoriasis.
Animals ; Carcinoma, Basal Cell ; Cnidium ; Condylomata Acuminata ; Ear ; Erythema ; Ethanol ; Keratin-6 ; Keratosis, Actinic ; Mice ; Peroxidase ; Psoriasis ; RNA, Messenger ; Skin Diseases ; Skin

The rate of malignant transformation in porokeratosis (PK) lesions is approximately 7.5%, and linear PK demonstrates the highest rate of malignancy. An 83-year-old woman presented with a rapidly enlarging mass on her left arm. Variably sized erythematous scaly patches were scattered across the left half of her trunk and arm. Additionally, generalized variably sized brownish annular patches with a hyperkeratotic outer ring were observed on her face, trunk and bilateral arms. A skin biopsy was performed on 3 lesions-a yellowish to erythematous appearing mass, an erythematous scaly patch, and a brownish annular patch. Histopathological evaluation of these 3 lesions revealed squamous cell carcinoma, actinic keratosis, and PK, respectively. The final diagnosis was disseminated superficial PK with linear PK on the left side of the body, and actinic keratosis and squamous cell carcinoma confined to the linear PK lesions. We report a case which represents the progressive and stepwise malignant transformation of PK into squamous cell carcinoma.
Aged, 80 and over ; Arm ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Humans ; Keratosis, Actinic ; Porokeratosis* ; Skin

Circumscribed palmar or plantar hypokeratosis is a rare condition characterized by the occurrence of an erythematous, well-circumscribed, and depressed macule or patch on the palms or soles. Histopathologically, it is characterized by sharp, stair-like abrupt thinning of the horny layer between the affected and unaffected skin. The pathogenesis of this condition remains unclear. Recently, the human papilloma virus has been implicated as a possible etiological contributor. Circumscribed palmar or plantar hypokeratosis usually shows a benign course. Previous reports have not described malignant changes in these lesions. However, its association with actinic keratosis has been reported in a previous case. We report a case of circumscribed palmar hypokeratosis showing bowenoid epidermal change with expression of the human papilloma virus types 6 and 16 in a patient who was successfully treated with ingenol mebutate gel and cryotherapy.
Cryotherapy ; Humans* ; Keratosis, Actinic ; Papillomaviridae* ; Skin

BACKGROUND: Actinic keratosis (AK) was an intraepidermal tumor which caused by ultraviolet irradiation-induced skin damage. OBJECTIVE: The aim was to screen biomarkers for development of skin disease by comparing the gene expression profiles between cutaneous squamous cell carcinoma (CSCC) and AK. METHODS: GSE45216 with 30 cutaneous squamous cell carcinoma patients and 10 actinic keratosis patients were downloaded and significance analysis of microarrays was processed to screen differently expressed genes (DEGs). Fisher's exact test was processed for DEGs enrichment. Pathway relationship network systematically reflected the signal conduction and synergism between enriched pathways based on Kyoto Encyclopedia of Genes and Genomes database. Gene co-expression network was constructed according to gene expression data. Quantitative real-time-PCR was used to verify screened biomarkers. RESULTS: Total 410 DEGs were screened and enriched into various functions, such as signal transduction and negative regulation of apoptotic process. They also participated into cytokine-cytokine receptor interaction and focal adhesion. The pathway relationship network was constructed with 27 nodes. Hub nodes with higher degree of this network were mitogen-activated protein kinase signaling pathway and apoptosis. The gene co-expression network was constructed with 39 nodes. Thereinto, hub node was ELOVL fatty acid elongase. The expression levels of ELOVL4 and HPGD were significantly higher in CSCC samples than that in AK samples, while the expression levels of INHBA and LAMC2 in CSCC samples were significantly lower than that in AK samples. CONCLUSION: These screened genes, including ELOVL4, HPGD, INHBA and LAMC2, played important roles in transformation from AK to CSCC.
Actins* ; Apoptosis ; Biomarkers* ; Carcinoma, Squamous Cell* ; Diagnosis* ; Epithelial Cells* ; Focal Adhesions ; Gene Expression* ; Genome ; Humans ; Keratosis, Actinic* ; Mass Screening* ; Protein Kinases ; Signal Transduction ; Skin Diseases* ; Skin* ; Transcriptome

Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder. It is histopathologically characterized by the presence of coronoid lamellae and clinically by lesions showing central atrophy with elevated borders. Squamous cell carcinoma originating in the classical Mibelli subtype of porokeratosis is well-documented; however, few reports have described squamous cell carcinoma in DSAP lesions. We report the case of a 76-year-old woman with DSAP who developed Bowen's disease, actinic keratosis, and keratoacanthoma on her face.
Aged ; Atrophy ; Bowen's Disease ; Carcinoma, Squamous Cell ; Female ; Humans ; Keratoacanthoma ; Keratosis, Actinic ; Porokeratosis* ; Skin*

BACKGROUND: It is well known that skin cancer and precancerous disease develop more frequently in patients undergoing solid organ transplantation than normal populations in the normal population in Western countries. However, to date, the clinical and demographic features of skin cancer and precancerous disease after solid organ transplantation are not established in Asian countries. We evaluated the clinical and demographic features of primary skin cancer and precancerous lesions after solid organ transplantation and compared these with the trends observed in Western countries. METHODS: We retrospectively reviewed the medical records of patients who underwent kidney, liver, heart, and lung transplantation between January 1995 and April 2017 and who developed skin cancer or precancerous lesions after transplantation. The various lesions observed were squamous and basal cell carcinoma, malignant melanoma, Kaposi sarcoma, Bowen's disease, and actinic keratosis. RESULTS: We identified 4604 patients who received organ transplant. The mean age of patients was 44.8 years (male, 64.6%; female, 35.4%), and the sum of the person-year of observation time was 31,024 person-years. The incidence rate per 100,000 person-years was 29.01 for squamous cell carcinoma, 19.34 for basal cell carcinoma, 6.45 for malignant melanoma 3.22 for Kaposi sarcoma, and 74.17 for Bowen's disease and actinic keratosis. The incidence rate per 100,000 person-years was the highest in patients undergoing heart transplantation (610.50), followed by those who underwent kidney transplantation (136.54) and liver transplantation (90.15). Koreans showed lower incidence rates than those observed in Westerners. CONCLUSION: The incidence of primary skin cancer and precancerous lesions after solid organ transplantation in Koreans was lower than that in Westerners. Squamous cell carcinoma was the most common skin cancer in patients undergoing solid organ transplantation and the incidence rate of skin cancer and precancerous lesions was the highest in patients undergoing heart transplantation.
Asian Continental Ancestry Group ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Female ; Heart ; Heart Transplantation ; Humans ; Incidence* ; Keratosis, Actinic ; Kidney ; Kidney Transplantation ; Korea* ; Liver ; Liver Transplantation ; Lung Transplantation ; Medical Records ; Melanoma ; Organ Transplantation* ; Retrospective Studies ; Sarcoma, Kaposi ; Skin Neoplasms* ; Skin* ; Transplants*

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is a malignant proliferation of keratinocytes of the epidermis. It may have the potential to metastasize distally in contrast to the cutaneous basal cell carcinoma. OBJECTIVE: We investigated the recent trend of cSCC development from a clinical, histopathological, and prognostic perspective. METHODS: One hundred and sixty cases of cSCC in patients who had visited the Samsung Changwon Hospital over the past 10 years (between 2006 and 2016) were retrospectively studied. We analyzed their age, sex, location, etiologic factor, histopathologic finding, and treatment. RESULTS: The average age of cSCC was 77 years old and the sex ratio was 1:2.27. The most commonly involved location was the head and neck (73.13%). The etiologic factors were unknown (61.88%), actinic keratosis (23.13%), Bowen's disease (10.63%), burn scar (2.5%), chronic eczema (0.63%) and chronic inflammatory disease (0.63%). The average tumor diameter and thickness were 18.1 mm and 3.58 mm, respectively. The degrees of differentiation were well-differentiated (68.75%), moderately differentiated (28.75%) and poorly differentiated (2.5%). The occurrence rate of cSCC metastasis was 6.25% (10 cases/160 cases). The most common primary locations of cSCC metastasis were the lower extremities (5 cases/10 cases) and head and neck (2 cases/10 cases). All 10 cases were metastasis to adjacent lymph nodes. Five cases showed metastasis to distant lymph nodes, the lungs, liver or bone. The average tumor diameter and thickness of cSCC metastasis were 45.3 mm and 9.46 mm, respectively. Histopathologically, the degrees of differentiation were well-differentiated, moderately differentiated and poorly differentiated type (4 cases, 5 cases, and 1 case, respectively). CONCLUSION: The location of the lower extremities (p=0.000) and a size larger than 20 mm (p=0.000) were related to cSCC metastasis. cSCC metastasis was found at an average of 7.5 months after diagnosis. High-risk cSCC patients should be followed closely, particularly during the first 2 years after diagnosis.
Bowen's Disease ; Burns ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Cicatrix ; Diagnosis ; Eczema ; Epidermis ; Epithelial Cells* ; Gyeongsangnam-do ; Head ; Humans ; Keratinocytes ; Keratosis, Actinic ; Liver ; Lower Extremity ; Lung ; Lymph Nodes ; Neck ; Neoplasm Metastasis* ; Retrospective Studies ; Sex Ratio