skin malignancies

  • 文章类型: Journal Article
    在21世纪,黑色素瘤和非黑色素瘤皮肤癌已成为世界范围内的流行病。因此,探索基于物理或生化机制的所有潜在的预防和治疗措施是必不可少的,通过了解精确的病理生理学途径(丝裂原激活的蛋白激酶,磷脂酰肌醇3-激酶通路,和Notch信号通路)以及此类皮肤恶性肿瘤的其他方面。纳米凝胶,一种直径为20-200nm的三维聚合物交联多孔水凝胶,具有水凝胶和纳米粒子的双重性质。具有更高热力学稳定性的高药物包封效率的能力,显著的溶解潜力,纳米凝胶的溶胀行为成为治疗皮肤癌的靶向给药系统的一个有希望的候选药物。纳米凝胶可以进行合成或结构修饰,以响应内部或外部刺激。包括辐射,超声,酶,磁性,pH值,温度,和氧化还原,以实现药物和几种生物活性分子如蛋白质的控制释放,肽,基因通过放大活性靶组织中的药物聚集和减少不良药理作用。几种药物,如具有短生物半衰期和快速酶降解能力的抗肿瘤生物分子,必须适用于采用化学桥接或物理构建的纳米凝胶框架的施用。全面综述了具有增强的药理潜力和保留的细胞内安全极限的靶向纳米凝胶的制备和表征方法的进展,以缓解皮肤恶性肿瘤,特别强调皮肤癌诱导的病理生理途径和皮肤恶性肿瘤靶向纳米凝胶的前瞻性研究机会。
    In the 21st century, melanoma and non-melanoma skin cancers have become an epidemic outbreak worldwide. Therefore, the exploration of all potential preventative and therapeutic measures based on either physical or bio-chemical mechanisms is essential via understanding precise pathophysiological pathways (Mitogen-activated protein kinase, Phosphatidylinositol 3-kinase Pathway, and Notch signaling pathway) and other aspects of such skin malignancies. Nano-gel, a three-dimensional polymeric cross-linked porous hydrogel having a diameter of 20-200 nm, possesses dual properties of both hydrogel and nanoparticle. The capacity of high drug entrapment efficiency with greater thermodynamic stability, remarkable solubilization potential, and swelling behavior of nano-gel becomes a promising candidate as a targeted drug delivery system in the treatment of skin cancer. Nano-gel can be either synthetically or architectonically modified for responding to either internal or external stimuli, including radiation, ultrasound, enzyme, magnetic, pH, temperature, and oxidation-reduction to achieve controlled release of pharmaceuticals and several bio-active molecules such as proteins, peptides, genes via amplifying drug aggregation in the active targeted tissue and reducing adverse pharmacological effects. Several drugs, such as anti-neoplastic biomolecules having short biological half-lives and prompt enzyme degradability capacity, must be appropriate for administration employing either chemically bridged or physically constructed nano-gel frameworks. The comprehensive review summarizes the advancement in the preparation and characterization methods of targeted nano-gel with enhanced pharmacological potential and preserved intracellular safety limits for the mitigation of skin malignancies with a special emphasize on skin cancer inducing pathophysiological pathways and prospective research opportunities for skin malignancy targeted nano-gels.
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  • 文章类型: Case Reports
    外阴鳞状细胞癌(VSCC)是最常见的外阴瘤,具有侵袭性和转移性。通常,手术是首选治疗方法。放射疗法通常用于不可切除的局部晚期肿瘤和早期患者,这些患者有手术严重并发症的风险或患有严重的伴随疾病,从而阻止他们进行手术。与外照射相比,三维适形放射治疗(3D-CRT),和调强放射治疗(IMRT),在早期VSCC中单独使用体积调节电弧疗法(VMAT)的各种研究很少有报道.在这种情况下,患者有大面积皮肤损伤,无淋巴结转移。手术切除会严重影响排尿功能和外阴形状,所以进行了根治性放疗。为了保证根治性治疗效果的辐射剂量,避免高剂量辐射到正常器官,选择容积调强放疗技术.治疗后,病人的外阴外观恢复正常,肿瘤完全缓解,无需进一步手术或化疗,没有局部复发或相关的毒副作用。提示单纯VMAT治疗早期VSCC疗效准确,值得临床推广。该患者从事铜冶炼和净化工作多年,对她来说,皮肤损伤如此大的表面积是不寻常的。结合她以前的鼻基底细胞癌病史,金属暴露过程中的氧化应激机制应进一步进行临床检查,因为它可能在恶性肿瘤的形成和进展中至关重要。
    Vulvar squamous cell carcinoma (VSCC) is the most frequent vulvar neoplasia, with invasiveness and metastasis. Typically, surgery is the preferred treatment. Radiotherapy is commonly used for unresectable locally advanced tumors and for early-stage patients who are at risk of serious complications from surgery or have a severe concomitant disease that prevents them from undergoing surgery. Compared to external irradiation, three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT), various studies using volumetric modulated arc therapy (VMAT) alone in early-stage VSCC have been reported rarely. In this case, the patient had a large skin lesion and no lymph node metastasis. Surgical excision would seriously affect the urinary function and vulvar shape, so radical radiotherapy was given. To ensure the radiation dose for the radical treatment effect and to avoid high-dose radiation to normal organs, the volumetric intensity-modulated radiotherapy technique was chosen. After treatment, the patient\'s vulvar appearance returned to normal, and the tumor achieved complete remission without further surgery or chemotherapy, with no local recurrence or associated toxic side effects. This suggests that the efficacy of VMAT alone in early-stage VSCC is accurate and worthy of clinical promotion. The patient had been engaged in copper smelting and purification for many years, and it is unusual for her to have skin lesions with such a large surface area. In conjunction with her previous history of nasal basal cell carcinoma, the mechanism of oxidative stress during metal exposure should be further clinically examined, as it may be crucial in the formation and progression of malignancies.
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  • 文章类型: Journal Article
    The skin is the largest organ of the human body and prone to various diseases, including cancer; thus, provides the first line of defense against exogenous biological and non-biological agents. Skin cancer, a complex and heterogenic process, with steep incidence rate often metastasizes due to poor understanding of the underlying mechanisms of pathogenesis and clinical challenges. Indeed, accumulating evidence indicates that deregulation of transcription factors (TFs) due to genetic, epigenetic and signaling distortions plays essential role in the development of cutaneous malignancies and therapeutic challenges including cancer stemness features and reprogramming. This review highlights the recent developments exploring underlying mechanisms how deregulated TFs (e.g., NF-κB, AP-1, STAT etc.,) orchestrates cutaneous onco-pathogenesis, reprogramming, stemness and poor clinical outcomes. Along this line, bioactive drugs, and their derivatives from natural and or synthetic origin has gained attention due to their multitargeting potential, potentially safer and effective therapeutic outcome for human malignancies. We also discussed therapeutic importance of targeting aberrantly expressed TFs in skin cancers with bioactive natural products and or synthetic agents.
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  • 文章类型: Journal Article
    背景:头皮区域是受良性和恶性皮肤肿瘤影响的常见区域,当需要重建时,它代表了一个手术挑战。这项研究的目的是介绍我们在全厚度头皮皮肤缺陷方面的经验,使用Matriderm®真皮替代品和分层厚度皮肤移植物(STSG)进行重建。
    方法:对16例接受头皮区域重建治疗的患者进行回顾性分析。所有患者均接受相同的程序:头皮全层肿瘤切除,同时使用Matriderm®进行重建,并在相同的手术时间内应用分层厚度的皮肤移植物。在随访期间,通过准确的伤口临床检查评估手术结果,采用温哥华疤痕量表(VSS)。
    结果:获得的结果令人满意:手术结束时伤口愈合最佳,移植皮肤与周围组织相似,在6个月至1次随访期间,色素沉着和血管减少。
    结论:使用Matriderm®和裂层植皮修复头皮全层缺损重建,稳定,和安全的程序,适合老年患者。
    BACKGROUND: The scalp region represent a common area affected by benignant and malignant skin tumor, and it represents a surgical challenge when it is needed to be reconstructed. The aim of this study is to present our experience with full-thickness scalp skin defects, reconstructed using Matriderm® dermal substitute and split-thickness skin graft (STSG).
    METHODS: A retrospective analysis of patients treated for scalp region reconstruction was conducted with 16 patients. All patients underwent the same procedure: scalp full-thickness tumor excision with simultaneous reconstruction with Matriderm® and the application of a split-thickness skin graft in the same surgical time. During follow-ups, the surgical outcome was evaluated by accurate clinical examination of the wound, adopting the Vancouver Scar Scale (VSS).
    RESULTS: The outcomes obtained were satisfying: wound healing at the end of the procedures was optimal, grafted skin resulted similar to surrounding tissue, and pigmentation and vascularity showed a decrease in the period between 6 months and 1 follow-up.
    CONCLUSIONS: The use of Matriderm® and split-thickness skin grafting for scalp full-thickness defects reconstruction resulted in an optimal, stable, and safe procedure, suitable for elderly patients.
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  • 文章类型: Journal Article
    根据文献,皮肤转移影响内脏器官恶性肿瘤患者的0.7%-10.4%,可能是癌症全身扩散的表现。皮肤转移可能是治疗后复发的第一个迹象,大约30%的皮肤转移病例在诊断内脏器官癌之前就被诊断出来。皮肤转移最常来自乳腺癌和黑色素瘤。它们可以呈现同步或异时。足够的警惕,结合临床表现和流行病学的知识,有助于准确的诊断和治疗。临床上,皮肤转移以非典型单发的形式发生,无痛结节,或肿瘤。肿块或浸润灶不显示有助于诊断的临床特征。体格检查期间皮肤变化更容易接近,并且更容易进行活检和提供组织学评估。皮肤镜,评估皮肤转移的有用的初始工具,可以导致快速准确的诊断和治疗。最终,转移性恶性肿瘤的诊断通过组织病理学检查得到证实。
    According to the literature, skin metastases affect 0.7%-10.4% of patients with malignant neoplasms of internal organs and may be 1 presentation of systemic spread of the cancer. Skin metastases may be the first sign of relapse after treatment and about 30% of cases of skin metastases are diagnosed before the diagnosis of internal organ cancer. Cutaneous metastases most often come from breast cancer and melanoma. They can present synchronous or metachronous. Adequate vigilance, combined with knowledge of the clinical picture and epidemiology, can contribute to accurate diagnosis and treatment. Clinically, skin metastases occur in the form of atypical solitary, painless nodules, or tumors. Lumps or infiltrating foci do not show clinical features that help in making a diagnosis. Skin changes are more accessible during physical examination, and it is easier to do a biopsy and provide histological assessment. Dermoscopy, a useful initial tool for the assessment of skin metastases, can lead to a rapid accurate diagnosis and treatment. Ultimately, the diagnosis of a metastatic malignancy is confirmed by histopathological examination.
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  • 文章类型: Journal Article
    Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however, the early-stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries to comprehensively highlight the various diagnostic, therapeutic, and outcome aspects of scalp melanomas. The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till May 2020 and reference lists of respective articles. Only articles published in English language were included.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    慢性结节性软骨皮炎是一种罕见的外耳非肿瘤性炎症和退行性过程,以真皮中延伸到软骨膜的坏死生物变化为特征。这种情况偶尔在局限性皮肤系统性硬化症患者中有报道,但在合并原发性胆汁性肝硬化的患者中没有报道;这种关联被称为雷诺兹综合征。我们报告了一名70岁的妇女,该妇女在47岁时被诊断为原发性胆汁性肝硬化,在54岁时患有皮肤系统性硬化症,在最后一次诊断后不久,左耳的螺旋边缘出现了疼痛的溃疡结节。因为怀疑是恶性肿瘤而切除了病灶,但组织病理学与慢性螺旋型结节性软骨皮炎一致。虽然这种情况很少见,有必要知道,因为它可能发生在系统性硬化症患者身上,被误认为是肿瘤,如基底细胞癌和鳞状细胞癌,这些患者患皮肤恶性肿瘤的风险增加。
    Chondrodermatitis nodularis chronica helicis is a rare non-neoplastic inflammatory and degenerative process of the external ear, characterized by necrobiotic changes in the dermis that extend down to the perichondrium. This condition has been occasionally reported in patients with limited cutaneous systemic sclerosis but not in those with concomitant primary biliary cirrhosis; this association is known as Reynolds syndrome. We report a 70-year-old woman diagnosed with primary biliary cirrhosis at age 47 and with limited cutaneous systemic sclerosis at age 54 who developed a painful ulcerated nodule on the helical rim of the left ear shortly after the last diagnosis. The lesion was excised because of the suspicion of malignancy, but the histopathology was consistent with chondrodermatitis nodularis chronica helicis. Although this condition is infrequent, it is necessary to know, because it may occur in patients with systemic sclerosis and be mistaken for neoplasms, such as basal cell and squamous cell carcinoma, and these patients have an increased risk for the development of skin malignancies.
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  • 文章类型: Journal Article
    BACKGROUND: The aim of this study is to retrospectively assess the prevalence of some of skin malignancies in our environment and to provide a data base for creating awareness for prevention and early detection of the diseases in order to reduce morbidity and mortality associated with these skin lesions in our environment.
    METHODS: This is a retrospective study of all histologically diagnosed malignant skin lesions which presented at Ladoke Akintola University of Technology Teaching Hospital Osogbo Osun State between January 2006 and December 2010.
    RESULTS: Ninety- eight patients presented with skin cancers out of which 60 (61.2%)were males and 38 (38.8%) were females. Malignant melanoma ranked highest followed by squamous cell carcinoma, dermatofibrosarcoma and basal cell carcinoma in that order. Malignant melanoma affects male more than female and it commonly affects lower limbs.
    CONCLUSIONS: Skin malignancies pose a burden to the economy of the country. Efforts should be directed toward prevention, early diagnosis and management in order to abolish or reduce morbidity, as well as mortality associated with late presentation of people in the developing countries.
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  • 文章类型: Journal Article
    BACKGROUND: The management of advanced cutaneous malignancies has been controversial. Thirteen patients with nonmelanoma skin neoplasias that had invaded the bone of the calvarium and scalp were treated in our centre.
    OBJECTIVE: The purpose of this study was to evaluate our experience in treating these malignancies with scalp resection and full or partial thickness cranium reconstruction.
    METHODS: From June 2008 to March 2012, thirteen patients with locally advanced tumours of the scalp invading the calvarium were treated with wide local excision of the scalp combined with an underlying craniectomy and dural resection if needed.
    RESULTS: Using histopathological diagnosis eleven patients were diagnosed with basal cell carcinoma and two patients with squamous cell carcinoma. A full thickness cranium resection was performed in seven patients and partial in six patients.
    CONCLUSIONS: These large cancers occasionally invade adjacent structures, as well as bone, presenting a challenging surgical problem. In general, giant rotational or island scalp flaps and free tissue transfers are needed to close the area. Finding clean margins are an important part of treating patients with bone involvement and can usually be attained using outer tabula curettage thus preventing unnecessary morbidity.
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