Actinic Keratosis

Resumen Las características de nuestro entorno sugieren que enfermedades como la quera-tosis actínica (QA) aumentarán su prevalencia y, en consecuencia, la demanda asistencial en los próximos años. Deben tenerse en cuenta una extensa lista de características clínicas en el abordaje terapéutico de la QA, hasta hace poco compuesto únicamente por técnicas abla-tivas y exclusivamente dirigidas a las lesiones, sin considerar el campo de cancerización. El incremento del arsenal terapéutico de los últimos años hace necesaria la homogenización de criterios que faciliten la elección de la mejor opción para cada paciente. La formulación de recomendaciones de consenso entre expertos a partir de la revisión de las evidencias científicas en cuanto a diagnóstico y tratamiento disponibles, permite aportar conocimiento dirigido a la mayor calidad en la atención de los pacientes, facilita una mayor homogeneidad en la toma de decisiones y promueve la sensibilización necesaria de todos los agentes sanitarios involucrados. Abstract Current trends in our setting indicate that the prevalence of actinic keratosis and similar diseases will increase in coming years and impose a greater burden on health care resources. A long list of clinical features must be taken into account when approaching the * Autor para correspondencia. Correo electrónico: [email protected] (C. Ferrándiz).

OBJECTIVE:

Cumulative exposure of the skin to ultraviolet radiation promotes mutation in keratinocytes and their abnormal growth led to the formation of scaly lesions, called actinic keratoses (AKs). Its incidence is growing at an emerging rate, becoming a worldwide problem especially for occupational ultraviolet (UV) rays exposure. Detectable lesions are often associated with field changes, where the surrounding skin is altered and subclinical lesions may be present. Thus, a field-directed therapy, such as topical treatment, should be preferred for the prevention of invasive cancer development. A retrospective analysis was made, evaluating the efficacy of ingenol-mebutate gel, using a novel device the 3D in vivo optical skin Imaging (Antera 3D, Miravex, Ireland).

PATIENTS AND METHODS:

We included all patients with multiple non-hypertrophic Aks, to whom it was prescribed ingenol-mebutate gel, applied at the dosages of 0.015 for lesions in the scalp/face (for 3 consecutive days) and at the dosage of 0.05% for lesions in the trunk and/or extremities (for 2 consecutive days).

RESULTS:

A reduction of the lesions and of median hemoglobin levels, after a follow-up of 60 days, was observed in 100% of patients.

CONCLUSIONS:

Ingenol mebutate gel, the last topical molecule appeared in the Italian market showed its efficacy using Antera 3D also in terms of hemoglobin reduction. Therefore, this camera could be considered an useful tool for the identification of the area to be treated and for therapeutic follow-up.

Book Description:
Inflammatory markers, oncogenes, tumor suppressor genes and cell cycle regulators in skin growths represent a series of reports and reviews on skin cancers and precancers, their host immune responses and correlations with medical literature data.
We were able to clearly identify an immune response in multiple skin cancers, as well as in cutaneous pre-cancerous conditions. In poorly differentiated tumor areas, some classic immunohistochemical stains did not stain as frequently described in the literature.
Other important phenomena we observed are that many cell cycle regulators, cell cycle checkpoints, oncogenes and tumor suppressor gene markers were not only positive inside the tumors, but also in cells around the tumor. Portions of adjacent skin appendices and in supposedly normal adjacent epidermal and dermal tissue also showed signs of these components. These common findings raised questions concerning marginal definition of cutaneous surgery; that is, many of the immunologic findings could not be correlated on classical hematoxylin and eosin reviews.
We also noted that many immunologic cells around skin cancers and/or pre-cancers showed high rates of division defined via markers such as Ki-67; our findings utilizing double color immunohistochemistry also showed that these immune cells are possibly actively duplicating as effector cells. Ki-67 has been cited as a superb proliferation marker in melanoma, but additional review of its utility is warranted given our results.
Finally, we also found double staining immunohistochemistry to be of excellent value in detecting melanoma cells metastasizing in blood vessels, lymphatics and/or nerves. (Imprint: Nova Biomedical)




Table of Contents:
Preface

Chapter 1
Inflammatory Markers, Oncogenes, and Tumor Suppressor Cell Cycle Regulators in Benign, Premalignant and Malignant Skin Lesions
(Ana Maria Abreu-Vélez, Juliana Calle-Isaza, Yulieth Alexandra Upegui-Zapata, Daniel Alberto Vásquez-Hincapié, Eduardo Upegui-Quiceño, Natalia Regina Mesa-Herrera, Carlos Andrés Valencia-Yepes, Jorge Enrique Velasquez-Velez, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 2
Vimentin, Bromodeoxyuridine and Topoisomerase II α Expression in a Mildly Dysplastic Compound Nevus
(Ana Maria Abreu Velez, Carlos Andres Valencia-Yepes, Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 3
A Basal Cell Carcinoma with Sebaceous and Squamous Differentiation, with Expression of Proliferating Cell Nuclear antigen, P27Kip1 and Vimentin
(Ana Maria Abreu Velez, DA Vásquez-Hincapié, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, GA, USA and others)

Chapter 4
A Case of an Inflamed Precancerous Wart, and Immune Response with Factor XIIIa, IgD, CD11c/CD18 and CD79a
(Ana Maria Abreu Velez, Billie L Jackson, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 5
Squamous Cell Carcinoma Immunohistochemical Staining Reveals Lateral Satellitosis, Undetected via Hematoxylin and Eosin
(Ana Maria Abreu Velez, Yulieth Alexandra Upegui-Zapata, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 6
Immunologic and Cell Cycle Regulatory Markers in an Inflamed Actinic Keratosis
(Ana Maria Abreu Velez, Harry D. Vildibill, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 7
Ribosomal Protein S6-pS240, CD45 and Cyclooxygenase-2 in an Inflamed Mildly Dysplastic Junctional Nevus
(Ana Maria Abreu-Velez, Charles J Douchy and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 8
Epidermis Above a Nodular Basal Cell Carcinoma Overexpressing Proliferating Cell Nuclear Antigen
(Ana Maria Abreu Velez, Billie L Jackson, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 9
Epidermal Tissue near a Basal Cell Carcinoma Overexpresses Proliferating Cell Nuclear Antigen, Cyclin D1, Topoisomerase IIα, Ki-67 and p27kip1
(Ana Maria Abreu Velez, Billie L. Jackson, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 10
Directed Host Immune Response against a Primary Cutaneous Squamous Cell Carcinoma
(Ana Maria Abreu Velez, Vickie M. Brown and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 11
Double Color Immunohistochemistry Analysis of the Immune Response, Angiolymphatic Invasion and Tumor Mitotic Rate in a Superficial Spreading Malignant Melanoma
(Ana Maria Abreu Velez, E. D. DeLoach, and Michael S. Howard, Georgia Dermatopathology Associates; Atlanta, Georgia, USA, and others)

Chapter 12
Aggressive Nodular Basal Cell Carcinoma with Expression of Proliferating Cell Nuclear Antigen and B-cell Lymphoma 2 Gene
(Ana Maria Abreu Velez, Rick Lockhart, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Chapter 13
Octamer Transcription Factor-2 (OCT-2) and CD25 Expression in a Recurrent Cutaneous Melanoma
(Ana Maria Abreu Velez, Harry D. Vildibill, and Michael S. Howard, Georgia Dermatopathology Associates, Atlanta, Georgia, USA, and others)

Index



  Series:
      Dermatology - Laboratory and Clinical Research
  Binding: Hardcover
  Pub. Date: 2016 - 1st Quarter
  Pages: 6x9 - (NBC-C)
  ISBN: 978-1-63484-303-4
  Status: AP