Morpheaform Basal Cell Carcinoma

Morpheaform basal cell carcinoma (BCC), also called as sclerosing BCC is a rare variant of basal cell carcinoma with more aggressive characteristics and atypical clinical presentation. The vast majority of basal cell carcinomas are nodular or superficial. Morpheaform basal cell carcinoma is considered a potentially more aggressive subtype

Causes of Morpheaform Basal Cell Carcinoma

The exact cause still remains unexplained, but genetic and environmental factors are believed to be predisposing factors for mBCC. Researchers suggest that ultraviolet rays from the sun may play an important role in genetic mutation.

Clinical features of Morpheaform basal cell carcinoma

MBCC present as solitary, pale, yellowish or skin colored, firm, ill-defined, flat or slightly depressed waxy or scar like lesion resembling many other benign lesions like Desmoplastic trichoepithelioma. mBCC is most frequently seen on head and neck areas, especially on the face [1,2,3] and less frequently in the trunk and limbs.

Treatment of Morpheaform Basal Cell Carcinoma

Several treatment modalities are being tried including imiquimod 5% cream, photodynamic therapy, Cryosurgery, Radiation Therapy, Curettage and Desiccation and local surgical excision. Although local surgical excision or other alternatives may be sufficient for most of the BCC or mBCC, recurrent rates may be high. For this reason Mohs micrographic surgery is suggested to avoid recurrence and for the high-risk and disfiguring anatomical sites like face where tissue conservation is very important [4].

References:

1. Burdon-Jones D, Thomas PW. One-fifth of basal cell carcinomas have a morphoeic or partly morphoeic histology: implications for treatment. Aust J Dermatol 2006; 47: 102–105.
2. Scrivener Y, Grosshands E, Cribier B. Variations of basal cell carcinomas according to gender, age, location and histopathological subtype. Br J Dermatol 2002; 147: 41–47
3. Erba P, Farhadi J, Wettstein R, Arnold A, Harr T, Pierer G. Morphoeic basal cell carcinoma of the face. Scand J Plast Reconstr Surg Hand Surg. 2007;41(4):184-8.
4. Rowe DE, Carroll RJ, Day CL Jr: Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol 15:424, 1989

Effect Of Global Warming On Skin Disorder

Global warming is a gradual increase in the average temperature of the earth’s near-surface air and oceans in recent decades and its projected continuation. It is the most current and widely discussed topics that might lead to ultimate end of existence of earth and and human being.

Global warming is directly or indirectly impacting on our lifes, including rise in sea levels, melting of ice,  and is responsible for significant changes in worldwide climate. Expert have agreed that melting of ice glaciers could release fungi, bacteria and virus incorporated during the freezing process that have been lying dormant for several thousands years that people might have thought have been eradicated already. Heat could make common virus develop strains to which people have no resistance and increase in the ranges of disease vector. This article will discuss the degree of impact and risk factors caused by global warming to our skin.

Ultraviolet Radiation:

Although Sun is the main factor for the existence of life on earth, but scientist believe that continue depletion of ozone layer has significient negative inpact on our skin too. Ultra violet rays are subdivided into three categories depending on their wave lengths, UVA-400-320 nm; UVB-320-290 nm; UVC-290-200 nm. Among all UVB radiation is by far the most harmful radiation that directly affect the skin causing different pigmentation disorder and increase risk of skin cancer. As ozone layer control the radiation, but recent depletion of ozone layer has increased the chances of many skin disease. Scientists believe that increase of temperature by 2% for a long-term due to changes of climate, might increase the carcinogenic effect of ultraviolet radiation by 10%.

Effects of Solar UVR on the Normal Skin The effects of UVR on skin can be classified into 2 caterogies depending on the duration of exposure .

Acute exposure:

Acute over exposure to Solar UVR might cause sunburn also called erythema. The redness of skin in sunburn is due to increase blood content of the skin due to the dilation of the superficial blood vessels in the skin. Excessive exposure might also results in blistering, swelling and peeling. It is estimated that UVA radiation contributes about 15-20% of sunburn reactions though it is less harmful than UVB. Another effects of exposure to UVR is tanning which is darkening of exposed skin due to UVA and invisible radiation. Immediate tanning can be noticed within 5-10 minutes and normally fades within 1-2 hours. Delayed tanning can be noticed after 1-2 days of sun exposure and persist for weeks to months.

Chronic Exposure

Chronic exposure to UVR might result in aging of skin normally called photoaging. Dryness, deep wrinkle, skin furrows, loss of elasticity, sagging, pigmentation and telangiectasia are the most common symptoms observed. Another common risk factors of Chronic exposure to UVR is Non-Melanoma Skin Cancer ( NMSC) . Most common form of NMSC are Squamous cell carcinoma ( SCC) and basal cell carcinoma ( BCC). BCC accounts for about 80% of all NMSC. Its is estimated that each 1% loss of total ozone layer have 3%-5% increase risk of skin cancer. It is believed that the increase in incidence of Melanoma is due to the changing pattern of sun exposure.

Impact of global warming in Sebaceous Glands and Acne:

The ideal temperature of  a human body is around 98.2°F.  Sweat glands and Sebaceous glands are heat sensitive and rapidly produce their secretions. As the temperature rises the activity of sebaseous glands increases resulting is over production of sebum, as a result sebum with dead cells together clogs the hair follicles and finally acne breakouts occur. Other oraganism like Staphylococcus and Streptococcus can colonize human in warmer climate resulting in many skin diseases which they cause.

Finally, We all should understand that global warming is a real serious issue which is affectiving us and our life directly on indirectly whether its environmental or medical. The solution is within us to stop this devastation by educating ourself and others with self awareness and health education.

Increased Incidence Of Skin Cancer Among Asian Living In Singapore

A Journal published at “Journal of the American Academy of dermatology” concludes that Incidence of skin cancer among peoples of singapore has increased from 1968 to 2006 and especially among older chinese.

The incidence rates of skin cancers in Caucasian populations are increasing. There is little information on skin cancer trends in Asians, who have distinctly different skin types. So this articles focus to study skin cancer incidence rates and time trends among the 3 Asian ethnic groups in Singapore.

These data of skin cancer were analyzed from the Singapore Cancer Registry from 1968 to 2006 using the Poisson regression model.

The data reports that there were 4044 reported cases of basal cell carcinoma, 2064 of squamous cell carcinoma, and 415 of melanoma. Overall skin cancer incidence rates increased from 2.9/100,000 in 1968 to 1972 to 8.4/100,000 in 1998 to 2002, declining to 7.4/100,000 in 2003 to 2006. Among older persons (?60 years), basal cell carcinoma rates increased the most, by 18.9/100,000 in Chinese, 6.0/100,000 in Malays, and 4.1/100,000 in Indians from 1968 to 1972 to 2003 to 2006. Squamous cell carcinoma rates among those aged 60 years and older increased by 2.3/100,000 in Chinese and by 1/100,000 in Malays and Indians. Melanoma rates were constant for all 3 races. Skin cancer rates among the fairer-skinned Chinese were approximately 3 times higher than in Malays and Indians, who generally have darker complexions.

Although appropriate population denominators were used, lack of data from 2007 could have affected the results for the last time period, which comprised 4 instead of 5 years.

Adapted from the article provided by Journal of the American Academy of dermatology

Successful Treatment Of Basal Cell Carcinoma With Imiquimod Cream

Researcher at North Queensland Centre for Cancer Research,James Cook University,Queensland,Australia found out some good success rate in treating superficial basal cell carcinoma with Imiquimod cream.

Superficial basal cell carcinoma comprise up to 25% of all histological sub-types. They are more likely to occur on younger persons and females and although generally more common on the trunk, also occur frequently on the exposed areas of the head and neck especially in areas of high sun exposure. In the last decade, new treatment options such as topical applications that modify the immune response have been trialed for effectiveness in treating these lesions.
Imiquimod 5% cream has been shown to stimulate the innate and cell mediated immune system. The short-term success of imiquimod 5% cream in randomized controlled trials comparing different treatment regimes and dosing as a treatment for small superficial basal cell carcinoma (BCC) not on the face or neck is in the range of 82% for 5 times per week application.
A high proportion of participants with good response rates to topical treatment (58%–92%) experience local side effects such as itching and burning, less commonly erosion and ulceration, but the proportion of participants ceasing treatment has not been high.

To date one long-term study indicates a treatment success rate of 78%–81% and that initial response is a predictor of long-term outcome. Recurrences tend to occur within the first year after treatment. Future research will compare this preparation to the gold standard treatment for superficial BCC – surgical excision.

Any Doubtful Non Itchy Painless Mass Could Be Skin Cancer

When cells of the skin multiply in a haphazard manner,they form small masses on the skin, and these are known as skin cancer.

There are mainly three types of skin cancer. The most common are squamous cell carcinoma and basal cell carcinoma. Squamous cell carcinoma present ulcerated masses on the lower half of the face, while basal cell carcinoma are skin coloured, pearly white or coloured masses on the upper half of the face. Both can be cured by surgical method.

Melanoma, on the other hand, is the most lethal cancers. They are like coloured moles, which grow repidly,can bleed,are itchy or change colour. They have to be excised very early. Any doubtful lesion or mass on the skin which doesn’t itch, painless has to be checked to rule out skin cancer.

Skin cancer is diagnosed clinically and confirmed by histopathological examination. If you have doubt or if you suspect of skin cancer it is better to consult a dermatologist as soon as possible for quick management and treatment.