Different Anatomical Distribution of Basal Cell Carcinoma Subtypes in Iranian Population: Association between Site and Subtype

BACKGROUND: Basal cell carcinoma (BCC) is the most common type of human cancer. Despite the high prevalence of these tumors, there is a lack of reliable epidemiological data in some regions including Iran. OBJECTIVE: To assess the relationship between BCC subtypes and anatomical distribution in the Iranian population. METHODS: There were 876 patients with a single BCC enrolled in this study (March 2007 to March 2010; Razi Dermatology Center, Tehran, Iran). RESULTS: Among 876 patients, 544 were males and 332 females. Of the lesions, 43% were nodular, 32.4% mixed type, 3% superficial and rest of other subtypes. In the lesion location, 58.2% were on the face, 29.2% on scalp, 6.2% on ears, 2.3% on neck, 1.7% on trunk and 1.3% on the extremities. There was no significant difference between male and female in the BCC subtypes, but anatomical distribution of the tumor was different (p=0.002). Most of the trunk-arising BCCs were superficial, and most of the facial BCCs were nodular subtype. Also, most of the BCC subtypes occurred in patients between 40 to 80 years old and mostly on the face and scalp (p=0.04). However, superficial BCCs mostly occurred in younger patients over others (p=0.001). CONCLUSION: Subtype is associated with a site, independent of gender or age. Also BCCs occurring on the trunk are mostly of the superficial subtype.

Incidence of incomplete excision in surgically treated cutaneous squamous cell carcinoma and identification of the related risk factors

Squamous cell carcinoma [SCC] is the second most common type of skin cancer with potential risks for metastasis and recurrence if left untreated or incompletely excised. This case series study was designed to determine the frequency of incompletely excised SCCs and the related risk factors. A total of 273 SCCs [253 patients] excised in Razi dermatology hospital of Tehran from 2006-2008, were evaluated and were analyzed by Chi-square or t-test. The incidence of incomplete excision was 17.58% and deep margin involvement was observed in 73% of lesions. Risk factors associated with incomplete excision of SCCs were being female, location of the tumors [in particular the lesions on lateral canthus, upper lip, foot, forehead, cheek, neck, nose and ear], large lesions and grafting method of repair. There was no statistically significant difference for the age, degree of histological differentiation, childhood history of radiotherapy for tinea capitis and the type of anesthesia. More care should be taken for high risk SCCs as complete excision avoids potential risk of recurrence and metastasis

Microscopic nikolsky's sign: Is it useful for diagnosis of pemphigus vulgaris?

Pemphigus vulgaris [PV] is an autoimmune blistering disease, caused by autoantibodies against desmoglein [Dsg] 3 and/or Dsg 1 which induce the loss of adhesion between keratinocytes. Nikolsky's sign is the ability to induce peripheral extension of a blister as a consequence of applying lateral pressure to the border of on intact blister. If the weakening of the intercellular adhesion is present but not marked, then the damage may be demonstrated only microscopically [microscopic Nikolsky's sign and can increase the sensitivity of the histopathological studies. We studied 40 patients and divided them randomly into two groups [A, B]. Group A were subjected to the tangential pressure over the perilesional skin before a biopsy specimen was taken from that site; group B patients were subjected to a biopsy without the tangential pressure technique. Histopathological changes of pemphigus vulgaris were present in 30% of the patients in group A and 5% of the patients in group B. They were not statistically different. The presence of microscopic Nikolsky's sign was significantly higher in patients with generalized disease. Microscopic Nikolsky sign can increase the sensitivity of histologic diagnosis of PV

epidemiologic study on basal cell carcinoma and its related risk factors in patients referred to Razi hospital tumor clinic in autumn 2005-2006

Basal cell carcinoma [BCC] is the most common cutaneous malignancy UV light is an important risk factor for BCC, as well as X-ray and other ionizing radiations. The aim of this study was evaluation and risk factor assessment of BCC cases referred to Razi hospital tumor clinic. Patients referred from general clinics with skin biopsies consistent with Basal Cell Carcinoma were enrolled. A questionnaire including epidemiologic data, risk factor exposure and specification of skin lesions was completed for each patient. From October 2005 to October 2006, a total of 476 patients with cutaneous malignancy referred to Tumor clinic of Razi hospital. Of them, 367 patients had BCC. 215 were male [58%] and 152 were female [42%]. Mean age of patients was 62 [ +/- 12.7] and 62 [ +/- 13.4] years for men and women, respectively. The most common risk factors for BCC were radiotherapy and chronic sun exposure. The most common tumor sites were scalp, nose and ears. Of different clinico-pathologic types, nodulo-ulcerative type was the most common. It seems that radiotherapy is an important risk factor in Iranian BCC patients and it is useful to have a screening program for case finding and treating patients in early stages

[Non-Hodgkin lymphoma in a 13-year-old boy with provisional hypomyopathic juvenile dermatomyositis]

Provisional hypomyopathic juvenile dermatomyositis is a subgroup of clinically amyopathic juvenile dermatomyositis provisional. The diagnostic criteria include: Classic dermatomyositis skin lesions - which have to be confirmed by biopsy, no involvement of proximal muscles, subclinical involvement of these muscles and normal level of muscle enzymes. These criteria should be present for a minimum of 6 months and maximum of 24 months. Here a 13-year-old boy is presented who developed non-Hodgkin lymphoma 15 months after the diagnosis of his dermatomyositis