A Case of Metastatic Basal Cell Carcinoma Occured After Radiation Therapy / 대한피부과학회지

Basal cell epithelioma is a common neoplasm that rarely metastasizes. The majority of metastatic BCE originates from chronic large, ulcerated tumors which have been refractory to several modalities of therapy. It usually metastasizes to regional lymph nodes, lung, bone, skin and liuer but any other organs may b~e also involved. We report a case of metastatic basal cell carcinoma in a 73-year-old male who had a large ulcerated tumor mass on the left orbital and periorbital area for 13 years. He received radiation therapy 4 years ago, which seemed to cause exaggeration of the ulcerative mass ensuing left side eyeball destruction. About 1 year ago, he first noticed an 1 x 1cm sized hard palpable mass on the left side of neck. Cervicil CT shows 1 x 1cm sized central necrotic tumor mass on the left cervical lymph node. Biopsy specimens taken from the left periorbital area and the left cervical mass revealed typical histopathologic findings of the basal cell carcinoma. The diagnosis of metastatic basal cell carcinoma wa,, finally made on clinical, radiological and histopathological findings. The occurence of MBCC has been reported rarely in Korean literature, so we report, this case of the MBCC of cervical lymph node after radiation therapy.

The Effect of Various Topical Agents on Sunburn Cell Formation by Ultraviolet Irradiation / 대한피부과학회지

BACKGROUND: The sunburn cell is an abnormal keratinocyte of the skin induced by ultraviolet (UV) irradiation, and is used as an indicator of cell damage. The sunburn cell is consideredas an apoptotic cell which has been caused by UV irradiation, and many studies have been performed to understand the mechanism of photodamage in relation to apoptosis. The mechanism of photodamage by UV irradiation is still unclear. However, it is suggested that oxygen stress by reactive oxygen species produced by the UV rays may play an important role. OBJECTIVE: This study was a med at evaluating whether various antioxidants and sunscreen can prevent sunburn cell formation. In addition, we studied whether or not the sunburn cell is identical to an apoptotic cell stained using the TUNEL method. METHODS: White mice (ICR strain) were used to test the potency of various topical agents which are used in the prevention of sunburn cell formation; the agents were various antioxidants of L-ascorbic acid, tocopherol, catalase, a reduced form of glutathione (GSH), and sunscreen PABA (para-amino benzoic acid). Each agent was topically applied daily for 5 consecutive days on the dorsal skin of the ears. 300 mJ/cm of UV-B was irradiated on the ears 30 mins after the final applicaion, and skin samples were taken 24 hrs after that. The sunburn cells in the H & E stain were counted per 1 mm under the microscope. Also, the same sections for the sunburn cell study were stained by the TUNEL method using the ApopTag In Situ Apoptosis Detection Kit (Oncor, Inc.). RESULTS: The number of sunburn cells increased in a UV-B dosage-dependent. manner up to 300 mJ/cm2. The potency in the reduction of sunburn cell formation was as follows in order,PABA (0.37 +/- 0,5), GSH (0.87 +/- 0.5), ascorbic acid (1.62 +/- 0.85) and tocopherol (1.75 +/- 1.12). However catalase (2.93 +/- 1.56) did not show any protective effect. Also, the finding that sunburn cells were the same as TUNEL-positive cells confirmed the notion that the sunburn cell is a kind of apototic cell. CONCLUSION: A sunburn cell is a kind of apoptotic cell that may be caused by reactive oxygen species induced by UV-B irradiation, in view of the fact that sunburn cell formation was inhibited by the topical application of various antioxidants. But the result that physical protection by PABA has the most potent protective effect in relation to sun damage suggests that protection using a combined physical and biochemical approach is important in the development of new topical agents which will inhibit sundamage to the skin.