Primary basosquamous carcinoma of the lower eyelid with ocular invasion A case report.

INTRODUCTION: Ocular invasion is extremely rare for a primary eyelid Basosquamous Carcinoma (BSC). It can however occur in neglected cases if the clinical signs are overseen and the BSC is misdiagnosed for a less aggressive skin carcinoma. MATERIALS AND METHODS: A 58-year-old man suffering from an inferior eyelid BSC that had been neglected for 7 years was referred to our clinic. A local infiltration of the maxillary sinus and the contents of the orbit by the tumor was discovered, and he was managed with a left orbital exenteration and resection of the involved orbital bone. A follow up was established. DISCUSSION: BSC is a rare type of skin malignancy which as an entity rests between Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), and its aggressive nature is often greater than that of the BCC and the SCC. Having no specific clinical features differentiating it from other BCC types, it can only be diagnosed by an adequate biopsy. Its early diagnosis is crucial in diminishing it's recurrence rate and it's metastatic potential. The standard therapeutical approach is the complete excision of the tumor, best performed by Mohs micrographic surgery. In cases of ocular infiltration, orbital exenteration is also usually necessary. CONCLUSIONS: Suspect, rapidly growing skin lesions should alert clinicians and an adequate biopsy should be performed. Regarding BSC, prompt and complete excision along with systemic exclusion of metastases and a close follow up are necessary. Adjuvant radiotherapy and chemotherapy could be beneficial to the patients. KEY WORDS: Basosquamous carcinoma (BSC), Basal cell carcinoma (BCC), Eyelid tumor, Ocular tissue invasion, Imiquimod, Maxillectomy, Metatypical basal cell carcinoma, Mohs micrographic surgery, Orbital exenteration, Orbit invasion, Squamous cell carcinoma (SCC), Vismodegib.

Socioeconomic status and substance use among Swiss young men: a population-based cross-sectional study.

BACKGROUND: Socioeconomic status (SES) is often inversely related to health outcomes and is likely to play a role in the use of psychoactive substances among young individuals, although little consensus exists on the association between SES and substance use. The purpose of the study was to determine the association of three SES indicators (perceived family income, education level of participants, and parental education level) with past year use of alcohol, tobacco, cannabis, other illicit drugs and non-medical use of prescription drugs (NMPD) among Swiss young men. METHODS: Population-based cross-sectional study of 5,702 men at mean age twenty. Associations between SES indicators and substance use were assessed with regression models adjusted for age and linguistic region. RESULTS: Participants with average or below average perceived family income were less likely to report any use of alcohol (OR = O.75) but more likely to use tobacco daily (OR = 1.31) and cannabis weekly (OR = 1.27) compared to those with perceived above average family income. Participants whose parents had only achieved obligatory education were less likely to engage in any use of alcohol (OR = 0.30), monthly risky single occasion drinking (RSOD, defined as 6 or more drinks per occasion) (OR = 0.48), any use of cannabis (OR = 0.53) and other illicit drugs (OR = 0.58), whereas those whose parents had only achieved secondary education were less at risk of engaging in cannabis (OR = 0.66 for any use and OR = 0.77 for more than once a week use) and other illicit drugs (OR = 0.74) use, compared to those whose parents had achieved tertiary education. Compared to participants who completed secondary or tertiary education, those who completed only obligatory education reported a higher risk of tobacco (OR = 1.18 for any use, OR = 1.31 for daily use), cannabis (OR = 1.23 for any use, OR = 1.37 for more than once a week use), and other illicit drugs (OR = 1.48) use. No association was found between NMPD and the studied SES variables. CONCLUSION: The relationship between SES and substance use was complex in this sample. Higher socioeconomic status was associated with more alcohol and other illicit drugs use, while lower socioeconomic status was related to more tobacco use. Education level and perceived family income may have different impacts on substance use and may vary by substance.