Treatment benefit of electrochemotherapy for superficial squamous cell carcinoma: a systematic review and single-arm meta-analysis.

OBJECTIVE: Treating aggressive superficial squamous cell carcinoma (SCC) poses challenges due to invasiveness. Palliative care is recommended for inoperable cases with extensive tumors near vital organs, risking disfigurement or functional impairment. Electrochemotherapy (ECT) is an emerging cutaneous tumor treatment, but its efficacy against superficial SCC remains uncertain. This study conducts a systematic review and single-arm meta-analysis to evaluate ECT's effectiveness against superficial SCC and provide current evidence for clinical practice. METHODS: Embase, PubMed and Cochrane Library were searched for studies up to May 2023. The random effects model analyzed complete response (CR) and partial response (PR), with subgroup assessment based on drug dosage, treatment response evaluation, tumor size, primary/recurrent status, and tumor location. RESULTS: Ten studies involving 162 patients and 208 tumors were included. Pooled CR and PR rates for ECT-treated superficial SCC were 66.5% (95% CI 48.4%-82.5%; I2 = 84%) and 20.3% (95% CI 10.5%-32.3%; I2 = 70%), respectively. Subgroup analysis indicated ECT's superiority in treating primary tumors (PR: 70%, CR: 30%) and tumors ≤ 3 cm (PR: 81.3%, CR: 10.1%) compared to recurrent tumors (PR: 56.7%, CR: 36.5%) and tumors > 3 cm (PR: 45.2%, CR: 34.4%). CONCLUSION: This single-arm meta-analysis confirms ECT's efficacy against superficial SCC, especially in primary tumors and those ≤ 3 cm in diameter. The study highlights the impact of tumor location and response evaluation on ECT's benefits, warranting further investigation through additional research.

Gene expression profiling analysis: the effect of hydrocortisone on keloid fibroblasts by bioinformatics.

BACKGROUND: We aimed to explore potential molecular basis of keloid formation and response mechanism of keloid to hydrocortisone (HC). METHODS: Transcriptional profile of GSE7890 which contained five normal scars with no HC treatment (NNHC), four normal scars treated with HC (NHC), five keloids with no HC treatment (KNHC), and five keloids treated with HC (KHC) samples was downloaded to identify differentially expressed genes (DEGs). Based on DEGs, hierarchical cluster analysis and pathway enrichment analysis were performed. Then, identification of characteristic pathway was performed, followed by calculation of pathway deviation score. RESULTS: Compared to NNHC group, total 1603 DEGs in NHC group, 895 DEGs in KHC group, and 832 DEGs in KNHC group were identified. Hierarchical cluster analysis revealed these four groups could be well distinguished. Total three pathways included cytokine-cytokine receptor interactions were significantly different between KNHC and NNHC groups. Besides, MAPK signaling pathway, endocytosis, and apoptosis were selected between KHC and KNHC groups. Genes of vascular endothelial growth factor C (VEGFC), tenascin C (TNC), and jun proto-oncogene (JUN) were selected as important DEGs in KHC, KNHC, and NHC groups, respectively. CONCLUSIONS: VEGF and TNC were, respectively, involved in KHC and KNHC in the mechanism of focal adhesion. JUN might be a potential molecular marker related to normal scar.

Surgical correction of residual facial deformity following conservative excision of a giant maxillary ossifying fibroma: A case report.

RATIONALE: Ossifying fibroma (OF) is a benign fibro-osseous lesion that can develop in the oral and maxillofacial region. OF is more common in females and has a marked predilection for the mandible, occurring rarely in the maxilla. Lesions grow slowly and are usually asymptomatic until growth produces an obvious swelling, pain, paresthesia, and facial deformity. With low rates of recurrence, treatment is usually curettage or resection. Very large lesions that invade other organs and that cannot be completely removed should be excised conservatively. PATIENT CONCERNS: We present a case of a 46-year-old female with a very large fibro-osseous lesion arising from the maxilla who was more concerned about the facial appearance and requested conservative treatment for economic reasons. DIAGNOSES: The pathological results based on conservative excision of the lesion confirmed the diagnosis of OF. INTERVENTIONS: We chose conservative excision via the Weber-Ferguson approach and followed up every 6 months. Facial deformity correction was performed 2 years postoperatively and right lower eyelid ectropion correction 3 years after the primary excision. OUTCOMES: The ectropion deformity in the right lower eyelid improved dramatically with a better facial appearance and no obvious swelling. LESSONS: Treatment programs for OF should be individualized based on the size, growth rate, invasion, and interference with facial function and esthetics. If lesions grow slowly, we suppose that it is feasible to excise conservatively when reconstruction cannot be performed due to esthetic and functional problems. Also regular postoperative follow-up is necessary to detect recurrence, and to improve facial appearance as required.

Pathogenic genes related to the progression of actinic keratoses to cutaneous squamous cell carcinoma.

BACKGROUND: Actinic keratosis (AK) is an incipient form of cutaneous squamous cell carcinoma (cSCC). Understanding the differentially expressed genes between AK and cSCC states would be helpful for the early prevention and treatment of cSCC. Consequently, this study aimed to screen the key genes associated with the progression of AK to cSCC. METHODS: The microarray dataset GSE45216 was downloaded from the Gene Expression Omnibus, which included 10 AK and 30 primary cSCC skin tissue samples. Differentially expressed genes (DEGs) in cSCC samples, compared to those in AK, were identified. Gene co-expression relationships were investigated, followed by miRNA prediction. The potential functions of the co-expressed genes were predicted by gene ontology (GO) and pathway enrichment analyses. In addition, the transcription factors and drug molecules, significantly related to the co-expressed genes, were obtained. RESULTS: A total of 320 DEGs were identified in the cSCC group, relative to the AK group. Moreover, 96 DEGs and 2,390 connecting edges were identified in the gene co-expression network. An miRNA regulatory network was constructed, including 96 DEGs and 16 miRNAs. In addition, three co-expression network modules were obtained; EIF4EBP1, SNX17, PRPF4, NXT1, and UBA5 were significant nodes in the modules. CONCLUSIONS: EIF4EBP1, SNX17, PRPF4, NXT1, and UBA5 may be the pathogenic genes contributing to the development of cSCC from AK.

Identification of the potential targets for keloid and hypertrophic scar prevention.

PURPOSE: We aimed to explore the molecular mechanism of pathologic skin scar and novel target for scar prevention. MATERIALS AND METHODS: Microarray data derived from keloid and hypertrophic scar were downloaded from ArrayExpress database. The common differentially expressed genes (DEGs) in keloid and hypertrophic scar samples were investigated by function and pathway analysis. The protein-protein interaction (PPI) network was constructed and the modules were screened. RESULTS: There were a total of 485 DEGs related with skin scar, including 247 up-regulated genes and 238 down-regulated genes. The up-regulated genes were closely related with Rho protein signal transduction, cytoskeleton organization, and Ras protein signal transduction related biological process. The down-regulated genes were enriched in sterol metabolic process, fatty acid metabolic process, and steroid metabolic process. PPI network was constructed with 680 protein pairs and modules 1 and 2 were screened out. Fos proto-oncogene (FOS) and early growth response 1 (EGR1) were significant transcriptional factors in the two modules. CONCLUSIONS: FOS and EGR1 may be potential targets for skin scar prevention.

Polycomb group proteins: Novel molecules associated with ultraviolet A-induced photoaging of human skin.

Epigenetic repressor polycomb group (PcG) proteins are thought to serve a role in a number of cellular processes, including carcinogenesis, senescence, apoptosis and DNA repair. In the present study, long-wave ultraviolet A (UVA) was used to irradiate human skin fibroblasts (HSFs) and embryonic skin fibroblasts (ESFs) in order to simulate photoaging of the skin. The results of cell proliferation, apoptosis, hyaluronic acid (HA) content and reverse transcription-quantitative polymerase chain reaction assays revealed that the expression levels of genes encoding key PcG proteins (BMI-1 and EZH2) were altered. In addition, the expression levels of these genes were associated with the expression of enzymes that regulate HA synthesis. Furthermore, the expression levels of PcG proteins differed between HSFs and ESFs, suggesting that PcG proteins serve a role in altering HA synthesis during the UVA-induced fibroblast aging process. This signaling pathway may represent a novel molecular mechanism regulating the photoaging of the skin. The findings of the present study provide important insights into the underlying mechanisms of photoaging of the human skin. Further studies are required to clarify the molecular mechanisms underling skin aging and to identify targets for the clinical treatment of photoaging.

Frontalis muscle flap suspension surgery for the treatment of blepharoptosis based on the anatomical study of the frontal muscle nerve in the third of the eyebrow / Cirugía de suspensión del colgajo muscular frontal en el tratamiento de blefaroptosis basado en el estudio anatómico del nervio del músculo occipitofrontal en el tercio de la ceja

The aim of this study was to investigate the course of the supraorbital nerve and temporal branch of the facial nerve, and to verify the clinical security of cutting the frontalis muscle flap to treat blepharoptosis in one-third of the eyebrow. Twenty cadavers were dissected. The relationship of the supraorbital nerve and the course of the frontotemporal branch of the facial nerve with the head and neck muscles was evaluated. Forty patients underwent clinical frontal muscular flap suspension surgery for the treatment of blepharoptosis. The postoperative curative and complication rates were determined. The courses of the supraorbital nerve and frontotemporal branch of the facial nerve were observed to determine a relatively safe area in one-third of the eyebrow. The average width of the zone was 25.0±3.5 mm. In forty cases, satisfactory results were achieved in correcting blepharoptosis by cutting the frontal muscular flap in the middle of eyebrow within the wide range of 17±2.1 mm. No secondary sensory and motor dysfunctions occurred. One-third of the eyebrow (eyebrow center, within 17±2.1 mm) was a relatively safe area and allowed for the prevention of damage to the temporal branch of the facial nerve inside the supraorbital nerve and supraorbital artery and the outer frontotemporal branch of the facial nerve.

El objetivo de este estudio fue investigar el curso del nervio supraorbital y la rama temporal del nervio facial, para verificar la seguridad clínica de cortar el vientre frontal del músculo occipitofrontal (colgajo de músculo frontal) para tratar la blefaroptosis en un tercio de la ceja. Veinte cadáveres fueron disecados. Se evaluó la relación del nervio supraorbital y el curso de la rama temporal del nervio facial con los músculos de la cabeza y cuello. Cuarenta pacientes fueron sometidos a la cirugía de confección del colgajo del músculo frontal para el tratamiento de la ptosis palpebral. Se determinaron las tasas de curación y de complicaciones postoperatorias. Se observaron los cursos del nervio supraorbital y la rama temporal del nervio facial para determinar un área relativamente segura en un tercio de la ceja. El ancho medio de la zona fue 25,0±3,5 mm. En cuarenta casos, se lograron resultados satisfactorios en la corrección de la blefaroptosis con el colgajo del músculo frontal en la mitad de la ceja en un rango de 17±2,1 mm. No se produjeron disfunciones sensoriales o motoras secundarias. El tercio de la ceja (centro del entrecejo, dentro de 17±2,1 mm) es una zona relativamente segura y permite la prevención de daños al ramo temporal del nervio facial ubicada medial al nervio supraorbitario y a la arteria supraorbitaria, además del ramo temporal lateral del nervio facial.

Changes of Transforming Growth Factor-ß1 and Extracellular Matrix in the Wound Healing Process of Rats Infected With Pseudomonas aeruginosa.

OBJECTIVE: This work aims to investigate the changes of transforming growth factor-ß1 (TGF-ß1) and extracellular matrix (ECM) proteins in rats with chronic skin ulcers infected with Pseudomonas aeruginosa. METHODS: Forty-eight female Wistar rats, aged 8 weeks, were randomly divided into a simple cutaneous wound group (group A) and a cutaneous wound plus Pseudomonas aeruginosa inoculation group (group B). On postoperative days 1, 3, 7, and 10, hematoxylin and eosin staining, real-time polymerase chain reaction, immunohistochemistry (IHC), and enzyme-linked immunosorbent assay (ELISA) methods were used to detect the epithelization rate, the mRNA, and the protein expressions of matrix metalloproteinases (MMP) 2, MMP-9, tissue inhibitors of metalloproteinases (TIMP)-1, and TGF-ß1. RESULTS: Compared with group A, the expression of TGF-ß1 and the epithelization rate were delayed in group B. At 3 days postoperation, the expression of collagen III was reduced in group B. At 7 days postoperation, MMP-9 had an extremely high expression but collagen and TIMP-1 had a low expression. Seven days after being infected with Pseudomonas aeruginosa, the expression of TGF-ß1 was reduced in the wounded skin of rats, and the dissolved ECM was much more than that synthesized in wounds. CONCLUSION: The authors' experiments suggest the wounded skin tissue infected with Pseudomonas aeruginosa delayed the expression of TGF-ß1, and then caused a change in the ECM biology relevant to fibrosis and regeneration, thus affecting the wound healing process.