RESUMEN
Skin aging is the result of physiological changes determined by genetically driven processes and intrinsic factors, and exacerbated by a combination of multiple environmental factors, the main one being sun exposure. The effects of photoaging are particularly apparent on the face, where the appearance of aging signs can have a significant impact on the emotions conveyed and well-being. Photoprotection and facial skin care for managing photoaging signs are thus of particular importance for both physical and mental health. Countries, like Australia and Brazil, where the level of sun exposure is high and the populations have predominantly outdoor lifestyles, are particularly aware of the harms of photoaging and have implemented several measures to help reduce the risk of skin cancer in their populations. However, sun-seeking behaviours are difficult to change, and it takes time before interventions provide perceptible results. Australia still has some of the highest skin cancer incidence and mortality rates in the world. Solutions that target individuals can also be used for minimizing the clinical signs of facial aging and for improving skin quality, with the ultimate aim being not only to improve the appearance of the skin but also to mitigate the occurrence of pre-malignant and malignant lesions. This review summarizes the features of facial skin photoaging in photo-exposed populations, based on evidence gained from studies of Australian individuals, and discusses the various available solutions for skin photoaging, in particular those that are most popular in Brazil, which is a country with many years of experience in managing photoaged skin.
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Cosmecéuticos , Envejecimiento de la Piel , Luz Solar , Protectores Solares , Humanos , Brasil , Australia , Luz Solar/efectos adversos , Protectores Solares/uso terapéutico , Cosmecéuticos/uso terapéutico , Neoplasias Cutáneas/prevención & control , Neoplasias Cutáneas/etiología , CaraRESUMEN
PURPOSE: Palpebral congenital melanocytic nevi (PCMN) is a rare congenital skin lesion affecting the eyelids that can lead to cosmetic and psychological concerns and potential health risks such as malignancy. Several authors have analyzed therapeutical strategies to treat PCMN. However, there was no consensus in the literature. This systematic review aimed to evaluate the effectiveness, safety, and success of treatments of PCMN. METHODS: We conducted a systematic review following PRISMA guidelines from October 2022 to April 2023. We included all types of study designs that described or compared PCMN treatments and interventions, as well as histology, recurrence, adverse events, patient satisfaction, and malignant transformation. The search strategy was based on specific search words through the following databases: PubMed, Embase, Latin American and Caribbean Health Sciences Literature (Lilacs), Web of Science, and Scopus. Ongoing studies and gray literature studies were included. RESULTS: We analyzed 25 case reports with 148 participants. The effectiveness, success, and satisfaction with various treatments for PCMN depend on the specific treatment method and the individual patient's case. CONCLUSIONS: Most of the studies showed that surgical procedures (exeresis) are able to treat PCMN in the eyelid. The variability in outcomes emphasizes the importance of further research to better understand the most effective and safe approaches for treating congenital melanocytic nevi.
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Nevo Pigmentado , Neoplasias Cutáneas , Humanos , Nevo Pigmentado/cirugía , Nevo Pigmentado/congénito , Párpados/patología , Piel/patología , Neoplasias Cutáneas/terapia , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/patologíaRESUMEN
BACKGROUND: Incidence of skin cancer has been increasing among U.S. Hispanics, who often are diagnosed with larger lesions and at later stage disease. Behaviors to decrease exposure to ultraviolet radiation can reduce risk of skin cancer. We describe skin cancer prevention behaviors and psychosocial variables among Hispanic participants recruited into a skin cancer prevention trial. METHODS: Self-reported Hispanic participants from eight primary care clinics in Tampa, Florida and Ponce, Puerto Rico were recruited into a randomized controlled prevention trial. Information on demographics, sun-related behaviors, and psychosocial variables were collected before intervention materials were provided. Multivariable regression models were used to compare baseline sun-related behaviors and psychosocial variables across groups defined by geographic location and language preference. RESULTS: Participants reported low levels of intentional outdoor tanning, weekday and weekend sun exposure, and very low levels of indoor tanning. However, only a minority of participants practiced sun-protective behaviors often or always, and about 30% experienced a sunburn in the past year. Participants had low levels of recent worry and concern about skin cancer, modest levels of perceived risk and severity, and high levels of response efficacy and self-efficacy. When comparing across groups defined by geographic location and language preference, English-preferring Tampa residents (hereafter referred to as Tampeños) had the highest proportion who were sunburned (35.9%) and tended toward more risky behavior but also had higher protective behavior than did Spanish-preferring Tampeños or Puerto Ricans. Spanish-preferring Puerto Ricans had higher recent concern about skin cancer, comparative chance of getting skin cancer, and response efficacy compared to either English- or Spanish-preferring Tampeños. Spanish-preferring Tampeños had the highest levels of familism and recent distress about skin cancer. CONCLUSIONS: Our results mirror previous observations of low levels of sun-protective behavior among U.S. Hispanics compelling the need for culturally appropriate and translated awareness campaigns targeted to this population. Because Hispanics in Tampa and Puerto Rico reported modest levels of perceived risk and severity, and high levels of response efficacy and self-efficacy, interventions aiming to improve skin cancer prevention activities that are anchored in Protection Motivation Theory may be particularly effective in this population subgroup.
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Neoplasias Cutáneas , Quemadura Solar , Humanos , Puerto Rico/epidemiología , Florida/epidemiología , Rayos Ultravioleta , Conductas Relacionadas con la Salud , Neoplasias Cutáneas/prevención & control , Neoplasias Cutáneas/etiología , Quemadura Solar/prevención & control , Hispánicos o Latinos/psicologíaRESUMEN
BACKGROUND: Actinic keratosis (AK) is a skin condition associated with age, sun exposure, and immunosuppression. Certain drugs, such as photosensitizing medications and calcium channel blockers (CCBs), have been linked to AK. This study explores the impact of individual, behavioral, and exposure factors on the severity of AKs on the face and scalp. METHODS: A multicenter cross-sectional study was conducted on immunocompetent individuals with at least one AK on their face or scalp and assessed demographic factors, sun exposure and protection, history of skin cancer, and medication use within the last 6 months. The primary outcome was the Actinic Keratosis Area and Severity Index (AKASI) score, and a hierarchical generalized linear model was used to evaluate the variation in AKASI scores, adjusting for gender, age, and skin phototype. RESULTS: Two hundred seventy subjects between 39 and 92 years were evaluated. The majority had phototype I or II (77%), male gender (51%), personal history of skin cancer (55%), and low adherence to sunscreen use (29%). The use of photosensitizing medications was reported by 61%. Through multivariate analysis, older age (ßSE = 0.14; P < 0.01), lighter skin phototype (ßSE = 0.15; P = 0.01), history of skin cancer (ßSE = 0.12; P < 0.01), sunburning (ßSE = 0.12; P < 0.01), and use of CCBs (ßSE = 0.11; P = 0.02) were identified as independent risk factors for AK severity. Photosensitizing drugs were not identified as risk factors. CONCLUSION: Older age, lower skin phototype classifications, and a personal history of skin cancer were confirmed as severity risk factors for AK, while the use of CCBs was associated with more severe AK.
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Queratosis Actínica , Neoplasias Cutáneas , Humanos , Masculino , Queratosis Actínica/tratamiento farmacológico , Bloqueadores de los Canales de Calcio/uso terapéutico , Estudios Transversales , Cuero Cabelludo , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Resultado del TratamientoRESUMEN
Endogenous photosensitizers play a critical role in both beneficial and harmful light-induced transformations in biological systems. Understanding their mode of action is essential for advancing fields such as photomedicine, photoredox catalysis, environmental science, and the development of sun care products. This review offers a comprehensive analysis of endogenous photosensitizers in human skin, investigating the connections between their electronic excitation and the subsequent activation or damage of organic biomolecules. We gather the physicochemical and photochemical properties of key endogenous photosensitizers and examine the relationships between their chemical reactivity, location within the skin, and the primary biochemical events following solar radiation exposure, along with their influence on skin physiology and pathology. An important take-home message of this review is that photosensitization allows visible light and UV-A radiation to have large effects on skin. The analysis presented here unveils potential causes for the continuous increase in global skin cancer cases and emphasizes the limitations of current sun protection approaches.
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Fármacos Fotosensibilizantes , Neoplasias Cutáneas , Humanos , Piel/efectos de la radiación , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Rayos Ultravioleta , LuzRESUMEN
Background People affected by Human Immunodeficiency Virus (HIV), are burdened by a higher risk of developing malignancies including non-melanoma skin cancer (NMSC) and melanoma skin cancer. Objective To evaluate the association of HIV with melanoma and NMSC at a University Hospital. Methods This is a cross-sectional retrospective study of HIV-infected and a matched comparison group, analyzing the associations between skin cancer and HIV infection. Results Compared to the HIV-uninfected, HIV-infected had 80% association with skin cancer (CI 95%: 1.3-2.4, P = 0.001) The risk was 45-fold higher by patients" age (CI 95%: 3.3-15.9: P = 0.001). When adjusted for patient age, sex and race, the risk was 6.4 fold ligher of having cancer if compared to the others (CI 95%: 49-84, P = 0.001). Melanoma was not found in HIV-infected. Conclusion With this study, we have demonstrated that HIV-infected patients have an increased risk of BCC and SCC. Preventive dermatologic management is pivotal in the care of immunosuppressed patients. These patients must undergo the dermatological examination annually and should receive extensive counseling regarding sun avoidance, use of sunscreens,and sun-protective clothing.
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Carcinoma Basocelular , Carcinoma de Células Escamosas , Infecciones por VIH , Melanoma , Neoplasias Cutáneas , Humanos , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Carcinoma Basocelular/complicaciones , Estudios Retrospectivos , Estudios Transversales , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/etiología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Melanoma/diagnóstico , Melanoma/epidemiología , Melanoma/complicaciones , Factores de RiesgoRESUMEN
BackgroundActinic keratosis (AK) is a skin condition associated with age, sun exposure,and immunosuppression. Certain drugs, such as photosensitizing medications and calciumchannel blockers (CCBs), have been linked to AK. This study explores the impact ofindividual, behavioral, and exposure factors on the severity of AKs on the face and scalp.MethodsA multicenter cross-sectional study was conducted on immunocompetentindividuals with at least one AK on their face or scalp and assessed demographic factors,sun exposure and protection, history of skin cancer, and medication use within the last6 months. The primary outcome was the Actinic Keratosis Area and Severity Index(AKASI) score, and a hierarchical generalized linear model was used to evaluate thevariation in AKASI scores, adjusting for gender, age, and skin phototype.ResultsTwo hundred seventy subjects between 39 and 92 years were evaluated. Themajority had phototype I or II (77%), male gender (51%), personal history of skin cancer(55%), and low adherence to sunscreen use (29%). The use of photosensitizingmedications was reported by 61%. Through multivariate analysis, older age (bSE=0.14;P<0.01), lighter skin phototype (bSE=0.15;P=0.01), history of skin cancer (bSE=0.12;P<0.01), sunburning (bSE=0.12;P<0.01), and use of CCBs (bSE=0.11;P=0.02)were identified as independent risk factors for AK severity. Photosensitizing drugs were notidentified as risk factors.ConclusionOlder age, lower skin phototype classifications, and a personal history of skincancer were confirmed as severity risk factors for AK, while the use of CCBs wasassociated with more severe AK
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Humanos , Masculino , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Neoplasias Cutáneas/epidemiología , Queratosis Actínica/tratamiento farmacológico , Cuero Cabelludo , Bloqueadores de los Canales de Calcio/uso terapéutico , Estudios Transversales , Resultado del TratamientoRESUMEN
BACKGROUND: Numerous pathogenic complications affect the skin and are preventable, such as skin cancer, microbial diseases, dermal irritations, and anaphylaxis. In this context, the correct use of skin products, including sunscreens and child makeup, is important for promoting skin health and preventing adverse health conditions. OBJECTIVE: This study aimed to use educational and playful activities to promote skin health for students. METHODS: This project was development in a municipal elementary school (Rio Grande do Sul State, Brazil). The interventions were divided into three moments. In the first day, a questionnaire was applied to find out the students' previous knowledge about photoprotection. On the second day, an intervention lecture was held addressing issues related to photoprotection and the use of makeup. Finally, we played educational and ludic games and after, the questionnaire was reapplied. This was done to evaluate these actions' effectiveness regarding photoprotection and record their habits by applying a structured questionnaire at the beginning and end of the activities. RESULTS: Students received positively and interacted significantly during all activities performed. Regarding the impact of this study, we observed that ten times more students considered using sunscreen as something important at the end of the project, as only 8.16% of participants knew what skin cancer was at the beginning of the experiment. After the educational activities, this number rose to 72.37%, and 92.86% of girls reported wearing makeup, with more than half being expired or unlabeled and only 21.6% being appropriate for child use. CONCLUSION: The measures demonstrated effectively improve students' level of information regarding skin cancer prevention and indicated that inappropriate habits concerning makeup use in childhood are quite common, demonstrating the importance of educational interventions for children, since can improve your health.
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Conocimientos, Actitudes y Práctica en Salud , Neoplasias Cutáneas , Niño , Femenino , Humanos , Protectores Solares/uso terapéutico , Promoción de la Salud , Estudiantes , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/prevención & control , Neoplasias Cutáneas/tratamiento farmacológico , Encuestas y CuestionariosRESUMEN
Complementary and alternative medicine or therapies (CAM) are frequently used by skin cancers patients. Patient's self-administration of CAM in melanoma can reach up to 40%-50%. CAMs such as botanical agents, phytochemicals, herbal formulas ("black salve") and cannabinoids, among others, have been described in skin cancer patients. The objective of this review article was to acknowledge the different CAM for skin cancers through the current evidence, focusing on biologically active CAM rather than mind-body approaches. We searched MEDLINE database for articles published through July 2022, regardless of study design. Of all CAMs, phytochemicals have the best in vitro evidence-supporting efficacy against skin cancer including melanoma; however, to date, none have proved efficacy on human patients. Of the phytochemicals, Curcumin is the most widely studied. Several findings support Curcumin efficacy in vitro through various molecular pathways, although most studies are in the preliminary phase. In addition, the use of alternative therapies is not exempt of risks physicians should be aware of their adverse effects, interactions with standard treatments, and possible complications arising from CAM usage. There is emerging evidence for CAM use in skin cancer, but no human clinical trials support the effectiveness of any CAM in the treatment of skin cancer to date. Nevertheless, patients worldwide frequently use CAM, and physicians should educate themselves on currently available CAMs.
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Terapias Complementarias , Curcumina , Melanoma , Neoplasias Cutáneas , Humanos , Curcumina/efectos adversos , Terapias Complementarias/efectos adversos , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/etiología , Melanoma/tratamiento farmacológico , Melanoma/etiologíaRESUMEN
Bee pollen is recommended as dietary supplement due to immunostimulating functions including antioxidant, anti-inflammatory and anti-carcinogenic properties. Nevertheless, the effectiveness of such properties is still not well understood. As diet can be associated with animal performance, microbiota modulation and potentially factor for cancer, this study aimed to analyze if bee pollen could influence growth, gut microbial and skin cutaneous melanoma development in zebrafish. Control diets based on commercial flakes and Artemia were compared with the same diet supplemented with bee pollen. Fish weight gain, increased length, intestinal bacteria metagenomics analysis, serum amyloid A gene expression and cutaneous melanoma transplantation assays were performed. Bee pollen affected microbiota composition and melanoma development. Differential abundance revealed higher abundance in the control group for Aeromonadaceae family, Aeromonas and Pseudomonas genus, A. sobria, A. schubertii, A. jandaei and P. alcaligenes species compared with pollen diet group. Pollen group presented higher abundance for Chromobacterium genus and for Gemmobacter aquaticus, Flavobacterium succinicans and Bifidobacterium breve compared with control group. Unexpectedly, fish fed with bee pollen showed higher tumor growth rate and larger tumor size than control group. This is the first study to report intestinal microbial changes and no protective cancer properties after bee pollen administration.
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Microbioma Gastrointestinal , Melanoma , Neoplasias Cutáneas , Animales , Abejas , Dieta , Melanoma/etiología , Polen , Neoplasias Cutáneas/etiología , Pez Cebra , Melanoma Cutáneo MalignoRESUMEN
Skin cancer incidence has been increasing worldwide, representing a particularly high burden for populations of European ancestry. Outdoor and indoor tanning using ultraviolet (UV) radiation devices are major risk factors for skin cancer. While tanning behaviours can be modified by targeted interventions to reduce skin cancer rates, there is insufficient evidence on the motivations for tanning preferences and their relationship with pigmentation phenotypes. The present observational and genetically-informed study investigates motives for tanning and the role that pigmentation phenotypes play on outdoor and indoor tanning behaviour in British young adults. This study included 3722 participants from the Avon Longitudinal Study of Parents and Children in South West England, with data on pigmentation features, tanning ability and preferences, and SNP genotypes. Liking to tan and outdoor tanning were strongly influenced by pigmentary traits and tanning ability. However, the association of these phenotypes with UV indoor tanning was weaker. Our results provide evidence to support the implementation of skin cancer preventative interventions that consider individual biological characteristics and motives for undergoing outdoor and indoor tanning.
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Neoplasias Cutáneas , Baño de Sol , Humanos , Estudios Longitudinales , Fenotipo , Pigmentación , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/genética , Adulto JovenRESUMEN
OBJECTIVE: The incidence of malignant eyelid tumors is considerably increasing, even in young patients. The purpose of this study was to identify particularities in individuals under 40 years of age affected by eyelid malignancies. METHODS: Clinical charts of patients under 40 years of age who underwent eyelid tumor excision from 2014 to 2020 in two reference centers, one in Brazil and one in the USA, were reviewed. Demographic and outcome measures included: age, gender, skin phototype, comorbidities, diagnosis, time until diagnosis, lesion location, recurrence and metastasis. In addition, associated characteristics, including chronic sun exposure, intentional tanning (outdoor or artificial), history of smoking, use of sunscreen, family history of skin cancer and exposure to pesticides or herbicides, were reviewed. RESULTS: A total of 24 malignant eyelid tumors from 17 patients were identified. Twelve (70.6%) patients were female, and the most prevalent tumor was basal cell carcinoma (62.5%). Three (17.6%) patients had xeroderma pigmentosum and presented with multiple lesions. Family history of skin cancer was reported by 47% of patients. Prolonged sun exposure was reported by 41.2%; history of smoking and intentional tanning were reported by 23.5 and 17.6%, respectively, and might have played a role in carcinogenesis. CONCLUSIONS: Although uncommon in young subjects, eyelid malignancies present some peculiarities in individuals under 40 years of age. Our results suggest that women with family history of skin cancer and history of chronic exposure to ultraviolet radiation are at risk. Association with genetic syndromes is also relevant among younger age groups.
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Neoplasias Óseas , Carcinoma Basocelular , Neoplasias de los Párpados , Neoplasias Cutáneas , Xerodermia Pigmentosa , Neoplasias Óseas/complicaciones , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/epidemiología , Neoplasias de los Párpados/etiología , Femenino , Humanos , Masculino , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Rayos Ultravioleta/efectos adversos , Xerodermia Pigmentosa/complicacionesRESUMEN
Photodynamic therapy (PDT) is an anticancer treatment involving administration of a tumour-localizing photosensitizer, followed by activation by light of a suitable wavelength. In previous work, we showed that the natural anthraquinone (AQ) Parietin (PTN), was a promising photosensitizer for photodynamic therapy of leukemic cells in vitro. The present work aimed to analyze the photosensitizing ability of PTN in the mammary carcinoma LM2 cells in vitro and in vivo in a model of subcutaneously implanted tumours. Photodynamic therapy mediated by parietin (PTN-PDT) (PTN 30 µM, 1 h and 1.78 J/cm2 of blue light) impaired cell growth and migration of LM2 cells in vitro. PTN per se induced a significant decrease in cell migration, and it was even more marked after illumination (migration index was 0.65 for PTN and 0.30 for PTN-PDT, *p < 0.0001, ANOVA test followed by Tukey's multiple comparisons test), suggesting that both PTN and PTN-PDT would be potential inhibitors of metastasis. Fluorescence microscopy observation indicated cytoplasmic localization of the AQ and no fluorescence at all was recorded in the nuclei. When PTN (1.96 mg) dissolved in dimethyl sulfoxide was topically applied on the skin of mice subcutaneously implanted with LM2 cells, PTN orange fluorescence was strongly noticed in the stratum corneum and also in the inner layers of the tumour up to approximately 5 mm. After illumination with 12.74 J/cm2 of blue light, one PDT dose at day 1, induced a significant tumour growth delay at day 3, which was not maintained in time. Therefore, we administered a second PTN-PDT boost on day 3. Under these conditions, the delay of tumour growth was 28% both on days 3 and 4 of the experiment (*p < 0.05 control vs. PTN-PDT, two-way ANOVA, followed by Sidak's multiple comparisons test). Histology of tumours revealed massive tumour necrosis up to 4 mm of depth. Intriguingly, a superficial area of viable tumour in the 1 mm superficial area, and a quite conserved intact skin was evidenced. We hypothesize that this may be due to PTN aggregation in contact with the skin and tumour milieu of the most superficial tumour layers, thus avoiding its photochemical properties. On the other hand, normal skin treated with PTN-PDT exhibited slight histological changes. These preliminary findings encourage further studies of natural AQs administered in different vehicles, for topical treatment of cutaneous malignancies.
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Antraquinonas/farmacología , Emodina/farmacología , Luz , Fotoquimioterapia , Fármacos Fotosensibilizantes/farmacología , Neoplasias Cutáneas/terapia , Animales , Antraquinonas/química , Línea Celular Tumoral , Movimiento Celular/efectos de los fármacos , Movimiento Celular/efectos de la radiación , Proliferación Celular/efectos de los fármacos , Proliferación Celular/efectos de la radiación , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Emodina/química , Femenino , Ratones , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/química , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/metabolismo , Resultado del Tratamiento , Células Tumorales CultivadasRESUMEN
Melanoma is the most aggressive and fatal type of skin cancer due to being highly proliferative. Acetylsalicylic acid (ASA; Aspirin) and salicylic acid (SA) are ancient drugs with multiple applications in medicine. Here, we showed that ASA and SA present anticancer effects against a murine model of implanted melanoma. These effects were also validated in 3D- and 2D-cultured melanoma B16F10 cells, where the drugs promoted pro-apoptotic effects. In both in vivo and in vitro models, SA and ASA triggered endoplasmic reticulum (ER) stress, which culminates with the upregulation of the pro-apoptotic transcription factor C/EBP homologous protein (CHOP). These effects are initiated by ASA/SA-triggered Akt/mTOR/AMPK-dependent activation of nitric oxide synthase 3 (eNOS), which increases nitric oxide and reactive oxygen species production inducing ER stress response. In the end, we propose that ASA and SA instigate anticancer effects by a novel mechanism, the activation of ER stress.
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Apoptosis/efectos de los fármacos , Aspirina/farmacología , Estrés del Retículo Endoplásmico/efectos de los fármacos , Melanoma/etiología , Melanoma/patología , Óxido Nítrico/metabolismo , Ácido Salicílico/farmacología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/patología , Proteínas Quinasas Activadas por AMP/metabolismo , Animales , Antineoplásicos , Aspirina/uso terapéutico , Línea Celular Tumoral , Modelos Animales de Enfermedad , Masculino , Melanoma/tratamiento farmacológico , Ratones Endogámicos C57BL , Terapia Molecular Dirigida , Óxido Nítrico Sintasa de Tipo III/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Ácido Salicílico/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Serina-Treonina Quinasas TOR/metabolismo , Regulación hacia Arriba/efectos de los fármacosAsunto(s)
Metformina/farmacología , Estrés Oxidativo/efectos de los fármacos , Traumatismos Experimentales por Radiación/prevención & control , Radiodermatitis/prevención & control , Proteína p53 Supresora de Tumor/metabolismo , Aldehídos/metabolismo , Animales , Carcinogénesis/efectos de los fármacos , Carcinogénesis/inmunología , Carcinogénesis/efectos de la radiación , Daño del ADN/inmunología , Daño del ADN/efectos de la radiación , Femenino , Humanos , Melanoma/etiología , Melanoma/patología , Melanoma/prevención & control , Metformina/uso terapéutico , Ratones , Estrés Oxidativo/genética , Estrés Oxidativo/inmunología , Traumatismos Experimentales por Radiación/inmunología , Traumatismos Experimentales por Radiación/patología , Radiodermatitis/inmunología , Radiodermatitis/patología , Piel/efectos de los fármacos , Piel/inmunología , Piel/patología , Piel/efectos de la radiación , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/prevención & control , Tirosina/análogos & derivados , Tirosina/metabolismo , Rayos Ultravioleta/efectos adversosRESUMEN
Introducción: La insuficiencia venosa crónica es el conjunto de síntomas y signos derivados de una hipertensión venosa en los miembros inferiores debido a un mal funcionamiento valvular de los sistemas venosos. Se han asociado varias complicaciones a esta entidad, una de ellas es el pseudosarcoma de Kaposi, enfermedad rara y caracterizada por una proliferación reactiva vascular, con lesiones cutáneas similares a las del sarcoma de Kaposi. Objetivo: Describir el proceso diagnóstico de una paciente con pseudosarcoma de Kaposi tipo Mali unilateral como complicación de la insuficiencia venosa crónica. Presentación del caso: Se presenta una paciente femenina, piel blanca, de 51 años de edad, con lesiones cutáneas de aproximadamente 9 años de evolución, tipo placas eritematomarronáceas y papuloescamocostrosas, en el miembro inferior derecho, que progresivamente fueron extendiéndose; la paciente presentaba además insuficiencia venosa crónica. Se diagnosticó pseudosarcoma de Kaposi tipo Mali unilateral, teniendo en cuenta, fundamentalmente, los antecedentes patológicos personales, el examen clínico realizado, la biopsia de la lesión, la inmunohistoquímica para anticuerpos CD 34 y el dúplex venoso de miembro inferior derecho. Se indicó terapia compresiva de la extremidad y ungüento esteroideo en lesiones, con mejoría de estas. Conclusiones: Una de las complicaciones asociadas a la insuficiencia venosa crónica es el pseudosarcoma de Kaposi. En esta rara entidad cutánea el estudio histopatológico y la inmunohistoquímica desempeñan un papel muy importante para su correcto diagnóstico y diferenciación del sarcoma de Kaposi, principal diagnóstico diferencial a tener en cuenta(AU)
Introduction: Chronic venous insufficiency is the set of symptoms and signs derived from venous hypertension in the lower limbs due to a valvular malfunction of the venous system. Several complications have been associated with this entity; one of them is Pseudo-Kaposi's sarcoma, a rare disease characterized by reactive vascular proliferation with skin lesions similar to those of Kaposi's sarcoma. Objective: To describe the diagnostic process of a patient with unilateral Mali-type Pseudo-Kaposi's sarcoma as a complication of chronic venous insufficiency. Case presentation: Fifty-one-year-old white female patient with about 9-year history of brownish erythematosus-type and squamous, crusty plaque-like skin lesions in the right lower limb that were progressively extending. The patient also presented chronic venous insufficiency. Unilateral Mali-type Pseudo-Kaposi's sarcoma was diagnosed, mainly considering the personal pathological antecedents, the clinical examination performed, the biopsy of the lesion, the immunohistochemistry for CD34 antibodies and the venous duplex imaging of the right lower limb. Compressive therapy of the limb and steroid ointment was indicated for the lesions, with improvement of the condition. Conclusions: Pseudo-Kaposi's sarcoma is one of the complications associated with chronic venous insufficiency. In this rare skin entity, the histopathological study and immunohistochemistry play a very important role in the correct diagnosis and differentiation of Kaposi's sarcoma, being this the main differential diagnosis to take into account(AU)
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Humanos , Femenino , Persona de Mediana Edad , Sarcoma de Kaposi/etiología , Neoplasias Cutáneas/etiología , Insuficiencia Venosa/complicaciones , PiernaRESUMEN
BACKGROUND: The main risk factor associated with basal cell carcinomas (BCCs) is believed to be exposure to ultraviolet radiation (UVR). In the case of lower limb BCC, the frequency is higher in women, possibly because of greater exposure of the leg to UVR. Chronic venous insufficiency (CVI), also more common in women, may have some association with leg BCCs. METHODS: We retrospectively evaluated the histopathological features of leg BCCs removed between 1993 and 2017 in a tertiary referral center. The patients' clinical data were obtained from medical records, considering, in particular, CVI. RESULTS: We selected 149 patients with leg BCCs, predominately occurring in elderly Caucasian women. Of those, 71 had a clinical diagnosis of CVI in whom the clinical tumor size and frequency of recurrences were significantly higher than patients without CVI. There was an association between clinical diagnosis of CVI and histological findings of (1) follicular induction in epidermis and (2) distal sweat duct hyperplasia. CONCLUSIONS: CVI, besides the already known UVR exposure, is probably associated with leg BCCs and may determine a worse BCC course.
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Carcinoma Basocelular/etiología , Pierna/irrigación sanguínea , Neoplasias Cutáneas/etiología , Insuficiencia Venosa/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/patología , Carcinoma Basocelular/cirugía , Enfermedad Crónica , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Factores de Tiempo , Resultado del Tratamiento , Carga Tumoral , Insuficiencia Venosa/diagnósticoRESUMEN
BACKGROUND The treatment of inflammatory bowel disease aims to induce and maintain disease remission, avoid complications, and restore quality of life. The treatments include the use of immunosuppressants and biological therapy. Despite the effectiveness of these treatments in controlling disease activity and in limiting complications, there remains an increased risk of developing malignancies. CASE REPORT A 70-year-old male patient with ulcerative colitis who had pancolitis was initially treated with mesalazine. In 2010, the medication was changed to azathioprine due to clinical disease activity. The patient demonstrated clinical and endoscopic response to the medication, but presented recurrent facial lesions identified as non-melanoma skin cancer in 2014, 2015, and 2016. Azathioprine was discontinued and anti-TNF therapy was started, but no satisfactory clinical or endoscopic response was observed. The patient developed hematuria and a ureter tumor was found with subsequent ureteronephrectomy. Moreover, the patient underwent total colectomy with ileostomy as a treatment for refractory ulcerative colitis. CONCLUSIONS Immunosuppressive therapy can facilitate the development of malignant neoplasms, accelerate tumor growth, and favor the onset of metastases. The types of tumors most associated with its use are lymphoproliferative tumors and non-melanoma skin cancer. The benefits of adequate control of inflammatory bowel disease are clear and the use of immunosuppressants should not be limited by these potential adverse outcomes; however, the risk-benefit profile of immunosuppression should always be assessed on a case-by-case basis.