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Skin cancer can be of 2 types mainly. They are malignant melanoma and non-malignant melanoma. Skin cancer mainly occurs due to exposure of sunlight. Ozone depletion and chemical exposures are other factors involved in precipitating skin cancer. Mutations of p53 gene are involved in UV- induced carcinogenesis. P53 gene acts vital in development of SCC. So, prevention of skin cancer is the main criteria. Regular application of sunscreens could be one of the primary prevention. The purpose of present review is to outline types, pathogenesis, diagnosis, prevention and treatment of skin cancer.
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S. Ramya Silpa et al. Int. Res. J. Pharm. 2013, 4 (8)
Page 83
Review Article
S. Ramya Silpa1*, Chidvila V2
1M. Pharmacy, Pharmacology, Sai Coral County, Aravinda nagar, Anantapur, India, Pharmacology, Assistant professor, St. Marys College of Pharmacy, St. Francis Street, Secunderabad, India
*Corresponding Author Email:
Article Received on: 19/07/13 Revised on: 20/07/13 Approved for publication: 12/08/13
DOI: 10.7897/2230-8407.04814
IRJP is an official publication of Moksha Publishing House. Website:
© All rights reserved.
Skin cancer can be of 2 t ypes mainly. They are malignant melanoma a nd non-malignant melanoma. Skin cancer mainly occurs due to exposure of sunlight.
Ozone depletion and chemical exposures are other factors involved in precipitating skin cancer. Mutations of p53 gene are involved in UV- induced
carcinogenesis. P53 gene acts vital in development of SCC. So, prevention of skin cancer is the main criteria. Regular application of sunscreens could be one
of the primary preventi on. The purpose of present review is to outli ne types, pathogenesis, diagnosis, prevention and treatment of skin cancer.
Keywords: Skin cancer, BCC, SCC, melanoma, UV-light.
The skin is an organ that separates human body and
environment. It acts as a barrier that protects body against
UV-radiation, toxic substances, infections.1 Epidermis is the
outermost layer of skin. Keratinocytes, dendritic
melanocytes, Merkel and Langerhans cells are different type
of cells present in epidermis. The underlying dermis contains
connective tissue with antigen presenting dermal dendritic
cells, mast cells and memory T-cells.2,3
Skin Cancer
The incidence of skin cancer in people has been increasing
day by day. The main reason for skin cancer is due to UV-
exposure because large amounts of UV-radiation reach
earths surface due to depletion of ozone layer.4,5 Skin cancer
can be of two types mainly. 1. Malignant melanoma 2. Non
malignant melanoma; which is divided into BCC and SCC;
BCC and SCC mainly occur due to chronic exposure of UV-
sunlight. MM may be due to intense sun exposure and history
of sun burn.6,7 80-85 % of non-melanoma skin cancers are
BCC and SCC. SCC is more dangerous and is responsible for
many deaths. Skin cancer in early stage can be cured easily
by simple procedures or techniques but advanced skin cancer
cannot be treated effectively by any medications. So there is a
need to detect and treat disease at early stage.8 Over all, 80 %
of skin cancers are BCC, 16 % are SCC and 4 % are
Figure 1: Skin Cancer
The causes for NMSC are environmental and host factors.
Environmental factors associated with NMSC are sun
exposure, ozone depletion, and chemical exposures. Host
factors are HPV, genetic susceptibilities, skin tone and
immunosuppression.10-12 Outdoor workers are more prone to
skin cancer as they may easily get affected by UV-exposure.
Exposure during weekends and holidays are involved in
chronic exposure to UV-light in children.13,14
Generally fair skin, red and blond hair, blue or green eyes are
more susceptible to skin cancer.15-18
Signs and Symptoms of Melanoma
· Changes in size, shape or color of mole19.
· Oozing or bleeding from mole.
· A mole that feels itchy, hard, lumpy or swollen.
Types of Skin Cancer
Basal cell carcinoma (BCC)
Figure 2: Basal Cell Carcinoma
The most common type of skin cancer is basal cell
carcinoma. They generally occur in head and neck regions
followed by trunk and extremities. They usually arise from
basal layer of epidermis.7,20 BCC is again classified into 3
types; Superficial, nodular and sclerosing / morpheaform.
Superficial form of BCC can be seen in trunk and extremities
as an erythematous plague. Nodular BCC lesions generally
seen on the head and neck and appear as pearly, telangiectatic
S. Ramya Silpa et al. Int. Res. J. Pharm. 2013, 4 (8)
Page 84
papules with rolled borders. Morpheaform lesions often
resemble scars and usually are the most difficult to identify
on visual inspection alone, often lacking the pearly and
telangiectatic characteristics seen in superficial and nodular
BCCs. Gorlin syndrome patients are often associated with
BCC. These people usually have BCC at centre of face or at
any anatomical site.21 NMSC like BCC and SCC arise from
keratinocytes. BCC undergo metastasis rarely but it has
tendency to cause more morbidity. But SCC undergoes rapid
metastasis. They may occur due to chronic sun exposure and
can be seen on different parts of sun-exposed areas of the
Epithelial Skin Cancer and Oncogenic Virus Infection
Non melanoma skin cancers like BCC, SCC, AK are most
commonly occurring types in transplanted patients. AK is
found to be precursor for BCC and SCC. AK was found to
occur 15 years prior in transplanted patients compared to
normal people. AK is found to be more frequent in heart than
in kidney and liver transplants. SCC > BCC can be seen in
transplanted patients and it is vice-versa in general
Kaposi Sarcoma
This is more commonly seen in elderly people. This occurs
mainly due to virus named KS associated human herpes virus
(KSHV) called as HHV-8.29-33 Lower limbs; trunk and at last
upper limbs are the targeted regions for Kaposi sarcoma to
occur. It can also involve oral mucosa, lymph nodes, stomach
and duodenum.34
Neuroendocrine Skin Cancer (Merkel cell carcinoma)
It usually occurs at head, neck and extremities of elderly
people. Immunosuppression plays an important role in
formation of such type of skin cancer. MCC in transplanted
patients found to be elevated when compared to normal
Figure 3: Melanoma
Melanoma is less common than other skin cancers. However,
it is much more dangerous if it is not found early. It causes
the majority (75 %) of deaths related to skin cancer.36 This
type of skin cancer is associated with melanocytes of
epidermal layer. They synthesize melanin pigment that
produces cells of skin with photo protection from mutagenic
UV-rays. MM is less common compared to BCC and SCC.
The treatment for melanoma completely is not familiar. There
is less curable rate for melanoma. Prevention is best method
for melanoma.37-39. It is the only preventable cancer that
continues to increase.40
Squamous Cell Carcinoma
SCC is considered to be second most common type of cancer
in US with 250000 cases diagnosed annually. It is usually
seen in black and Asian Indians representing 30 % to 65 % of
skin cancers in both races. It occurs on sun exposed sites of
head and neck. Generally, the long-term outcome is positive,
as less than 4 % of Squamous-cell carcinoma cases are at risk
of metastasis (and hence life-threatening)39,41
Figure 4: Squamous Cell Carcinoma
UV-light is a major cause for skin cancer. Both UV-A and
UV-B play a crucial role in causing skin cancer.42
UV-induced DNA Damage
Sunlight can be categorized into three types depending on
wavelength UVC (200 280 nm), UVB (280 320 nm) and
UVA (320 -400 nm). UVC do not reach earth surface as it is
filtered by ozone layer. UVB (1 10 %) and UVA (90 99
%) reaches earth surface.5 UVB is primarily responsible for
DNA damage. It has the tendency to induce all phases of skin
cancer. (Initiation, promotion and progression).43 As the
ozone layer is slowly depleted due to environmental changes,
large amount of UV-light reaches earth surface. This is
responsible for increased incidence of skin cancer all over the
world. Research implies that there is positive correlation
between skin cancer and past UV exposure.44 Sun beds are
also involved in etiology of skin cancer. UVA has constituted
much higher proportion of total UV released by these devices
relative to that in solar radiation since early 1980s.45
UVB-induced MAPK Signaling Pathways. UVB has been
shown to signal through the MAPK cascade and includes
ERK, JNK and p38. In this simplified model, UVB-
irradiation activates acidic sphingomyelinases which in turn
activates ceramide followed by activation of atypical PKCs.
Atypical PKCs (PKC-_ or PKC-_/_) phosphorylate and
activate MEK, followed by ERK. ERK phosphorylates and
activates TCF which then binds with SRF to an SRE site
within the promoter of specific genes. Activation of this
pathway results in c-Fos expression followed by AP-1
activation. UVB also activates PKC_ and _ followed by
activation of JNK and c-Jun. Another affect of UVB is
activation of the p38 pathway. UVB can also induce
signaling through the Ras pathway. The ultimate result of
these signal transduction cascades is a cellular response such
as proliferation, differentiation, apoptosis or tumorigenesis.
The postulated molecular targets of the chemoprevention
agents EGCG, perillyl alcohol, aspirin, and retinoids are
shown.5 If a foreign antigen enters into human body, immune
system gets activated and fights against foreign antigen. But
incase of UV-radiation, this phenomenon doesnt occur
because UV can cause the suppression of immune system that
t leads to inadequate prevention of tumor development.46
S. Ramya Silpa et al. Int. Res. J. Pharm. 2013, 4 (8)
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Figure 5: UVB-induced M APK Signaling Pat hways
This is most commonly seen in elderly people; because they
have weak immune system power. Immunosuppressive drugs
like cyclosporine, steroids and azathioprine can potentially
impair SIS defence capacity leading to an increased incidence
of different types of skin cancer.47-50
Mutations of p53 Gene in Skin Cancer
P53 is crucial in maintaining genomic integrity by blocking
DNA replication in response to DNA damage from exposure
to agents like UV-light.51,52 Exposure to normal epidermal
keratinocytes to UV-light results in transient increase in p53
protein levels and resultant arrest in G1 phase of cell cycle.
So, mutations of p53 can be seen in UV- induced
carcinogenesis. P53 gene plays a predominant role in
development of SCC.5,53-56
At most, there is a need to educate the people about skin
cancer completely. So, that there might be a chance to
prevent skin cancer to some extent. The measures to be taken
to prevent skin cancer include staying out of the sun during
hottest part of the day, wearing or applying sunscreen when
expose to sunlight, avoiding exposure to sunlamps. Use of
sun beds need to be prevented.19 SEB: It is biological event
that takes place between exposure and subsequent
development of cancer. They acts as predictors to identify
persons that are on verge of developing cancer. BCC or SCC
incidence and multiplicity, AK incidence and multiplicity are
considered to be clinical or histological endpoints that are
targets for human skin cancer chemoprevention trials.
Wearing protective clothes found to be best method to
prevent skin cancer during sun exposure. Even though
effective sunscreen lotions prevent direct exposure to sun and
UV-light, they have the capacity to prevent formation of
BCC and SCC and mixed. Some trials indicates no effect on
NMSC incidence can be seen by using sunscreens.57,58
Primary prevention involves regular application of
sunscreens along with protective measures recommended by
the World Health Organization (WHO), the International
Commission on Non-Ionizing Radiation Protection (ICNIRP)
and the European Society of Skin Cancer Prevention
(EUROSKIN). Secondary prevention involves early
assessment of malignancies that are curable in early stages of
development; because skin cancer cant be treated completely
at later or advanced stage. So, there is a need for secondary
The first step in the evaluation of skin cancer in patients
comprises of thorough history, focusing on general medical
and drug history, personal and family history of skin cancer,
number of moles including presence of dysplastic naevil and
comprehensive social history, carcinogen or sun
exposure.59,60 The choice of treatment should be determined
by the histological type of the lesion, its size and location,
and the age of the patient. No single treatment method is
ideal for all lesions.61 The treatment goals are total removal
of the tumor, preservation of function, and a good cosmetic
outcome. Curettage and electro desiccation, cryosurgery,
topical chemotherapy, laser surgery, radiotherapy,
immunotherapy, Mohs micrographic surgery, and
conventional surgical excision are all effective therapeutic
options for selective types of BCC.42,62 As the treatment for
skin cancer needs to be initiated at early stage, intervention
soon after diagnosis is required for effective cure of disease.
Radiotherapy is effective in treating early stage lesions.63
New molecular therapeutic approaches for skin cancer
include several medications like cryosurgery,
immunomodulation with imiquimod, 5-FU, photodynamic
therapy and radiation. Small molecule regulators have been
identified for variety of pathways that leads to skin cancer.
The pathways are SHH, Ras / Raf, P17INK4A/CDK4/Rb and
ARF / p53. Research mainly focuses on these pathways and
treatment for skin cancer can be augmented by small changes
of pathways.64-66
Chemotherapy for Melanoma Skin Cancer
Several chemo drugs may be used to treat melanoma:
Dacarbazine (also called DTIC), Temozolomide, Paclitaxel,
Carmustine (also known as BCNU), Cisplatin, Carboplatin,
Vinblastine, Dacarbazine, temozolomide and paclitaxel may
be given either alone or along with some of the other drugs
on the list. It is not clear if using combinations of drugs is
more helpful than using a single drug, but it can add to the
side effects like hair loss, mouth sores, loss of appetite,
nausea and vomiting, diarrhea, increased risk of infection
(from too few white blood cells), easy bruising or bleeding
S. Ramya Silpa et al. Int. Res. J. Pharm. 2013, 4 (8)
Page 86
(from too few blood platelets), fatigue (from too few red
blood cells).67
Treatment for BCC
Primary radiotherapy is considered to be treatment of BCC
involving nose, lower eyelids or ears. The limitation for
radiotherapy is lack of histological control of margins and
fault that often leads to inadequate or excessive treatment.
Morpheaform of BCC found to be resistant to radiotherapy
treatment. Morpheaform, mutatypical, adenoid,
basosquamous and infiltrative types can be treated with
Mohns surgery or conventional surgical excision.62 So, the
early detection of skin cancer is the key to cure especially in
malignant melanoma. Several sensitive mole imaging
systems are available in market that has the tendency to
identify lesions that might ordinarily missed using standard
clinical tools.68
How to Examine
There should be a method to the examination that allows for
visual scanning of the entire surface of the patients skin
before focusing on individual suspect lesions. The feet and
hands including the palms, nails and areas between the toes
and fingers should be examined. The anterior of the body
then the posterior surface should be examined, including the
intertriginous areas. If the patient gives consent, the border
zones of the oral and ocular mucosae and genital area should
also be examined. Special attention should be paid to the
head and neck region, and the scalp should also be examined
with a combination of direct visual examination and
palpation. Dermascopic examination of individual lesions can
allow visualization of deeper layers of the skin and, in expert
hands, can be useful. However, practitioners must be trained
in its use and the significance of dermascopic changes. In the
most common skin cancers, the genetic traits of an individual
form the base upon which environmental factors established
over a period interplay to result in disease. Pale complexion,
light-coloured eyes, red or blond hair (related to
nonfunctioning MC1R mutations2),69 freckles and a Northern
European or Celtic background are important risk factors.
Squamous cell carcinoma (SCC) is more common in outdoor
workers and occurs on body sites of maximum sun exposure.
The ears and lower lips are frequently unprotected and may
be exposed to cocarcinogens, e.g. tobacco. SCC at these sites
is more aggressive, with a significantly higher risk of
The incidence of skin cancer has been drastically elevating
day-to-day. Skin cancer in early stage can be cured easily by
simple procedures or techniques but advanced skin cancer
cannot be treated effectively by any medications. So there is a
need to detect and treat disease at early stage. Overall, 80 %
of skin cancers are BCC, 16 % are SCC and 4 % are
melanoma. UV-A and B are mainly responsible for skin
cancer. Outdoor workers are more prone to skin cancer
because they get easily exposed to skin cancers. So,
precautionary measures like application of sunscreen lotions
need to be done. SEB play an important role in identifying
extent of skin cancer in particular person. It can be treated at
initial stages, as the duration is extended, the chances for
treating skin cancer gets hastened. New molecular therapeutic
approaches for skin cancer include several medications like
cryosurgery, immunomodulation with imiquimod, 5-FU,
photodynamic therapy and radiation.
AK: Actinic keratosis
BCC: Basal Cell carcinoma
ERK: Extracell ular Signal-Regulated Kinases
EUROSKIN: European Society of Skin Cancer Prevention
HHV-8: Human Herpes Virus-8
ICNIRP: Ionizing Radi ation Protection
KSHV: Kaposi's sarcoma-a ssociated herpes virus
MM: Malignant M elanoma
MAPK: Mitogen acti vated Protein Kinase
NMSC: Non melanoma skin cancer
PKC: Protein Kinase C
SCC: Squamous cell carcinoma
SEB: surrogate Endpoint Biomarker
WHO: World Health Organization
UV: ultra violet
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Cite this article as:
S. Ramya Silpa, Chidvila V. A review on skin cancer. Int. Res. J. Pharm.
2013; 4(8):83-88
Source of support: Nil, Conflict of interest: None Declared
... The lifetime risk of being affected by melanoma is about 2.6% (1 in 38) for whites, 0.1% (1 in 1,000) for Blacks, and 0.6% (1 in 167) for Hispanics [5]. Earlystage detection of melanoma skin cancer can be beneficial in curing it [12,37,11,3]. The early diagnosis survival rate of skin cancer is more than 90 percent [2]. ...
Full-text available
Melanoma skin cancer is one of the most dangerous and life-threatening cancer. Exposure to ultraviolet rays may damage the skin cell's DNA, which causes melanoma skin cancer. However, it is difficult to detect and classify melanoma and nevus mole at the immature stages. In this work, an automatic deep learning system is developed based on the intensity value estimation with a convolutional neural network model (CNN) to detect and classify melanoma and nevus mole more accurately. Since intensity levels are the most distinctive features for object or region of interest identification, the high-intensity pixel values are selected from the extracted lesion images. Incorporating those high-intensity features into the CNN improves the overall performance of the proposed model than the state-of-the-art methods for detecting melanoma skin cancer. To evaluate the system, we used 5-fold cross-validation. Experimental results show that a superior percentage of accuracy (92.58%), sensitivity (93.76%), specificity (91.56%), and precision (90.68%) are achieved.
... Kanker kulit di Indonesia menempati urutan ketiga setelah kanker serviks dan kanker payudara. Beberapa faktor yang dapat menjadi pencetus timbulnya kanker kulit antara lain, faktor genetik, peningkatan radiasi sinar UV (Silpa & V, 2013), infeksi human papillomavirus dan pola hidup yang tidak sehat (Hendaria, dkk, 2013). ...
ABSTRAK Kanker kulit merupakan penyakit yang ditimbulkan oleh perubahan karakteristik sel penyusun kulit dari normal menjadi ganas, yang menyebabkan sel tersebut membelah secara tidak terkendali dan merusak DNA. Deteksi dini dan diagnosis yang akurat diperlukan untuk membantu masyarakat mengindentifikasi apakah kanker kulit atau hanya kelainan kulit biasa. Pada studi ini, dirancang sebuah sistem yang dapat mengklasifikasi kanker kulit dengan memanfaatkan citra kulit pasien yang kemudian diolah menggunakan metode Convolutional Neural Network (CNN) arsitektur VGG-16. Dataset yang digunakan berupa citra jaringan kanker sebanyak 4000 gambar. Proses diawali dengan input citra, pre-processing, pelatihan model dan pengujian sistem. Hasil terbaik diperoleh pada pengujian tanpa pre-processing CLAHE dan Gaussian filter, dengan menggunakan hyperparameter optimizer SGD, learning rate 0,001, epoch 50 dan batch size 32. Akurasi yang diperoleh sebesar 99,70%, loss 0,0055, presisi 0,9975, recall 0,9975 dan f1-score 0,9950. Kata kunci: Kanker kulit, CNN, VGG-16 ABSTRACT Skin cancer is a disease caused by changes in the characteristics of skin cells from normal to malignant, which causes the cells to divide uncontrollably and damage DNA. Early detection and accurate diagnosis are necessary to help the public identify whether skin cancer or just a common skin disorder. In this study, a system was designed that can classify skin cancer by utilizing images of patients' skin which is then processed using the Convolutional Neural Network (CNN) method of VGG-16 architecture. Dataset used in the form of cancer tissue imagery as many as 4000 images. The process begins with image input, pre-processing, model training and system testing. The best results were obtained on testing without pre-processing CLAHE and Gaussian filters, using hyperparameters, SGD optimizer, learning rate 0.001, epoch 50 and batch size 32. Accuracy obtained by 99.70%, loss 0.0055, precision 0.9975, recall 0.9975 and f1-score 0.9950. Keywords: Skin cancer, CNN, VGG-16
... J Haematol Stem Cell Res. 2022; 2(1):[26][27][28][29][30][31][32][33][34][35] ...
Stem cells are defined as specific undifferentiated cells with self-replicating ability which are common to multicellular organisms. They possess the characteristics to replace, generate and endure terminally differentiated cells.Normal adult stem cells reside in most somatic tissues, where they form the cellular basis for tissue homeostasis, maintenance, and repair, as has been shown, for example, in the skin.It has been recently suggested that oncogenic mutations and other genetic and epigenetic defects could be inherited from transformed normal stem cells, giving rise to some of the cell populations observed in many tumors . A number of hypotheses, mostly based on new experimental evidences, have been proposed to explain the presence of cancer stem cells in cancer and the implications for future therapies.
... The topic was chosen as it is a highly relevant issue for young people, regardless of other factors, such as gender or medical history. Moreover, young people are especially vulnerable, as they often engage in risky sun exposure behavior (Gambla et al., 2017;Heckman et al., 2011), which, in turn, can have serious consequences for people's health as high UV radiation is the leading cause of skin cancer (Ferlay et al., 2019;Silpa & V, 2013) and is associated with several eye diseases, such as eyelid malignancies, photokeratitis, cataract, and pterygium (tissue growth on the cornea of the eye; Yam & Kwok, 2014). ...
Although the importance of emotions for the effects of gain-loss framed messages has been supported, the emotional effects of mixed frames have not been sufficiently investigated. To fill this gap, this experimental study exposed participants (N = 154) to single gain- or loss-framed vs. mixed frame messages about sun-protection outcomes. Integrating the idea of mixed frames with the concept of emotional flow, data were analyzed using a serial mediation model with emotional experience (as indexed by valence and arousal) and intention as factors mediating the effect of shifts on actual behavior, measured two weeks after message exposure. Results demonstrate that mixed messages and their impact on emotional experiences are not generally more effective than pure gain or pure loss messages. However, the application of mixed frame or purely loss-framed messages offers a higher potential to increase behavioral health intentions (resulting in respective behaviors) than messages simply focusing on gain frames.
... Skin protects the inner organs from injuries and infections. It contains nerves, which help in sensing the environment [1]. There are two main organizational parts of the derma known as epidermis and dermis. ...
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Background: Skin protects the inner organs from injuries and infections. The various structural parts of the skin are the epidermis, the dermis and the skin appendages. Multiple group Skin cancer benign and uncontrollable abnormal growth of cells. Outcome of extracutaneous and cutaneous cells. Cases of skin cancer increased, so it has led to finding its procedure of tumor development by their mechanism and their prevention techniques. Aim: The aim of this article is to review an updated mechanism of action which involved in Skin Carcinoma and associations of their endogenous risk factors. Method: The selection of data was done by studying combination of review and research papers and those with relevant data were taken into account and those with irrelevant data were excluded from a different databases such as PubMed, NCBI and Web of Science from the year 1985-2020. Result: There is a clear association between mechanism of action involved in Skin Carcinoma and associations of endogenous risk factors. Conclusion: This brief review about the mechanisms of formation and progression of Skin carcinoma by UV radiation which causes DNA damage and mutations, Loss of cell cycle control and carcinogenesis by mutation, Glycosyltransferases related to skin cancer, Target proteins of N-glycosylation involved in skin cancer, Integrins, CD147, Melanocortin 1 receptor (MC1R), PD-1, EGFR.
... BCC and SCC belong to the group of non-melanoma skin neoplasms. Despite the fact that the NMSC exhibit a high percent of occurrence, they are much less aggressive than potentially lethal melanoma [4]. Malignant melanoma is the most dangerous type of skin neoplasms, causing the majority (75%) of skin malignancy deaths. ...
Introduction For decades, finding effective long-term or disease-modifying treatments for skin disorders has been a major focus of scientists. The conventional drug delivery systems showed poor efficacy with high doses and are associated with side effects which leads to challenges in adherence to therapy. Therefore, to overcome the limitations of conventional drug delivery systems, drug delivery research has focused on topical, transdermal, and intradermal drug delivery systems. Among all, the dissolving microneedles have gained attention with a new range of advantages of drug delivery in skin disorders like breaching skin barriers with minimal discomfort and its simplicity of application to the skin which allows patients to administer it themselves. Areas covered This review highlighted the insights into dissolving microneedles for different skin disorders in detail. Additionally, it also provides evidence for its effective utilization in the treatment of various skin disorders. The clinical trial status and patents of dissolving microneedles for the management of skin disorders are also covered. Expert opinion The current review on dissolving microneedles for skin drug delivery is accentuating the breakthroughs achieved so far in the management of skin disorders. The output of the discussed case studies anticipated that dissolving microneedles can be a novel drug delivery strategy for the long-term treatment of skin disorders.
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Skin cancer is a type of dangerous disease, and early detection is necessary to increases the survival rate. In recent years, deep learning models applied to computerized skin cancer discovery has become a standard. These models can improve their performance by being able to access more data and its main task is to the classification of images. This task is exceptionally valuable in the field of medicine, it has the ability to assist doctors and specialists to make the right decision and diagnose the patient’s condition with high accuracy. In this paper, a deep learning network has been selected and trained by the author for the analysis of more than 24,000 skin cancer images by convolutional neural network (ConvNet) model applying with three architectures (InceptionV3, ResNet, and VGG19) with many parameters to identify the best architectures in the classification of these images and getting extremely acceptable results; and classifying the cancer type as benign or malignant with high accuracy. The dataset contains high-resolution images obtained from the ISIC archive between 2019 and 2020. After all the tests were done, the best architecture is InceptionV3. This architecture has achieved a diagnostic accuracy of approximately 86.90%, precision of 87.47%, sensitivity of 86.14%, and the specificity of 87.66%.
Skin cancer rates are rising dramatically. The condition is now being seen on a daily basis by all healthcare professionals, not only dermatologists and plastic surgeons. As a result, there is a crucial need to educate all these groups on recognizing patients with this cancer. The basic rule of physical examination applies, with due emphasis on precise and methodical visual inspection supplemented by gentle palpation.
In the general population Merkel's cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer. More than 600 cases have been reported. MCC seems to be common in transplant recipients, with 41 cases being reported to the Cincinnati Transplant Tumor Registry, and another 11 in the transplant literature. In the general population, it is a disease of older adults, with only 5% of cases occurring below the age of 50 years. In transplant patients, the mean age at diagnosis was 53 (range 33-78) years, and 29% of recipients were <50 years old. The tumor appeared from 5 to 286 (mean 91.5) months after the transplant. Of 44 lesions that occurred in 41 patients, the distribution was similar to that seen in the general population, with 36% occurring on the head and neck, 32% on the upper extremities, 16% on the trunk, 9% at unknown sites, and 7% on the lower extremities. Twenty of the patients (49%) had 22 other malignancies, the great majority of which (91%) were other skin cancers. Treatment depended on the stage of the disease and included wide surgical excision, radical lymph node dissection, radiation therapy, and chemotherapy. In transplant patients, MCC probably proved to be more aggressive than in the general population in that 68% of patients developed lymph node metastases and 56% died of their malignancies. Furthermore, one third of surviving patients still have active cancers from which they may die. Also, follow-up of survivors has been relatively short, with a mean of only 18 (range 0-135) months.
Skin cancer, of various types, is the most common cancer in the UK and rates are rising dramatically. The disease is being seen on a daily basis not only by dermatologists and plastic surgeons but by all healthcare professionals. As a result, there is a crucial need to educate all these groups in how to recognize patients with skin cancer. The basic rule of physical examination applies, with due emphasis on precise and methodical visual inspection supplemented by gentle palpation. Baseline whole-body photography is particularly useful for ongoing follow-up of high-risk patients especially for monitoring suspicious naevi. In expert hands, dermoscopy plays a vital role both in the diagnosis and in determining management of skin lesions.
Malignant skin cancers are common and are increasing annually. They can be divided into two main groups, non-melanoma skin cancers (NMSC), which include basal cell carcinoma and squamous cell carcinoma, and malignant melanoma. This article reviews the various surgical and non-surgical treatment modalities available for the management of skin cancers.
Kaposi's sarcoma (KS), a vascular tumour that contains characteristic spindle cells forming slit-like spaces, may have an infectious aetiology. Recently, sequences of a new human herpesvirus, KSHV/HHV-8, have been identified in both HIV-associated and classical KS. We sought to identify the target cell of this virus in KS tumour tissue. Using PCR in situ hybridization (PCR-ISH) we show that KSHV/HHV-8 is present in the flat endothelial cells lining vascular spaces of KS lesions as well as in typical KS spindle cells. These findings show that KSHV/HHV-8 is present in the cell types thought to represent neoplastic cells in these lesions.
Background: Human herpesvirus type 8 (HHV-8) has been associated with Kaposi's sarcoma, body cavity-based lymphoma (BCBL), and multicentric Castleman's disease through DNA, in situ hybridization, and serologic studies. HHV-8 has been visualized only in HHV-8-positive/Epstein-Barr virus (EBV)-negative/cytomegalovirus (CMV)-negative BCBL cell lines, but not in HHV-8-positive/EBV-negative/CMV-negative Kaposi's sarcoma lesions. Design: Kaposi's sarcoma of the skin, lymph node, and spleen from three patients with AIDS were analysed for HHV-8, EBV and CMV DNA by polymerase chain reaction (PCR), for HHV-8 RNA (T1.1 riboprobe) by in situ hybridization (ISH), for viral inclusions by light microscopy, and for herpesviruses by transmission electron microscopy (TEM). Sections were also labeled with T1.1 counterstained with CD34, an endothelial cell marker. Results: The skin lesion was DNA PCR-positive for HHV-8 and CMV (nested, but not single PCR), the lymph node was positive for HHV-8 and EBV, and the spleen was positive for only HHV-8. TEM revealed infection by a virus displaying the typical morphology and cytopathicity of herpesviruses. Hexagonal nucleocapsids and mature enveloped virions were present in vasoformative spindle cells and mononuclear cells, often resembling lymphocytes. Extrapolating from TEM to standard light microscopy on hematoxylin and eosin-stained paraffin sections, eosinophilic, targetoid intranuclear inclusions were identified within spindle cells which often lined vascular lumina. The T1.1-riboprobe labeled CD34+ spindle cells containing intranuclear inclusions, as well as mononuclear cells within Kaposi's sarcoma and residual lymphoid tissue. Conclusion: The herpesvirus visualized in Kaposi's sarcoma lesions has morphologic and cytopathic features typical of human herpesviruses, productively infects vasoformative spindle cells and mononuclear cells, and is consistent with HHV-8. It can also form intranuclear inclusions that are identifiable by light microscopy in hematoxylin and eosin sections and by ISH.
Kaposi's sarcoma (KS) has been shown by molecular techniques to be associated with infection with human herpesvirus 8 (HHV8/KSHV), but specific ultrastructural characterization of the virus has been impaired by the frequent presence in these lesions of other herpesviruses, particularly cytomegalovirus (CMV). Since the ultrastructural appearance of HHV8/KSHV has been studied in the cell line KS-1 uninfected with other viruses including CMV, it was possible to undertake a comparative study of CMV and HHV8/KSHV in KS lesions. HHV8/KSHV was sparsely present and lytic infection was restricted to endothelial cells. The following specific ultrastructural features allowed distinction between HHV8/KSHV and CMV: the viral particles were more delicate and less numerous in cases of HHV8/KSHV infection; the viral tegument was more electron-dense in CMV than in HHV8/KSHV; dense bodies characteristic of CMV were absent in HHV/KSHV; complete CMV viral particles were more variable in size and generally larger (150–200 nm) than HHV8/KSHV (120–150 nm); and finally, the viral envelope was more pleomorphic in CMV than in KSHV/HHV8. Similarities between CMV and HHV8/KSHV included the basic structure of the nucleocapsids and the presence of capsids lacking central DNA cores (so-called non-infectious enveloped particles). These observations show that electron microscopy can be used to identify HHV8/KSHV and confirm the relationship between HHV8/KSHV and KS. © 1997 John Wiley & Sons, Ltd.
Skin cancers are the most common form of malignancy. Early diagnosis and treatment provides the best chance for survival and reduced morbidity. However, some patients have recurrent or resistant lesions. In patients with basal cell carcinoma (BCC), prognosis is relatively good for all four types of lesions (superficial, nodular, infiltrative, and morpheaform), but the highest recurrence rates and greatest morbidity are associated with infiltrative and morpheaform BCC, and prognosis is least favorable when perineural invasion has occurred. Research into the etiology of BCC and other skin cancers has led to the identification of several genetic mutations-those of the Patched and Hedgehog genes. By targeting these pathways, treatments aimed at driver mutations hold promise for new nonsurgical treatments.