Basal Cell Carcinoma Health, Medicine, Nursing Essay (Essay Sample)

Basal Cell Carcinoma
Author Name
Institution
Author Note
Basal Cell Carcinoma
Name of Disease
The following paper pursues to discuss the different aspects related to basal cell carcinoma (BCC).
History of BCC
BCC patients present with a history of slow-growing lesions that bleed following trauma. These lesions often occur on the face of a patient. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UYmbal4o","properties":{"formattedCitation":"(Zhao et al., 2018)","plainCitation":"(Zhao et al., 2018)","noteIndex":0},"citationItems":[{"id":5812,"uris":["http://zotero.org/users/4283279/items/GQJKF7CK"],"uri":["http://zotero.org/users/4283279/items/GQJKF7CK"],"itemData":{"id":5812,"type":"article-journal","title":"Incidence of Basal Cell Carcinoma and Squamous Cell Carcinoma in Patients on Antiprogrammed Cell Death-1 Therapy for Metastatic Melanoma","container-title":"Journal of Immunotherapy","page":"343","volume":"41","issue":"7","source":"journals.lww.com","abstract":"Systemic melanoma therapies have the potential to affect basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cuSCC) development. In this study, we aim to compare the incidence of BCC and cuSCC in patients with metastatic melanoma treated with antiprogrammed cell death-1 (anti-PD1), BRAF inhibitor (BRAFi) monotherapy or dabrafenib and trametinib combination therapy (CombiDT) with a group of control patients having similar risk factors. We reviewed the records of melanoma patients on anti-PD1, BRAFi, or CombiDT, and patients from the High-Risk Melanoma Clinic, Westmead Hospital. We also performed an immunohistochemical analysis of BCCs under anti-PD1 compared with controls using PD1, PD-L1, CD3, CD8, and CD20 stains. For the results, in all, 340 patients were included; 82 on anti-PD1, 134 on BRAFi, 69 on CombiDT, and 55 controls. BRAFi had the highest incidence of BCC (12.7%), followed by CombiDT (10.1%) and anti-PD1 (2.4%). The incidence of BCC was significantly lower in patients on anti-PD1 (2.4% vs. 19.4%; P<0.001) compared with controls. Patients on anti-PD1 were 8.54 times less likely to develop BCC than the controls [hazard ratio, 0.117 (95% confidence interval, 0.026–0.526), P=0.005]. BRAFi and CombiDT showed no significant differences in BCC incidence compared with controls. BRAFi had the highest cuSCC incidence (23.9%), followed by anti-PD1 (7.3%) and CombiDT (2.9%). The incidence of cuSCC was significantly higher in patients on BRAFi (23.9% vs. 3.5%; P<0.001) compared with controls, but anti-PD1 and CombiDT showed no differences in cuSCC incidence compared with controls. Immunohistochemistry analysis of 10 BCC from under anti-PD1 and 8 BCC from controls patients showed that while all BCC had negative PD-L1 staining, the percentage of PD1 staining in anti-PD1 group is significantly lower than that of the control group (independent t test, 8% vs. 26%; P<0.001). In conclusion, our study suggests that anti-PD1 therapy decreases the incidence of BCC, as a result of the PD1/PD-L1 blockade. Future studies investigating the role of anti-PD1 in suppressing or treating BCC may be warranted.","DOI":"10.1097/CJI.0000000000000237","ISSN":"1524-9557","language":"en-US","author":[{"family":"Zhao","given":"Cathy Yunjia"},{"family":"Hwang","given":"Shelley Ji Eun"},{"family":"Anforth","given":"Rachael"},{"family":"Carlos","given":"Giuliana"},{"family":"Chou","given":"Shaun"},{"family":"Carlino","given":"Matteo"},{"family":"Fernández-Peñas","given":"Pablo"}],"issued":{"date-parts":[["2018",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Zhao et al. (2018) highlighted that the incidence rate of BCC remains significant worldwide as a result of limited knowledge of its etiology and the disparity of disease indicators.
Anatomy of the System Involved
The primary system that BCC affects is the skin surface where disease features (lesions) occurs. Research shows that these tumors tend to appear in areas that come to direct contact with sunlight ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"o8B9OWFG","properties":{"formattedCitation":"(Otsuka, Levesque, Dummer, & Kabashima, 2015; Wiznia & Federman, 2016)","plainCitation":"(Otsuka, Levesque, Dummer, & Kabashima, 2015; Wiznia & Federman, 2016)","noteIndex":0},"citationItems":[{"id":5806,"uris":["http://zotero.org/users/4283279/items/QXHAV4KH"],"uri":["http://zotero.org/users/4283279/items/QXHAV4KH"],"itemData":{"id":5806,"type":"article-journal","title":"Hedgehog signaling in basal cell carcinoma","container-title":"Journal of Dermatological Science","page":"95-100","volume":"78","issue":"2","source":"www.jdsjournal.com","abstract":"

Abstract

Basal cell carcinoma (BCC), the most common type of skin cancer, is occasionally aggressive with deep invasion, destruction of adjacent structures, recurrence and, on very rare occasions, regional and distant metastases. Mutations that occur in BCC in hedgehog (Hh) pathway genes primarily involve the genes encoding patched homolog (PTCH) and smoothened homolog (SMO). Several animal models have demonstrated the functional relevance of genetic alterations in the Hh pathway during tumorigenesis. Recently, targeted therapy has become available both commercially and in the context of human clinical trials. Interestingly, Hh pathway inhibitors not only suppress BCC progression but also promote acquired immune responses. Since immune responses are crucial for long-term tumor control, new clinical trials, such as those involving a combination of Hh inhibitors with immune modifiers, are needed to supplement standard methods of tumor control.