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      Keratoacanthoma‐like squamous cell carcinoma successfully treated by the surgery combined with ALA‐PDT

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          Abstract

          Keratoacanthoma‐like squamous cell carcinoma (KA‐like SCC) is a malignant classification of KA. We report here a case of surgical combined with 5‐aminolevulinic acid‐photodynamic therapy (ALA‐PDT) to treat KA‐like SCC in an elderly male with successful tumor removal. The tumor resection was performed before ALA‐PDT. One week later, the lesion site was further treated with 20% ALA for 3 h when it was unknown whether the tumor was resected entirely or not. The irradiation was performed with a 633 nm light‐emitting diode lamp at 100 mW/cm 2 for 200 J/cm 2 after wiping off the ALA cream. Two sessions of ALA‐PDT were performed at a 2 weeks interval. One month after ALA‐PDT, the surgical trace of the lesion was found to have disappeared entirely, with a little scab, and the cancer did not recur. After 1 year of follow‐up, there was no recurrence. The combination with surgery and ALA‐PDT may provide a new idea for the treatment of KA‐like SCC for a wide range of patients.

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          Most cited references15

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          Photodynamic therapy in dermatology: state-of-the-art.

          Photodynamic therapy (PDT) has become an established treatment modality for dermatooncologic conditions like actinic keratosis, Bowen's disease, in situ squamous cell carcinoma and superficial basal cell carcinoma. There is also great promise of PDT for many non-neoplastic dermatological diseases like localized scleroderma, acne vulgaris, granuloma anulare and leishmaniasis. Aesthetic indications like photo-aged skin or sebaceous gland hyperplasia complete the range of applications. Major advantages of PDT are the low level of invasiveness and the excellent cosmetic results. Here, we review the principal mechanism of action, the current developments in the field of photosensitizers and light sources, practical aspects of topical PDT and therapeutical applications in oncologic as well as non-oncologic indications.
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            Keratoacanthoma (KA): An update and review.

            Keratoacanthoma (KA) is a common but underreported tumor of the skin. Two striking features of KA are its clinical behavior with spontaneous regression after rapid growth and its nosological position on the border between benignity and malignancy. We review current knowledge on the clinical, histopathological, and dermoscopic features of KA to ensure a proper diagnosis and describe its variants, including different types of multiple KAs. We highlight current concepts of KA ethiopathogenesis with special emphasis on the genetic background of multiple familial KA, the role of Wnt signaling pathway, and induction of KA by BRAF inhibitors and procedures of esthetic dermatology. Finally, treatment strategies are presented with surgical excision as a first option, followed by other modalities, including intralesional chemotherapy, topical and systemic agents, lasers, cryotherapy, and photodynamic therapy.
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              Erlotinib in the treatment of recurrent or metastatic cutaneous squamous cell carcinoma: A single-arm phase 2 clinical trial

              Background Cutaneous squamous cell carcinoma (CSCC) is a very common malignancy. Most patients present with localized disease. Recurrent and metastatic disease is rare, and there is no standard therapy for these patients. These tumors frequently overexpress the epidermal growth factor receptor (EGFR). We conducted a phase II trial to determine the response rate to therapy with erlotinib, an EGFR tyrosine kinase inhibitor (TKI), in patients with locoregionally recurrent or metastatic CSCC that was not amenable to curative treatment. Methods Eligible patients had CSCC not amenable to curative intent therapy. Patients who had previously received anti-EGFR targeted therapy were excluded. All patients received therapy with erlotinib 150 mg PO daily. Response was assessed every eight weeks, and treatment continued until progression, unacceptable toxicity, or withdrawal of consent. Primary endpoint was overall response rate (ORR) by RECIST 1.1. Results 39 patients received treatment on trial; 29 of these patients were evaluable for response. ORR was 10% (3/29); all responses were partial responses (PRs). Disease control rate (PR + stable disease) was 72% (21/29). Median progression free survival was 4.7 months (95% CI: 3.5, 6.2 months); median overall survival was 13 months (95% CI 8.4, 20.5 months). No unexpected toxicities were seen. Conclusions Erlotinib therapy was feasible for the majority of patients with incurable CSCC and associated with expected toxicities. However only a modest response rate of 10% was observed. Further study of EGFR TKIs in this patient population is not warranted. (NCT01198028)
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                Author and article information

                Contributors
                Journal
                Translational Biophotonics
                Transl Biophotonics
                Wiley
                2627-1850
                2627-1850
                March 2023
                June 23 2022
                March 2023
                : 5
                : 1
                Affiliations
                [1 ] Department of Dermatology, Huadong Hospital Fudan University Shanghai China
                [2 ] Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
                Article
                10.1002/tbio.202200005
                118d5066-6f6f-4712-88a7-8be4c497c0ad
                © 2023

                http://creativecommons.org/licenses/by/4.0/

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