Aim: To compare the depth spread of basal cell carcinoma (BCC) measured by histological examination and high-frequency ultrasound (HFUS) imaging with 30-MHz and 75-MHz probes.Materials and methods: HFUS skin imaging was used to examine 27 BCCs. A specialized high-resolution digital ultrasound imaging system DUB (TPM GmbH, Germany) with 75-MHz and 30-MHz probes was used. After HFUS scanning, the BCCs biopsy samples were collected by punch biopsy or surgical excision for the morphological examination. Based on the histomorphology results obtained, the tumors were divided into thin (≤1 mm invasion depth) and thick (>1 mm invasion depth). Each BCC spread depth was measured during the HFUS examination with 75-MHz and 30-MHz ultrasound probes and morphological examination.Results: Thin BCCs average invasiondepth measured histologically was 0.494±0.212 mm. Its average depth obtained with HFU examination with 75-MHz and 30-MHz probes was 0.591±0.265 and 0.734±0.123 mm, respectively. High, statistically significant correlation betweenthe histological and 75 MHz HFU measurements was obtained (r=0.870). The correlation was weak (r=0.290) when using a 30 MHz transducer. The average thick BCC invasion depth values obtained with the histological examination and 30 MHz HFUS scanning was 1.845±0.718 mm and 1.995±0.699 mm, respectively. High, statistically significant (r=0.951) correlation between the thick BCC spread depth measured with 30 MHz transducer and histomorphological examination was obtained.Conclusions: In cases of BCCs with thickness of ≤1 mm, there was a high correlation (r=0.870) of the tumor spread depth between micromorphological measurements and the results obtained using a 75 MHz transducer and in cases of BCCs with thickness of >1 mm, a very high correlation (r=0.951) of the tumor spread depth was observed between histomorphometry and30 MHz transducer measurements.
Aim: To describe the ultrasonographic findings of surface and nodular basal cell skin cancer (BCC) using high frequency ultrasonography.Materials and methods: We examined 60 primary BCCs in different locations with the High Frequency Ultrasound (HFU) system DUB Skin Scanner using 75 MHz and 30 MHz probes. Epidermis, dermis, and depth of tumors spread in the region of interest (ROI) were measured. Visually unchanged, contralateral skin areas were examined as the control. Results: The surface BCC most often had elongated contours, clear margins and hypoechoic structure, while the nodular BCC had round or oval outlines and diffusely hypo-heterogeneous structure with clear margins. Sclerodermiform BCCs were visualized as hypoechoic areas of irregular shape penetrating in the dermis, with wavy fuzzy margins. The average thickness of the surface BCC in the US examination was 556.28±136.95 μ, the nodular BCC thickness was 2439.71±865.92 μ and the sclerodermiform thickness was 1500±325.33 μ. A statistically significant increase in the average thickness of tumors of the nodularand scleroderma forms was observed in comparison with the surface clinical variant (p<0.05). Hyperechoic inclusions were observed in 11% of the surface BCC’s and in the 100% of the nodular BCC’s. Their average number was 2±0.57 and 4±4.8, with the average area of 0.03±0.02 mm2 and 0.04±0.03 mm2 (p>0.05), respectively. In the surface BCC, they were mainly located along the periphery of the hypoechoic zones. In nodular BCC, the inclusions had a peripheral and combined (center and peripheral) distribution.Conclusions: Ultrasound allows differentiating BCC as diffuse-heterogeneous, hypoechoic, formations in the dermis with distinct contours. Depending on the clinical picture, they differ in form, depth of bedding, as well as in the quantitative ratio and distribution of the point hyperechoic structures in them.
Rationale: Type IV collagen is the main component of the basal membrane ensuring its integrity. Basal membrane destruction is associated with absent type IV collagen expression being directly related to an increased tumor invasion risk. Specifics of the protein expression in various morphological types of basal cell carcinoma have not been well described.Aim: To study the association between type IV collagen expression and basal cell carcinoma morphological structure and invasion potential.Materials and methods: We performed an immunohistochemistry analysis with anti-type IV collagen antibodies on 30 biopsy specimens of the skin involved with basal cell carcinoma.Results: The superficial multicentric type of basal cell carcinoma differed from the solid, micronodular, and infiltrative types by linear continuous type IV collagen expression (р<0.0083). Most often, there was no type IV collagen expression in the micronodular and infiltrative basal cell carcinomas; however, no significant difference of the solid type and each of the abovementioned types was found. Aggressive basal cell carcinoma types (micronodular and infiltrative, taken together) were significantly different (р=0.033) from the solid type by the absence of type IV collagen expression. Linear continuous expression was seen exclusively in basal cell carcinomas with the invasion of≤0.825 mm.Conclusion: We have identified the difference in type IV collagen expression depending on the morphological type of basal cell skin carcinoma, prevailing linear continuous expression in the superficial multicentric type and its absence in the micronodular and infiltrative types.
According to modern ideas, a reasonable choice of an effective method of treating plaque scleroderma is based on the diagnosis of the pathological process prevailing in the tissues (inflammation-sclerosis). Therefore, an urgent problem of a personalized approach to dermatosis therapy is the possibility of an objective assessment of the prevailing process using non-invasive diagnostic methods. The article presents a clinical case of widespread plaque scleroderma in a 66-year-old patient, demonstrating the possibility of using laser fluorescence spectroscopy and laser Doppler flowmetry to determine the degree of activity of the focus and determine the leading pathological process. We selected three pathological skin foci localized in the abdomen and characterizing three clinical stages of the disease (inflammation, induration, sclerosis). The analysis of fluorescence and laser Doppler flowmetry data showed that in areas clinically defined as inflammation, there is an increase in the average values of the indices of tissue content of porphyrins, lipofuscin and microcirculation index compared with intact skin, while the intensity of collagen fluorescence does not differ significantly. In the induration zone, along with an increase in the fluorescence indices of lipofuscin and porphyrins, there is an increase in the average values of collagen fluorescence indices at effective registration waves. The data obtained by us indicate an active inflammatory process in these foci and the process of fibrosis in the induration zone. In the sclerosis zone, there is an increase in the average values of collagen fluorescence indices compared with intact skin, and the fluorescence of optical markers of inflammation (lipofuscin and porphyrins) do not differ significantly in comparison with the control intact skin. When analyzing the fluorescence spectra and laser Doppler flowmetry data after treatment, we found that in the zones of induration and inflammation, the average values of the fluorescence indices of porphyrins, lipofuscin, collagen and microcirculation index are reduced relative to the initial values (before treatment), but remain higher in comparison with intact skin. The data obtained may indicate that active inflammation in these foci persists at the time of the study. In the study of the focus of sclerosis, the obtained autofluorescence and microcirculation data in dynamics do not differ significantly from the initial values. The data for laser Doppler flowmetry and laser fluorescence spectroscopy are consistent with ultrasound examination of the skin. In our study, the potential possibility of using laser fluorescence spectroscopy and laser Doppler flowmetry methods to establish the degree of activity of the focus, determine the leading pathological process, as well as to evaluate the effectiveness of therapy was demonstrated for the first time.
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