Imiquimod, an immune-modulating imidazoquinoline compound, has been approved in topical formulation for the treatment of actinic keratoses, superficial basal cell carcinomas, and external genital warts. Its use in the treatment of field cancerization, in particular, has been rapidly evolving. With the recent approval of a new drug application for a new concentration, as well as generic formulat...

Sunscreens have long being recognized as substances to provide effective protection against the detrimental effects of solar radiation. The deleterious effects of sun exposure can be either acute (e.g. sunburn and drug-induced photo toxicity) or chronic (potential long-term risks of repeated sun exposures like solar elastosis, keratoses, induction of skin cancers, and alteration of immune respo...

Objectives To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. Design Controlled trial randomised by practice. Setting General practices in Perth, Western Australia. Participants 468 general practitioners in 223 practices. Interventions Intervention practices were given an algorithm and instant came...

BACKGROUND Photodynamic therapy is a form of treatment in which a photosensitizing substance is applied to tissue and activated by a light source at a specific wavelength, thus selectively destroying cells. New light sources are being evaluated for use in the treatment of actinic keratoses. OBJECTIVES To evaluate the efficacy of photodynamic therapy with delta-aminolevulinic acid using a ligh...

Ultraviolet radiation exposure is the dominant environmental determinant of all major forms of skin cancer; however, the nature of the association is incompletely understood. Existing instruments to capture sun exposure history tend to yield reproducible results, but the validity of these responses is unknown. To address this question, the authors examined the relation between responses to a st...

OBJECTIVES To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. DESIGN Controlled trial randomised by practice. SETTING General practices in Perth, Western Australia. PARTICIPANTS 468 general practitioners in 223 practices. INTERVENTIONS Intervention practices were given an algorithm and inst...

Mr LA has long been troubled with actinic damage to his skin, especially his face. He has had many squamous cell carcinomas (SCCs) removed and many solar keratoses managed. On this occasion Mr LA had two actinic lesions on his left cheek that failed to respond to cryotherapy. A biopsy of each site produced a surprise. Histology of the superior lesion revealed sebaceous carcinoma. This is an unc...

OBJECTIVE To compare the repetitive DNA patterns of human actinic keratoses and squamous cell carcinomas to determine the genetic alterations that are associated with malignant transformation. INTRODUCTION Cancer cells are prone to genomic instability, which is often due to DNA polymerase slippage during the replication of repetitive DNA and to mutations in the DNA repair genes. The progressi...

For solar keratoses and superficial basal cell carcinoma, loose crusts and debris are removed with a small curette or blade, and the lesion surface is roughened by gentle scraping. Damage to the surrounding normal skin should be avoided. For nodular BCC, the epidermal keratin layer (which can impede absorption) is removed with a scalpel blade or curette, and the exposed tumour material gently r...

Facial lentigo maligna melanoma can be a diagnostic challenge in daily clinical practice as it has similar clinical and morphological features to other lesions such as solar lentigines and pigmented actinic keratoses. Confocal microscopy is a noninvasive technique that provides real-time images of the epidermis and superficial dermis with cellular-level resolution. We describe 3 cases of suspec...