tretinoin and Facial-Neoplasms

Recent evidence suggests that statins may prevent cancer.. To quantify the association between statin use and the occurrence of keratinocyte carcinoma in high-risk veterans.. Cohort study.. 6 Veterans Affairs medical centers.. 1037 participants of the Veterans Affairs Topical Tretinoin Chemoprevention Trial, a randomized, multicenter, double-blind, vehicle-controlled trial of topical tretinoin, 0.1%, for prevention of keratinocyte carcinoma conducted from November 1998 to November 2004.. Time to first occurrence of keratinocyte carcinoma on the face or ears. Participants using a statin at randomization, according to the Veterans Affairs Pharmacy Benefits Management database, were considered exposed. Study dermatologists conducted physical examinations at baseline and every 6 months during follow-up. The association between statin use at randomization and the outcome was evaluated by using propensity score matching (n = 608) and Cox proportional hazards regression (n = 1037).. Among the 1037 participants, 37% used a statin at randomization (n = 397) for a median duration of at least 900 days over a median follow-up of 3.5 years. In the propensity score-matched analysis, statin use at randomization was not associated with keratinocyte carcinoma (rate ratio, 0.92 [95% CI, 0.73 to 1.16]), a finding that was consistent with the estimates derived from the Cox proportional hazards regression (rate ratio, 0.84 [CI, 0.70 to 1.02]).. The extent of residual confounding is unknown, and the confidence bounds around the measures of association were wide. These data may not be generalizable to lower-risk populations.. These data show no conclusive or consistent relationship between long-term statin use and risk for keratinocyte carcinoma.

Topics: Administration, Topical; Aged; Aged, 80 and over; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Confounding Factors, Epidemiologic; Double-Blind Method; Drug Administration Schedule; Ear Neoplasms; Facial Neoplasms; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Risk Factors; Skin Neoplasms; Tretinoin

Topical tretinoin is a medication commonly used for acne that has potential application in the long-term treatment of photodamaged skin. However, there are few published data regarding the tolerability of high-dose tretinoin with long-term use.. To assess the long-term tolerability of tretinoin 0.1% cream.. A randomized, multicentre, double-blind, controlled trial for chemoprevention of keratinocyte carcinomas (i.e. basal cell or squamous cell carcinomas) using topical tretinoin cream to the face and ears was conducted. All participants were veterans and had a history of two or more keratinocyte carcinomas over the previous 5 years. Participants were examined (by a study dermatologist) and interviewed every 6 months (for up to 5.5 years to May 2004). Treatment comprised tretinoin 0.1% cream or vehicle control cream once daily, then twice daily as tolerated. Participants were instructed to step down application frequency to once daily or less if twice daily was not tolerated. The main outcome measures were reported side-effects, frequency of cream application and attendance at study visits. Appropriate data were available for four of the six clinical sites of this trial.. Data from 736 randomized participants (mean age 71 years; 97% men) from four clinical sites were analysed. The tretinoin group more commonly reported one or more side-effects at the 6-month follow-up than the control group (61% vs. 42%, P < 0.0001). Side-effects decreased over time in both groups, but to a greater extent in the tretinoin group, and the difference became nonsignificant at 30 months. Burning was the most common side-effect (39% tretinoin vs. 17% control, P < 0.0001). There was no difference in severity of side-effects among those affected. Of the participants who reported burning in either group, most reported mild burning; only 11% of those with burning in the tretinoin group reported it as severe (mild 62% tretinoin vs. 70% placebo; severe 11% vs. 5%; P = 0.4). Itching (24% vs. 16%, P = 0.01) and other local cutaneous reactions (12% vs. 6%, P = 0.01) were also more commonly reported by the tretinoin group at 6 months. There was no difference in numbness (2% vs. 2%, P = 0.9). Participants in the tretinoin group were less likely to apply cream twice daily at 6 months (29% vs. 43%, P = 0.0002). This difference persisted over the entire duration of follow-up. There was little difference between groups in attendance at study visits or completion of telephone interviews (92% vs. 95%, P = 0.06). No unexpected adverse events were reported.. Overall, the tolerability level of topical tretinoin was high in this study population, with almost 40% of the tretinoin group reporting no side-effects, and the majority (67%) tolerating at least once-daily dosing at 6-month follow-up. High-dose topical tretinoin is feasible for long-term use in this population.

Topics: Administration, Topical; Aged; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Ear Neoplasms; Ear, External; Facial Neoplasms; Female; Humans; Male; Skin Neoplasms; Time Factors; Treatment Outcome; Tretinoin; Veterans

We sought to determine the interobserver reliability of the histopathologic diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) (keratinocyte carcinomas) in the setting of a Department of Veteran Affairs multicenter chemoprevention study.. Interobserver concordance was assessed by blinded review of histopathologic slides by study dermatopathologists.. Overall interobserver agreement between the two dermatopathogists was kappa = 0.69 (95% confidence interval [CI] 0.67-0.69). The dermatopathologists' interobserver agreement was highest for basal cell carcinoma at kappa = 0.88 (95% CI 0.84-0.91) and for a diagnostic category in the SCC-actinic keratosis spectrum at kappa = 0.80 (95% CI 0.73-0.86). The largest disagreements between the two reference dermatopathologists were regarding the categories of invasive SCC at kappa = 0.62 (95% CI 0.52-0.72), SCC in situ at kappa = 0.42 (95% CI 0.29-0.56), and actinic keratosis at kappa = 0.51 (95% CI 0.40-0.62). Agreement between the local pathologists and central reference dermatopathologists were similar to the agreement between the central dermatopathologists. The morphea subtype of basal cell carcinoma was the only reliably diagnosed subtype (kappa = 0.79, 95% CI 0.51-1.00), and tumor depth was reliably measured.. A limitation of this study was the use of only two reference dermatopathologists.. Because of the impact on physician decision making and patient care, researchers and clinicians need to be aware of reliability of histopathology results, particularly pertaining to the SCC and actinic keratosis spectrum.

Topics: Biopsy; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Ear Neoplasms; Facial Neoplasms; Humans; Keratinocytes; Keratolytic Agents; Keratosis; Neoplasm Invasiveness; Observer Variation; Photosensitivity Disorders; Reproducibility of Results; Tretinoin

Melasma and acquired dermal melanocytosis (ADM; acquired bilateral nevus of Ota-like macules) are both seen most commonly symmetrically on the face of women with darker skin and are also known as difficult conditions to treat.. Our topical bleaching protocol with 0.1 to 0.4% tretinoin gel and 5% hydroquinone was performed repeatedly (1-3 times) for melasma (n=163), and a combination treatment with topical bleaching and Q-switched ruby (QSR) laser was performed repeatedly (1-3 times) for ADM (n=62).. There is a significant correlation between clinical results (clearance of pigmentation) and the number of sessions in both melasma (p=.019) and ADM (p<.0001).. The repeated treatment protocol for melasma and ADM showed successful clinical results compared with conventional ones, and they may be applied to other pigment conditions. It may be better that epidermal and dermal pigmentations are treated separately, especially in dark-skinned people who are more likely to suffer postinflammatory hyperpigmentation after inflammation-inducing therapies.

Topics: Adult; Antioxidants; Asian People; Combined Modality Therapy; Drug Therapy, Combination; Facial Neoplasms; Female; Follow-Up Studies; Humans; Hydroquinones; Keratolytic Agents; Low-Level Light Therapy; Male; Melanosis; Middle Aged; Nevus, Pigmented; Retreatment; Skin Neoplasms; Treatment Outcome; Tretinoin

Topics: Aged; Antineoplastic Agents; Facial Neoplasms; Hemangiosarcoma; Humans; Interferon alpha-2; Interferon-alpha; Male; Neoplasm Recurrence, Local; Recombinant Proteins; Skin Neoplasms; Treatment Outcome; Tretinoin

More than 100 years has passed since the first report of a nevus comedonicus. The earliest reports emphasized the inflammatory aspect of the nevus comedonicus as being the most significant problem. In the past 30 years, publications have ignored the inflammatory aspect of nevus comedonicus while emphasizing a variety of associated malformations. In this review, we describe five prepubertal children with prominent and persistent inflammatory changes limited to areas within a nevus comedonicus. In our experience, inflammation can be severe and resistant to treatment. Ultimately, surgical removal of the involved skin was required in two children.

Topics: Acne Vulgaris; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antineoplastic Agents; Cheek; Child; Child, Preschool; Drug Therapy, Combination; Facial Neoplasms; Female; Humans; Infant; Male; Nevus; Shoulder; Skin Neoplasms; Thoracic Neoplasms; Tretinoin

A new human cell line, termed Muraoka, has been established from the recurrent tumor of a case of congenital primitive neuroectodermal tumor (PNET) arising at the temporofacial region of a male infant. The microscopic findings of this cell line were epithelioid, and the xenografted tumor in a nude mouse consisted of the malignant epithelioid cells. Immunohistochemically, the cells were positive for neuron-specific enolase, S-100 protein, carcinoembryonic antigen, cytokeratin, epithelial membrane antigen, and glial fibrillary acidic protein. These findings were quite similar to those of the epithelioid cells in the original tumor and of the xenografted tumor cells. Neither chromosomal abnormalities nor N-myc amplification were observed. Morphological differentiation after treatment with N6-2'-O-dibutyryladenosine 3':5'-cyclic monophosphate (Bt2-cAMP), all-trans-retinoic acid (RA), prostaglandin E1 (PGE1), and 5-bromo-2'-deoxyuridine (BrdU) showed two different results. Bt2-cAMP and PGE1 induced neuronal differentiation with the extension of neurites, whereas RA and BrdU predominantly induced Schwannian differentiation (flat cells). In these respects, the cell line Muraoka seems to be useful for studying characteristics of PNET as well as for developing the new treatments against such tumors.

Topics: Animals; Bromodeoxyuridine; Bucladesine; Carcinoembryonic Antigen; Cell Line; Facial Neoplasms; Glial Fibrillary Acidic Protein; Humans; Infant, Newborn; Karyotyping; Male; Mice; Mice, Nude; Neurites; Neuroblastoma; Neuroectodermal Tumors, Primitive, Peripheral; Phosphopyruvate Hydratase; S100 Proteins; Tretinoin

Topics: Facial Neoplasms; Female; Hamartoma; Humans; Isotretinoin; Middle Aged; Neoplasms, Multiple Primary; Tretinoin

A florid case of osteoma cutis was observed following isotretinoin treatment of severe cystic acne in which a few scattered osteomata of the skin were observed prior to the treatment with isotretinoin.

Topics: Acne Vulgaris; Adult; Facial Neoplasms; Female; Humans; Isomerism; Isotretinoin; Osteoma; Skin Neoplasms; Time Factors; Tretinoin

Topics: Adult; Basal Cell Nevus Syndrome; Carcinoma, Basal Cell; Cell Transformation, Neoplastic; Etretinate; Facial Neoplasms; Humans; Male; Tretinoin