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Exploring Skin Cancer: Insights into New Diagnostic, Prognostic, and Therapeutic...
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Exploring Skin Cancer: Insights into New Diagnostic, Prognostic, and Therapeutic Strategies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Tumor Microenvironment".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 3293

Special Issue Editor

Dr. Emi Dika

E-Mail Website
Guest Editor
1. Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
2. Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Interests: melanoma; NMSC; skin cancer; medical oncology; clinical trials; surgery; medical treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Skin cancer is among the most prevalent malignancies worldwide, representing one-third of all cancer diagnoses. It encompasses a diverse spectrum of tumors, each presenting unique prognostic and therapeutic challenges. While cutaneous melanoma is well known for its aggressive nature and metastatic potential, squamous cell carcinoma and basal cell carcinoma account for nearly 90% of skin cancers, imposing a significant global healthcare burden. Moreover, rare but highly aggressive tumors, such as Merkel cell carcinoma, pose further diagnostic, prognostic, and therapeutic complexities. Recent breakthroughs in non-invasive and AI-powered imaging, as well as biomarker-based screening, have transformed skin cancer detection. At the same time, innovative therapeutic approaches—such as immune checkpoint inhibitors, targeted therapies, and nanotechnology-driven drug delivery systems—have reshaped treatment paradigms and enhanced precision medicine in skin cancer care. This Special Issue explores the latest innovations in skin cancer diagnosis, prognosis, and treatment, focusing on their clinical significance and future role in personalized medicine. By integrating emerging technologies with established approaches and current evidence, clinicians and researchers may optimize both diagnostic and therapeutic strategies, thereby improving patient outcomes.

Dr. Emi Dika
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • melanoma
  • non-melanoma skin cancer
  • NMSC
  • Merkel cell carcinoma
  • tumor microenvironment
  • prognosis
  • treatment

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Published Papers (3 papers)

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Research

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12 pages, 686 KB  
Article
Association Between Area Deprivation Index and Melanoma Stage at Presentation
by Rachael Cowan, Elizabeth Baker, Mohammad Saleem, Victoria Jiminez, Gabriela Oates, Lucia Juarez, Ariann Nassel, De’Travean Williams and Nabiha Yusuf
Cancers 2025, 17(17), 2772; https://doi.org/10.3390/cancers17172772 - 26 Aug 2025
Viewed by 736
Abstract
Background/Objectives: Later-stage melanoma at diagnosis is associated with increased mortality. Health care access, socioeconomic status, and neighborhood-level factors likely influence stage at presentation. This study aimed to examine whether neighborhood disadvantage, as measured by the Area Deprivation Index (ADI), is associated with [...] Read more.
Background/Objectives: Later-stage melanoma at diagnosis is associated with increased mortality. Health care access, socioeconomic status, and neighborhood-level factors likely influence stage at presentation. This study aimed to examine whether neighborhood disadvantage, as measured by the Area Deprivation Index (ADI), is associated with later-stage melanoma diagnosis. Methods: We conducted a cross-sectional analysis of a retrospective cohort of 941 patients diagnosed with melanoma at a large academic medical center between 2010 and 2019. Residential addresses were geocoded and linked to ADI and rurality data. Covariates included race, ethnicity, age, gender, and insurance status. Multivariable logistic regression models with robust standard errors clustered at the census tract level were used to assess associations with melanoma stage at diagnosis. Results: Of 941 patients (63% male, 92.8% non-Hispanic White, mean age 64 years), 432 (46%) were diagnosed with late-stage melanoma. Mean ADI was higher among late-stage cases (5.4) compared to early-stage cases (3.3) (p < 0.001), even after adjustment for covariates. Non-Hispanic White race, private insurance, older age, and urban residences were associated with earlier stage at diagnosis. Racial disparities were attenuated after adjusting for ADI, with no significant interaction between race and ADI. Conclusions: Neighborhood disadvantage is significantly associated with later-stage melanoma diagnosis and contributes to observed racial and socioeconomic disparities. These findings highlight the need for targeted educational interventions and health policy initiatives to reduce late-stage melanoma diagnoses in vulnerable populations. Full article
(This article belongs to the Special Issue Exploring Skin Cancer: Insights into New Diagnostic, Prognostic, and Therapeutic Strategies)
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Review

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41 pages, 5261 KB  
Review
Merkel Cell Carcinoma: An Updated Review Focused on Bone and Bone Marrow Metastases
by Biagio Scotti, Elisabetta Broseghini, Costantino Ricci, Barbara Corti, Costanza Viola, Cosimo Misciali, Carlotta Baraldi, Sabina Vaccari, Martina Lambertini, Federico Venturi, Elisabetta Magnaterra, Aurora Alessandrini, Tiziano Ferrari, Massimo Lepri, Gabriele Argenziano, Barbara Melotti, Elena Campione, Davide Campana, Manuela Ferracin and Emi Dika
Cancers 2025, 17(13), 2253; https://doi.org/10.3390/cancers17132253 - 6 Jul 2025
Cited by 2 | Viewed by 2182
Abstract
Background/objectives: Despite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is marked by an unfavorable prognosis with a 5-year relative survival rate of 65%, based primarily on data collected prior to the introduction of immunotherapy. [...] Read more.
Background/objectives: Despite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is marked by an unfavorable prognosis with a 5-year relative survival rate of 65%, based primarily on data collected prior to the introduction of immunotherapy. Regional nodal metastases affect 40–50% of MCC patients, while approximately 33% experience distant dissemination. Among these, bone and bone marrow metastases are particularly notable, although the characteristics and clinical implications of this metastatic disease in MCC remain poorly understood. Methods: A comprehensive review was conducted using the Medline database (via PubMed) up to January 2025. The search strategy included the string “(Merkel cell carcinoma AND (bone OR marrow))”. Results: A total of 1133 (69.3% male and 30.7% female) patients diagnosed with advanced MCC were collected. The median (IQR) age at diagnosis was 67.5 (12.65) years old. Overall, 201 (20.8%) cases of bone and/or bone marrow metastases were identified and linked to a primary known MCC in 75.7% of cases. Bone metastases (BMs) appear as the third most common metastatic site, following the liver (second) and lymph nodes (first). They show mixed biological and radiological behavior, with a marked preference for the axial skeleton over the appendicular one. Addressing the characteristics of metastatic bone disease, neurological symptoms were the most documented, whereas bone marrow involvement and leukemic spread seemed to be primarily related to immunosuppression. Multimodal treatment strategies, including platinum-based chemotherapy and radiotherapy, were the primary approaches adopted, reflecting therapeutic practices from the pre-immunotherapy era. Conclusions: The pattern of metastatic spread in MCC differs among studies, with the bones resulting as the third most common site of distant spread. Excluding head and neck MCC, which seems to be more regularly associated with liver metastases, the relationship between the primary tumor site and the development of bone or bone marrow metastases appears inconsistent. Overall, BMs mostly correlated with advanced MCC stages and poorer survival outcomes, with a median overall survival (OS) of 8 months (range 12.75–4). The integration of international guidelines, evolving evidence from clinical trials, and the expanding role of immune checkpoint inhibitors (ICIs) will contribute to improving systemic disease control and enhance patient care. Full article
(This article belongs to the Special Issue Exploring Skin Cancer: Insights into New Diagnostic, Prognostic, and Therapeutic Strategies)
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Other

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35 pages, 1601 KB  
Systematic Review
From Diagnosis to Therapy in Primary Cutaneous Extramammary Paget’s Disease: A Systematic Review of Non-Invasive and Non-Surgical Approaches
by Francesco D’Oria, Francesco Piscazzi, Matteo Liberi, Giulio Foggi, Luigi Lorini, Katia Maria Calcara, Emi Dika, Mario Valenti, Salvador González and Marco Ardigò
Cancers 2025, 17(21), 3594; https://doi.org/10.3390/cancers17213594 - 6 Nov 2025
Abstract
Background/Objectives: Extramammary Paget’s disease (EMPD) is a rare cutaneous malignancy arising in areas rich in apocrine glands that poses diagnostic and therapeutic difficulties. Although surgery remains the standard of care, achieving clear margins is challenging and recurrence rates are high. This review [...] Read more.
Background/Objectives: Extramammary Paget’s disease (EMPD) is a rare cutaneous malignancy arising in areas rich in apocrine glands that poses diagnostic and therapeutic difficulties. Although surgery remains the standard of care, achieving clear margins is challenging and recurrence rates are high. This review explores the contribution of non-invasive imaging for diagnosis and monitoring, and evaluates conservative, non-surgical therapies as alternatives to radical surgery. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic review was conducted: eligible studies included interventional and observational research, as well as case series and reports, assessing non-invasive diagnostic methods or non-surgical treatments for EMPD. Data extraction and risk-of-bias evaluation were performed independently by multiple reviewers, and a narrative synthesis summarized therapeutic outcomes and diagnostic performance. Results: Of 808 identified records, 82 met the inclusion criteria: 66 focused on non-surgical therapies, 15 on diagnostic techniques, and one on both. Reflectance confocal microscopy (RCM) and photodynamic diagnosis (PDD) showed high concordance with histopathology, aiding both diagnosis and margin delineation. Among therapies, topical imiquimod and photodynamic therapy (PDT) demonstrated encouraging response rates, while radiotherapy, laser ablation, and systemic chemotherapy were less consistently reported. Evidence quality was limited by small cohorts, heterogeneous regimens, and variable follow-up. Conclusions: Non-invasive imaging enhances diagnostic accuracy and surgical planning, while non-surgical treatments—particularly imiquimod and PDT—offer viable alternatives in selected cases. Larger prospective studies are needed to establish standardized protocols and clarify long-term outcomes. Full article
(This article belongs to the Special Issue Exploring Skin Cancer: Insights into New Diagnostic, Prognostic, and Therapeutic Strategies)
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