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Clinical Management of Skin Cancer: From Pathology Advances to Techniques...
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Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: 15 October 2025 | Viewed by 8590

Special Issue Editor

Dr. Guy Orchard

E-Mail Website
Guest Editor
St. John’s Dermatopathology, Tissue Sciences, Synnovis Analytics, St. Thomas’ Hospital, London, UK
Interests: immunocytochemistry; Mohs micrographic surgery; alopecia; malignant melanoma; cutaneous lymphoma

Special Issue Information

Dear Colleagues,

Skin cancer is a global threat with incidence rates set to rise steadily over the next few decades. The most effective treatments for the majority of both melanoma and non-melanoma skin lesions still largely rely on early detection with surgical removal. The investigation and treatment of skin cancers focus on strategies such as surgery, radiotherapy, chemotherapy, photothermal therapy, and combination therapy. Recently, there has been a rise in the evaluation of molecular targets that are implicated in skin cancer growth and metastasis. In this Special Issue, we seek to highlight the importance of continued expansion in the field of translational and clinical research to provide better insights into single and combined therapies for treating skin cancer. We welcome authors to submit papers on the clinical management of skin cancer through advanced technical applications with an emphasis on pathological advances in our understanding of skin cancer biology.

Dr. Guy Orchard
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • skin cancer
  • surgery
  • chemotherapy
  • radiotherapy
  • photothermal therapy
  • combination therapy
  • molecular target strategies

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Published Papers (6 papers)

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Research

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11 pages, 250 KiB  
Article
Cost-Effectiveness Analysis of Topical Treatments for Actinic Keratosis in Italian National Health System
by Mariafrancesca Hyeraci, Gianluca Pistore, Francesco Ricci, Francesco Moro, Giovanni Di Lella, Elena Dellambra, Damiano Abeni and Luca Fania
J. Clin. Med. 2024, 13(21), 6312; https://doi.org/10.3390/jcm13216312 - 22 Oct 2024
Viewed by 1369
Abstract
Introduction: Actinic keratosis (AK) is a widespread pre-cancerous skin condition that may evolve to squamous cell carcinoma, a non-melanoma skin cancer, which is able to become locally invasive and metastatic. Thus, it is important to treat AK. Methods: We conducted a cost-effectiveness [...] Read more.
Introduction: Actinic keratosis (AK) is a widespread pre-cancerous skin condition that may evolve to squamous cell carcinoma, a non-melanoma skin cancer, which is able to become locally invasive and metastatic. Thus, it is important to treat AK. Methods: We conducted a cost-effectiveness analysis for the field-directed therapeutic approaches: local application of drugs containing 5-fluorouracil, both alone at a 4% concentration and associated to 10% salicylic acid at a 0.5% concentration (0.5% 5-FU + 10% SA cut. sol.); diclofenac-hyaluronic acid gel; imiquimod, both at 3.75% and 5% (5% IMQ cream) concentrations; and tirbanibulin ointment. The effectiveness data were abstracted from the literature. The cost-effectiveness analysis was performed by considering the prices reported by Agenzia Italiana del Farmaco (AIFA) for each medicine. Results: We obtained the total cost for each treatment by computing the cost of a single treatment for its duration. Application of 0.5% 5-FU + 10% SA cut. sol. appeared as the most convenient approach, as it was more effective and less expensive than all treatments except for 5% IMQ cream. For this last option, the incremental cost/effectiveness ratio analysis showed that a modest gain in effectiveness has a cost of EUR 7.94, therefore making it less cost effective. Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)

Review

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18 pages, 13878 KiB  
Review
Advances in Skin Ultrasonography for Malignant and Benign Tumors of the Head and Neck: Current Insights and Future Directions
by Katarzyna Stawarz, Adam Galazka, Magdalena Misiak-Galazka, Monika Durzynska, Anna Gorzelnik, Karolina Bienkowska-Pluta, Jacek Korzon, Filip Kissin and Jakub Zwolinski
J. Clin. Med. 2025, 14(7), 2298; https://doi.org/10.3390/jcm14072298 - 27 Mar 2025
Viewed by 628
Abstract
Ultrasound imaging has become an indispensable diagnostic tool across various medical fields. In recent years, there has been growing interest in the use of ultrasonography for the evaluation of skin lesions. However, scientific reports detailing the precise role of ultrasound in determining the [...] Read more.
Ultrasound imaging has become an indispensable diagnostic tool across various medical fields. In recent years, there has been growing interest in the use of ultrasonography for the evaluation of skin lesions. However, scientific reports detailing the precise role of ultrasound in determining the morphology of malignant skin tumors still remain limited. Malignant skin lesions, particularly in the head and neck region—their most common location—pose significant challenges due to the complex anatomy of these areas. The primary treatment for non-melanoma skin cancers, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is surgical excision. Mohs micrographic surgery is considered the gold standard due to its tissue-sparing approach and high cure rates. However, it is a time-consuming and resource-intensive procedure that is not always widely accessible. In contrast, standard surgical excision, while more widely available, often results in incomplete tumor removal, necessitating subsequent surgical radicalization or the use of adjuvant therapies. Routine ultrasound evaluation of both benign and malignant skin lesions could enhance early detection and facilitate timely treatment. However, the current body of evidence for the usage of skin ultrasound in presurgical evaluation is poor and lacks standardization. Given these challenges, in this review, we aim to highlight the potential value of preoperative skin ultrasonography in accurately assessing benign and malignant skin lesion dimensions and morphology. Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)
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13 pages, 3650 KiB  
Review
Personalized Treatment for Scalp Angiosarcoma
by Adriana Nicoleta Cristescu, Ioana Dumitrescu, Irina Tudose, Cristina Beiu, Ana-Maria Dumitrescu and Liliana Gabriela Popa
J. Clin. Med. 2025, 14(4), 1278; https://doi.org/10.3390/jcm14041278 - 14 Feb 2025
Viewed by 807
Abstract
Cutaneous angiosarcoma is a rare and aggressive malignant tumor that originates from the endothelial cells of blood vessels or lymphatic vessels. More than half of cutaneous angiosarcoma cases occur in the head and neck regions, particularly on the scalp. However, due to its [...] Read more.
Cutaneous angiosarcoma is a rare and aggressive malignant tumor that originates from the endothelial cells of blood vessels or lymphatic vessels. More than half of cutaneous angiosarcoma cases occur in the head and neck regions, particularly on the scalp. However, due to its rarity, scalp angiosarcoma is often overlooked in clinical practice. The lack of distinctive symptoms usually delays the diagnosis and, implicitly, the initiation of appropriate treatment. The treatment of cutaneous angiosarcoma poses great challenges due to its multifocal occurrence and the frequent extensive microscopic spread. A personalized, multimodal therapeutic approach is essential for ensuring a favorable outcome, consisting of a wide surgical excision associated with adjuvant radiotherapy in localized tumors, concurrent adjuvant radiotherapy and chemotherapy, targeted treatments, or immunotherapy in advanced or metastatic diseases. The aim of this manuscript is to review the literature data regarding the individualized management of cutaneous angiosarcoma and to share our own experiences in the field. We wish to underscore the importance of considering cutaneous angiosarcoma in the differential diagnosis of scalp tumors, especially in patients with a history of scalp irradiation as early detection, accurate diagnosis, and a multidisciplinary, personalized management, including surgery with clear margins and adjuvant radiation therapy, are crucial for ensuring a favorable outcome. Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)
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15 pages, 716 KiB  
Review
Immunotherapy in Basal Cell Carcinoma
by Loredana Ungureanu, Alina Florentina Vasilovici, Salomea-Ruth Halmágyi, Ioana Irina Trufin, Adina Patricia Apostu, Manuela Prisecaru and Simona Corina Șenilă
J. Clin. Med. 2024, 13(19), 5730; https://doi.org/10.3390/jcm13195730 - 26 Sep 2024
Cited by 2 | Viewed by 1573
Abstract
Basal cell carcinoma (BCC) is the most frequent of all cancers, with an increasing incidence. The first line therapy is surgical excision, but topical therapies can be used in low-risk superficial BCCs, while the more advanced, unresectable, or metastatic BCCs benefit from systemic [...] Read more.
Basal cell carcinoma (BCC) is the most frequent of all cancers, with an increasing incidence. The first line therapy is surgical excision, but topical therapies can be used in low-risk superficial BCCs, while the more advanced, unresectable, or metastatic BCCs benefit from systemic therapies with hedgehog inhibitors and immunotherapy. The purpose of this review is to highlight local and systemic immunotherapies and their efficacy in the management of BCCs. Local therapies can be considered in superficial and low-risk nodular BCCs, with imiquimod frequently used for its antitumor and immunoregulatory properties. Imiquimod alone demonstrated higher histological clearance rates, but patients treated with imiquimod experienced more adverse events than ones treated with other therapies. Imiquimod can be used as an adjuvant before Mohs micrographic surgery and can also be combined with other local therapies, like curettage, electrodesiccation, cryosurgery, and photodynamic therapy, with some treatment methods yielding results comparable with the surgery. Interferons and Interleukin-2 were evaluated in a small number of studies with different results. Systemic immunotherapies with programmed death-ligand 1 (PD-L1) inhibitors showed inconsistent results in patients with advanced BCCs, being effective in some patients that progressed on or were intolerant to hedgehog pathway inhibitors (HHI). Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)
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21 pages, 1886 KiB  
Review
One-Stop Shop: Diagnosis and Treatment of Basal Cell Carcinoma in One Step
by Kristina Fünfer, Marco Mozaffari, Oliver Mayer, Sophia Schlingmann, Julia Welzel and Sandra Schuh
J. Clin. Med. 2024, 13(13), 3830; https://doi.org/10.3390/jcm13133830 - 29 Jun 2024
Viewed by 1335
Abstract
Monitoring the tumor margins of basal cell carcinomas is still a challenge in everyday clinical practice. Usually, the clinical margins of the tumor are marked by the naked eye or, even better, with dermoscopy before surgery and then examined in detail after the [...] Read more.
Monitoring the tumor margins of basal cell carcinomas is still a challenge in everyday clinical practice. Usually, the clinical margins of the tumor are marked by the naked eye or, even better, with dermoscopy before surgery and then examined in detail after the operation using histological examination. In order to achieve tumor freedom, several surgical steps are sometimes necessary, meaning that patients spend longer periods in hospital and the healthcare system is burdened more as a result. One way to improve this is the one-stop shop method, which requires precise diagnostics and margin marking before and during surgery so that tumor freedom can be achieved after just one surgery. For this reason, the current status of the diagnosis and treatment of basal cell carcinomas before and after surgery is to be examined following extensive literature research using devices and methods that have already been tested in order to determine how a simplified process of tumor margin control of basal cell carcinomas can be made possible both in vivo and ex vivo. Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)
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Other

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12 pages, 11679 KiB  
Case Report
Successful Treatment of Cutaneous Squamous Cell Cancer with Cemiplimab—A Report of Two Cases Demonstrating the Management of Pseudoprogression and Adverse Events
by Paulina Żukowska, Katarzyna Ciepiela, Aleksandra Kudrymska, Kajetan Kiełbowski and Rafał Becht
J. Clin. Med. 2024, 13(14), 4236; https://doi.org/10.3390/jcm13144236 - 19 Jul 2024
Cited by 2 | Viewed by 2059
Abstract
Background: Cutaneous squamous cell carcinoma is a common malignancy, which frequently develops in the areas exposed to the sun. Patients with locally advanced disease in the head and neck region are frequently disqualified from surgical resection and require systemic treatment. Methods: [...] Read more.
Background: Cutaneous squamous cell carcinoma is a common malignancy, which frequently develops in the areas exposed to the sun. Patients with locally advanced disease in the head and neck region are frequently disqualified from surgical resection and require systemic treatment. Methods: In this report, we present the clinicopathological features and treatment of two patients who received cemiplimab, a monoclonal antibody targeting programmed cell death receptor 1 (PD-1). Results: An 80-year-old female and 82-year-old male patient were admitted to the hospital for the treatment of large tumors diagnosed as squamous cell carcinomas. In both patients, surgical treatment was not recommended due to the large dimensions of the tumors. These patients qualified for systemic treatment with cemiplimab. In the first patient, immunotherapy was interrupted due to adverse events. Nevertheless, a continuous regression of the tumor was observed despite treatment cessation. The second patient experienced a pseudoprogression, which is an increase in the tumor size caused by infiltration of immune cells. The treatment significantly reduced tumor size in both patients, which highly improved their quality of life. Conclusions: Cemiplimab offers clinical benefits in patients with cutaneous squamous cell carcinoma who are ineligible for surgical treatment. Systemic treatment can significantly improve the quality of life and reduce tumor diameters. Full article
(This article belongs to the Special Issue Clinical Management of Skin Cancer: From Pathology Advances to Techniques Applications)
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