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Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes
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Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes

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

Deadline for manuscript submissions: closed (20 April 2026) | Viewed by 2782

Special Issue Editors

Dr. Athanassios A. Kyrgidis

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Guest Editor
Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
Interests: skin cancer; head and neck cancer; melanoma; clinical pharmacology; patient-reported outcome measures; clinical biomarkers; prognostic factors; epidemiology; oral and maxillofacial surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Aimilios Lallas

E-Mail Website
Guest Editor
First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54006 Thessaloniki, Greece
Interests: skin cancer; melanoma; basal cell carcinoma; squamous cell carcinoma; Merkel cell carcinoma; dermatoscopy; artificial intelligence; immunotherapy; biomarkers
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Skin cancer incidence is increasing. Different forms of skin cancer include melanoma, basal cell carcinoma, and squamous cell carcinoma, each with varying degrees of severity and treatment requirements. The economic impact of skin cancer is substantial, as it involves not only the direct expenses associated with diagnosis and treatment, but also the long-term management of survivors and the prevention efforts required to reduce its incidence. Consequently, healthcare systems require considerable financial resources, specialized personnel, and infrastructure to meet the growing demand for skin cancer care and mitigate its profound impact on patients and society as a whole. Skin cancer can significantly impact the quality of life of individuals, as it may lead to physical discomfort, disfigurement, emotional distress, and limitations in daily activities due to the disease itself or the necessary treatments. The treatment outcomes are important as new treatments emerge that need to be administered to patients on the grounds of sufficient evidence. Quality of life (QoL) outcome research in dermatology focuses on understanding how skin conditions impact a patient's overall well-being, including physical and psychological. This research utilizes patient-reported outcome measures (PROMs), such as questionnaires, to assess the effects of dermatological conditions and their treatments. Accordingly, a Special Issue called “Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes” is announced. This Special Issue calls for original research and systematic reviews that investigate clinical, dermoscopic, diagnostic, or therapeutic features of skin cancers and their impact on patients’ outcomes.

Dr. Athanassios A. Kyrgidis
Prof. Dr. Aimilios Lallas
Guest Editors

Manuscript Submission Information

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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. 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
  • melanoma
  • squamous cell carcinoma
  • basal cell carcinoma
  • clinical biomarkers
  • dermoscopy
  • quality of life

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Published Papers (4 papers)

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Research

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10 pages, 1187 KB  
Article
Clinical Characteristics at the Diagnosis of New Primary Melanoma in Italy: A Multicenter Retrospective Study Before and After the COVID-19 Pandemic
by Elisabetta Pennacchioli, Luca Nespoli, Dario Piazzalunga, Virginia Caliendo, Piero Rossi, Marco Clementi, Matteo Mascherini, Ferdinando Cananzi, Salvatore Asero, Corrado Caracò, Paolo Carcoforo, Paolo Del Fiore, Sara Coppola, Martina Pellegrini, Chiara Trevisiol, Franco Picciotto, Maria Gabriella Valente, Cosimo Di Raimondo, Irene Tucceri Cimini, Franco De Cian, Samà Laura, Francesco Cavallin, Alessandra Buja, Pietro Gallina and Marco Rastrelliadd Show full author list remove Hide full author list
J. Clin. Med. 2026, 15(7), 2715; https://doi.org/10.3390/jcm15072715 - 3 Apr 2026
Viewed by 374
Abstract
Background/Objectives: During the pandemic, access to healthcare was severely disrupted, inevitably affecting melanoma diagnosis. While this was clearly evident during the pandemic itself, it is less clear whether clinical presentation has returned to baseline levels in subsequent years. Our study aimed to [...] Read more.
Background/Objectives: During the pandemic, access to healthcare was severely disrupted, inevitably affecting melanoma diagnosis. While this was clearly evident during the pandemic itself, it is less clear whether clinical presentation has returned to baseline levels in subsequent years. Our study aimed to compare the current clinical presentation of melanoma with that in the pre-pandemic setting. Methods: We conducted a retrospective multicenter study involving Italian melanoma referral centers within the SICO network. Patients with a newly diagnosed primary cutaneous melanoma were included in the study and were grouped into four time periods: pre-pandemic (March 2019 to February 2020); pandemic (March 2021 to February 2022); the first post-pandemic year (March 2022 to February 2023); and the second post-pandemic year (March 2023 to February 2024). Our focus was on clinically relevant features at diagnosis, including Breslow thickness, ulceration, stage and sentinel lymph node status. We evaluated differences across periods using regression models that accounted for the multicenter design. Results: A total of 4938 patients were included in the study. Compared with the pre-pandemic period, melanomas diagnosed during and after the pandemic were thicker, more frequently ulcerated and more likely to be in stages II–III. The rate of sentinel lymph node positivity also increased. Notably, these patterns did not normalize over time, remaining evident even in the second post-pandemic year. The results were consistent after adjusting for age and sex. Conclusions: In this large Italian study, melanoma continues to be diagnosed at a later stage than in the pre-pandemic period. This persistent shift may reflect a combination of delayed access to care and ongoing system-level constraints. These findings emphasize the importance of restoring timely access to dermatological evaluation and reinforcing early detection strategies. Full article
(This article belongs to the Special Issue Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes)
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14 pages, 1657 KB  
Article
Nasal Reconstruction After Skin Cancer Excision: Clinical and Patient-Reported Outcomes from a Retrospective Study
by Fabiana Battaglia, Michele Rosario Colonna, Simone Filistad, Roberta Giuffrida and Gabriele Delia
J. Clin. Med. 2026, 15(6), 2274; https://doi.org/10.3390/jcm15062274 - 17 Mar 2026
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Abstract
Background/Objectives: Nasal reconstruction after non-melanoma skin cancer excision remains challenging due to the need to restore both nasal form and function while ensuring oncologic safety. Beyond surgical success, patient-reported outcomes are increasingly recognized as essential components of postoperative evaluation. The aim of [...] Read more.
Background/Objectives: Nasal reconstruction after non-melanoma skin cancer excision remains challenging due to the need to restore both nasal form and function while ensuring oncologic safety. Beyond surgical success, patient-reported outcomes are increasingly recognized as essential components of postoperative evaluation. The aim of this study was to retrospectively assess oncologic, surgical, and patient-reported outcomes in a real-world cohort of patients undergoing nasal reconstruction following skin cancer excision. Methods: A retrospective cohort study was conducted on 60 patients treated at the University Hospital “G. Martino” (Messina, Italy) between 2019 and 2022. Reconstructive techniques included direct closure, full-thickness skin grafts, local or regional flaps. Oncologic outcomes and postoperative complications were recorded during routine follow-up. Patient-reported outcomes were evaluated using a semi-structured PROM-derived questionnaire adapted from the FACE-Q Skin Cancer Module, NOSE, and SCaFF domains. Internal consistency of the questionnaire was assessed using Cronbach’s alpha. Results: Basal cell carcinoma was the most frequent diagnosis (55%), and the nasal ala, dorsum, and tip were the most commonly involved subunits. Local flaps were performed in 42% of cases. No histologically confirmed recurrences were observed in the flap-reconstructed subgroup during the available follow-up, whereas recurrences were observed in patients managed with non-flap reconstructive approaches. Postoperative complications were uncommon; however, one fatal infectious event occurred in a high-risk patient undergoing complex reconstruction for recurrent disease. The PROM-derived questionnaire demonstrated good internal consistency (Cronbach’s α = 0.82). Functional symptoms were rare, with 93% of patients reporting no snoring or nasal obstruction and 97% reporting no nasal voice alteration. Aesthetic satisfaction was rated as satisfactory or very satisfactory by 63% of patients, and social relationships were not affected in 85%. Patient-perceived recurrence risk (38%) exceeded histologically confirmed recurrence (15%). Conclusions: In this elderly real-world cohort, flap-based nasal reconstruction was associated with generally favorable patient-centered outcomes and low complication rates. The discrepancy between patient-perceived and confirmed recurrence highlights the role of oncologic anxiety. Prospective studies using fully validated PROMs are warranted to support standardized outcome comparison and guide clinical decision-making. Full article
(This article belongs to the Special Issue Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes)
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55 pages, 4985 KB  
Systematic Review
Clinical, Dermatoscopic, Histological and Molecular Prognostic and Predictive Factors of Metastatic Melanoma Response to Immunotherapy: A Systematic Review and Drug Class Meta-Analysis
by Michail C. Papazoglou, Chrysostomos Avgeros, Eleni Sogka, Anestis Chrysostomidis, Georgios Karakinaris, Anastasios Boutis, Aimilios Lallas and Athanassios Kyrgidis
J. Clin. Med. 2026, 15(6), 2145; https://doi.org/10.3390/jcm15062145 - 11 Mar 2026
Viewed by 585
Abstract
Introduction: Immune checkpoint inhibitors (ICIs) have transformed the treatment of metastatic melanoma; however, predictive markers of therapeutic response remain poorly defined. This study systematically assesses clinical, histological, and molecular predictors associated with survival outcomes in melanoma patients treated with ICIs. Methods: Following the [...] Read more.
Introduction: Immune checkpoint inhibitors (ICIs) have transformed the treatment of metastatic melanoma; however, predictive markers of therapeutic response remain poorly defined. This study systematically assesses clinical, histological, and molecular predictors associated with survival outcomes in melanoma patients treated with ICIs. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, a systematic search was conducted in MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies published between January 2018 and October 2025. Eligible studies reported associations between predictive factors and overall survival (OS) or progression-free survival (PFS) in adult melanoma patients receiving ICIs. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) from univariate (UVA) and multivariate analyses (MVA) were synthesized using random-effects meta-analyses. Results: Sex was not a consistent predictor (contradictory effects; PFS heterogeneity I2 ≈ 90%), whereas older age predicted worse OS (MVA continuous: HR 1.05, 95% CI 1.02–1.08; UVA ≥ 65 vs. <65: HR 1.70, 95% CI 1.36–2.12). Poor performance status, assessed using the Eastern Cooperative Oncology Group (ECOG) scale, strongly predicted inferior outcomes (ECOG ≥ 1 vs. 0: MVA OS HR 2.01, 95% CI 1.61–2.51; MVA PFS HR 1.49, 95% CI 1.18–1.88; ECOG ≥ 2 vs. <2: MVA OS HR 2.24, 95% CI 1.79–2.81). Elevated lactate dehydrogenase (LDH) was consistently associated with poorer survival (MVA OS HR 1.71, 95% CI 1.53–1.91; MVA PFS HR 1.61, 95% CI 1.41–1.85), whereas body mass index (BMI) > 25 kg/m2 was associated with improved OS (HR 0.82, 95% CI 0.68–0.98). Higher disease burden predicted worse prognosis (Stage IV vs. III: MVA OS HR 1.57, 95% CI 1.16–2.13; >2 metastatic sites vs. ≤2: MVA OS HR 2.38, 95% CI 1.40–4.07; brain metastases: MVA OS HR 1.69, 95% CI 1.30–2.20; MVA PFS HR 1.52, 95% CI 1.00–2.33). Histologic and molecular factors showed prognostic value: ulceration worsened OS (UVA HR 2.08, 95% CI 1.25–3.44) and PFS (UVA HR 2.97, 95% CI 1.39–6.32); acral subtype had poorer OS than cutaneous melanoma (MVA HR 2.99, 95% CI 1.63–5.48); high tumor mutational burden (TMB) improved PFS (UVA HR 0.47, 95% CI 0.33–0.70); and cutaneous immune-related adverse events (irAEs) were associated with favorable outcomes (skin disorders: UVA OS HR 0.26, 95% CI 0.14–0.47; UVA PFS HR 0.50, 95% CI 0.34–0.74). In contrast, detectable circulating tumor DNA (ctDNA) predicted markedly worse PFS (MVA HR 4.72, 95% CI 2.31–9.65) and a non-significant trend toward worse OS (MVA HR 3.34, 95% CI 0.96–11.67). Liver metastases and programmed death-ligand 1 (PD-L1) expression were not significantly associated with survival. Discussion: This meta-analysis synthesizes evidence on clinicopathologic, laboratory, and histopathologic predictors of immunotherapy outcomes in metastatic melanoma. Performance status, age, LDH, BMI, and metastatic burden consistently correlated with prognosis, while ulceration, disease stage, and TMB emerged as key histologic determinants. Conversely, PD-L1 and gender showed no consistent predictive value, whereas cutaneous immune-related adverse events and ctDNA reflected favorable and poor outcomes, respectively. These findings highlight the multifactorial nature of immunotherapy response and support the further development of integrated prognostic models to refine patient stratification and optimize treatment outcomes. Full article
(This article belongs to the Special Issue Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes)
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9 pages, 1537 KB  
Case Report
Verrucous Carcinoma of the Lower Lip: A Rare Case Mimicking Benign Lesion
by Dong Gyu Kim and Kyung Ah Lee
J. Clin. Med. 2025, 14(24), 8763; https://doi.org/10.3390/jcm14248763 - 11 Dec 2025
Viewed by 969
Abstract
Background: Verrucous carcinoma (VC) is a rare, well-differentiated subtype of squamous cell carcinoma characterized by slow growth and local invasiveness. Although it can arise in various anatomical regions, involvement of the lip is uncommon. Because VC may clinically resemble benign verrucous lesions such [...] Read more.
Background: Verrucous carcinoma (VC) is a rare, well-differentiated subtype of squamous cell carcinoma characterized by slow growth and local invasiveness. Although it can arise in various anatomical regions, involvement of the lip is uncommon. Because VC may clinically resemble benign verrucous lesions such as squamous cell papilloma, accurate diagnosis is often delayed. This case report aims to illustrate the diagnostic pitfalls encountered when lower-lip VC is managed as a benign verrucous lesion and to emphasize the need for adequately deep or excisional biopsy in persistent lesions that fail to respond to conservative treatment. Methods: We report the case of a 75-year-old man who presented with a persistent, cauliflower-like lesion on the lower lip initially diagnosed as verruca. Despite repeated cryotherapy, the lesion enlarged. Wide local excision was performed under general anesthesia, and frozen biopsy suggested malignancy. The resultant defect was reconstructed using a step-ladder advancement flap designed to preserve lip symmetry and function. Results: Histopathologic examination revealed a well-differentiated squamous epithelium with parakeratinized invaginations extending into the stroma, confirming VC. The postoperative course was uneventful, with preserved oral competence and no evidence of recurrence during follow-up. Conclusions: Verrucous carcinoma of the lip can be misdiagnosed as a benign papillomatous or verrucous lesion, particularly when only a superficial biopsy is obtained and management relies on prolonged conservative therapy such as repeated cryotherapy. Persistent verrucous lesions of the lip that do not respond to an apparently adequate course of treatment should prompt reconsideration of the diagnosis and performance of an adequately deep or excisional biopsy. Complete excision with negative margins remains the treatment of choice, and increased clinical awareness, together with careful histopathologic evaluation, are essential for early detection and appropriate management, ultimately improving patient outcomes and minimizing morbidity. Full article
(This article belongs to the Special Issue Skin Cancer: Prevention, Diagnosis, Quality of Life and Treatment Outcomes)
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