Background: Vismodegib is approved for advanced cases of basal cell carcinomas not amenable to surgery or radiotherapy. Large studies on the use of vismodegib in clinical practice are scarce. Objectives: The main objective of the study was to analyse the evolution and therapeutic management of relapses and lack of response in patients who had received vismodegib for locally advanced and/or multiple basal cell carcinomas in a real-life multicentre setting. Methods: This nationwide retrospective study collected data on patients treated with vismodegib in 15 specialized centres. We included patients who first received vismodegib until intolerable toxicity, maximum response, or progressive disease. Exploratory research variables referred to patient and tumour characteristics, vismodegib effectiveness and safety, relapse rate and management, and mortality. A multivariable logistic regression model was used to identify predictors of complete clinical response. Results: 133 patients with advanced BCC were included in the registry. The objective response rate (ORR) was 77.5% and nearly half of the patients (45.9%) achieved complete remission. Long-term information and detailed information of subsequent treatments after a regime of vismodegib was available for 115 patients. Only 34% of the patients in this group were subsequently treated with other therapies or vismodegib rechallenge. Sixty-nine percent of the patients who had shown a complete remission with vismodegib remained free of recurrence while 30.7% relapsed. Almost half of the patients who received additional therapies after the first course of vismodegib achieved complete tumour remission. Three and 2 out of 9 patients who were rechallenged with vismodegib achieved complete and partial responses, respectively, with an ORR of 55.5%. Conclusion: Our study confirms efficacy of vismodegib in routine clinical practice. The risk of recurrence after achieving complete response with vismodegib was lower than previous reports. Rechallenge with vismodegib is feasible and most patients responded to re-treatment.

The human papillomavirus (HPV) has been associated with the carcinogenesis of cutaneous squamous cell carcinoma (cSCC), especially in immunosuppressed patients. This article reviews the microbiology of HPV and its role in tissue tropism, invasion, and oncogenesis. It also describes possible HPV oncogenic ability due to the inactivation of the host p53 and retinoblastoma protein (pRb) by HPV oncoproteins E6 and E7, producing a suppression of cell cycle checkpoints and uncontrolled cell proliferation that may eventually result in invasive carcinoma. We will focus on β-HPV types and their role in epidermodysplasia verruciformis (EV), as well as α types and their ability to cause cutaneous and mucosal pathology. We also intend to examine the clinical characteristics of cSCC related to HPV and host immunosuppression conditions such as solid organ transplant in order to provide management guidelines for patients with cSCC associated with HPV based on available data. Other topics addressed in this article include particular locations of cSCC, such as nails; the prognosis; the recurrence; therapeutic modalities; and the role of HPV vaccines.

We report a 70-year-old man with asymptomatic reddish papules on the glans penis that histologically showed metastases of prostate adenocarcinoma. He had a medical history of a stage IV undifferentiated prostate adenocarcinoma that was currently being treated with chemotherapy. The medical history of advanced stage prostate adenocarcinoma associated with the clinical and pathological findings confirmed the diagnosis of penile metastatic prostate adenocarcinoma. This is an example of the relevance of a thorough history combined with histopathological and immunohistochemical correlation which allowed the diagnosis of a penile lesion that may be the first manifestation of prostate metastatic progression and should therefore be included among the differential diagnoses of penile tumors.

Scars from skin cancer surgery impact patients' quality of life. In recent years, fractional CO₂ (fCO₂) laser has been used for scar improvement. A single-center retrospective study (n = 22) was conducted to evaluate the safety and efficacy of the fCO₂ laser in improving the aesthetic outcome of post-surgical skin cancer scars, using the validated Vancouver Scar Scale (VSS). We obtained a mean VSS reduction of 44.5% and an absolute decrease of 2.77 points (p < .001). Statistically significant improvements were observed in all VSS parameters except for pigmentation. No significant correlation was found between time since surgery and reduction in VSS. Fractional CO₂ laser is a safe and effective approach for improving surgical scars following skin cancer treatment. Its efficacy is not limited to early scars.

Identify all potential conflicts of interest that might be relevant to your comment. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. Err on the side of full disclosure. If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response. Not all submitted comments are published. Please see our commenting policy for details.