Rafael Aguayo Ortiz

Background: There have been multiple studies on the use of Doppler ultrasound to define skin inflammation, but the visible vessels of healthy skin have yet to be described. Objective: This study aimed to evaluate the visible vessels of healthy skin using Doppler ultrasound. Methods: Prospective multicenter study using Doppler ultrasound to analyze healthy skin. The color percentage, flow velocity, and maximum vessel diameter were calculated. Results: 943 images from 152 patients were recorded. The most frequently used mode was color Doppler (40.6%), followed by power Doppler (30.4%). Visible vessels were detected in 18.23%; in positive Doppler images, color occupied less than 5%. The malar region exhibited the highest visible vessels. The 22 MHz probe detected smaller vessels with slower flows than the 18 MHz probe. Spectral Doppler showed peak systolic values of less than 10 cm/s and a vessel diameter of less than 1 mm. In most of the participating centers, the operators had less than 10 years of experience in performing skin ultrasound examinations. Sensitivity of the Doppler may vary according to the device. Conclusions: With the used ultrasound equipment, it was uncommon to visualize vessels in healthy skin. When seen, they covered less than 5% of the image with low flow and small size.

Summary: Background: A dramatic rise in the incidence rates of basal cell carcinoma (BCC) in young women has been reported.Objectives: We investigate potential risk factors (RF) for sporadic BCC in young patients and the current distribution of such RF in the general population of Catalonia, comparing the differences among men and women.Patients and Methods: A case‐control study was performed, 69 BCCs diagnosed in patients ≤ 45 years of age vs. 69 healthy controls. Afterward, 1,078 participants from the general population completed an RF questionnaire.Results: Repeated sunburns were more frequent in instances of early‐onset BCC in covered skin than in sun‐exposed skin (P = 0.029). In the general population, 39.1 % of participants reported sunbed use (50.1 % in women, 10.9 % in men). Sunbed use was the only relevant RF more predominant in women than men, favoring the trend to female predominance of BCCs above other RF. Additionally, we found a significant trend in young participants for reduced sunbed use (P < 0.001), although they had the same percentage of repeated sunburns. Repeated sunburns are the most relevant RF for early‐onset BCCs that can be targeted in prevention campaigns.Conclusions: We should be aware of the more relevant RF for early‐onset BCCs and their distribution among the general population to address preventive campaigns.

The analysis of Tumor Interstitial Fluid (TIF) composition is a valuable procedure to identify anti-metastatic targets, and different laboratories have set up techniques for TIF isolation and proteomic analyses. However, those methods had never been compared in samples from the same tumor and patient. In this work, we compared the two most used methods, elution and centrifugation, in pieces of the same biopsy samples of cutaneous squamous cell carcinoma (cSCC). First, we established that high G-force (10000g) was required to obtain TIF from cSCC by centrifugation. Secondly, we compared the centrifugation method with the elution method in pieces of three different cSCC tumors. We found that the mean protein intensities based in the number of peptide spectrum matches was significantly higher in the centrifuged samples than in the eluted samples. Regarding the robustness of the methods, we observed higher overlapping between both methods (77-80%) than among samples (50%). These results suggest that exists an elevated consistence of TIF composition independently of the method used. However, we observed a three-fold increase of extracellular proteins in non-overlapped proteome obtained by centrifugation. We therefore conclude that centrifugation is the method of choice to study the proteome of TIF from cutaneous biopsies.

Constitutive activation of the Erk pathway can lead to oncogenic transformation. However, the Erk pathway is not activated in human basal cell carcinomas (BCCs); although in animal models, this seems to be important.To help understand the role of Erk activity in BCC formation.The authors assayed the specific levels of phosphorylated Erk by immunohistochemistry in BCCs and normal skin biopsies. They have also analyzed Erk activation by immunoblot in fibroblasts isolated from BCC.By immunohistochemical analysis, the authors have observed that 10 of BCCs (56%) did not show phosphor-Erk staining in tumor masses and 7 (40%) showed a gradient staining exhibiting phospho-Erk only in the epidermal side of tumor masses. Remarkably, 15 BCC samples (83%) showed phospho-Erk accumulation in stroma. Six of the 9 independent cultures of dermal fibroblasts isolated from BCC maintained Erk activation "in vitro."The authors propose that there is a specific cell-type regulation of Erk activity in BCC, and this feature may be relevant during BCC formation. Stroma region from BCCs showed Erk activation and reduced proliferation. Conversely, Erk activation is barely detectable in proliferative BCCs.