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Advances in the Diagnosis and Treatment of Skin Cancer
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Advances in the Diagnosis and Treatment of Skin Cancer

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

Deadline for manuscript submissions: 25 April 2026 | Viewed by 4944

Special Issue Editors

Dr. Konstantinos Lallas

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Guest Editor
Department of Medical Oncology, School of Medicine, Faculty of Health Sciences, Aristotle University, 54006 Thessaloniki, Greece
Interests: skin cancer; melanoma; basal cell carcinoma; squamous cell carcinoma; merkel cell carcinoma; dermatoscopy; artificial intelligence; immunotherapy; biomarkers; prognosis; meta-analysis; epidemiology
Prof. Dr. Aimilios Lallas

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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,

Advances in imaging techniques, such as dermatoscopy, confocal microscopy and total body photography, have significantly enhanced the early detection of skin tumors, leading to improved patient outcomes. In concordance, novel immunotherapeutic combinations and targeted agents have revolutionized the treatment landscape of both melanoma and keratinocyte skin tumors (including basal and squamous cell carcinoma), offering patients more effective treamtment options. Furthermore, the integration of clinical and histological factors into nomograms has enabled the provision of personalized care for patients. This Special Issue seeks to highlight new research, innovative techniques, and emerging trends in the field. We are particularly interested in submissions that address topics such as early detection methods, advanced imaging techniques, novel therapeutic approaches, biomarkers and personalized medicine.

We encourage researchers, clinicians, and healthcare professionals from around the world to submit their original research articles, reviews, and meta-analyses to this Special Issue for consideration.

Dr. Konstantinos Lallas
Dr. Aimilios Lallas
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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
  • keratinocyte carcinoma
  • basal cell carcinoma
  • squamous cell carcinoma
  • biomarkers
  • immuno-therapy
  • prognosis

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Published Papers (4 papers)

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Research

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12 pages, 1911 KB  
Article
Basal Cell Carcinoma Infiltrating the Facial Bones—Is It Really a Thing of the Past? Personal Experience over 30 Years and a Review of the Literature
by Urszula Kozinska, Iwona Chlebicka, Klaudia Knecht-Gurwin, Andrzej Bieniek, Filip Majda and Jacek C. Szepietowski
J. Clin. Med. 2026, 15(1), 254; https://doi.org/10.3390/jcm15010254 - 29 Dec 2025
Viewed by 455
Abstract
Background/Objectives: Basal cell carcinoma (BCC) is the most common form of skin cancer, typically exhibiting slow growth and limited metastatic potential. However, in rare, long-standing cases, particularly in high-risk facial regions, deep infiltration into structures such as bone may occur. This study aimed [...] Read more.
Background/Objectives: Basal cell carcinoma (BCC) is the most common form of skin cancer, typically exhibiting slow growth and limited metastatic potential. However, in rare, long-standing cases, particularly in high-risk facial regions, deep infiltration into structures such as bone may occur. This study aimed to evaluate whether BCC with bone involvement remains a relevant clinical issue, based on three decades of clinical experience, supplemented by a review of the existing literature. Methods: Medical records of patients treated for facial BCC between 1994 and 2025 at a dermatologic surgery department in Lower Silesia were retrospectively reviewed. Among more than 10,000 cases, eight instances of histologically confirmed bone invasion were identified. Clinical and surgical parameters were analyzed, including patient age, tumor size and location, prior treatment and reconstruction method. Relevant literature was incorporated to provide broader clinical context. Results: Patients with bone-invasive BCC were elderly (mean age: 75.3 years, SD: 10.94 years) and lesions were typically large (mean diameter 38.9 mm), most frequently located on the nose and forehead. Many cases lacked previous treatment. Smaller nasal tumors were managed with local flaps, while larger lesions on the forehead and temple required skin grafts. Findings from the literature confirm that bone invasion is rare and usually associated with long-standing tumors in anatomically high-risk areas. Conclusions: Although rare, BCC with bone infiltration remains a clinically relevant phenomenon, particularly in elderly patients with advanced or recurrent tumors. Early diagnosis, complete excision with histologically clear margins, and individualized surgical planning are essential to prevent deep tissue involvement. Imaging should be reserved for cases in which advanced local invasion is clinically suspected. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Skin Cancer)
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12 pages, 7495 KB  
Article
Streamlined Management of Basal Cell Carcinoma with Dermoscopy: A Retrospective Case–Control Study
by Francisca Donoso, Rosario Aguero, Marie-Chantal Caussade, Dominga Peirano, Leonel Hidalgo, Sofía Villagrán, Pascal De Amesti, Víctor Meza, Josefina Hasenberg, Katherine Droppelmann, Álvaro Abarzúa-Araya, Juan Camilo Castro-Ayala, John Paoli, Pablo Uribe and Cristián Navarrete-Dechent
J. Clin. Med. 2025, 14(24), 8945; https://doi.org/10.3390/jcm14248945 - 18 Dec 2025
Viewed by 391
Abstract
Background/Objective: The standard approach for managing suspected basal cell carcinoma (BCC) involves performing a biopsy to confirm the diagnosis before treatment. This process often leads to multiple visits and increased healthcare costs. We aimed to evaluate the effectiveness of direct surgical excision of [...] Read more.
Background/Objective: The standard approach for managing suspected basal cell carcinoma (BCC) involves performing a biopsy to confirm the diagnosis before treatment. This process often leads to multiple visits and increased healthcare costs. We aimed to evaluate the effectiveness of direct surgical excision of BCCs diagnosed clinically and dermoscopically, without the need for prior biopsy. Methods: We conducted a retrospective case–control study at a tertiary cancer center. Lesions suspected to be BCC, based on clinical and dermoscopic criteria, were divided into two groups: (1) a streamlined treatment group (cases), in which lesions were treated without a confirmatory biopsy (either excised with a 4 mm margin or managed with curettage and electrodesiccation); (2) and a biopsied group (controls). Clinical and histopathological data were analyzed and compared between groups to assess diagnostic accuracy, margin status, and treatment outcomes. Results: Of 389 BCCs, 167 (42.9%) were streamlined, while 222 (57.1%) underwent a biopsy before definitive treatment. The streamlined group demonstrated higher diagnostic accuracy, with 94.6% of excised lesions confirmed as BCC, compared with 73.4% in the biopsy group (p < 0.001). Among lesions excised with 4 mm margins, 97.9% achieved clear margins with the streamlined approach. Margin involvement was associated with high-risk BCC (p = 0.048), particularly with recurrent BCCs (p = 0.023). Conclusions: Streamlined management of BCC through direct excision without prior biopsy is an efficient and cost-effective strategy that reduces patient visits, costs, and waiting times, particularly for low-risk BCCs and older patients. Advances in dermoscopy and non-invasive tools support their accuracy, making it a feasible option in resource-limited settings. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Skin Cancer)
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Review

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14 pages, 1700 KB  
Review
Castleman Disease and Kaposi Sarcoma: A Review of the Literature and a Case Series
by Nerina Denaro, Lucia Brambilla, Federica Scarfì, Athanasia Tourlaki, Antonio Muscatello, Cinzia Solinas, Nicolò Rampi, Alessandra Bandera and Ornella Garrone
J. Clin. Med. 2025, 14(18), 6563; https://doi.org/10.3390/jcm14186563 - 18 Sep 2025
Cited by 2 | Viewed by 1547
Abstract
Castleman disease and Kaposi sarcoma (KS) are both associated with infection by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). This virus plays a critical role in the pathogenesis of both conditions, particularly in immunocompromised individuals, such as those with [...] Read more.
Castleman disease and Kaposi sarcoma (KS) are both associated with infection by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). This virus plays a critical role in the pathogenesis of both conditions, particularly in immunocompromised individuals, such as those with HIV/AIDS. Multicentric Castleman disease (MCD) generally presents with systemic inflammatory symptoms, lymphadenopathy, and organ dysfunction, while Kaposi sarcoma typically appears as vascular tumors on the skin, with occasional involvement of mucous membranes or internal organs. We present four clinical cases, with concurrent KS and MCD, treated with chemotherapy and rituximab, with a satisfactory response. We highlighted the essential role of prompt investigation of systemic or inflammatory manifestations (fever, vital parameter alterations such as palpitation, high breath frequency, edema, and kidney impairment) as underlined in our case series, which might underscore possible complications. Multiorgan failure, opportunistic infections, or rapid clinical deterioration might occur if the diagnosis is not adequately assessed. Therefore, this paper emphasizes the importance of timely diagnosis, as it enables the prompt initiation of appropriate antiviral, immunomodulatory, or oncologic therapies—interventions that can significantly improve outcomes and may be life-saving in advanced or aggressive disease presentations. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Skin Cancer)
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Other

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25 pages, 697 KB  
Systematic Review
Comparative Meta-Analysis of Survival, Risk, and Treatment Efficacy in Immunotherapy for Metastatic Melanoma Using Random-, Fixed-, and Mixed-Effects Models
by Jelena Ivetić, Jovana Dedeić, Srđan Milićević, Katarina Vidojević and Marija Delić
J. Clin. Med. 2025, 14(14), 5017; https://doi.org/10.3390/jcm14145017 - 15 Jul 2025
Cited by 1 | Viewed by 2060
Abstract
Background: Immune checkpoint inhibitors (ICIs) have reshaped the treatment landscape of metastatic melanoma. While combination regimens often demonstrate improved response and survival compared to monotherapy, they are also associated with a higher incidence of immune-related adverse events (irAEs). Understanding the balance between benefit [...] Read more.
Background: Immune checkpoint inhibitors (ICIs) have reshaped the treatment landscape of metastatic melanoma. While combination regimens often demonstrate improved response and survival compared to monotherapy, they are also associated with a higher incidence of immune-related adverse events (irAEs). Understanding the balance between benefit and risk is essential for making informed treatment decisions, especially given the variability in reported outcomes across clinical trials. Methods: We conducted a systematic review and meta-analysis of 14 clinical trials (comprising 22 treatment arms and >5000 patients) comparing ICI monotherapy (nivolumab, ipilimumab, or pembrolizumab) and combination therapy (nivolumab + ipilimumab) in advanced melanoma. Treatment-related outcomes were synthesized using fixed-effects, random-effects, or generalized linear mixed models (GLMMs), depending on study variability. Survival data were extracted from published Kaplan–Meier curves and analyzed using longitudinal GLMMs to capture trends over time. Results: Compared to monotherapy, combination immunotherapy achieved higher clinical benefit, with an overall response of 52.2% (vs. 31.6%), a five-year overall survival of 55.7% (vs. 34.3%), and a five-year progression-free survival of 39.0% (vs. 17.2%). However, this benefit came with a higher risk of toxicity: immune-related adverse events occurred in 93.2% of patients receiving combination therapy versus in 81.9% receiving monotherapy. Differences were consistent across all individual severe toxicities. Conclusions: Combination immunotherapy offers greater long-term clinical benefit than monotherapy in metastatic melanoma but at the cost of increased toxicity. By applying models adapted to study variability, we provide more reliable estimates of treatment efficacy and risk. GLMMs provide the most robust estimates and enable the modeling of survival dynamics over time. These findings support evidence-based decision-making and highlight the value of model-informed meta-analysis in oncology. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Skin Cancer)
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