“Keratinocyte Carcinoma” is the New Term for Non-Melanoma Skin Cancer (NMSC)

It’s time for “Keratinocyte Carcinoma” to replace the term “Non-Melanoma Skin Cancer (NMSC)”.

Karimkhani C, Boyers LN, Dellavalle RP, Weinstock MA.

J Am Acad Dermatol. 2015 Jan;72(1):186-7. doi: 10.1016/j.jaad.2014.09.036. No abstract available.

Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are the 2 most common cancers of the skin and are probably derived from epidermal cells called keratinocytes.

Thus “Keratinocyte Carcinoma” Replaces Non-melanoma Skin Cancer (NMSC).

Indeed “NMSC” includes SCC and BCC but the term can also refer to other skin cancers, such as Merkel cell carcinoma, dermatofibrosarcoma protuberans (DFSO), cutaneous lymphoma, sebaceous carcinoma, angiosarcoma, malignant fibrous histiocytoma, various malignant appendage tumors, and any other cancer of the skin except melanoma….this is a whole variety of skin cancers which behave differently and carry different prognoses

Comments

-The term “keratinocyte carcinoma” is a term which defines SCC and BCC; they are the most common skin cancers and they are generally managed in a similar fashion.
-This makes perfect sense in terms of health care delivery and funding. It also makes it clearer to the community of changes in terminology alongside our understanding of skin cancer
–Critics, most likely specialists and perhaps less acquainted with the wider perspective will readily highlight the some of the differences between these 2 skin cancers:

-Basal Cell Carcinoma (BCC) :

• is locally invasive but rarely metastasize.
• malignant keratinocytes are derived from Basal Cells in the fair follicle (they generally no not occur in glabrous skin)
• The BCC sonic hedgehog pathway is known to be dysregulated

-Squamous Cell Carcinoma (SCC)

• is less invasive locally but they have an ability to metastasize (in around 5%) of cases
• is sometimes preceded by premalignant and “in situ” forms: Actinic Keratosis (AK), Bowen’s disease (Squamous Cell Carcinoma in situ: “in situ” refers to neoplasms which have not invaded the basal membrane and therefore malignant cells cannot enter the bloodstream
• is derived from malignant keratinocytes derived from the spinous layer (Stratum Spinosum)

Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland