Mechanisms and efficacy of vismodegib in the treatment of basal cell carcinoma.

Historically patients with advanced basal cell carcinoma have been subjected to large surgical resections for the treatment of their disease. However, with the development of vismodegib, a first in class molecule that acts to inhibit the hedgehog pathway, patients with advanced and metastatic basal cell carcinoma may have renewed hope in limiting the morbidity involved with surgery. Preliminary data shows a relatively good safety profile and promising results, although further research remains to be conducted.

Hedgehog antagonist GDC-0449 is effective in the treatment of advanced basal cell carcinoma.

Objectives/hypothesis: To demonstrate the efficacy of the hedgehog pathway inhibitor GDC-0449 in the treatment of advanced basal cell carcinoma.

Design Study: Case series.

Methods: Three patients treated in a referral center for locally advanced basal cell carcinoma, one with metastases, were referred for treatment in a GDC-0449 phase I clinical trial.

Expanded applications of the dorsal nasal flap.

Objective: To describe new applications for the dorsal nasal flap technique of facial reconstruction.

Methods: Retrospective review of surgical records of patients in whom the dorsal nasal flap technique was used.

Results: The dorsal nasal flap technique was used in 61 patients to repair defects ranging in size from 12 x 17 mm to 35 x 40 mm.

Malignant proliferating pilar tumors arising in KID syndrome: a report of two patients.

We report on two young adults with KID syndrome and follicular hyperkeratosis, hidradenitis suppurativa of the groin, progressive development of proliferative pilar cysts and dissecting cellulitis of the scalp, who developed metastatic malignant pilar tumors. Based on our findings, we believe that cancer surveillance in patients with KID syndrome should include screening for pilar tumors and their early removal to avoid development of malignant proliferating pilar tumors with poor prognosis.