{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T07:58:56Z","timestamp":1763193536230,"version":"3.45.0"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    : Basal cell carcinoma (BCC) is the most common form of skin cancer, mainly occurring in the elderly. Studies on BCC patients under the age of 40 (early\u2010onset BCC) are scarce.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Patients and Methods<\/jats:bold>\n                    : 52 BCCs (48 patients, median age: 35\u00a0years) were investigated using immunohistochemistry, focusing on the cell cycle, immunogenicity, and HER2 expression. We used PCR to test for Human Papilloma Virus (HPV) and chromogenic in\u2010situ hybridization for HER2 subclassification.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : 69% of cases were classified as non\u2010aggressive subtypes, and 31% as aggressive. Changes\u00a0in p16 and\/or p53 were observed in 44% of cases. No HPV\u2010DNA was detected. Overexpression of p16 was associated with an aggressive growth pattern, whereas p53 changes were independent of the growth pattern. Aggressive subtypes and p16\u2010positivity correlated with higher expression levels of cyclin E1 and Ki\u201067, as well as a stronger B\u2010cell response. Similar findings were observed in p53\u2010altered basal cell carcinomas with respect to Ki\u201067 expression and B\u2010lymphocyte infiltration; however, cyclin E1 expression was reduced in this subgroup. 71% of tumors belonged to the HER2\u2010low group, which was associated with higher expression levels of cyclin E1 and Ki\u201067 and a more pronounced immunogenic response.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : This is the largest immunohistochemical characterization of early\u2010onset BCC to date. The classification into non\u2010aggressive and aggressive subtypes appears appropriate, as applied in the elderly. Further sub\u2010classification based on p16, p53, and HER2 may reflect disrupted cell cycle mechanisms combined with an immunogenic response.\n                  <\/jats:p>","DOI":"10.1111\/ddg.15819","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T06:25:29Z","timestamp":1752819929000},"page":"1414-1421","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An immunohistochemical characterization of basal cell carcinoma in patients below 40\u00a0years of age"],"prefix":"10.1111","volume":"23","author":[{"given":"Vincent","family":"Waller","sequence":"first","affiliation":[{"name":"Institute of Pathology University of Leipzig Medical Center  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Boeschen","sequence":"additional","affiliation":[{"name":"Institute of Pathology University of Leipzig Medical Center  Leipzig 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