<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">IJCM</journal-id><journal-title-group><journal-title>International Journal of Clinical Medicine</journal-title></journal-title-group><issn pub-type="epub">2158-284X</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/ijcm.2011.24080</article-id><article-id pub-id-type="publisher-id">IJCM-7563</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  Topical Solasodine Rhamnosyl Glycosides Derived From the Eggplant Treats Large Skin Cancers: Two Case Reports
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>ill</surname><given-names>E. Cham</given-names></name><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><author-notes><corresp id="cor1">* E-mail:<email>bill.cham@gmail.com</email></corresp></author-notes><pub-date pub-type="epub"><day>30</day><month>09</month><year>2011</year></pub-date><volume>02</volume><issue>04</issue><fpage>473</fpage><lpage>477</lpage><history><date date-type="received"><day>May</day>	<month>25th,</month>	<year>2011</year></date><date date-type="rev-recd"><day>June</day>	<month>29th,</month>	<year>2011</year>	</date><date date-type="accepted"><day>July</day>	<month>20th,</month>	<year>2011.</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Solasodine rhamnosyl glycosides (BEC) are a new class of antineoplastics that show superior efficacy than many established anticancer drugs as shown by intravenous, intraperitoneal and intralesion administrations. Previous studies have described the efficacy of BEC on nonmelanoma skin cancers by topical application. Two cases are now reported which show that BEC in a cream formulation Curaderm is very effective for the treatment of large nonmelanoma skin cancers that are considered difficult to treat by existing modalities. Moreover, the cosmetic outcomes are very impressive.
 
</p></abstract><kwd-group><kwd>Nonmelanoma Skin Cancers</kwd><kwd> Solasodine Rhamnosyl Glycosides</kwd><kwd> Curaderm</kwd><kwd> Solamargine</kwd><kwd> Solasonine</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>There is an alarming increase in skin cancer incidence. In the US alone, more than two million people develop over 3.5 million nonmelanoma skin cancers every year. This constitutes a more than 300 percent increase in cancer incidence since 1992 [<xref ref-type="bibr" rid="scirp.7563-ref1">1</xref>].</p><p>Nonmelanoma skin cancers, such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are the most common forms of skin cancer. Though BCCs are rarely life-threatening, they can be disfiguring when not diagnosed and treated in a timely manner. SCCs can metastasize (spread) to distant tissues or organs and are potentially terminal.</p><p>The incidence of skin cancer is higher than all other cancers combined and is considered by some as an epidemic.</p><p>A variety of treatments are available for nonmelanoma skin cancers with good outcomes, especially if the cancers are detected and treated in the early stages of development. However, there are some serious disadvantages with the most common treatments. Some disadvantages of current treatments are:</p><p>• margin around cancer may not be free of cancer</p><p>• moderately painful</p><p>•slow healing</p><p>• scarring</p><p>•specialized training by health professionals with appropriate facilities</p><p>• expensive</p><p>• activity restriction after surgery if skin graft or flap is needed</p><p>• limited cosmetic results In addition high recurrence rates of treated skin cancers have been reported [<xref ref-type="bibr" rid="scirp.7563-ref2">2</xref>].</p><p>The treatment and management of nonmelanoma skin cancers cost the USA health care system more than US$1.4 billion per year and this value is increasing dramatically each year.</p><p>There is a need for novel treatments for nonmelanoma skin cancers. It has previously been shown in a large number of studies that the glycoalkaloids solasodine rhamnosyl glycosides (SRGs) induce apoptosis in a wide variety of cancer cells [3-7]. SRGs are present in a diversity of solanaceous plants such as the Devil’s Apple (Solanum linnaeanum) and Eggplant (S. melongena). SRGs display specificity towards cancer cells when compared with normal cells and the unique mode of action has been described [8,9]. Anticancer therapies with SRGs in animals and humans have been used intravenously [<xref ref-type="bibr" rid="scirp.7563-ref10">10</xref>], intraperitoneally [<xref ref-type="bibr" rid="scirp.7563-ref11">11</xref>], intralesionally [<xref ref-type="bibr" rid="scirp.7563-ref12">12</xref>] and topically [13-17]. A constant mixture of SRGs, known as BEC, consisting of solasodine containing triglycosides solasonine (β-solatriose) (33%), solamargine (β-chacotriose) (33%), and di-and monoglycosides (34%), are present in a cream formulation which contains 0.005% BEC (Curaderm). Curaderm is reportedly effective for treating nonmelanoma skin cancers as shown by uncontrolled [13-16] and controlled studies [<xref ref-type="bibr" rid="scirp.7563-ref17">17</xref>]. Here, two cases of large skin cancers treated with the cream formulation Curaderm are reported.</p></sec><sec id="s2"><title>2. Case Reports</title><sec id="s2_1"><title>2.1. Case Report 1</title><p>A 68 year old farmer was referred for consultation because he had a large basal cell carcinoma (BCC). Dermatologists and surgeons had recommended surgical excision and radiotherapy followed by surgical reconstruction with skin grafting. The patient who had this BCC for at least 3 years elected to treat the lesion with the cream formulation Curaderm. The patient exhibited a large lesion, 4 cm &#215; 4 cm &#215; 2 cm, on the right side of his face next to his ear (<xref ref-type="fig" rid="fig1">Figure 1</xref> top row). Histological analysis of a biopsy determined that it was a BCC.</p></sec><sec id="s2_2"><title>2.2. Case Report 2</title><p>A 63 year old retired man had a histologically confirmed squamous cell carcinoma (SCC), 4 cm in diameter, on his head (<xref ref-type="fig" rid="fig2">Figure 2</xref>(a)). This patient who had this SCC for at least 2 years refused other treatments and decided to have Curaderm therapy.</p></sec><sec id="s2_3"><title>2.3. Materials and Methods</title><p>The cream formulation Curaderm is available to patients</p><p>in several countries. Curaderm contains the glycoalkaloids BEC at 0.005% as a topical cream formulation. The cream was applied twice daily (when possible every 12 hrs) under occlusive dressing (micropore paper tape) until the lesion had clinically regressed.</p></sec></sec><sec id="s3"><title>3. Results</title><p><xref ref-type="fig" rid="fig1">Figure 1</xref> top row shows the extent of the BCC just before treatment with Curaderm. The lesion responded rapidly to the treatment. The middle row of <xref ref-type="fig" rid="fig1">Figure 1</xref> shows the appearance of the lesion after 2 weeks of treatment. It can be seen that minor bleeding had occurred during treatment. The bottom row of <xref ref-type="fig" rid="fig1">Figure 1</xref> shows the treated area after 14 weeks of Curaderm therapy. The lesion was eliminated by the treatment and the cosmetic end result was outstanding. Note, there was no scar tissue and the hairs had regrown where the lesion was originally. This patient did not experience side effects during Curaderm therapy other than some bleeding had occurred. There has been no recurrence one year after treatment.</p></sec></body><back><ref-list><title>References</title><ref id="scirp.7563-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">H. W. Rogers, N. A. Weinstock, A. R. Harris, M. R. Hinckley, S. R. Feldman, A. B. Fleischer and B. M. Coldiron, “Incidence Estimate of Nonmelanoma Skin Cancer in the United States,” Archives of Dermatology, Vol. 146, No. 3, 2010, pp. 283-287.  
doi:10.1001/archdermatol.2010.19</mixed-citation></ref><ref id="scirp.7563-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">L. A. E. Sussman and D. F. Liggins, “Incompletely Excised Basal Cell Carcinoma a Management Dilemma?” Australian and New Zealand Journal of Surgery, Vol. 66, No. 5, 1996, pp. 276-278.  
doi:10.1111/j.1445-2197.1996.tb01184.x</mixed-citation></ref><ref id="scirp.7563-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">K. W. Kuo, S. H. Hsu, Y. P. Li, W. L. Lin, L. F. Liu, L. C. Chang, C. C. Lin, C. N. Lin and H. M. Sheu, “Anticancer Activity Evaluation of the Solanum Glycoalkaloid Solamargine. Triggering Apoptosis in Human Hepatoma Cells,” Biochemical Pharmacology, Vol. 60, No. 12, 2000, pp. 1865-1873.  
doi:10.1016/S0006-2952(00)00506-2</mixed-citation></ref><ref id="scirp.7563-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">C. H. Liang, L. F. Liu, L. Y. Shiu, Y. S. Huang, L. C. Chang and K. W. Kuo, “Action of Solamargine on TNFs and Cisplatin-Resistant Human Lung Cancer Cells,” Biochemical and Biophysical Research Communications, Vol. 322, No. 3, 2004, pp. 751-758.</mixed-citation></ref><ref id="scirp.7563-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">L. Y. Shiu, L. C. Chang, C. H. Liang, Y. S. Huang, H. M. Sheu and K. W. Kuo, “Solamargine Induces Apoptosis and Sensitizes Breast Cancer Cells to Cisplatin,” Food and Chemical Toxicology, Vol. 45, No. 11, 2007, pp. 2155-2164. doi:10.1016/j.fct.2007.05.009</mixed-citation></ref><ref id="scirp.7563-ref6"><label>6</label><mixed-citation publication-type="other" xlink:type="simple">L. Y. Shiu, C. H. Liang, Y. S. Huang, H. M. Sheu and K. W. Kuo, “Downregulation of HER2/neu Receptor by Solamargine Enhances Anticancer Drug-Mediated Cytotoxicity in Breast Cancer Cells with High-Expressing HER2/neu,” Cell Biology and Toxicology, Vol. 24, No. 1, 2008, pp. 1-10. doi:10.1007/s10565-007-9010-5</mixed-citation></ref><ref id="scirp.7563-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">L. Sun, Y. Zhao, H. Yuan, X. Li, A. Cheng and H. Lou, “Solamargine, a Steroidal Alkaloid Glycoside, Induces Oncosis in Human K562 Leukemia and Squamous Cell Carcinoma KB Cells,” Cancer Chemotherapy and Pharmacology, Vol. 65, No. 4, 2010, pp. 1125-1130.</mixed-citation></ref><ref id="scirp.7563-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham and B. Daunter, “Solasodine Glycosides. Selective Cytotoxicity for Cancer Cells and Inhibition of Cytotoxicity by Rhamnose in Mice with Sarcoma 180,” Cancer Letters, Vol. 55, No. 3, 1990, pp. 221-225.  
doi:10.1016/0304-3835(90)90122-E</mixed-citation></ref><ref id="scirp.7563-ref9"><label>9</label><mixed-citation publication-type="other" xlink:type="simple">B. Daunter, B. E. Cham, “Solasodine Glycosides. In vitro Preferential Cytotoxicity for Human Cancer Cells,” Cancer Letters, Vol. 55, No. 3, 1990, pp. 209-220.  
doi:10.1016/0304-3835(90)90121-D</mixed-citation></ref><ref id="scirp.7563-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">M. Millward, A. Powell, P. Daly, S. Tyson, R. Ferguson and S. Carter, “Results of Phase I Clinical Trials of Coramsine in Patients with Advanced Solid Tumours,” Journal of Clinical Oncology, Vol. 24, No. 18S, 2006, p. 2070.</mixed-citation></ref><ref id="scirp.7563-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham, M. Gilliver and L. Wilson, “Antitumour Effects of Glycoalkaloids Isolated from Solanum Sodomaeum L.,” Planta Medica, Vol. 53, No. 1, 1987, pp. 34- 36. doi:10.1055/s-2006-962612</mixed-citation></ref><ref id="scirp.7563-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham, “Cancer Intralesion Chemotherapy with Solasodine Rhamnosyl Glycosides,” Research Journal of Biological Sciences, Vol. 3, No. 9, 2008, pp. 1008-1017.</mixed-citation></ref><ref id="scirp.7563-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham, “Solasodine Rhamnosyl Glycosides Specifically Bind Cancer Cell Receptors and Induce Apoptosis and Necrosis. Treatment for Skin Cancer and Hope for Internal Cancers,” Research Journal of Biological Sciences, Vol. 2, No. 4, 2007, pp. 503-514.</mixed-citation></ref><ref id="scirp.7563-ref14"><label>14</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham, B. Daunter and R. Evans, “Topical Treatment of Malignant and Premalignant Skin Cancers by Very Low Concentrations of a Standard Mixture of Solasodine Glycosides,” Cancer Letters, Vol. 59, No. 3, 1991, pp. 183-192. doi:10.1016/0304-3835(91)90140-D</mixed-citation></ref><ref id="scirp.7563-ref15"><label>15</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham, “Solasodine Rhamnosyl Glycosides in a Cream Formulation is Effective for Treating Large and Troublesome Skin Cancers,” Research Journal of Biological Sciences, Vol. 2, No. 7, 2007, pp. 749-761.</mixed-citation></ref><ref id="scirp.7563-ref16"><label>16</label><mixed-citation publication-type="other" xlink:type="simple">B. E. Cham and M. M. Meares, “Glycoalkaloids from Solanum sodomaeum L. Are Effective in the Treatment of Skin Cancers in Man,” Cancer Letters, Vol. 36, No. 2, 1987, pp. 111-118. doi:10.1016/0304-3835(87)90081-4</mixed-citation></ref><ref id="scirp.7563-ref17"><label>17</label><mixed-citation publication-type="other" xlink:type="simple">S. Punjabi, L. J. Cook, P. Kersey, R. Marks and R. Cerio, “Solasodine Glycoalkaloids: A Novel Topical Therapy for Basal Cell Carcinoma. A Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Multicentre Study,” International Journal of Dermatology, Vol. 47, No. 1, 2008, pp. 78-82. doi:10.1111/j.1365-4632.2007.03363.x</mixed-citation></ref><ref id="scirp.7563-ref18"><label>18</label><mixed-citation publication-type="other" xlink:type="simple">K. W. Kuo and C. N. Lin, “Pharmacological Composition for Treating Cancer Cells,” United states Patent, No. US 9/435521, 1999.</mixed-citation></ref><ref id="scirp.7563-ref19"><label>19</label><mixed-citation publication-type="other" xlink:type="simple">L. Y. Shiu, L. C. Chang, C. H. Liang, Y. S. Huang, H. M. Sheu and K. W. Kuo, “Solamargine Induces Apoptosis and Sensitizes Breast Cancer Cells to Cisplatin,” Food and Chemical Toxicology, Vol. 45, No. 11, 2007, pp. 2155-2164. doi:10.1016/j.fct.2007.05.009</mixed-citation></ref></ref-list></back></article>