RESUMO
BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.
Assuntos
Bexaroteno , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Tetra-Hidronaftalenos , Humanos , Bexaroteno/uso terapêutico , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Tetra-Hidronaftalenos/uso terapêutico , Tetra-Hidronaftalenos/efeitos adversos , Micose Fungoide/tratamento farmacológico , Síndrome de Sézary/tratamento farmacológico , Espanha , Linfoma Cutâneo de Células T/tratamento farmacológico , Resultado do Tratamento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversosRESUMO
BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.
Assuntos
Bexaroteno , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Tetra-Hidronaftalenos , Humanos , Bexaroteno/uso terapêutico , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Tetra-Hidronaftalenos/uso terapêutico , Tetra-Hidronaftalenos/efeitos adversos , Micose Fungoide/tratamento farmacológico , Síndrome de Sézary/tratamento farmacológico , Espanha , Linfoma Cutâneo de Células T/tratamento farmacológico , Resultado do Tratamento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversosRESUMO
OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.
Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasia de Células Basais , Neoplasias Cutâneas , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Melanoma/complicações , Cirurgia de Mohs , Estudos Prospectivos , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/cirurgiaAssuntos
Carcinoma Basocelular/cirurgia , Cartilagem da Orelha/transplante , Recidiva Local de Neoplasia/cirurgia , Neoplasias Nasais/cirurgia , Nariz/cirurgia , Rinoplastia/métodos , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Idoso , Feminino , Humanos , Cirurgia de Mohs , Transplante AutólogoAssuntos
Eosinofilia/etiologia , Foliculite/etiologia , Linfoma Cutâneo de Células T/complicações , Gamopatia Monoclonal de Significância Indeterminada/complicações , Dermatopatias Vesiculobolhosas/etiologia , Neoplasias Cutâneas/complicações , Bexaroteno , Complexo CD3/análise , Antígenos CD4/análise , Eosinofilia/diagnóstico , Eosinofilia/patologia , Foliculite/diagnóstico , Foliculite/patologia , Humanos , Interferon-alfa/uso terapêutico , Linfoma Cutâneo de Células T/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Terapia PUVA , Indução de Remissão , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/patologia , Neoplasias Cutâneas/tratamento farmacológico , Subpopulações de Linfócitos T/química , Subpopulações de Linfócitos T/imunologia , Tetra-Hidronaftalenos/uso terapêuticoAssuntos
Micose Fungoide/patologia , Neoplasias Cutâneas/patologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The nasal pyramid is frequently affected by nonmelanoma skin cancer. Sometimes the aggressiveness of tumours entails the extirpation of the mucosa, the cartilage, and the nasal skin. Reconstruction of the cartilaginous portion can be a surgical challenge. We demonstrate that titanium mesh can be an effective substitute for the cartilaginous portion of the nose in nasal reconstruction. We present five patients with nasal basal cell carcinoma who were treated by Mohs micrographic surgery. The partial loss of the cartilaginous structure was replaced by a 0.1 mm fenestrated titanium mesh. We have not observed any rejection or other complication in any of our patients. Good functional and aesthetic results have been obtained. Because of its biocompatibility, titanium mesh is a useful substitute for nasal cartilage. It avoids harvesting natural cartilage, reduces the risk of graft necrosis, and prevents morbidity in the donor area.
Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias Nasais/cirurgia , Rinoplastia/métodos , Telas Cirúrgicas , Titânio , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Deformidades Adquiridas Nasais/cirurgia , Retalhos Cirúrgicos , Resultado do TratamentoAssuntos
Carcinoma Basocelular/cirurgia , Neoplasias Palpebrais/cirurgia , Sobrevivência de Enxerto/efeitos dos fármacos , Nitroglicerina/administração & dosagem , Retalhos Cirúrgicos , Vasodilatadores/administração & dosagem , Administração Cutânea , Aerossóis , Idoso de 80 Anos ou mais , Humanos , Masculino , Nitroglicerina/uso terapêutico , Fumar/efeitos adversos , Vasodilatadores/uso terapêuticoRESUMO
We observed a 73-year-old man with necrobiotic xanthogranuloma (NXG) on the eyelids and concurrent multiple myeloma. The treatment was surgery followed by administration of melphalan. No relapse was seen in 19 months of follow-up. We consider that surgical removal of xanthogranuloma is an advisable rapid treatment that involves fewer side-effects than other treatments.
Assuntos
Granuloma Anular/patologia , Mieloma Múltiplo/patologia , Xantomatose/patologia , Idoso , Biópsia por Agulha , Análise Química do Sangue , Seguimentos , Granuloma Anular/complicações , Granuloma Anular/tratamento farmacológico , Humanos , Imuno-Histoquímica , Masculino , Melfalan/uso terapêutico , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Doenças Raras , Medição de Risco , Resultado do Tratamento , Xantomatose/complicações , Xantomatose/tratamento farmacológicoRESUMO
Whitish lesions in oral mucosa are usually diagnosed as candidosis, lichen planus or dysplasias. However, other infrequent entities associated with leukoplakia should be borne in mind. We present the case of a 7-year-old girl with whitish lesions in the oral mucosa. Laboratory, mycological and histopathological investigations were performed and the patient was diagnosed with oral white sponge nevus.
Assuntos
Leucoplasia Oral/diagnóstico , Neoplasias Bucais/diagnóstico , Nevo/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Mucosa BucalRESUMO
Lymphangioma circumscriptum is a benign disease of the lymph ducts and an unusual pathologic process that rarely affects the vulva. The etiology of this lesion is not clear, but obstruction of the lymph vessels has been suggested as a possible cause in some cases. We report the case of a 44-year-old woman with lesions similar to lymphangioma circumscriptum of the vulva and chronic idiopathic lymphedema of the lower right limb. Because there was no obvious cause, we propose that the lymphangioma was caused by the lymphedema.
Assuntos
Linfangioma/diagnóstico , Neoplasias Vulvares/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Perna (Membro) , Linfangioma/etiologia , Linfangioma/patologia , Linfedema/complicações , Neoplasias Vulvares/etiologia , Neoplasias Vulvares/patologiaRESUMO
A 65-year-old woman on whom a cardiac catherization using iodine contrast had been performed developed 5 days later acute renal failure, respiratory insufficiency and cutaneous lesions consisting of two great vegetating masses located on both cheeks and pustular vesicular lesions on the extremities. A fortnight later, the patient died. We would like to stress this case because of the exceptional nature of vegetating iododerma at present, and the importance of recognizing a possibly fatal disease.