Assuntos
Carcinoma de Células Escamosas/patologia , Ceratose Seborreica/diagnóstico , Neoplasias Laríngeas/patologia , Síndromes Paraneoplásicas/patologia , Idoso , Biópsia por Agulha , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/métodos , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Ceratose Seborreica/complicações , Ceratose Seborreica/etiologia , Neoplasias Laríngeas/complicações , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/etiologia , Estudos de Amostragem , Irmãos , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Carcinoma de Células Escamosas/diagnóstico , Cicatriz/diagnóstico , Cicatriz/radioterapia , Lúpus Vulgar/diagnóstico , Lúpus Vulgar/radioterapia , Idoso , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/terapia , Cicatriz/complicações , Humanos , Lúpus Vulgar/complicações , MasculinoAssuntos
Carcinoma de Células Escamosas/patologia , Condiloma Acuminado/patologia , Epidermodisplasia Verruciforme/patologia , Lesões Pré-Cancerosas/patologia , Neoplasias Cutâneas/patologia , Adulto , Canal Anal , Biópsia por Agulha , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Condiloma Acuminado/diagnóstico , Epidermodisplasia Verruciforme/diagnóstico , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Radioterapia Adjuvante , Medição de Risco , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Procedimentos Cirúrgicos Operatórios/métodos , Resultado do TratamentoRESUMO
Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by a unique susceptibility to cutaneous infection by a group of phylogenetically related human papilloma viruses (HPVs). These patients show a defect in cell-mediated immunity specific toward the causative HPVs that lead to lifelong disease. The defect is usually inherited as autosomal recessive trait and presents clinically with plane warts, pityriasis versicolor-like lesions and reddish verrucous plaques. Dysplastic and malignant changes in the form of actinic keratoses, Bowen's disease and squamous cell carcinoma (SCC) are common but metastasis occurs rarely. A totally effective treatment against EV is as yet highly desirable. Two siblings having autosomal dominant EV presented with multiple actinic keratoses in addition to classic lesions. One of them had also developed well-differentiated SCC over forehead with metastases to regional lymph nodes. They were treated with combination of excision of small malignant/premalignant lesions, topical 5-flurouracil and sun protection. Additionally, elective excision/grafting of large SCC was performed after chemotherapy/radiotherapy in patient with metastatic SCC. Oral acitretin (25 mg/day) was of benefit in the other patient. Overall clinicotherapeutic experience in both the patients is discussed here.
Assuntos
Epidermodisplasia Verruciforme/genética , Epidermodisplasia Verruciforme/patologia , Genes Dominantes , Adulto , Antineoplásicos/uso terapêutico , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Epidermodisplasia Verruciforme/terapia , Saúde da Família , Feminino , Humanos , Masculino , Cirurgia de Mohs , Irmãos , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Adulto JovemAssuntos
Carcinoma de Células Escamosas/patologia , Hanseníase Virchowiana/complicações , Neoplasias Cutâneas/patologia , Úlcera Cutânea/patologia , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/terapia , Doença Crônica , Evolução Fatal , Feminino , Humanos , Hanseníase Virchowiana/tratamento farmacológico , Neoplasias Cutâneas/terapia , Úlcera Cutânea/terapiaRESUMO
DNA-hsp65, a DNA vaccine encoding the 65-kDa heat-shock protein of Mycobacterium leprae (Hsp65) is capable of inducing the reduction of established tumors in mouse models. We conducted a phase I clinical trial of DNA-hsp65 in patients with advanced head and neck carcinoma. In this article, we report on the vaccine's potential to induce immune responses to Hsp65 and to its human homologue, Hsp60, in these patients. Twenty-one patients with unresectable squamous cell carcinoma of the head and neck received three doses of 150, 400 or 600 microg naked DNA-hsp65 plasmid by ultrasound-guided intratumoral injection. Vaccination did not increase levels of circulating anti-hsp65 IgG or IgM antibody, or lead to detectable Hsp65-specific cell proliferation or interferon-gamma (IFN-gamma) production by blood mononuclear cells. Frequency of antigen-induced IL-10-producing cells increased after vaccination in 4 of 13 patients analyzed. Five patients showed disease stability or regression following immunization; however, we were unable to detect significant differences between these patients and those with disease progression using these parameters. There was also no increase in antibody or IFN-gamma responses to human Hsp60 in these patients. Our results suggest that although DNA-hsp65 was able to induce some degree of immunostimulation with no evidence of pathological autoimmunity, we were unable to differentiate between patients with different clinical outcomes based on the parameters measured. Future studies should focus on characterizing more reliable correlations between immune response parameters and clinical outcome that may be used as predictors of vaccine success in immunosuppressed individuals.
Assuntos
Vacinas Anticâncer/uso terapêutico , Carcinoma de Células Escamosas/terapia , Neoplasias de Cabeça e Pescoço/terapia , Proteínas de Choque Térmico/imunologia , Imunoterapia/métodos , Vacinas de DNA/imunologia , Adulto , Idoso , Formação de Anticorpos/imunologia , Vacinas Anticâncer/imunologia , Esquema de Medicação , Ensaio de Imunoadsorção Enzimática , Feminino , Proteínas de Choque Térmico/genética , Humanos , Imunidade Celular/imunologia , Masculino , Pessoa de Meia-Idade , Vacinas de DNA/genéticaAssuntos
Ceratose/terapia , Lesões Pré-Cancerosas/terapia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/terapia , Curetagem/métodos , Humanos , Ceratose/complicações , Ceratose/tratamento farmacológico , Lesões Pré-Cancerosas/tratamento farmacológico , Lesões Pré-Cancerosas/etiologiaRESUMO
Se estudian las úlceras en la lepra, su etiología, frecuencia y localización, la mayoría de carácter neurotrófico. Se describen diferentes tratamientos tópicos y quirúrgicos, resaltando las dificultades terapéuticas y la cronicidad (AU)