Advances in Management and Therapeutics of Cutaneous Basal Cell Carcinoma.

Basal cell carcinoma (BCC), the most common cancer in humans, is a malignant neoplasm of cells derived from the basal layer of the epidermis. Tumor characteristics such as histologic subtype, primary versus recurrent tumor, anatomic location, size, and patient attributes determine the risk level and acceptable treatment options. Surgical options offer histologic confirmation of tumor clearance. Standard excision provides post-treatment histologic assessment, while Mohs micrographic surgery (MMS) provides complete margin assessment intraoperatively. Additional treatment options may be employed in the correct clinical context. Small and low-risk BCCs, broad field cancerization, locally-advanced disease, metastatic disease, cosmetic concerns, or morbidity with surgical approaches raise consideration of other treatment modalities. We review herein a range of treatment approaches and advances in treatments for BCC, including standard excision, MMS, electrodesiccation and curettage, ablative laser treatment, radiation therapy, targeted molecular therapies, topical therapies, field therapies, immunotherapy, and experimental therapies.

Patient Impressions and Outcomes After Clinic-Based Hidradenitis Suppurativa Surgery.

IMPORTANCE: Surgical intervention is frequently needed to treat hidradenitis suppurativa (HS). Patient satisfaction is high based on previous studies, but reports of patient impressions of clinic-based operative experiences and postoperative recovery are limited. OBJECTIVE: To characterize patient impressions, outcomes, and recovery time after clinic-based surgical treatment of HS and examine patient characteristics associated with outcomes. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included patients 12 years or older who underwent clinic-based surgical procedures for treatment of HS at a single subspecialty HS clinic at the University of North Carolina Department of Dermatology from April 2014 to December 2018. Data analysis was performed from January to September 2021. EXPOSURES: Clinic-based deroofing and excisional procedures performed as part of routine care. MAIN OUTCOMES AND MEASURES: The primary outcomes were patient-reported recurrence of HS at the site of surgery, patient satisfaction with the procedures and outcomes, and patient-reported pain and recovery associated with surgery obtained from electronic medical record review and patient questionnaires. RESULTS: Outcomes of 194 procedures for 78 patients (65 [83%] female; mean [SD] age, 35.1 [12.1] years) were analyzed. Self-reported rate of recurrence was 41% (79 procedures). Despite recurrence, most patients (148 procedures [76%]) were very satisfied with their surgical results. The median number of missed days of work or school was 2 (IQR, 1-7 days), and the median number of days until return to normal activity was 10 (IQR, 3-14 days). In addition, for 126 of the 194 procedures (65%), patients stated that pain during an HS flare was worse than pain during surgical recovery. CONCLUSIONS AND RELEVANCE: In this cohort study, patients reported high rates of satisfaction with clinic-based HS surgery. Recovery was typically rapid, with most patients rating postsurgical pain as less severe than their HS pain.

"Live Sun Smart!" Testing the effectiveness of a sun safety program for middle schoolers.

BACKGROUND: Skin cancer is a well-recognized public health issue, and primary prevention is the most effective strategy for reducing skin cancer risk. The current recommendations are that behavioral counseling for sun safety measures is most beneficial and effective for children and adolescents and that targeting this population at primary and middle schools is the ideal intervention strategy to increase sun-protective behaviors and reduce UV exposure, sunburn incidence, and formation of new moles. Numerous studies on the effectiveness of school-based sun safety interventions among elementary and middle school students have shown an increase in sun safety knowledge, attitudes, and behaviors following the intervention. OBJECTIVE: To conduct a pilot feasibility study of "Live Sun Smart!," (LSS) a school-based, multicomponent, interactive sun safety presentation, at changing sun safety knowledge, attitudes, and behaviors among middle school students. METHODS: A non-randomized, single-group pretest-posttest interventional pilot study of the LSS program among children enrolled in grade 6. RESULTS: After exposure to LSS, participants were more likely to give correct answers to knowledge-based sun safety questions and to report negative attitudes toward tanning. Minimal and not significant changes were found in self-reported sun safety behaviors, though students did report an intention to change behaviors following the intervention. Participants were satisfied with the program and believed it increased their sun safety knowledge. CONCLUSION: Live Sun Smart! appears to be an effective school-based, multicomponent sun safety program for improving sun safety knowledge and attitudes toward tanning among middle school students in this initial test of it. The strengths and weaknesses of this pilot study have implications for future research.

Metabolic syndrome and inflammatory skin conditions.

PURPOSE OF REVIEW: Several chronic inflammatory skin disorders have been linked to metabolic syndrome (MetS) and an increased risk for cardiovascular disease. In this review, we will summarize the recent evidence on the association between psoriasis, hidradenitis suppurativa (HS), and atopic dermatitis (AD) and metabolic syndrome with careful attention to this association among the pediatric population. RECENT FINDINGS: Historically, psoriasis has exhibited the most robust association with MetS in the literature. Recent studies show that the prevalence of MetS appears to be higher among patients with HS and can be associated with MetS even in mild disease. A relationship between AD and MetS is still under debate, but research has shown a clear link between pediatric AD and being overweight or obese. SUMMARY: There are no current consensus guidelines for metabolic syndrome in the pediatric population, and its clinical implications in children are still unclear. Nevertheless, providers should be aware of the shared underlying inflammatory state and link between several cutaneous disorders and metabolic syndrome. Early diagnosis and proper disease management of these at risk populations has the potential to assist in disease control and mitigate future cardiovascular disease.

Genome comparison of Listeria monocytogenes serotype 4a strain HCC23 with selected lineage I and lineage II L. monocytogenes strains and other Listeria strains.

More than 98% of reported human listeriosis cases are caused by specific serotypes within genetic lineages I and II. The genome sequence of Listeria monocytogenes lineage III strain HCC23 (serotype 4a) enables whole genomic comparisons across all three L. monocytogenes lineages. Protein cluster analysis indicated that strain HCC23 has the most unique protein pairs with nonpathogenic species Listeria innocua. Orthology analysis of the genome sequences of representative strains from the three L. monocytogenes genetic lineages and L. innocua (CLIP11262) identified 319 proteins unique to nonpathogenic strains HCC23 and CLIP11262 and 58 proteins unique to pathogenic strains F2365 and EGD-e. BLAST comparison of these proteins with all the sequenced L. monocytogenes and L. innocua revealed 126 proteins unique to serotype 4a and/or L. innocua; 14 proteins were only found in pathogenic serotypes. Some of the 58 proteins unique to pathogenic strains F2365 and EGD-e were previously published and are already known to contribute to listerial virulence.

Descriptive experiences and sexual vs. nurturant aspects of cuddling between adult romantic partners.

Touch is a critical factor in intimate bonds between romantic partners. Although cuddling is a key expression of intimacy, it has received little empirical attention. Past research suggests that cuddling has some sexual aspects (e.g., it increases testosterone [T]), but there are theoretical reasons to expect cuddling to also involve nurturant intimacy (which should decrease T). In this article, we examined the phenomenon of partner cuddling to: (1) provide a descriptive examination; (2) determine if cuddling involved only nurturant intimacy or also sexual intimacy; and (3) test whether cuddling was perceived as nurturant but experienced as sexual. Via an online questionnaire, 514 participants (338 women) responded to quantitative and qualitative questions about cuddling with their romantic partners. Results suggested that cuddling occurred frequently and for relatively long durations, and was viewed very positively. Findings also showed that cuddling was perceived as nurturant and non-sexual but was experienced as at least somewhat sexual, which may explain why past research had found that cuddling increased T. Correlational analyses linked cuddling frequency and enjoyment positively with partnered sexual activities, but negatively with solitary sexuality. Results were discussed relative to evolutionary theories of distinct but overlapping neurobiological systems underlying pair bonding that involve sexual and nurturant intimacy.

Genome sequence of lineage III Listeria monocytogenes strain HCC23.

More than 98% of reported human listeriosis cases are caused by Listeria monocytogenes serotypes within lineages I and II. Serotypes within lineage III (4a and 4c) are commonly isolated from environmental and food specimens. We report the first complete genome sequence of a lineage III isolate, HCC23, which will be used for comparative analysis.