Abstract Background: The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology. Objectives: To evaluate the immediate and mid-term impact of diagnosis delay on melanoma. Methods: A retrospective observational study of melanoma diagnosed between March 14th 2019 and March 13th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively. Results: A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p > 0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9 mm, p < 0.05) resulting in a significant upstaging according to the AJCC 8th ed. (p < 0.05). Study limitations: The main limitation is that this is a single-center study. Conclusions: The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.
BACKGROUND: The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology. OBJECTIVES: To evaluate the immediate and mid-term impact of diagnosis delay on melanoma. METHODS: A retrospective observational study of melanoma diagnosed between March 14th 2019 and March 13th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively. RESULTS: A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p>0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9mm, p<0.05) resulting in a significant upstaging according to the AJCC 8th ed. (p<0.05). STUDY LIMITATIONS: The main limitation is that this is a single-center study. CONCLUSIONS: The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.
COVID-19 , Melanoma , Skin Neoplasms , Humans , COVID-19/epidemiology , Communicable Disease Control , Melanoma/diagnosis , Melanoma/epidemiology , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Prognosis , Retrospective Studies , Melanoma, Cutaneous Malignant
Poststeroid panniculitis is a rare disorder usually reported in children after a sudden decrease or withdrawal of corticosteroid therapy. We report a case in an adult, a finding very rarely reported in English literature. The case report is about a 34-year-old man with multiple erythematous, firm and tender subcutaneous nodules on both thighs and legs after the withdrawal of long-term doses of dexamethasone prescribed before and after surgery for a frontoinsular anaplastic oligodendroglioma. Histopathologic study revealed mainly lobular and also septal panniculitis with fat necrosis and characteristic needle-shaped clefts in radial arrangement within fat cells and multinucleated giant cells. The lesions resolved in about 5 months, after weight loss and application of topical corticosteroids for 1 month, leaving only residual hyperpigmentation.
Adrenal Cortex Hormones/adverse effects , Dexamethasone/adverse effects , Panniculitis/chemically induced , Panniculitis/pathology , Adult , Antineoplastic Agents, Hormonal/adverse effects , Brain Neoplasms/therapy , Combined Modality Therapy , Humans , Male , Oligodendroglioma/therapy
The association of familial totalis leukonychia with multiple pilar cysts is a rare condition that could represent a separate syndromic entity. Since Bauer described a family with totalis leukonychia and sebaceous cysts in 1920, only four new affected families have been reported. We report a five-generation family with a total leukonychia and multiple pilar cysts on the scalp. The hypothesis of a deficiency of a gene regulating the structure of keratin has been postulated but the exact genetic mechanism has not been yet determined. In our family, no other keratinizing structures were involved.
Blepharitis/diagnosis , Epidermal Cyst/diagnosis , Hair Diseases/diagnosis , Hypopigmentation/diagnosis , Nail Diseases/congenital , Pigmentation Disorders/diagnosis , Retinal Diseases/diagnosis , Adult , Blepharitis/genetics , Epidermal Cyst/genetics , Female , Genetic Predisposition to Disease , Hair Diseases/genetics , Humans , Hypopigmentation/genetics , Infant , Male , Middle Aged , Nail Diseases/diagnosis , Nail Diseases/genetics , Pigmentation Disorders/genetics , Retinal Diseases/genetics
