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1.
J Drugs Dermatol ; 23(5): 376-379, 2024 05 01.
Article in English | MEDLINE | ID: mdl-38709686

ABSTRACT

Merkel cell carcinoma (MCC) is a rare, highly aggressive cutaneous malignancy. Immunosuppression increases the risk of MCC and is associated with poor prognosis. Organ transplant recipients (OTR) have worse overall survival (OS) than patients with immunosuppression due to other causes. Treating MCC after organ transplantation is challenging, as checkpoint inhibitor immunotherapy, the standard of care for treating MCC, increases the risk of transplant rejection. This paper reviews the cases of two simultaneous pancreas-kidney transplant (SPKT) recipients with MCC and explores the role of immunosuppression in the development of MCC. Immunosuppression was discontinued and checkpoint inhibitor therapy was initiated in the first patient and considered by the second patient. In both cases, treatment failed, and the patients died shortly after developing metastatic MCC. These cases illustrate the need for improved multidisciplinary treatment regimens for MCC in OTRs. J Drugs Dermatol. 2024;23(5):376-377.     doi:10.36849/JDD.8234  .


Subject(s)
Carcinoma, Merkel Cell , Kidney Transplantation , Pancreas Transplantation , Skin Neoplasms , Humans , Carcinoma, Merkel Cell/therapy , Carcinoma, Merkel Cell/surgery , Carcinoma, Merkel Cell/diagnosis , Carcinoma, Merkel Cell/pathology , Kidney Transplantation/adverse effects , Skin Neoplasms/pathology , Pancreas Transplantation/adverse effects , Male , Fatal Outcome , Middle Aged , Immune Checkpoint Inhibitors/adverse effects , Immune Checkpoint Inhibitors/therapeutic use , Female , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Immunosuppression Therapy/adverse effects
3.
J Drugs Dermatol ; 23(5): e132-e133, 2024 05 01.
Article in English | MEDLINE | ID: mdl-38709690

ABSTRACT

Skin self-examinations play a vital role in skin cancer detection and are often aided by online resources. Available reference photos must display the full spectrum of skin tones so patients may visualize how skin lesions can appear. This study investigated the portrayal of skin tones in skin cancer-related Google Images, discovering a significant underrepresentation of darker skin tones. J Drugs Dermatol. 2024;23(5):e132-e133.     doi:10.36849/JDD.7886e.


Subject(s)
Skin Neoplasms , Skin Pigmentation , Humans , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Photography , Self-Examination/methods , Skin/pathology , Internet , Search Engine
4.
J Drugs Dermatol ; 23(5): 380, 2024 05 01.
Article in English | MEDLINE | ID: mdl-38709685

ABSTRACT

Wound repair of the pretibial and forearm regions presents a challenge during dermatologic surgery as these areas are under significant tension and exhibit increased skin fragility. Various methodologies have been proposed for the closure and repair of such wounds, however, the use of the bilayered suture technique may be simpler and more effective than other techniques such as the pinch stitch, pully stitch, slip-knot stitch, pulley set-back dermal suture, horizontal mattress suture, pully stitch, and tandem pulley stitch. Our objective was to describe a novel method for the repair of pretibial and forearm wounds following Mohs micrographic surgery utilizing bilayered closure followed by tissue adhesive application.  J Drugs Dermatol. 2024;23(5):380.     doi:10.36849/JDD.7139  .


Subject(s)
Forearm , Mohs Surgery , Skin Neoplasms , Suture Techniques , Wound Healing , Humans , Mohs Surgery/adverse effects , Mohs Surgery/methods , Forearm/surgery , Skin Neoplasms/surgery , Tissue Adhesives , Leg/surgery , Male , Female
6.
J Drugs Dermatol ; 23(5): e137-e138, 2024 05 01.
Article in English | MEDLINE | ID: mdl-38709691

ABSTRACT

When patients self-detect suspicious skin lesions, they often reference online photos prior to seeking medical evaluation. Online images must be available in the full spectrum of skin tones to provide accurate visualizations of disease, especially given the increased morbidity and mortality from skin cancer in patients with darker skin tones. The purpose of this study was to evaluate the representation of skin tones in photos of skin cancer on patient-facing websites. Six federally-based and organization websites were evaluated, and of the 372 total representations identified only 49 depicted darker skin tones (13.2%). This highlights the need to improve skin tone representation on patient-facing online resources. J Drugs Dermatol. 2024;23(5):e137-e138.     doi:10.36849/JDD.7905e.


Subject(s)
Internet , Patient Education as Topic , Skin Neoplasms , Skin Pigmentation , Humans , Skin Neoplasms/diagnosis , Patient Education as Topic/methods , Photography , Skin
7.
Skin Res Technol ; 30(5): e13706, 2024 May.
Article in English | MEDLINE | ID: mdl-38721854

ABSTRACT

BACKGROUND: The incidence rates of cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) skin cancers are rising, while the current diagnostic process is time-consuming. We describe the development of a novel approach to high-throughput sampling of tissue lipids using electroporation-based biopsy, termed e-biopsy. We report on the ability of the e-biopsy technique to harvest large amounts of lipids from human skin samples. MATERIALS AND METHODS: Here, 168 lipids were reliably identified from 12 patients providing a total of 13 samples. The extracted lipids were profiled with ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS-MS) providing cSCC, BCC, and healthy skin lipidomic profiles. RESULTS: Comparative analysis identified 27 differentially expressed lipids (p < 0.05). The general profile trend is low diglycerides in both cSCC and BCC, high phospholipids in BCC, and high lyso-phospholipids in cSCC compared to healthy skin tissue samples. CONCLUSION: The results contribute to the growing body of knowledge that can potentially lead to novel insights into these skin cancers and demonstrate the potential of the e-biopsy technique for the analysis of lipidomic profiles of human skin tissues.


Subject(s)
Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Electroporation , Lipidomics , Skin Neoplasms , Skin , Humans , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/metabolism , Carcinoma, Basal Cell/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/metabolism , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/chemistry , Lipidomics/methods , Biopsy , Skin/pathology , Skin/metabolism , Skin/chemistry , Female , Male , Electroporation/methods , Middle Aged , Aged , Lipids/analysis , Tandem Mass Spectrometry/methods
8.
Front Immunol ; 15: 1354710, 2024.
Article in English | MEDLINE | ID: mdl-38726010

ABSTRACT

Cancer vaccines are gaining ground as immunotherapy options. We have previously demonstrated in cutaneous melanoma (CM) patients that adjuvant treatment with VACCIMEL, a mixture of four irradiated CM cell lines co-adjuvanted with BCG and GM-CSF, increases the cellular immune response to melanocyte differentiation antigens, cancer-testis antigens and neoantigens, with respect to basal levels. On the other hand, it is also known that treatment with anti-PD-1 monoclonal antibodies (MAbs), acting on pre-existing tumor-reactive lymphocytes, induces clinical responses in CM patients, albeit in a fraction of treated patients. A combination of both treatments would appear therefore desirable. In this paper, we describe CM patients who, having progressed even years after vaccination, were treated with anti-PD-1 MAbs. In 5/5 of such progressor patients, complete responses were obtained which lasted between 3 and 65+ months. Three of the patients remain disease-free and two recurred. One of the patients passed away after a recurrence of brain metastases. We suggest that clonally expanded reactive lymphocytes induced by VACCIMEL partially remain as memory cells, which may be recalled after tumor recurrence and may foster ulterior activity of anti-PD-1 MAbs.


Subject(s)
Cancer Vaccines , Melanoma , Programmed Cell Death 1 Receptor , Skin Neoplasms , Humans , Melanoma/immunology , Melanoma/therapy , Melanoma/drug therapy , Skin Neoplasms/immunology , Skin Neoplasms/therapy , Skin Neoplasms/drug therapy , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Programmed Cell Death 1 Receptor/immunology , Cancer Vaccines/immunology , Cancer Vaccines/therapeutic use , Cancer Vaccines/administration & dosage , Male , Female , Middle Aged , Aged , Immune Checkpoint Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Melanoma, Cutaneous Malignant , Treatment Outcome , Adjuvants, Immunologic/therapeutic use , Adjuvants, Immunologic/administration & dosage
10.
Int J Mol Sci ; 25(9)2024 Apr 28.
Article in English | MEDLINE | ID: mdl-38732030

ABSTRACT

Melanoma, the deadliest type of skin cancer, has a high propensity to metastasize to other organs, including the brain, lymph nodes, lungs, and bones. While progress has been made in managing melanoma with targeted and immune therapies, many patients do not benefit from these current treatment modalities. Tumor cell migration is the initial step for invasion and metastasis. A better understanding of the molecular mechanisms underlying metastasis is crucial for developing therapeutic strategies for metastatic diseases, including melanoma. The cell adhesion molecule L1CAM (CD171, in short L1) is upregulated in many human cancers, enhancing tumor cell migration. Earlier studies showed that the small-molecule antagonistic mimetics of L1 suppress glioblastoma cell migration in vitro. This study aims to evaluate if L1 mimetic antagonists can inhibit melanoma cell migration in vitro and in vivo. We showed that two antagonistic mimetics of L1, anagrelide and 2-hydroxy-5-fluoropyrimidine (2H5F), reduced melanoma cell migration in vitro. In in vivo allograft studies, only 2H5F-treated female mice showed a decrease in tumor volume.


Subject(s)
Cell Movement , Melanoma , Neural Cell Adhesion Molecule L1 , Cell Movement/drug effects , Animals , Humans , Melanoma/drug therapy , Melanoma/metabolism , Melanoma/pathology , Mice , Neural Cell Adhesion Molecule L1/metabolism , Cell Line, Tumor , Female , Xenograft Model Antitumor Assays , Skin Neoplasms/pathology , Skin Neoplasms/drug therapy , Skin Neoplasms/metabolism , Pyrimidines/pharmacology
14.
Skin Res Technol ; 30(5): e13607, 2024 May.
Article in English | MEDLINE | ID: mdl-38742379

ABSTRACT

BACKGROUND: Timely diagnosis plays a critical role in determining melanoma prognosis, prompting the development of deep learning models to aid clinicians. Questions persist regarding the efficacy of clinical images alone or in conjunction with dermoscopy images for model training. This study aims to compare the classification performance for melanoma of three types of CNN models: those trained on clinical images, dermoscopy images, and a combination of paired clinical and dermoscopy images from the same lesion. MATERIALS AND METHODS: We divided 914 image pairs into training, validation, and test sets. Models were built using pre-trained Inception-ResNetV2 convolutional layers for feature extraction, followed by binary classification. Training comprised 20 models per CNN type using sets of random hyperparameters. Best models were chosen based on validation AUC-ROC. RESULTS: Significant AUC-ROC differences were found between clinical versus dermoscopy models (0.661 vs. 0.869, p < 0.001) and clinical versus clinical + dermoscopy models (0.661 vs. 0.822, p = 0.001). Significant sensitivity differences were found between clinical and dermoscopy models (0.513 vs. 0.799, p = 0.01), dermoscopy versus clinical + dermoscopy models (0.799 vs. 1.000, p = 0.02), and clinical versus clinical + dermoscopy models (0.513 vs. 1.000, p < 0.001). Significant specificity differences were found between dermoscopy versus clinical + dermoscopy models (0.800 vs. 0.288, p < 0.001) and clinical versus clinical + dermoscopy models (0.650 vs. 0.288, p < 0.001). CONCLUSION: CNN models trained on dermoscopy images outperformed those relying solely on clinical images under our study conditions. The potential advantages of incorporating paired clinical and dermoscopy images for CNN-based melanoma classification appear less clear based on our findings.


Subject(s)
Dermoscopy , Melanoma , Neural Networks, Computer , Skin Neoplasms , Humans , Melanoma/diagnostic imaging , Melanoma/pathology , Melanoma/classification , Dermoscopy/methods , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology , Skin Neoplasms/classification , Deep Learning , Sensitivity and Specificity , Female , ROC Curve , Image Interpretation, Computer-Assisted/methods , Male
15.
J Investig Med High Impact Case Rep ; 12: 23247096241253337, 2024.
Article in English | MEDLINE | ID: mdl-38742532

ABSTRACT

Subcutaneous panniculitis-like T-cell lymphoma (SPTLP), a unique variant of primary cutaneous T-cell lymphomas, clinically mimics subcutaneous panniculitis. It is typified by the development of multiple plaques or subcutaneous erythematous nodules, predominantly on the extremities and trunk. Epidemiological findings reveal a greater incidence in females than males, affecting a wide demographic, including pediatric and adult cohorts, with a median onset age of around 30 years. Diagnosis of SPTLP is complex, hinging on skin biopsy analyses and the identification of T-cell lineage-specific immunohistochemical markers. Treatment modalities for SPTLP are varied; while corticosteroids may be beneficial initially for many patients, a substantial number require chemotherapy, especially in cases of poor response or relapse. Generally, SPTLP progresses slowly, yet approximately 20% of cases advance to hemophagocytic lymphohistiocytosis (HLH), often correlating with a negative prognosis. We report a case of a young male patient presenting with prolonged fever, multiple skin lesions accompanied by HLH, a poor clinical course, and eventual death, diagnosed postmortem with SPTLP. In addition, we also present a literature review of the current evidence of some updates related to SPTLP.


Subject(s)
Lymphohistiocytosis, Hemophagocytic , Lymphoma, T-Cell , Panniculitis , Humans , Lymphohistiocytosis, Hemophagocytic/pathology , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/complications , Male , Panniculitis/pathology , Panniculitis/diagnosis , Lymphoma, T-Cell/pathology , Lymphoma, T-Cell/complications , Lymphoma, T-Cell/diagnosis , Fatal Outcome , Adult , Skin Neoplasms/pathology , Skin Neoplasms/complications , Skin/pathology , Biopsy , Lymphoma, T-Cell, Cutaneous/pathology , Lymphoma, T-Cell, Cutaneous/complications , Lymphoma, T-Cell, Cutaneous/diagnosis , Diagnosis, Differential
16.
Psychooncology ; 33(5): e6343, 2024 May.
Article in English | MEDLINE | ID: mdl-38697780

ABSTRACT

OBJECTIVE: It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. METHODS: The sample included 268 individuals followed-up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non-melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. RESULTS: Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p < 0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. CONCLUSIONS: The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings.


Subject(s)
Life Change Events , Melanoma , Skin Neoplasms , Stress, Psychological , Humans , Female , Male , Skin Neoplasms/epidemiology , Skin Neoplasms/psychology , Middle Aged , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Melanoma/epidemiology , Melanoma/psychology , Retrospective Studies , Adult , Aged , Surveys and Questionnaires , Incidence , Risk Factors , Adaptation, Psychological , Adverse Childhood Experiences/statistics & numerical data
17.
Cesk Patol ; 60(1): 35-48, 2024.
Article in English | MEDLINE | ID: mdl-38697826

ABSTRACT

Spitz tumors represent a heterogeneous group of challenging melanocytic neoplasms, displaying a range of biological behaviors, spanning from benign lesions, Spitz nevi (SN) to Spitz melanomas (SM), with intermediate lesions in between known as atypical Spitz tumors (AST). They are histologically characterized by large epithelioid and/or spindled melanocytes arranged in fascicles or nests, often associated with characteristic epidermal hyperplasia and fibrovascular stromal changes. In the last decade, the detection of mutually exclusive structural rearrangements involving receptor tyrosine kinases ROS1, ALK, NTRK1, NTRK2, NTRK3, RET, MET, serine threonine kinases BRAF and MAP3K8, or HRAS mutation, led to a clinical, morphological and molecular based classification of Spitz tumors. The recognition of some reproducible histological features can help dermatopathologist in assessing these lesions and can provide clues to predict the underlying molecular driver. In this review, we will focus on clinical and morphological findings in molecular Spitz tumor subgroups.


Subject(s)
Nevus, Epithelioid and Spindle Cell , Skin Neoplasms , Humans , Nevus, Epithelioid and Spindle Cell/pathology , Nevus, Epithelioid and Spindle Cell/genetics , Skin Neoplasms/pathology , Skin Neoplasms/genetics , Skin Neoplasms/diagnosis , Melanoma/pathology , Melanoma/genetics , Melanoma/diagnosis
18.
Cesk Patol ; 60(1): 49-58, 2024.
Article in English | MEDLINE | ID: mdl-38697827

ABSTRACT

The section on mesenchymal tumors in 5th edition of WHO classification of skin tumors has undergone several changes, the most important of which, as usual, is the inclusion of newly identified tumor entities, which will be the main focus of this review article. These specifically include three novel cutaneous mesenchymal tumors with melanocytic differentiation, and rearrangements of the CRTC1::TRIM11, ACTIN::MITF, and MITF::CREM genes. In addition, EWSR1::SMAD3-rearranged fibroblastic tumors, superficial CD34-positive fibroblastic tumors, and NTRK-rearranged spindle cell neoplasms were newly included. Of the other changes, only the most important ones will be briefly mentioned.


Subject(s)
Skin Neoplasms , World Health Organization , Humans , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Skin Neoplasms/classification
19.
Cesk Patol ; 60(1): 12-34, 2024.
Article in English | MEDLINE | ID: mdl-38697825

ABSTRACT

Melanocytic lesions are instable tumors, the genome of which and its changes determinate their morphology and biological properties. Intermediate lesions share histomorphological features of both, nevi and melanoma. Melanocytomas represent a group of them separated on the basis of recent molecular-biological studies. The article summarizes benign, intermediate, malignant and combined melanocytic skin lesions and offers practical recommendations for diagnosis.


Subject(s)
Melanoma , Nevus, Pigmented , Skin Neoplasms , Humans , Skin Neoplasms/pathology , Skin Neoplasms/diagnosis , Melanoma/pathology , Melanoma/diagnosis , Nevus, Pigmented/pathology , Nevus, Pigmented/diagnosis
20.
Arch Dermatol Res ; 316(5): 147, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38698273

ABSTRACT

Mohs Micrographic Surgery (MMS) is effective for treating common cutaneous malignancies, but complex repairs may often present challenges for reconstruction. This paper explores the potential of three-dimensional (3D) bioprinting in MMS, offering superior outcomes compared to traditional methods. 3D printing technologies show promise in advancing skin regeneration and refining surgical techniques in dermatologic surgery. A PubMed search was conducted using the following keywords: "Three-dimensional bioprinting" OR "3-D printing" AND "Mohs" OR "Mohs surgery" OR "Surgery." Peer-reviewed English articles discussing medical applications of 3D bioprinting were included, while non-peer-reviewed and non-English articles were excluded. Patients using 3D MMS models had lower anxiety scores (3.00 to 1.7, p < 0.0001) and higher knowledge assessment scores (5.59 or 93.25% correct responses), indicating better understanding of their procedure. Surgical residents using 3D models demonstrated improved proficiency in flap reconstructions (p = 0.002) and knowledge assessment (p = 0.001). Additionally, 3D printing offers personalized patient care through tailored surgical guides and anatomical models, reducing intraoperative time while enhancing surgical. Concurrently, efforts in tissue engineering and regenerative medicine are being explored as potential alternatives to address organ donor shortages, eliminating autografting needs. However, challenges like limited training and technological constraints persist. Integrating optical coherence tomography with 3D bioprinting may expedite grafting, but challenges remain in pre-printing grafts for complex cases. Regulatory and ethical considerations are paramount for patient safety, and further research is needed to understand long-term effects and cost-effectiveness. While promising, significant advancements are necessary for full utilization in MMS.


Subject(s)
Bioprinting , Mohs Surgery , Printing, Three-Dimensional , Skin Neoplasms , Humans , Bioprinting/methods , Mohs Surgery/methods , Skin Neoplasms/surgery , Tissue Engineering/methods , Models, Anatomic , Plastic Surgery Procedures/methods , Plastic Surgery Procedures/instrumentation , Surgical Flaps , Skin , Regenerative Medicine/methods
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