RESUMEN
The prognostic value of the sentinel lymph node in Merkel cell carcinoma (MCC) has been examined previously in heterogeneous retrospective studies. The current retrospective study included a homogeneous population of patients with a localized MCC, all staged with sentinel lymph node biopsy. Factors associated with 3-year progression-free survival were analysed using logistic regression. The sentinel lymph node was positive in 32% of patients. The recurrence rate was 26.9%. In first analyses (n = 108), gender (p = 0.0115) and the presence of immunosuppression (p = 0.0494) were the only significant independent factors. In further analyses (n = 80), excluding patients treated with regional radiotherapy, sentinel lymph node status was the only significant prognostic factor (p = 0.0281). Immunosuppression and positive sentinel lymph node are associated with a worse prognosis in patients with MCC. Nodal irradiation impacts on the prognostic value of the sentinel lymph node status.
Asunto(s)
Carcinoma de Células de Merkel/terapia , Huésped Inmunocomprometido , Ganglios Linfáticos/patología , Recurrencia Local de Neoplasia , Neoplasias Cutáneas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células de Merkel/inmunología , Carcinoma de Células de Merkel/mortalidad , Carcinoma de Células de Merkel/patología , Distribución de Chi-Cuadrado , Supervivencia sin Enfermedad , Estudios de Factibilidad , Femenino , Francia , Humanos , Estimación de Kaplan-Meier , Modelos Logísticos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Biopsia del Ganglio Linfático Centinela , Factores Sexuales , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/patología , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Exogenous acne refers to acneiform lesions due to external factors such as cosmetic agents, exposure to various oils, skin rubbing or friction or chloracne, now better called metabolizing acquired dioxin-induced skin hamartoma (MADISH). Here we report a new form of severe inflammatory exogenous acne due to the association of two factors: facial friction with cosmetic agents. OBSERVATIONS: A 15-, 17- and 19-year-old female presented at the department with severe inflammatory acne. In all cases, the face had been strongly rubbed in a compulsory manner in the previous weeks with cosmetic agents. The disease has not responded to various conventional acne treatments and was well controlled by a combination of oral corticosteroids and low-dose isotretinoin. CONCLUSION: Because cosmetic face friction as a cosmetic care becomes more and more fashionable, dermatologists should be aware of this severe clinical condition, which can occur in patients without a personal history of acne.