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5.
Actas Dermosifiliogr ; 113(5): 451-458, 2022 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35431059

RESUMEN

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.


Asunto(s)
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasias Basocelulares , Neoplasias Cutáneas , Carcinoma Basocelular/epidemiología , Carcinoma Basocelular/patología , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Estudios de Cohortes , Femenino , Humanos , Masculino , Melanoma/complicaciones , Cirugía de Mohs , Estudios Prospectivos , Factores de Riesgo , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/cirugía
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 7-19, ene.-feb. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-191480

RESUMEN

El nevo de Spitz es una neoplasia melanocítica de células epitelioides o fusiformes que suele aparecer en la infancia. Su naturaleza es benigna, aunque en ocasiones puede mostrar unas características difíciles de distinguir del melanoma. En las últimas décadas se han clasificado las neoplasias melanocíticas spitzoides en 3tipos: nevus de Spitz, tumor de Spitz atípico y melanoma spitzoide. El tumor de Spitz atípico hace referencia a las neoplasias melanocíticas spitzoides que tienen unas características histopatológicas atípicas insuficientes para realizar el diagnóstico de melanoma y cuyo potencial maligno, actualmente, es incierto. Nuestro objetivo es revisar los aspectos clínicos, dermatoscópicos, histopatológicos e inmunohistoquímicos de este conjunto de tumores


A Spitz nevus is a melanocytic neoplasm of epithelioid and/or spindle cells that usually appears in childhood. These lesions are by nature benign, but their features can sometimes make them difficult to distinguish from melanomas. Spitzoid melanocytic lesions have been grouped into 3 types in recent decades: Spitz nevi, atypical Spitz tumors, and spitzoid melanomas. Atypical Spitz tumors are spitzoid melanocytic proliferations that have atypical histopathologic features that are insufficient to support a diagnosis of melanoma. The malignant potential of these lesions is at present uncertain. This review examines the clinical, dermoscopic, and histopathologic features of this group of lesions


Asunto(s)
Humanos , Niño , Nevo de Células Epitelioides y Fusiformes/diagnóstico , Nevo de Células Epitelioides y Fusiformes/patología , Neoplasias Cutáneas/diagnóstico , Melanoma/diagnóstico , Nevo de Células Fusiformes/diagnóstico , Inmunohistoquímica , Nevo de Células Epitelioides y Fusiformes/epidemiología , Neoplasias Cutáneas/patología , Nevo de Células Fusiformes/patología
9.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(1): 20-25, ene.-feb. 2020. graf
Artículo en Español | IBECS | ID: ibc-191481

RESUMEN

Las neoplasias melanocíticas con morfología spitzoide (nevo de Spitz, tumor de Spitz atípico y melanoma spitzoide) abarcan un espectro desde lesiones benignas a malignas. Debido al potencial maligno incierto de los tumores de Spitz atípicos, el abordaje terapéutico ha generado durante años controversia. El desarrollo de nuevas técnicas moleculares parece prometedor y ha contribuido a una mejor predicción del comportamiento biológico de los tumores de Spitz. Nuestro objetivo es revisar las características citogenéticas de los tumores de Spitz, el pronóstico y actualizar las últimas recomendaciones de manejo


Melanocytic neoplasms with spitzoid morphology (Spitz nevi, atypical Spitz tumors, and spitzoid melanomas) may be benign or malignant. Because the malignant potential of atypical Spitz tumors is uncertain, the proper therapeutic approach has been much debated over the years. Promising new techniques for molecular analysis have enabled better predictions of the biological behavior of these tumors. We review their cytogenetic features and prognosis and also provide an update of the most recent recommendations for management


Asunto(s)
Humanos , Niño , Nevo de Células Epitelioides y Fusiformes/diagnóstico , Nevo de Células Epitelioides y Fusiformes/genética , Citogenética/métodos , Pronóstico , Melanoma/diagnóstico , Nevo de Células Epitelioides y Fusiformes/terapia , Melanoma/genética , Estudios de Casos y Controles , Citogenética
10.
Actas Dermosifiliogr (Engl Ed) ; 111(1): 20-25, 2020 Jan 02.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31739993

RESUMEN

Melanocytic neoplasms with spitzoid morphology (Spitz nevi, atypical Spitz tumors, and spitzoid melanomas) may be benign or malignant. Because the malignant potential of atypical Spitz tumors is uncertain, the proper therapeutic approach has been much debated over the years. Promising new techniques for molecular analysis have enabled better predictions of the biological behavior of these tumors. We review their cytogenetic features and prognosis and also provide an update of the most recent recommendations for management.


Asunto(s)
Nevo de Células Epitelioides y Fusiformes/diagnóstico , Nevo de Células Epitelioides y Fusiformes/terapia , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/terapia , Niño , Análisis Citogenético , Humanos , Técnicas de Diagnóstico Molecular , Nevo de Células Epitelioides y Fusiformes/genética , Pronóstico , Neoplasias Cutáneas/genética
11.
Actas Dermosifiliogr (Engl Ed) ; 111(1): 7-19, 2020 Jan 02.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31787210

RESUMEN

A Spitz nevus is a melanocytic neoplasm of epithelioid and/or spindle cells that usually appears in childhood. These lesions are by nature benign, but their features can sometimes make them difficult to distinguish from melanomas. Spitzoid melanocytic lesions have been grouped into 3 types in recent decades: Spitz nevi, atypical Spitz tumors, and spitzoid melanomas. Atypical Spitz tumors are spitzoid melanocytic proliferations that have atypical histopathologic features that are insufficient to support a diagnosis of melanoma. The malignant potential of these lesions is at present uncertain. This review examines the clinical, dermoscopic, and histopathologic features of this group of lesions.


Asunto(s)
Nevo de Células Epitelioides y Fusiformes/diagnóstico , Neoplasias Cutáneas/diagnóstico , Niño , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Nevo de Células Epitelioides y Fusiformes/patología , Neoplasias Cutáneas/patología
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