Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma (Review).

According to current predictions, one-fifth of all Americans will develop skin cancer during their lifetime. Cutaneous squamous cell carcinoma (cSCC) most commonly occurs in the head and neck region, which is the area of the body with the highest level of sun exposure. High-risk head and neck cSCC (HNcSCC) is a broad category with numerous high-risk factors that are associated with unfavorable results. In cSCC staging systems, clinical and tumor traits that are likely to result in poor outcomes are identified. Metastasis occurs in ~2.5% of patients with cSCC, most often in the local lymph nodes, and there is some indication that lymph node metastasis has a distinct pattern based on the tumor site. Current findings on tumor molecular targets have suggested the use of systemic treatments, particularly immunotherapy (such as cemiplimab, pembrolizumab and nivolumab), over radiotherapy or chemotherapy for this type of metastasis. However, when used simultaneously with immunotherapy, radiotherapy may be beneficial in the treatment of metastatic HNcSCC by improving the efficacy of immunotherapy. The present review aims to assess the existing literature on metastatic HNcSCC pathways and treatment options, in order to define current and future directions. Notably, there is an urgent need to identify patients who may benefit from local or systemic cancer treatments. The treatment of lymph node metastasis presents a therapeutic challenge and requires comprehensive management.

MRI Findings in Axial Psoriatic Spondylarthritis.

Psoriatic arthritis is a significant medical condition with a high prevalence, a wide variety of non-specific symptoms, and a high degree of overlap with other spondylarthritis disorders, particularly ankylosing spondylitis. Hence, knowledge of the magnetic resonance imaging (MRI) manifestations and a multidisciplinary strategy are required for the better management of these patients. We searched publications from the last 10 years and focused on the most relevant ones which discussed the classification criteria, the MRI characteristics of axial psoriatic arthritis, the importance of MRI for follow up, and the reliability of skin and synovial biopsy. Axial spondylarthritis can be diagnosed and followed up on using the well-established MRI technique and, additionally, a biopsy. The analysis and concordance between them can provide new directions for future studies.

Insight on common forms of cutaneous head and neck carcinoma (Review).

To improve the outcome and quality of life for patients with head and neck carcinoma, an increasing amount of research has been performed on the particularities of this type of cancer and its treatment methods. Starting from clinical aspects, including histology and imaging features, up-to-date studies from different parts of the world have determined new data leading to a better understanding of the mechanisms behind the disease and proposed new treatment protocols. The head and neck areas are predisposed to almost all skin neoplasms, most commonly those related to ultraviolet exposure. Squamous cell carcinoma and basal cell carcinoma account for almost 90% of non-melanoma skin cancers in this region; therefore, reviewing the literature on cutaneous carcinomas of the head and neck area and sharing particular aspects of their physiopathology are beneficial for a great number of patients.

Oral Mucositis Induced by Chemoradiotherapy in Head and Neck Cancer-A Short Review about the Therapeutic Management and the Benefits of Bee Honey.

Background and Objectives: Oral mucositis, a severe non-hematological complication, can be induced by chemoradiotherapy. It is associated with severe local dysfunction, severely affecting the patient's quality of life; it increases the risk of oral infections and interrupts oncological treatment, thus prolonging the duration and cost of hospitalization. Besides all of the agents used in the prevention and treatment of oral mucositis induced by oncological treatment, can there be found an easier one to administer, with an effective preparation, high addressability, both for adults and paediatric patients, without side effects, and at the same time cheap and easy to purchase? The aim of the present paper is to demonstrate the existence of this product, which is available to everyone, having multiple benefits. Materials and Methods: For the purpose of writing this article, materials were searched in electronic databases in between 2019 and 2021, taking into consideration papers where authors have demonstrated the effectiveness of this product through its topical or systemic use. Results: Numerous studies have highlighted the benefits of honey on oral mucositis. Through its analgesic, anti-inflammatory, anti-cancerous and antibacterial action, honey has proved to have a major impact on the patient's quality of life and nutritional status by promoting tissue epithelialization and healing of the chemoradiotherapy-induced lesions. Conclusions: Superior to many natural agents, bee honey can be successfully used in both preventing and treating oral mucositis. There are currently numerous studies supporting and recommending the use of bee honey in the management of this oncological toxicity.

Nasopharyngeal carcinoma: A new synthesis of literature data (Review).

Nasopharyngeal carcinoma (NPC) is an epithelial tumor, which develops most frequently from the lateral pharyngeal recess and holds some complex epidemiological characteristics. Its unusual race and geographic distribution suggests that not only the environmental factors are a contributing factor to the development of this rare cancer type, but also the genetic traits play an important role, along with nitrosamine-containing food consumption and Epstein-Barr virus infection. The signs and symptoms which a patient can present and suffer from are various and include nasal, otic, neurological as well as general ones; the way this tumor manifests being dependent on the stage of the tumor. The therapeutic management applicable in NPC needs to be established according to the case of the patient and include radiotherapy, chemotherapy, surgery, immune therapy, targeted therapy or combined treatment. The main objective of the treatment is local and regional tumor control; relapse is an important factor for future development of distant metastases. New therapeutic concepts are always sought of, current research focusing on precision medicine, meaning systemic treatment with a personalized radiotherapy approach according to the characteristics of the tumor.

New Perspectives on Diagnosing Psoriatic Arthritis by Imaging Techniques.

Psoriatic arthritis is a chronic inflammatory condition that can lead to severe functional impairment and irreversible damage. The diagnosis can be difficult in early cases where the clinical exam is often scarce. The lack of a serological biomarker can lead to a considerable delay in diagnosis. In this review, we discuss the existent imaging methods that have improved the diagnosis of psoriatic arthritis (PsA). The degree and type of musculoskeletal involvement cannot be assessed by only one imaging method. We think that a combination of methods is the best approach to evaluate both structural damage and inflammatory lesions and that ultrasound (US) could be the best tool to screen a patient when considering the diagnosis of PsA. US is an accessible, non-ionizing technique that offers information regarding active inflammation in joints, entheses, and soft tissues.

Fulminant Brain Atrophy and Vasculitis on Vessel-Wall Imaging in Neuropsychiatric Lupus: Case Report and Literature Review.

Brain atrophy, typically slowly progressive, is a hallmark of neuropsychiatric (NP) systemic lupus erythematosus (SLE). In this article, we report a case of a young female patient with previously diagnosed SLE, without known NPSLE, with abrupt neurological deterioration and rapidly progressive diffuse atrophy in a few months. A comprehensive diagnostic work-up and follow-up magnetic resonance imaging (MRI), including high-resolution advanced vessel-wall sequences, revealed underlying cerebral vasculitis. The novelty factors that the present report brings are the rapid progressive atrophy demonstrated on follow-up MRI in a patient with SLE, and the depiction of an underlying vasculitis on specific vessel-wall MRI techniques. We also reviewed the literature and discussed the main current applications of vessel-wall MRI sequences. The aim of the report is to recognize this dramatic form of presentation of NPSLE and the utility of the new MRI techniques for the diagnosis.

Musculoskeletal Clinical and Imaging Manifestations in Inflammatory Bowel Diseases.

Rheumatic musculoskeletal manifestations are increasingly recognized as a major cause of morbidity and impaired quality of life in patients with inflammatory bowel diseases (IBDs). IBDs are associated with a variety of musculoskeletal pathologies, from peripheral arthritis to axial involvement, and from localized or regional pathologies to diffuse metabolic disorders. Recent advances, especially in imaging techniques, allow a better understanding of these pathologies, and assist their recognition even in the preclinical phase. This review aims to describe the musculoskeletal clinical and imaging manifestations in IBD with special emphasis on the current concepts and the updated radiological work-up.

Future Perspectives in the Diagnosis of Neuropsychiatric Lupus by Advanced Magnetic Resonance Imaging Techniques.

Neuropsychiatric (NP) syndromes are an important cause of morbi-mortality in patients with Systemic Lupus Erythematosus (SLE). Despite remarkable recent progress, there are no definite methods to diagnose neuropsychiatric SLE (NPSLE) or to differentiate primary NPSLE from secondary causes. NPSLE remains a diagnosis of exclusion, and the clinical judgment is still the main approach to the correct diagnosis. Within this complex context, the Magnetic Resonance Imaging (MRI) has both a diagnostic role, by showing the nervous system involvement on one hand and excluding other causes on the other hand, and a prognostic role, help in assessing the lesions and monitoring the evolution. Conventional MRI shows brain involvement in around half of the patients, although the described findings are rather non-specific and present in many other diseases. However, many advanced MRI techniques are becoming increasingly used over the last period, showing abnormalities even in normal-appearing brains on conventional MRI. These MRI techniques hold promise to have a higher sensitivity and specificity than conventional MRI for NPSLE related changes. This review explores the place and the future perspectives of different advanced MRI techniques in NPSLE.