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Hematology/oncology Clinics of North... Feb 2021Melanoma skin cancer is derived from skin melanocytes and has a high risk of metastatic spread. The era of molecular genetics and next-generation sequencing has... (Review)
Review
Melanoma skin cancer is derived from skin melanocytes and has a high risk of metastatic spread. The era of molecular genetics and next-generation sequencing has uncovered the role of oncogenic BRAFV600E mutations in many melanomas, validated the role of ultraviolet-induced DNA mutations in melanoma formation, and uncovered many of the molecular events that occur during melanoma development. Targeted therapies and immunotherapy have dramatically improved outcomes and provided an increased rate of cure for metastatic melanoma. This article reviews the formation of melanoma, the molecular events involved in melanoma growth and metastasis, and the biology underlying resistance to melanoma therapies.
Topics: Carcinogenesis; Drug Resistance, Neoplasm; Humans; Immunotherapy; Melanocytes; Melanoma; Microphthalmia-Associated Transcription Factor; Skin Neoplasms; Ultraviolet Rays
PubMed: 33759772
DOI: 10.1016/j.hoc.2020.08.010 -
Dermatologic Clinics Jan 2023Mohs micrographic surgery (MMS) is widely accepted as the gold standard for skin cancer cure, and properly trained surgeons who carry out this procedure are experts in... (Review)
Review
Mohs micrographic surgery (MMS) is widely accepted as the gold standard for skin cancer cure, and properly trained surgeons who carry out this procedure are experts in the science and management of skin cancer. There are many potential pitfalls and challenges that a surgeon may encounter while carrying out MMS, and these can increase the likelihood of tumor recurrence and increased patient morbidity. With precise surgical technique, careful tissue handling, and laboratory processes that safeguard against errors, this procedure can provide excellent cure rates for most skin cancers, including melanoma, while maximizing tissue conservation in a low-cost outpatient clinical setting.
Topics: Humans; Mohs Surgery; Neoplasm Recurrence, Local; Skin Neoplasms; Melanoma
PubMed: 36410982
DOI: 10.1016/j.det.2022.07.006 -
Hematology/oncology Clinics of North... Feb 2019Basal cell carcinoma (BCC) is the most common malignancy and the incidence is rising. BCCs have low mortality but can cause significant morbidity primarily through local... (Review)
Review
Basal cell carcinoma (BCC) is the most common malignancy and the incidence is rising. BCCs have low mortality but can cause significant morbidity primarily through local destruction. The pathogenesis is linked to the interplay between environmental and patient-derived characteristics. There are multiple therapeutic modalities, and appropriate selection requires knowledge of complications, cosmetic outcomes, and recurrence rates. This article reviews the epidemiology, staging, treatment, and prevention of BCC.
Topics: Carcinoma, Basal Cell; Combined Modality Therapy; Disease Management; Disease Susceptibility; Humans; Incidence; Neoplasm Grading; Neoplasm Staging; Risk Factors; Skin Neoplasms; Treatment Outcome
PubMed: 30497670
DOI: 10.1016/j.hoc.2018.09.004 -
Hematology/oncology Clinics of North... Feb 2019Cutaneous squamous cell carcinoma represents 20% of all skin cancers, resulting in 1 million cases in the United States each year. The lifetime risk of developing... (Review)
Review
Cutaneous squamous cell carcinoma represents 20% of all skin cancers, resulting in 1 million cases in the United States each year. The lifetime risk of developing squamous cell carcinoma continues to increase annually and will likely continue to increase because of the aging population. Most cutaneous squamous cell carcinoma are treated locally, with a subset leading to recurrence, metastasis, and death. This review of cutaneous squamous cell carcinoma covers incidence, recurrence rates, mortality rates, risk factors, staging systems, treatment, prevention, and monitoring.
Topics: Carcinoma, Squamous Cell; Combined Modality Therapy; Disease Management; Disease Susceptibility; Genetic Predisposition to Disease; Humans; Incidence; Neoplasm Grading; Neoplasm Staging; Risk Factors; Skin Neoplasms; Symptom Assessment; Treatment Outcome
PubMed: 30497667
DOI: 10.1016/j.hoc.2018.08.001 -
Clinics in Plastic Surgery Oct 2021The Spitz nevus is an uncommon melanocytic nevus. These lesions classically appear in childhood as a red, dome-shaped papule. They appear rarely in adults and may be... (Review)
Review
The Spitz nevus is an uncommon melanocytic nevus. These lesions classically appear in childhood as a red, dome-shaped papule. They appear rarely in adults and may be pigmented. The Spitz nevus can develop suddenly and grow rapidly, reaching a 1-cm diameter in 6 months or less. There are 3 classes of spitzoid neoplasms: typical Spitz nevus, atypical Spitz nevus, and spitzoid melanoma. The diagnosis should be cautiously differentiated, especially in children. Immunohistochemistry and molecular studies have been helpful in differentiating difficult cases; however, no set of criteria has been accepted to predict biological behavior of atypical Spitz nevi.
Topics: Adult; Child; Diagnosis, Differential; Humans; Immunohistochemistry; Melanoma; Nevus, Epithelioid and Spindle Cell; Skin Neoplasms
PubMed: 34503728
DOI: 10.1016/j.cps.2021.06.002 -
Journal of the American Academy of... Feb 2018Cutaneous squamous cell carcinoma (cSCC), a malignant proliferation of cutaneous epithelium, represents 20% to 50% of skin cancers. Although the majority of cSCCs are... (Review)
Review
Cutaneous squamous cell carcinoma (cSCC), a malignant proliferation of cutaneous epithelium, represents 20% to 50% of skin cancers. Although the majority of cSCCs are successfully eradicated by surgical excision, a subset of cSCC possesses features associated with a higher likelihood of recurrence, metastasis, and death. The proper identification of these aggressive cSCCs can guide additional work-up and management. In the first article in this continuing medical education series, we discuss the incidence, recurrence rates, mortality rates, and risk factors associated with cSCC and review the staging systems used to stratify patients into high- and low-risk groups. The second article in this series reviews the treatment options for cSCC, with focused attention on the management of high-stage tumors.
Topics: Carcinoma, Squamous Cell; Humans; Immunocompromised Host; Incidence; Neoplasm Grading; Neoplasm Recurrence, Local; Neoplasm Staging; Risk Factors; Skin Neoplasms
PubMed: 29332704
DOI: 10.1016/j.jaad.2017.08.059 -
Journal of the European Academy of... Jan 2022The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing. A growing part of this patient group is formed by immunocompromised patients, for... (Review)
Review
The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing. A growing part of this patient group is formed by immunocompromised patients, for example organ-transplant recipients (OTR). Although over 90% of the cSCC show a relatively harmless clinical behaviour, there is also a chance of developing advanced cSCC and metastases. Locally advanced cSCC are defined as cSCC that have locally advanced progression and are no longer amenable to surgery or radiation therapy. Better understanding of the clinical behaviour of cSCC is essential to discriminate between low- and high-risk cSCC. Staging systems are important and have recently been improved. Genetic characterisation of SCC will likely become an important tool to help distinguish low and high-risk cSCC with an increased potential to metastasise in the near future. Available treatments for high-risk and advanced cSCC include surgery, radiotherapy, chemotherapy and targeted therapy with epidermal growth factor receptors inhibitors. Anti-PD-1 antibodies show promising results with response rates of up to 50% in both locally advanced and metastatic cSCC but, in its present form, is not suitable for OTR.
Topics: Carcinoma, Squamous Cell; Humans; Immunocompromised Host; Neoplasm Staging; Skin Neoplasms
PubMed: 34855246
DOI: 10.1111/jdv.17728 -
Science (New York, N.Y.) Apr 2015Adoptive cell therapy (ACT) is a highly personalized cancer therapy that involves administration to the cancer-bearing host of immune cells with direct anticancer... (Review)
Review
Adoptive cell therapy (ACT) is a highly personalized cancer therapy that involves administration to the cancer-bearing host of immune cells with direct anticancer activity. ACT using naturally occurring tumor-reactive lymphocytes has mediated durable, complete regressions in patients with melanoma, probably by targeting somatic mutations exclusive to each cancer. These results have expanded the reach of ACT to the treatment of common epithelial cancers. In addition, the ability to genetically engineer lymphocytes to express conventional T cell receptors or chimeric antigen receptors has further extended the successful application of ACT for cancer treatment.
Topics: Antigens, Neoplasm; Genetic Engineering; Humans; Immunotherapy, Adoptive; Lymphocyte Depletion; Melanoma; Mutation; Neoplasms; Precision Medicine; Skin Neoplasms; T-Lymphocytes
PubMed: 25838374
DOI: 10.1126/science.aaa4967 -
Hematology/oncology Clinics of North... Feb 2019Although rare, cutaneous metastases portend a poor prognosis and are often an indicator of widespread disease. Breast cancer and melanoma are the most common types of... (Review)
Review
Although rare, cutaneous metastases portend a poor prognosis and are often an indicator of widespread disease. Breast cancer and melanoma are the most common types of cancer that are associated with spread to and within the skin; however, other malignancies, such as lung, colon, head and neck, and hematologic, have been described with a degree of relative frequency. A variety of clinical appearances and syndromes of cutaneous metastases are presented and described in this article. Possible treatment options, including skin-directed therapies and immunotherapies, are also discussed.
Topics: Combined Modality Therapy; Disease Management; Humans; Neoplasm Staging; Prognosis; Skin; Skin Neoplasms; Treatment Outcome
PubMed: 30497674
DOI: 10.1016/j.hoc.2018.08.008 -
Hematology/oncology Clinics of North... Feb 2019Melanoma is an increasingly common cancer in the United States, although mortality has likely stabilized. Diagnosis relies on a skilled practitioner with the aid of... (Review)
Review
Melanoma is an increasingly common cancer in the United States, although mortality has likely stabilized. Diagnosis relies on a skilled practitioner with the aid of dermoscopy and initial local surgical management is a mainstay of treatment. Recent changes in staging emphasize continued use of sentinel lymph node biopsy to aid in prognostication although routine complete lymph node dissection has fallen out of favor. Advances in systemic treatment options, including targeted and immunotherapy, have dramatically changed the treatment paradigm for advanced melanoma and improved outcome. Prevention via sun protection remains a critical tool in efforts to limit the burden of this disease.
Topics: Combined Modality Therapy; Disease Management; Disease Susceptibility; Humans; Melanoma; Neoplasm Grading; Neoplasm Metastasis; Neoplasm Staging; Risk Factors; Skin Neoplasms; Treatment Outcome; Melanoma, Cutaneous Malignant
PubMed: 30497675
DOI: 10.1016/j.hoc.2018.09.005