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Dermatologic Surgery : Official... Oct 2023Survival outcomes in acral lentiginous melanoma (ALM) are worse than for cutaneous melanoma. Diagnostic delays are believed to contribute to worse outcomes in ALM,... (Review)
Review
BACKGROUND
Survival outcomes in acral lentiginous melanoma (ALM) are worse than for cutaneous melanoma. Diagnostic delays are believed to contribute to worse outcomes in ALM, including advanced-stage disease at initial presentation. Acral lentiginous melanoma, especially in its early stages, may be difficult to discern from benign pigmented acral lesions.
OBJECTIVE
The purpose of this article is to provide a comprehensive review of the diagnosis and management of acral pigmented lesions.
MATERIALS AND METHODS
A literature review was performed. The outcomes included were the clinical and dermoscopic features and the management frameworks and considerations for acquired and congenital melanocytic nevi, acral melanosis, nonmelanocytic pigmented lesions, and ALM.
RESULTS
Original research studies were primarily included. The use of dermoscopy, such as the 3-step algorithm and blotch (irregular), ridge pattern (parallel), asymmetry of structures, asymmetry of colors, furrow pattern (parallel), fibrillar pattern (BRAAFF) checklist, increases the diagnostic accuracy of acral pigmented lesions with high specificity and sensitivity. Short-term digital dermoscopic surveillance can be used to manage acral lesions, and histopathology should be collected when there is a concern for ALM.
CONCLUSION
The use of dermoscopy and an understanding of how to manage acral lesions may limit the number of biopsies performed on the acral skin, decrease the time to diagnosis, and facilitate early detection of ALM.
Topics: Humans; Melanoma; Skin Neoplasms; Nevus, Pigmented; Dermoscopy; Melanoma, Cutaneous Malignant
PubMed: 37556446
DOI: 10.1097/DSS.0000000000003891 -
Clinical and Experimental Dermatology Jul 2023Sarcomas arising in the skin are rare but potentially fatal. These tumours originate from mesenchymal cells and can be divided between those that arise in soft tissue... (Review)
Review
Sarcomas arising in the skin are rare but potentially fatal. These tumours originate from mesenchymal cells and can be divided between those that arise in soft tissue and those arising from bone. General guidelines exist for the management of soft-tissue sarcomas; however, there are no specific guidelines for cutaneous sarcomas. Current literature was reviewed for management of seven cutaneous sarcomas including atypical fibroxanthoma, pleomorphic dermal sarcoma, dermal and subcutaneous leiomyosarcoma, dermatofibroma sarcoma protuberans, Kaposi sarcoma, cutaneous angiosarcoma and malignant peripheral nerve sheath tumour. All suspected sarcomas should be discussed in a sarcoma multidisciplinary team meeting. This article is not a clinical guideline but should serve as a practical summary of how these tumours present, how they are recognized histologically, and how best to manage and follow-up patients. The aim is to support clinicians and facilitate the best and most evidence-based standard of care available.
Topics: Humans; Skin Neoplasms; Sarcoma; Leiomyosarcoma; Sarcoma, Kaposi; Hemangiosarcoma
PubMed: 37127912
DOI: 10.1093/ced/llad166 -
Advances in Therapy Aug 2023The incidence of cutaneous melanoma (CM) is increasing. CM is defined as melanoma in situ when limited within the epidermis and invasive when atypical melanocytes... (Review)
Review
The incidence of cutaneous melanoma (CM) is increasing. CM is defined as melanoma in situ when limited within the epidermis and invasive when atypical melanocytes progressively invade the dermis. Treatment of CM is challenging. On one hand, melanoma in situ does not require further treatment except for a limited secondary excision with reduced margins to minimize the risk of local recurrences; on the other, invasive melanoma requires a personalized approach based on tumor staging. Consequently, an association of surgical and medical treatments is often necessary for invasive forms of the disease. In this scenario, new knowledge on melanoma pathogenesis has led to the development of safe and effective treatments, and several drugs are currently under investigation. However, extensive knowledge is required to offer patients a tailored-tail approach. The aim of our article was to review current literature to provide an overview of treatment options for invasive melanoma, highlighting strategical approaches that can be used in patients with these forms of disease.
Topics: Humans; Melanoma; Skin Neoplasms; Treatment Outcome; Neoplasm Staging; Melanoma, Cutaneous Malignant
PubMed: 37306810
DOI: 10.1007/s12325-023-02555-5 -
Laryngo- Rhino- Otologie Aug 2023Merkel cell carcinoma represents a neuroendocrine tumour which can grow rapidly and metastasizes early. The median age of patients is 75-80 years. Given the continuously...
Merkel cell carcinoma represents a neuroendocrine tumour which can grow rapidly and metastasizes early. The median age of patients is 75-80 years. Given the continuously rising population age Merkel cell carcinoma is diagnosed more often. Besides surgery, radiotherapy and chemotherapy immunooncology plays an important role in the treatment of this aggressive tumour.
Topics: Humans; Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Skin Neoplasms
PubMed: 36693386
DOI: 10.1055/a-1949-3751 -
Archives of Dermatological Research Oct 2023Full body skin exams and self-skin exams are screening methods associated with reduced skin cancer incidence due to earlier detection and treatment of lesions. We...
Full body skin exams and self-skin exams are screening methods associated with reduced skin cancer incidence due to earlier detection and treatment of lesions. We performed a retrospective analysis on skin cancer screening and risk factors from the Health Information National Trends Survey (HINTS). The study cohort comprised a weighted population of 478,008,736 respondents, of whom 26,727,370 were patients with disabilities. Respondents with disabilities reported a lower frequency of full body skin exams (OR 0.74; CI 95% 0.69-0.79; P < 0.001) and self-skin exams (OR 0.85; CI 95% 0.78-0.91; P < 0.001), compared to respondents without disabilities. Lower rates of self-guided and clinician-guided screening may adversely affect skin cancer-related morbidity and mortality in persons with disabilities. Future research is needed to identify barriers to self-skin exams and full body skin exams in this population.
Topics: Humans; Prevalence; Retrospective Studies; Skin Neoplasms; Surveys and Questionnaires; Disabled Persons
PubMed: 37010568
DOI: 10.1007/s00403-023-02599-1 -
Current Oncology (Toronto, Ont.) Jul 2023Non-melanoma skin cancer of the head and neck (NMSCHN) is one of the most common malignancies worldwide, and its incidence is growing at a significant rate. It has been... (Review)
Review
Non-melanoma skin cancer of the head and neck (NMSCHN) is one of the most common malignancies worldwide, and its incidence is growing at a significant rate. It has been found to be aggressive in its spread and has the capacity to metastasize to regional lymph nodes. Cutaneous squamous cell carcinoma (cSCC) has a considerably high mortality rate. It has remarkable characteristics: diameter >2 cm, depth >5 mm, high recurrence, perineural invasion, and locoregional metastases. Aggressive cSCC lesions most commonly metastasize to the parotid gland. Also, immunocompromised patients have a higher risk of developing this aggressive cancer along with the worst prognostic outcomes. It is very important to discuss and assess the risk factors, prognostic factors, and outcomes of patients with cSCC, which will give clinicians future directives for making modifications to their treatment plans. The successful treatment of aggressive cSCC of the head and neck includes early detection and diagnosis, surgery alone or adjuvant chemotherapy, and radiotherapy as required. Multimodal therapy options should be considered by clinicians for better outcomes of aggressive cSCC of the head and neck.
Topics: Humans; Carcinoma, Squamous Cell; Squamous Cell Carcinoma of Head and Neck; Skin Neoplasms; Head and Neck Neoplasms; Neoplasm Staging
PubMed: 37504347
DOI: 10.3390/curroncol30070487 -
International Journal of Molecular... Jan 2024Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics.... (Review)
Review
Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker. In melanoma, PRAME is typically highly expressed, in contrast to its weak or absent expression in benign nevi, thereby improving the accuracy of differential diagnoses. The diagnostic value of PRAME extends to various lesions. It is significantly expressed in uveal melanoma, correlating to an increased risk of metastasis. In acral melanomas, especially those with histopathological ambiguity, PRAME helps to improve diagnostic accuracy. However, its expression in spitzoid and ungual melanocytic lesions is inconsistent and requires a comprehensive approach for an accurate assessment. In soft tissue sarcomas, PRAME may be particularly helpful in differentiating melanoma from clear cell sarcoma, an important distinction due to their similar histological appearance but different treatment approaches and prognosis, or in detecting dedifferentiated and undifferentiated melanomas. In non-melanoma skin cancers such as basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma, the variable expression of PRAME can lead to diagnostic complexity. Despite these challenges, the potential of PRAME as a therapeutic target in melanoma is significant. Emerging immunotherapies, including T-cell-based therapies and vaccines targeting PRAME, are being investigated to exploit its cancer-specific expression. Ongoing research into the molecular role and mechanism of action of PRAME in skin cancer continues to open new avenues in both diagnostics and therapeutics, with the potential to transform the management of melanoma and related skin cancers.
Topics: Humans; Male; Antigens, Neoplasm; Biomarkers, Tumor; Diagnosis, Differential; Melanocytes; Melanoma; Prognosis; Skin Neoplasms; Transcription Factors
PubMed: 38338862
DOI: 10.3390/ijms25031582 -
European Journal of Cancer (Oxford,... Aug 2023Immunotherapy with checkpoint inhibitors has revolutionised the outcomes for melanoma patients. In the metastatic setting, patients treated with nivolumab and ipilimumab...
Immunotherapy with checkpoint inhibitors has revolutionised the outcomes for melanoma patients. In the metastatic setting, patients treated with nivolumab and ipilimumab have an expected 5-year survival of> 50%. For patients with resected high-risk stage III disease, adjuvant pembrolizumab, nivolumab or dabrafenib and trametinib are associated with a significant improvement in both relapse-free survival (RFS) and distant metastasis-free survival (DMFS). More recently neoadjuvant immunotherapy has shown very promising outcomes in patients with clinically detectable nodal disease and is likely to become a new standard of care. For stage IIB/C disease, two pivotal adjuvant trials of pembrolizumab and nivolumab have also reported a significant improvement in both RFS and DMFS. However, the absolute benefit is low and there are concerns about the risk of severe toxicities as well as long-term morbidity from endocrine toxicity. Ongoing registration phase III trials are currently evaluating newer immunotherapy combinations and the role of BRAF/MEK-directed targeted therapy for stage II melanoma. However, our ability to personalise therapy based on molecular risk stratification has lagged behind the development of novel immune therapies. There is a critical need to evaluate the use of tissue and blood-based biomarkers, to better select patients that will recur and avoid unnecessary treatment for the majority of patients cured by surgery alone.
Topics: Humans; Nivolumab; Neoplasm Recurrence, Local; Melanoma; Skin Neoplasms; Melanoma, Cutaneous Malignant
PubMed: 37301717
DOI: 10.1016/j.ejca.2023.05.003 -
Journal of Veterinary Dentistry Dec 2023Canine oral lymphoma is an infrequently diagnosed malignancy in dogs and reports in the literature are lacking. Most cases are due to epitheliotropic lymphoma, in which... (Review)
Review
Canine oral lymphoma is an infrequently diagnosed malignancy in dogs and reports in the literature are lacking. Most cases are due to epitheliotropic lymphoma, in which lesions are often multifocal and involve the skin as well as the oral cavity. Epitheliotropic lymphoma is an uncommon form of lymphoma that is characterized by neoplastic T-lymphocyte tropism for epithelial tissues. However, not all cases of oral lymphoma are due to epitheliotropic lymphoma, and B-cell disease is also possible. This article describes very different cases of oral lymphoma in dogs including the history at presentation, examination and radiographic findings, treatments, and outcomes. The cases highlight the variability in signalment, examination findings, and clinical courses that are found with oral lymphoma.
Topics: Animals; Dogs; Skin Neoplasms; Dog Diseases; Mouth
PubMed: 36855316
DOI: 10.1177/08987564231158511 -
Public Health Feb 2024This study aimed to explore the published research on the relationship between climate change and skin cancer and the implications for prevention, management and further... (Review)
Review
OBJECTIVES
This study aimed to explore the published research on the relationship between climate change and skin cancer and the implications for prevention, management and further research.
STUDY DESIGN
Scoping review.
METHODS
This scoping review following JBI methodology reviewed English articles identified in searches of MEDLINE, Embase, CINAHL, Web of Science and Scopus on 14 April 2023. The screening of articles was completed by two independent reviewers. Data were extracted by a single reviewer and checked by another. A causal pathway diagram was iteratively developed throughout the review and was used to categorise the findings.
RESULTS
The search identified 1376 papers, of which 45 were included in the final review. Nine papers reported primary research, and 36 papers were reviews, perspectives, commentaries, editorials, or essays. The papers examined climate change influencing behaviours related to ultraviolet exposure (30 papers), ambient temperature (21 papers) and air pollution (five papers) as possible risk factors; occupational, rural, and contextual factors affecting skin cancer (11 papers); and prevention and access to health care in the context of climate change (seven papers). Most papers were published in journals in subject areas other than health.
CONCLUSIONS
This review identified ultraviolet radiation, occupation, rising temperature, individual behaviour and air pollution as possible influences on skin cancer rates. Furthermore, it highlights the complexity and uncertainties in the relationship between climate change and skin cancer and the need for further research on this relationship, including primary epidemiological research and reviews that follow recognised review guidelines and include assessment of health services and social determinants in the causal pathways of this relationship.
Topics: Humans; Climate Change; Ultraviolet Rays; Skin Neoplasms; Health Facilities
PubMed: 38262229
DOI: 10.1016/j.puhe.2023.12.003