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Archives of Dermatological Research May 2024
Topics: Humans; Mohs Surgery; Skin Neoplasms; Language; Surveys and Questionnaires
PubMed: 38787433
DOI: 10.1007/s00403-024-02956-8 -
Archives of Dermatological Research May 2024The use of botulinum toxin for off-label indications has become more prevalent, but the specific benefits in Mohs micrographic surgery (MMS) have not yet been fully... (Review)
Review
The use of botulinum toxin for off-label indications has become more prevalent, but the specific benefits in Mohs micrographic surgery (MMS) have not yet been fully elucidated. A systematic review was performed of PubMed, Cochrane, EMBASE, and Scopus databases to identify all articles describing the use of botulinum toxin in MMS. Analysis was subdivided into scar minimization, parotid injury, and pain management. A total of nine articles were included. Scar minimization and treatment of parotid injury were the most reported uses. One case reported the use of botulinum toxin for pain management. Off label uses of botulinum toxin are being explored. Additional research is warranted to determine the efficacy and utility of botulinum toxin in MMS.
Topics: Humans; Mohs Surgery; Off-Label Use; Cicatrix; Skin Neoplasms; Botulinum Toxins, Type A; Botulinum Toxins; Pain Management; Parotid Gland
PubMed: 38787406
DOI: 10.1007/s00403-024-02904-6 -
Archives of Dermatological Research May 2024Cutaneous squamous cell carcinoma in-situ (SCCis) is an intraepithelial tumor with a good prognosis. Standard treatment includes both surgical and non-surgical...
Cutaneous squamous cell carcinoma in-situ (SCCis) is an intraepithelial tumor with a good prognosis. Standard treatment includes both surgical and non-surgical interventions. We determined the clearance rate for SCCis and residual SCCis identified on frozen section during Mohs micrographic surgery (MMS) after treatment with topical fluorouracil 5% cream (5-FU). All MMS cases were initiated for biopsy-proven invasive squamous cell carcinoma (SCC). A retrospective chart review was conducted from January 2017-February 2024 at Columbia University Irving Medical Center (CUIMC) to identify patients with SCCis who were treated with topical 5-FU as primary therapy or adjuvant therapy (AT) for residual SCCis post-MMS for invasive SCC. 41 patients were included (80% males, 70.1 ± 11.8 years). The average follow-up time for the primary therapy group was 25.4 ± 12.8 months, and for the post-MMS AT group 22.5 ± 11.1 months. In the group treated with topical 5-FU as primary therapy (n = 28), 27 patients (96.43%, 95% confidence interval: 81.65-99.91%) achieved complete clearance. One patient had recurrence at 8 months post-treatment. Of the patients in the post-MMS adjuvant treatment group (n = 13), 12 (92.3% clearance, 95% confidence interval 63.97-99.81%) achieved complete clearance. One patient had recurrence at 8 months post-treatment. This study found that topical 5-FU cream is effective as both primary therapy for SCCis and as adjuvant therapy for residual SCCis following MMS of invasive SCC.
Topics: Humans; Fluorouracil; Male; Female; Aged; Retrospective Studies; Middle Aged; Skin Neoplasms; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Aged, 80 and over; Treatment Outcome; Mohs Surgery; Antimetabolites, Antineoplastic; Carcinoma in Situ; Administration, Topical; Follow-Up Studies; Neoplasm Recurrence, Local; Administration, Cutaneous
PubMed: 38787403
DOI: 10.1007/s00403-024-02906-4 -
International Journal of Dermatology May 2024
PubMed: 38780065
DOI: 10.1111/ijd.17243 -
SAGE Open Medical Case Reports 2024Basal cell carcinoma of the areola-nipple complex poses diagnostic and therapeutic challenges due to its rarity and unique anatomical location. This subtype of basal...
Basal cell carcinoma of the areola-nipple complex poses diagnostic and therapeutic challenges due to its rarity and unique anatomical location. This subtype of basal cell carcinoma necessitates meticulous management to address potential recurrence and metastasis. Surgical excision with clear margins remains the cornerstone treatment for basal cell carcinoma of the areola-nipple complex, while alternative modalities such as radiation therapy, Mohs surgery, and systemic therapies may be considered in specific cases. However, optimal management strategies remain contentious, with varying opinions on the necessity of aggressive surgical intervention to minimize recurrence and metastasis risks. Additionally, the absence of standardized diagnostic criteria and treatment guidelines complicates clinical decision-making. Herein, we present a rare case of basal cell carcinoma of the areola-nipple complex in a 47-year-old woman with a notable medical history of hypertension, type 2 diabetes, and untreated psychosis, alongside a family history of breast cancer in her aunt. The patient exhibited a non-regressing ulceration on the right areolar region of the breast, persisting for approximately 10 years and progressively extending over time. Following surgical excision, a favorable post-therapeutic course was observed during follow-up. This case underscores the diagnostic challenges and nuanced management considerations inherent in basal cell carcinoma of the areola-nipple complex, underscoring the imperative for tailored treatment approaches.
PubMed: 38778911
DOI: 10.1177/2050313X241255233 -
JAAD International Sep 2024
PubMed: 38774348
DOI: 10.1016/j.jdin.2024.03.001 -
Journal of the American Academy of... May 2024Mohs Micrographic Surgery (MMS) for treatment of melanoma offers several advantages over wide local excision (WLE), including complete histologic margin evaluation,... (Review)
Review
Mohs Micrographic Surgery (MMS) for treatment of melanoma offers several advantages over wide local excision (WLE), including complete histologic margin evaluation, same-day resection and closure, and sparing of healthy tissue in critical anatomic sites. Recently, a large volume of clinical data demonstrating efficacy in MMS treatment of melanoma was published, leading to emerging patient safety considerations of incurred treatment costs, risk of tumor upstaging, and failure of care coordination for sentinel lymph node biopsy (SLNB). MMS offers a safe, effective, and value-based treatment for both melanoma in situ (MIS) and invasive melanoma (IM), particularly with immunohistochemistry use on frozen sections. Compared to wide local excision, MMS treatment demonstrates similar or improved outcomes for local tumor recurrence, melanoma-specific survival, and overall survival at long-term follow-up. Tumor upstaging risk is low, and if present, alteration to clinical management is minimal. Discussion of SLNB for eligible head and neck IM cases should be done prior to MMS. Though challenging, successful multidisciplinary coordination of SLNB with MMS has been demonstrated. Herein, we provide a detailed clinical review of evidence for MMS treatment of cutaneous melanoma and offer recommendations to address current controversies surrounding the evolving paradigm of surgical management for both MIS and invasive melanoma (IM).
PubMed: 38768857
DOI: 10.1016/j.jaad.2024.05.024 -
Journal of the American Academy of... May 2024
PubMed: 38763287
DOI: 10.1016/j.jaad.2024.03.053 -
Dermatology Online Journal Mar 2024Verrucous carcinoma (VC) is a rare, low-grade variant of well-differentiated squamous cell carcinoma. Plantar verrucous carcinoma presents as a slow-growing, exophytic,...
Verrucous carcinoma (VC) is a rare, low-grade variant of well-differentiated squamous cell carcinoma. Plantar verrucous carcinoma presents as a slow-growing, exophytic, verrucous plaque on weight bearing areas of the foot. Verrucous carcinomas have low metastatic potential, but are high risk for local invasion. We describe a patient with a 20-year history of a slowly growing, ulcerated, verrucous plaque on the sole of the left foot that was erroneously treated for years as verruca plantaris and was eventually diagnosed as invasive verrucous carcinoma. Verrucous carcinomas are a diagnostic challenge due to clinical and histopathologic mimicry of benign lesions. Mohs micrographic surgery should be employed to allow the ability to intraoperatively assess tumor margins while excising the minimal amount of necessary tissue. It is important for clinicians to recognize the characteristics and accurately diagnose verrucous carcinomas. Delays in treatment may require more extensive dissection or amputation.
Topics: Humans; Carcinoma, Verrucous; Warts; Skin Neoplasms; Male; Mohs Surgery; Diagnosis, Differential; Middle Aged; Diagnostic Errors; Aged; Foot Diseases
PubMed: 38762863
DOI: 10.5070/D330163293 -
Basal cell carcinoma has greater subclinical extension than squamous cell carcinoma: a cohort study.Archives of Dermatological Research May 2024
Topics: Humans; Carcinoma, Basal Cell; Skin Neoplasms; Carcinoma, Squamous Cell; Male; Female; Aged; Middle Aged; Cohort Studies; Aged, 80 and over
PubMed: 38761227
DOI: 10.1007/s00403-024-02916-2