Mostrando entradas con la etiqueta skincancer. Mostrar todas las entradas
Mostrando entradas con la etiqueta skincancer. Mostrar todas las entradas
martes, 6 de marzo de 2018
Proposed Technical Guidelines for the Acquisition of Clinical Images of Skin-Related Conditions.
jueves, 22 de febrero de 2018
Prognostic role of the histological subtype of melanoma on the hands and feet in Caucasians.
PubMed
Prognostic role of the histological subtype of melanoma on the hands and feet in Caucasians.
Acral melanoma (AM) is associated with a poor prognosis in part because of delayed diagnosis, but probably also because of other intrinsic characteristics of location. The aim of this study was to review the specific characteristics and outcome of AM in Caucasians.
This was a cross-sectional retrospective clinical-pathological study of 274 patients identified with AM in the database of a referral unit in Europe from 1986 to 2010. The mean age of the patients was 56.6 (SD 17.7) years. 269 cases could be histologically classified and included in the study. In all, 222 (82.5%) were located on feet.
According to melanoma subtype, 165 (61.3%) were acral lentiginous melanoma (ALM), 84 (31.2%) were superficial spreading melanoma (SSM), and 20 (7.5%) were nodular melanoma (NM). SSM patients were characterized by female predominance (77.4%), younger age, and classic melanoma-risk phenotype (fair skin and multiple nevi). Among the 198 invasive cases with a mean follow-up of 56.2 months, the mean (SD) Breslow's thickness was 3.1 (3.6) mm, being 1.4 (1.4) mm in SSM, 3.5 (4.1) mm in ALM and 4.9 (2.9) mm in NM (P<0.001). Ulceration was present in 33.3%, 2.9% in SSM, 38.6% in ALM, and 76.9% in NM (P<0.001). A total of 29.3% relapsed (7.3% of SSM, 35% of ALM and 55% of NM) and 24.2% died because of AM.
In multivariate analysis, age at diagnosis, Breslow, and histopathological subtype were independent prognostic factors for both disease-free and AM-specific survival. The ALM and NM subtypes presented poorer outcome after weighting Breslow and age (P=0.02). Histological subtype of AM could have an impact on biological behavior, ALM and NM subtypes presenting a poorer prognosis after adjusting for age and Breslow's thickness.
https://www.ncbi.nlm.nih.gov/pubmed/28296711
#cristinacarrera #josepmalvehy #susanapuig #breslow #melanoma #skincancer #breslowthickness #carcinoma #acrallentiginousmelanoma #alm #melanomacaucasians #acralmelanoma #melanomarisk
Prognostic role of the histological subtype of melanoma on the hands and feet in Caucasians.
Acral melanoma (AM) is associated with a poor prognosis in part because of delayed diagnosis, but probably also because of other intrinsic characteristics of location. The aim of this study was to review the specific characteristics and outcome of AM in Caucasians.
This was a cross-sectional retrospective clinical-pathological study of 274 patients identified with AM in the database of a referral unit in Europe from 1986 to 2010. The mean age of the patients was 56.6 (SD 17.7) years. 269 cases could be histologically classified and included in the study. In all, 222 (82.5%) were located on feet.
According to melanoma subtype, 165 (61.3%) were acral lentiginous melanoma (ALM), 84 (31.2%) were superficial spreading melanoma (SSM), and 20 (7.5%) were nodular melanoma (NM). SSM patients were characterized by female predominance (77.4%), younger age, and classic melanoma-risk phenotype (fair skin and multiple nevi). Among the 198 invasive cases with a mean follow-up of 56.2 months, the mean (SD) Breslow's thickness was 3.1 (3.6) mm, being 1.4 (1.4) mm in SSM, 3.5 (4.1) mm in ALM and 4.9 (2.9) mm in NM (P<0.001). Ulceration was present in 33.3%, 2.9% in SSM, 38.6% in ALM, and 76.9% in NM (P<0.001). A total of 29.3% relapsed (7.3% of SSM, 35% of ALM and 55% of NM) and 24.2% died because of AM.
In multivariate analysis, age at diagnosis, Breslow, and histopathological subtype were independent prognostic factors for both disease-free and AM-specific survival. The ALM and NM subtypes presented poorer outcome after weighting Breslow and age (P=0.02). Histological subtype of AM could have an impact on biological behavior, ALM and NM subtypes presenting a poorer prognosis after adjusting for age and Breslow's thickness.
https://www.ncbi.nlm.nih.gov/pubmed/28296711
#cristinacarrera #josepmalvehy #susanapuig #breslow #melanoma #skincancer #breslowthickness #carcinoma #acrallentiginousmelanoma #alm #melanomacaucasians #acralmelanoma #melanomarisk
jueves, 15 de febrero de 2018
Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study
PubMed
Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study
https://www.ncbi.nlm.nih.gov/pubmed/28888850
Different protocols have been used to follow up melanoma patients in stage I-II. However, there is no consensus on the complementary tests that should be requested or the appropriate intervals between visits. Our aim is to compare an ultrasound-based follow-up with a clinical follow-up.
Analysis of two prospectively collected cohorts of melanoma patients in stage IB-IIA from two tertiary referral centres in Barcelona (clinical-based follow-up [C-FU]) and Turin (ultrasound-based follow-up [US-FU]). Kaplan-Meier curves were used to evaluate distant metastases-free survival (DMFS), disease-free interval (DFI), nodal metastases-free survival (NMFS) and melanoma-specific survival (MSS).
A total of 1149 patients in the American Joint Committee on Cancer stage IB and IIA were included in this study, of which 554 subjects (48%) were enrolled for a C-FU, and 595 patients (52%) received a protocolised US-FU. The median age was 53.8 years (interquartile range [IQR] 41.5-65.2) with a median follow-up time of 4.14 years (IQR 1.2-7.6). During follow-up, 69 patients (12.5%) in C-FU and 72 patients (12.1%) in US-FU developed disease progression. Median time to relapse for the first metastatic site was 2.11 years (IQR 1.14-4.04) for skin metastases, 1.32 (IQR 0.57-3.29) for lymph node metastases and 2.84 (IQR 1.32-4.60) for distant metastases. The pattern of progression and the total proportion of metastases were not significantly different (P = .44) in the two centres. No difference in DFI, DMFS, NMFS and MSS was found between the two cohorts.
Ultrasound-based follow-up does not increase the survival of melanoma patients in stage IB-IIA.
#melanoma #josepmalvehy #malvehy #americanjointcommitteeoncancer #metastases, #susanapuig #aliciabarreiro #cristinacarrera #skincancer #dermatologiabarcelona #dermatologobarcelona #centrodermatologico #dermatologicalcenter #topdoctors #aad18
Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study
https://www.ncbi.nlm.nih.gov/pubmed/28888850
INTRODUCTION:
PATIENTS AND METHODS:
RESULTS:
CONCLUSION:
jueves, 8 de febrero de 2018
Dermoscopic Clues for Diagnosing Melanomas That Resemble Seborrheic Keratosis.
PubMed
Abstract
Importance:
Objective:
Design, Setting, and Participants:
Main Outcomes and Measures:
Results:
Conclusions and Relevance:
https://www.ncbi.nlm.nih.gov/pubmed/28355453
jueves, 1 de febrero de 2018
Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna
PubMed
Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna
BACKGROUND:
Several dermoscopic and in vivo reflectance confocal microscopy (RCM) diagnostic criteria of lentigo maligna (LM)/lentigo maligna melanoma (LMM) have been identified. However, no study compared the diagnostic accuracy of these techniques.
We evaluated the diagnostic accuracy of dermoscopy and RCM for LM/LMM using a holistic assessment of the images.
223 facial lesions were evaluated by 21 experts. Diagnostic accuracy of the clinical, dermoscopic and RCM examination were compared. Inter-investigator variability and confidence level in the diagnosis were also evaluated.
Overall diagnostic accuracy of the two imaging techniques was good (area under the curve of the sROC function: 0.89). RCM was more sensitive (80%, versus 61%) and less specific (81% versus 92%) than dermoscopy for LM/LMM. In particular RCM showed a higher sensitivity for hypomelanotic and recurrent LM/LMM. RCM had a higher inter-investigator agreement and a higher confidence level in the diagnosis than dermoscopy.
RCM and dermoscopy are both useful techniques for the diagnosis of facial lesions and in particular LM/LMM. RCM is particularly suitable for the identification of hypomelanotic and recurrent LM/LMM. This article is protected by copyright. All rights reserved.
https://www.ncbi.nlm.nih.gov/pubmed/29341263
Dermoscopy versus reflectance confocal microscopy for the diagnosis of lentigo maligna
BACKGROUND:
OBJECTIVE:
METHODS:
RESULTS:
CONCLUSION:
This article is protected by copyright. All rights reserved.
martes, 23 de enero de 2018
Position Statement of the Spanish Academy of Dermatology and Venereology on Teledermatology
PubMed:
Position Statement of the Spanish Academy of Dermatology and Venereology on Teledermatology
https://www.ncbi.nlm.nih.gov/pubmed/29096871
#teledermatology, #malvehy, #dermatology #skincancer #aedv
Position Statement of the Spanish Academy of Dermatology and Venereology on Teledermatology
https://www.ncbi.nlm.nih.gov/pubmed/29096871
#teledermatology, #malvehy, #dermatology #skincancer #aedv
lunes, 22 de enero de 2018
Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study.
Sentinel lymph node biopsy versus observation in thick melanoma: A multicenter propensity score matching study.
https://www.ncbi.nlm.nih.gov/pubmed/28960289
The clinical value of sentinel lymph node (SLN) biopsy in thick melanoma patients (Breslow >4 mm) has not been sufficiently studied. The aim of the study is to evaluate whether SLN biopsy increases survival in patients with thick cutaneous melanoma, and, as a secondary objective, to investigate correlations between survival and lymph node status. We included 1,211 consecutive patients with thick melanomas (>4 mm) registered in the participating hospitals' melanoma databases between 1997 and 2015. Median follow-up was 40 months. Of these patients, 752 were matched into pairs by propensity scores based on sex, age, tumor location, histologic features of melanoma, year of diagnosis, hospital and adjuvant interferon therapy. The SLN biopsy vs. observation was associated with better DFS [adjusted hazard ratio (AHR), 0.74; 95% confidence interval (CI) 0.61-0.90); p = 0.002] and OS (AHR, 0.75; 95% CI, 0.60-0.94; p = 0.013) but not MSS (AHR, 0.84; 95% CI, 0.65-1.08; p = 0.165). SLN-negative patients had better 5- and 10-year MSS compared with SLN-positive patients (65.4 vs. 51.9% and 48.3 vs. 38.8%; p = 0.01, respectively). As a conclusion, SLN biopsy was associated with better DFS but not MSS in thick melanoma patients after adjustment for classic prognostic factors. SLN biopsy is useful for stratifying these patients into different prognostic groups.
#melanoma #josepmalvehy #susanapuig #Mohs #dermoscopy #sentinellymphnode #skincancer #topdoctors #dermatologiabarcelona #cutaneousbarcelona #diagnosisdermatologica
https://www.ncbi.nlm.nih.gov/pubmed/28960289
Abstract
Melanocortin 1 receptor (MC1R) polymorphisms' influence on size and dermoscopic features of nevi.
Melanocortin 1 receptor (MC1R) polymorphisms' influence on size and dermoscopic features of nevi.
https://www.ncbi.nlm.nih.gov/pubmed/28950052
Abstract
The melanocortin 1 receptor (MC1R) is a highly polymorphic gene. The loss-of-function MC1R variants ("R") have been strongly associated with red hair color phenotype and an increased melanoma risk. We sequenced the MC1R gene in 175 healthy individuals to assess the influence of MC1R on nevus phenotype. We identified that MC1R variant carriers had larger nevi both on the back [p-value = .016, adjusted for multiple parameters (adj. p-value)] and on the upper limbs (adj. p-value = .007). Specifically, we identified a positive association between the "R" MC1R variants and visible vessels in nevi [p-value = .033, corrected using the FDR method for multiple comparisons (corrected p-value)], dots and globules in nevi (corrected p-value = .033), nevi with eccentric hyperpigmentation (corrected p-value = .033), a high degree of freckling (adj. p-value = .019), and an associative trend with presence of blue nevi (corrected p-value = .120). In conclusion, the MC1R gene appears to influence the nevus phenotype.
#melanocortin #josepmalvehy #susanapuig #dermoscopic #confocal #Mohs #dermatology #topdoctors #mc1r #melanoma #skincancer #dermatologiabarcelona #clinicadermatologica #cedilp
https://www.ncbi.nlm.nih.gov/pubmed/28950052
Abstract
viernes, 19 de enero de 2018
Seven Non-melanoma Features to Rule Out Facial Melanoma.
Seven Non-melanoma Features to Rule Out Facial Melanoma.
https://www.ncbi.nlm.nih.gov/pubmed/28761960
Facial melanoma is difficult to diagnose and dermatoscopic features are often subtle. Dermatoscopic non-melanoma patterns may have a comparable diagnostic value. In this pilot study, facial lesions were collected retrospectively, resulting in a case set of 339 melanomas and 308 non-melanomas. Lesions were evaluated for the prevalence (> 50% of lesional surface) of 7 dermatoscopic non-melanoma features: scales, white follicles, erythema/reticular vessels, reticular and/or curved lines/fingerprints, structureless brown colour, sharp demarcation, and classic criteria of seborrhoeic keratosis. Melanomas had a lower number of non-melanoma patterns (p< 0.001). Scoring a lesion suspicious when no prevalent non-melanoma pattern is found resulted in a sensitivity of 88.5% and a specificity of 66.9% for the diagnosis of melanoma. Specificity was higher for solar lentigo (78.8%) and seborrhoeic keratosis (74.3%) and lower for actinic keratosis (61.4%) and lichenoid keratosis (25.6%). Evaluation of prevalent non-melanoma patterns can provide slightly lower sensitivity and higher specificity in detecting facial melanoma compared with already known malignant features.
#melanoma #malvehy #skincancer #dermatologobarcelona #cedilp #susanapuig #melanomas #dermatoscopic #diagnosisofmelanoma #lentigo
https://www.ncbi.nlm.nih.gov/pubmed/28761960
Abstract
A practical guide to the handling and administration of talimogene laherparepvec in Europe.
A practical guide to the handling and administration of talimogene laherparepvec in Europe.
https://www.ncbi.nlm.nih.gov/pubmed/28814886
Talimogene laherparepvec is a herpes simplex virus-1-based intralesional oncolytic immunotherapy and is the first oncolytic virus to be approved in Europe. It is indicated for the treatment of adults with unresectable melanoma that is regionally or distantly metastatic (stage IIIB, IIIC, and IVM1a) with no bone, brain, lung, or other visceral disease. Talimogene laherparepvec is a genetically modified viral therapy, and its handling needs special attention due to its deep freeze, cold-chain requirements, its potential for viral shedding, and its administration by direct intralesional injection. This review provides a practical overview of handling, storage, and administration procedures for this agent in Europe. Talimogene laherparepvec vials should be transported/stored frozen at a temperature of -90°C to -70°C, and once thawed, vials must not be refrozen. Universal precautions for preparation, administration, and handling should be followed to avoid accidental exposure. Health care providers should wear personal protective equipment, and materials that come into contact with talimogene laherparepvec should be disposed of in accordance with local institutional procedures. Individuals who are immunocompromised or pregnant should not prepare or administer this agent. Talimogene laherparepvec is administered by intralesional injection into cutaneous, subcutaneous, and/or nodal lesions that are visible, palpable, or detectable by ultrasound. Treatment should be continued for ≥6 months. As with other immunotherapies, patients may experience an increase in the size of existing lesion(s) or the appearance of new lesions (ie, progression) prior to achieving a response ("pseudo-progression"). As several health care professionals (eg, physicians [dermatologists, surgeons, oncologists, radiologists], pharmacists, nurses) are involved in different stages of the process, there is a need for good interdisciplinary collaboration when using talimogene laherparepvec. Although there are specific requirements for this agent's storage, handling, administration, and disposal, these can be effectively managed in a real-world clinical setting through the implementation of training programs and straightforward standard operating procedures.
#melanoma #skincancer #confocal #malvehy #doctormalvehy #cedilp #cancerdepiel #talimogene
#dermatologiabarcelona #dermatologobarcelona #cancerdepielbarcelona
https://www.ncbi.nlm.nih.gov/pubmed/28814886
Abstract
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