1
|
Fellon CM, Elsensohn AN, Kraus CN, Virgen CA. Vulvar Squamous Cell Carcinoma Guidelines May Benefit From Consideration of Tissue-Sparing Techniques as Treatment Options. J Clin Oncol 2024; 42:2723-2724. [PMID: 38776487 DOI: 10.1200/jco.24.00572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 03/18/2024] [Accepted: 04/01/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Corey M Fellon
- Corey M. Fellon, BS, Albany Medical College, Albany, NY; Ashley N. Elsensohn, MD, MPH, Loma Linda University, Department of Dermatology, Loma Linda, CA, Loma Linda University, Department of Pathology, Loma Linda, CA; Christina N. Kraus, MD, University of California, Irvine, Department of Dermatology, Irvine, CA; and Cesar A. Virgen, MD, PhD, Department of Dermatology, Brigham and Women's Hospital, Boston, MA, Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Ashley N Elsensohn
- Corey M. Fellon, BS, Albany Medical College, Albany, NY; Ashley N. Elsensohn, MD, MPH, Loma Linda University, Department of Dermatology, Loma Linda, CA, Loma Linda University, Department of Pathology, Loma Linda, CA; Christina N. Kraus, MD, University of California, Irvine, Department of Dermatology, Irvine, CA; and Cesar A. Virgen, MD, PhD, Department of Dermatology, Brigham and Women's Hospital, Boston, MA, Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Christina N Kraus
- Corey M. Fellon, BS, Albany Medical College, Albany, NY; Ashley N. Elsensohn, MD, MPH, Loma Linda University, Department of Dermatology, Loma Linda, CA, Loma Linda University, Department of Pathology, Loma Linda, CA; Christina N. Kraus, MD, University of California, Irvine, Department of Dermatology, Irvine, CA; and Cesar A. Virgen, MD, PhD, Department of Dermatology, Brigham and Women's Hospital, Boston, MA, Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| | - Cesar A Virgen
- Corey M. Fellon, BS, Albany Medical College, Albany, NY; Ashley N. Elsensohn, MD, MPH, Loma Linda University, Department of Dermatology, Loma Linda, CA, Loma Linda University, Department of Pathology, Loma Linda, CA; Christina N. Kraus, MD, University of California, Irvine, Department of Dermatology, Irvine, CA; and Cesar A. Virgen, MD, PhD, Department of Dermatology, Brigham and Women's Hospital, Boston, MA, Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, Harvard Medical School, Boston, MA
| |
Collapse
|
2
|
Ito T, Tanaka Y, Kaku-Ito Y, Oda Y, Nakahara T. FOXM1: a new therapeutic target of extramammary Paget disease. Sci Rep 2024; 14:4048. [PMID: 38374400 PMCID: PMC10876583 DOI: 10.1038/s41598-024-54773-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/16/2024] [Indexed: 02/21/2024] Open
Abstract
Extramammary Paget disease (EMPD) is a rare skin cancer that primarily affects older individuals predominantly in areas with apocrine sweat glands. Although most early EMPD lesions are indolent, patients with metastatic EMPD have a poor prognosis due to the lack of effective systemic treatment. In this study, we investigated the role of forkhead box M1 (FOXM1), a potent transcription factor, in EMPD and assessed the potential of FOXM1 as a therapeutic target. Immunohistochemistry of 112 primary and 17 metastatic EMPD samples revealed that FOXM1 expression increased with tumor progression. Patients in whom FOXM1 was expressed in more than 10% of tumor cells had significantly shorter disease-specific survival than the other patients (p = 0.0397). In in vitro studies using our newly established EMPD cell line, KS-EMPD-1, we found high expression of FOXM1. Knockdown of FOXM1 impaired tumor cell viability, migration, and invasion. Inhibition of FOXM1 using thiostrepton also reduced tumor cell viability in a dose-dependent manner. These findings suggest that FOXM1 is a promising therapeutic target for patients with EMPD.
Collapse
Affiliation(s)
- Takamichi Ito
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yuka Tanaka
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yumiko Kaku-Ito
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
3
|
Bruce KH, Kilts TP, Lohman ME, Vidal NY, Fought AJ, McGree ME, Keeney GL, Baum CL, Brewer JD, Bakkum-Gamez JN, Cliby WA. Mohs surgery for female genital Paget's disease: a prospective observational trial. Am J Obstet Gynecol 2023; 229:660.e1-660.e8. [PMID: 37633576 PMCID: PMC10872642 DOI: 10.1016/j.ajog.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Extramammary Paget's disease recurs often after traditional surgical excision. Margin-controlled surgery improves the recurrence rate for male genital disease but is less studied for female anatomy. OBJECTIVE This study aimed to compare surgical and oncologic outcomes of margin-controlled surgery vs traditional surgical excision for female genital Paget's disease. STUDY DESIGN We conducted a prospective observational trial of patients with vulvar or perianal Paget's disease treated with surgical excision guided by Mohs micrographic surgery between 2018 and 2022. The multidisciplinary protocol consisted of office-based scouting biopsies and modified Mohs surgery followed by surgical excision with wound closure under general anesthesia. Modified Mohs surgery cleared peripheral disease margins using a moat technique with cytokeratin 7 staining. Medial disease margins (the clitoris, urethra, vagina, and anus) were assessed using a hybrid of Mohs surgery and intraoperative frozen sections. Surgical and oncologic outcomes were compared with the outcomes of a retrospective cohort of patients who underwent traditional surgical excision. The primary outcome was 3-year recurrence-free survival. RESULTS Three-year recurrence-free survival was 93.3% for Mohs-guided excision (n=24; 95% confidence interval, 81.5%-100.0%) compared to 65.9% for traditional excision (n=63; 95% confidence interval, 54.2%-80.0%) (P=.04). The maximum diameter of the excisional specimen was similar between groups (median, 11.3 vs 9.5 cm; P=.17), but complex reconstructive procedures were more common with the Mohs-guided approach (66.7% vs 30.2%; P<.01). Peripheral margin clearance was universally achieved with modified Mohs surgery, but positive medial margins were noted in 9 patients. Reasons included intentional organ sparing and poor performance of intraoperative hematoxylin and eosin frozen sections without cytokeratin 7. Grade 3 or higher postoperative complications were rare (0.0% for Mohs-guided excision vs 2.4% for traditional excision; P=.99). CONCLUSION Margin control with modified Mohs surgery significantly improved short-term recurrence-free survival after surgical excision for female genital Paget's disease. Use on medial anatomic structures (the clitoris, urethra, vagina, and anus) is challenging, and further optimization is needed for margin control in these areas. Mohs-guided surgical excision requires specialized, collaborative care and may be best accomplished at designated referral centers.
Collapse
Affiliation(s)
- Kelly H Bruce
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN
| | - Toni P Kilts
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Sarasota Memorial Healthcare System, Sarasota, FL
| | - Mary E Lohman
- Department of Dermatology, Mayo Clinic, Rochester, MN
| | - Nahid Y Vidal
- Department of Dermatology, Mayo Clinic, Rochester, MN
| | - Angela J Fought
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Michaela E McGree
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | | | | | | | - William A Cliby
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.
| |
Collapse
|
4
|
Kosche C, Rossi AM. Perianal Malignancies: A Review for the Dermatologic Surgeon. Dermatol Surg 2023; 49:914-920. [PMID: 37643240 DOI: 10.1097/dss.0000000000003906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Perianal malignancies are rare tumors with unique presentations and treatment options. OBJECTIVE To review published literature about primary malignancies that present on perianal skin and published guidelines and treatment options. MATERIALS AND METHODS A PubMed search was conducted for original articles about perianal malignancies. RESULTS Squamous cell carcinoma, basal cell carcinoma, melanoma, and extramammary Paget disease are the most common tumors to present on perianal skin. Anal squamous cell carcinoma incidence is increasing and certain populations may benefit from screening. Surgical management is often recommended for localized perianal tumors. CONCLUSION Dermatologic surgeons should be familiar with the presentation and treatment options available for perianal malignancies.
Collapse
Affiliation(s)
- Cory Kosche
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
- Weill Cornell Medical College, New York, New York
| |
Collapse
|
5
|
Light JG, Muñoz G, Council ML. Treatment of penoscrotal basal cell carcinoma - an institutional retrospective review. Arch Dermatol Res 2023; 315:2423-2425. [PMID: 37024690 DOI: 10.1007/s00403-023-02617-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
Basal cell carcinoma (BCC) of the sun-protected genital region is rare. We examined all penoscrotal BCC at a single institution over an 18-year period. A total of 7 cases were identified, 5 scrotal and 2 penile. Four cases (57%) were treated with Mohs micrographic surgery (MMS) and 3 cases (43%) with conventional excision. A prior retrospective review of vulvar BCC at our institution during the same time period showed that MMS was utilized in 4 (11%) of 35 cases. Functional preservation is vital when performing surgery on the genitals and tissue-sparing MMS provides optimal tumor clearance and outcomes for both males and females.
Collapse
Affiliation(s)
- Jeremy G Light
- Division of Dermatology, Washington University School of Medicine, 660 S. Euclid Ave., CB 8123, St. Louis, MO, 63110, USA.
| | - Genevieve Muñoz
- Division of Dermatology, Washington University School of Medicine, 660 S. Euclid Ave., CB 8123, St. Louis, MO, 63110, USA
| | - M Laurin Council
- Division of Dermatology, Washington University School of Medicine, 660 S. Euclid Ave., CB 8123, St. Louis, MO, 63110, USA
- Center for Dermatologic and Cosmetic Surgery, Division of Dermatology, Department of Medicine, Washington University, St. Louis, MO, USA
| |
Collapse
|
6
|
Chen M, Yunqiong Wang Y. Survival Outcomes of Mohs Surgery versus Wide Local Excision for Less Common Nonmelanoma Skin Cancers: A Stabilized Inverse Probability of Treatment Weighting Analysis. Dermatology 2023; 239:877-888. [PMID: 37699383 DOI: 10.1159/000533350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 07/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Compared with wide local excision (WLE), Mohs micrographic surgery (MMS) can not only remove the tumor tissue but also ensure a negative margin. However, there is limited evidence on whether there is a difference in prognosis between the two techniques for less common nonmelanoma skin cancers (NMSCs). OBJECTIVES The aim of our study was to compare the survival outcomes of MMS and WLE for less common NMSCs. METHODS This study retrospectively analyzed data from the Surveillance, Epidemiology, and End Results dataset between 2003 and 2018. The less common NMSCs include Merkel cell carcinoma, skin appendage neoplasm, fibromatous malignancy, and other rare NMSCs. The stabilized inverse probability of treatment weighting (SIPTW) and the Kaplan-Meier methods were adopted to assess the overall survival (OS) and cancer-specific survival (CSS). Furthermore, the Cox proportional hazards, Fine-and-Gray regression analysis, and subgroup analysis models were applied to examine the effects of MMS versus WLE based on all-cause and cancer-specific mortality. RESULTS We identified 6,582 individuals with less common NMSCs for survival analysis, among which 1,946 patients (29.5%) had undergone MMS and 4,636 (70.5%) had received WLE. Diseases diagnosed in the most recent year, older age, the White race, married status, eyelid/face site, small tumor size, and localized disease were factors significantly associated with MMS treatment. Compared with the WLE group, the MMS group had comparable OS before and after the SIPTW analysis. Additionally, after adjusting for other confounding covariates, the surgery type (WLE vs. MMS) did not show significant associations with all-cause mortality (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 0.94-1.14, p = 0.517) and disease-specific mortality (HR: 1.16, 95% CI: 0.95-1.42, p = 0.134). Moreover, the subgroup analysis validated these findings. CONCLUSION MMS and WLE have comparable OS and CSS for less common NMSCs.
Collapse
Affiliation(s)
- Ming Chen
- Department of Dermatology, Maternal and Child Health Hospital of Hubei Province Affiliated to Huazhong University of Science and Technology, Wuhan, China
| | - Yunqiong Yunqiong Wang
- Department of Dermatology, Maternal and Child Health Hospital of Hubei Province Affiliated to Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
7
|
Ito T, Tanaka Y, Ichiki T, Kaku-Ito Y, Nakahara T. KS-EMPD-1: a novel cell line of primary extramammary Paget's disease. Hum Cell 2023; 36:1813-1829. [PMID: 37432591 DOI: 10.1007/s13577-023-00951-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
Extramammary Paget's disease (EMPD) is a rare skin cancer that mainly occurs in apocrine sweat gland-rich areas in elderly people. The prognosis of metastatic EMPD is unfavorable because of the lack of fully effective systemic therapies. However, the difficulty in establishing a model of EMPD has hampered basic research for exploring its pathogenesis and optimal treatments. Here, we established for the first time an EMPD cell line (named KS-EMPD-1) from a primary tumor on the left inguinal region of an 86-year-old Japanese male. The cells were successfully maintained for more than 1 year, with a doubling time of 31.2 ± 0.471 h. KS-EMPD-1 exhibited constant growth, spheroid formation, and invasiveness, and was confirmed to be identical to the original tumor by short tandem repeat analyses, whole exome sequencing, and immunohistochemistry (CK7+CK20-GCDFP15+). Western blotting of the cells revealed the protein expression of HER2, NECTIN4, and TROP2, which have recently attracted attention as potential therapeutic targets for EMPD. KS-EMPD-1 was highly sensitive to docetaxel and paclitaxel on chemosensitivity test. The KS-EMPD-1 cell line is a promising resource for basic and preclinical research on EMPD to better define the tumor characteristics and treatment strategy of this rare cancer.
Collapse
Affiliation(s)
- Takamichi Ito
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yuka Tanaka
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshio Ichiki
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yumiko Kaku-Ito
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
8
|
Approaches to Tumors of the Nail Unit and Genitalia. Dermatol Clin 2022; 41:163-174. [DOI: 10.1016/j.det.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
9
|
Alcalá NE, Reines KL, Merritt B, Figler BD, Bjurlin MA. Mohs microsurgery for localized penile carcinoma: 10 year retrospective review of local recurrence rates and surgical complications. Urol Oncol 2022; 40:457.e1-457.e7. [DOI: 10.1016/j.urolonc.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/02/2022] [Accepted: 08/06/2022] [Indexed: 11/26/2022]
|
10
|
Sakalis VI, Campi R, Barreto L, Garcia-Perdomo HA, Greco I, Zapala Ł, Kailavasan M, Antunes-Lopes T, Marcus JD, Manzie K, Osborne J, Ayres B, Moonen LM, Necchi A, Crook J, Oliveira P, Pagliaro LC, Protzel C, Parnham AS, Albersen M, Pettaway CA, Spiess PE, Tagawa ST, Rumble RB, Brouwer OR. What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes. EUR UROL SUPPL 2022; 40:58-94. [PMID: 35540709 PMCID: PMC9079254 DOI: 10.1016/j.euros.2022.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/25/2022] Open
Abstract
Context The primary lesion in penile cancer is managed by surgery or radiation. Surgical options include penile-sparing surgery, amputative surgery, laser excision, and Moh’s micrographic surgery. Radiation is applied as external beam radiotherapy (EBRT) and brachytherapy. The treatment aims to completely remove the primary lesion and preserve a sufficient functional penile stump. Objective To assess whether the 5-yr recurrence-free rate and other outcomes, such as sexual function, quality of life, urination, and penile preserving length, vary between various treatment options. Evidence acquisition The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane HTA, DARE, HEED), Google Scholar, and ClinicalTrials.gov were searched for publications from 1990 through May 2021. Randomized controlled trials, nonrandomized comparative studies (NRCSs), and case series (CSs) were included. Evidence synthesis The systematic review included 88 studies, involving 9578 men from 16 NRCSs and 72 CSs. The cumulative mean 5-yr recurrence-free rates were 82.0% for penile-sparing surgery, 83.9% for amputative surgery, 78.6% for brachytherapy, 55.2% for EBRT, 69.4% for lasers, and 88.2% for Moh’s micrographic surgery, as reported from CSs, and 76.7% for penile-sparing surgery and 93.3% for amputative surgery, as reported from NRCSs. Penile surgery affects sexual function, but amputative surgery causes more appearance concerns. After brachytherapy, 25% of patients reported sexual dysfunction. Both penile-sparing surgery and amputative surgery affect all aspects of psychosocial well-being. Conclusions Despite the poor quality of evidence, data suggest that penile-sparing surgery is not inferior to amputative surgery in terms of recurrence rates in selected patients. Based on the available information, however, broadly applicable recommendations cannot be made; appropriate patient selection accounts for the relative success of all the available methods. Patient summary We reviewed the evidence of various techniques to treat penile tumor and assessed their effectiveness in oncologic control and their functional outcomes. Penile-sparing as well as amputative surgery is an effective treatment option, but amputative surgery has a negative impact on sexual function. Penile-sparing surgery and radiotherapy are associated with a higher risk of local recurrence, but preserve sexual function and quality of life better. Laser and Moh’s micrographic surgery could be used for smaller lesions.
Collapse
|
11
|
Importance of Addressing the Psychosocial Impact of Penile Cancer on Patients and Their Families. Semin Oncol Nurs 2022; 38:151286. [DOI: 10.1016/j.soncn.2022.151286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
12
|
Assaf J, Sarkis J, Lilly E, Ghazi R, Sarkis P, Stephan F. Latest updates in Mohs micrographic surgery for the management of penile squamous cell carcinoma. Int J Dermatol 2022; 61:e339-e342. [PMID: 35388468 DOI: 10.1111/ijd.16217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Joy Assaf
- Department of Dermatology, Hôtel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Julien Sarkis
- Department of Urology, Hôtel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Eddy Lilly
- Department of Urology, Hôtel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Rabih Ghazi
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Pierre Sarkis
- Department of Urology, Saint-Joseph Hospital, Beirut, Lebanon
| | - Farid Stephan
- Department of Dermatology, Hôtel-Dieu de France University Hospital, Saint-Joseph University, Beirut, Lebanon
| |
Collapse
|
13
|
Dika E, Venturi F. Reply to: "Mohs micrographic surgery for male genital tumors: Local recurrence rates and patient-reported outcomes". J Am Acad Dermatol 2021; 85:e307. [PMID: 34343600 DOI: 10.1016/j.jaad.2021.05.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Emi Dika
- IRCCS Azienda Ospedaliero-Universitaria of Sant'Orsola, Bologna, Italy; Dermatology Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.
| | - Federico Venturi
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| |
Collapse
|
14
|
Shwe S, Elsensohn AN, Ortiz C, Kraus CN. Mohs micrographic surgery for vulvar malignancies: A systematic review. J Am Acad Dermatol 2021; 87:159-162. [PMID: 34237353 DOI: 10.1016/j.jaad.2021.06.875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Samantha Shwe
- Department of Dermatology, University of California, Irvine, California
| | - Ashley N Elsensohn
- Department of Dermatology, University of California, San Diego, California.
| | - Camila Ortiz
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Christina N Kraus
- Department of Dermatology, University of California, Irvine, California
| |
Collapse
|