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Bourkas AN, Sibbald C, Chan AW, Schechter T, Ali M, Pullattayil AK, Levy R. Characterizing the cutaneous late effects of allogeneic hematopoietic stem cell transplantation: A systematic review. Pediatr Transplant 2024; 28:e14618. [PMID: 37786978 DOI: 10.1111/petr.14618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/14/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND There is a well-documented risk of secondary cutaneous malignancies following allogeneic hematopoietic stem cell transplant (HSCT), but data on risk in pediatric populations are limited. The objective of this study is to perform a systematic review of reported features and outcomes of skin cancers in pediatric allogeneic HSCT recipients. METHODS MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science were systematically searched (Prospero CRD42022342139). Studies reporting cutaneous cancer outcomes were included if the age at transplant was ≤19 years. Titles, abstracts, and full-text articles were screened in duplicate. RESULTS Out of 824 citations that were screened, 12 articles were selected for analysis. The final sample included 67 pediatric HSCT recipients, comprising 65 allogeneic transplant recipients and 2 cases of HSCT with an unknown donor type. The median age at transplant and skin cancer diagnosis were 7.4 and 13 years, respectively. Out of the 67 pediatric HSCT recipients, some patients developed more than one lesion, resulting in 71 lesions. The most common skin cancer type was cutaneous squamous cell carcinoma (32 lesions), followed by basal cell carcinoma (25 lesions). The median latency period between HSCT and skin cancer diagnosis ranged from 0 to 29 years. Identified risk factors for skin cancers included younger age at the time of transplant, exposure to total body irradiation, prolonged post-transplant immunosuppression, graft versus host disease, and sunburn. CONCLUSION Skin cancers are reported in pediatric allogeneic HSCT recipients, and the risk appears to be increased. More data are needed to better characterize this risk.
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Affiliation(s)
- Adrienn N Bourkas
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cathryn Sibbald
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Tal Schechter
- Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Ali
- Division of Haematology/Oncology/BMT, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Rebecca Levy
- Division of Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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2
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Shope C, Andrews L, Brailsford C, Lee LW. Risk factors for development of skin cancer differ between allogenic and autogenic hematopoietic stem cell transplant recipients. J Am Acad Dermatol 2023:S0190-9622(23)00522-4. [PMID: 37061915 DOI: 10.1016/j.jaad.2023.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Chelsea Shope
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina.
| | - Laura Andrews
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Caroline Brailsford
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina; Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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3
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Skin Biopsy in Pediatric Oncology/Hematopoietic Stem Cell Transplantation Patients. Am J Dermatopathol 2022; 44:728-733. [PMID: 35925552 DOI: 10.1097/dad.0000000000002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The aim of this study was to review the dermatopathological findings in skin biopsy specimens from pediatric oncology and hematopoietic stem cell transplantation patients over a 20-year period. Three hundred fifty-two skin biopsies from 240 patients were reviewed, and the findings were grouped into 6 categories: index neoplasms, nonindex neoplasms, infections, graft-versus-host disease, other treatment complications, and others. Among the index neoplasms identified on skin biopsy, the most common conditions were Langerhans cell histiocytosis (14 patients) and melanoma (7 patients), with other hematological malignancies and an array of soft-tissue tumors accounting for the bulk of the remainder. Neoplastic conditions common in general dermatopathological practice such as basal cell carcinoma and squamous cell carcinoma were uncommon, each being identified in only 1 patient younger than the age of 18, although basal cell carcinomas developing subsequently in young adult life were identified in 7 patients. Infections were common, with infectious agents or viral cytopathic effects (not including human papillomavirus) identified in 34 biopsies. A significant proportion (74%) represented invasive fungal infections, which are of very significant clinical importance. Biopsies performed for a clinical suspicion of graft-versus-host seldom showed histological features to suggest an alternative diagnosis, with only a single case suggesting a diagnosis of toxic erythema of chemotherapy identified.
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4
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Chang CH, Sung WW. Nevi, dysplastic nevi, and melanoma: Molecular and immune mechanisms involving the progression. Tzu Chi Med J 2022; 34:1-7. [PMID: 35233349 PMCID: PMC8830542 DOI: 10.4103/tcmj.tcmj_158_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/28/2020] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Melanocytic nevi, dysplastic nevi, and melanoma are all derived from the pigment-producing cells, namely melanocytes. Concerning the clinical spectrum, cutaneous melanoma is the most aggressive skin cancer with a low survival rate, while nevi are the most common benign lesions in the general population, and dysplastic nevi place in between nevi and melanoma. Ultraviolet (UV) radiation is a well-recognized extrinsic risk factor for all three. BRAFV600E is a well-recognized driver mutation that activates the RAS-BRAF-mitogen-activated protein kinase (MAPK) signaling pathway among 40%–60% of melanoma cases. Interestingly, BRAFV600E mutation is detected even more in acquired nevi, approximately 80%. However, in nevi, several tumor suppressors such as p53 and phosphatase and tensin homolog (PTEN) are intact, and senescence factors, including p15INK4b, p16INK4a, p19, and senescence-associated acidic β-galactosidase, are expressed, leading to cell senescence and cell cycle arrest. Although loss of p53 function is rarely found in melanoma, decreased or loss of PTEN with an activated PI3k/Akt signaling pathway is common in nevi, which may abolish senescence status and allow further progression into dysplastic nevi or melanoma. At present, mouse models closely resembling human nevi are used for investigating these phenomena. Melanocortin 1 receptor deficiency, an intrinsic risk factor for melanomagenesis, is related to the production of procarcinogenic pheomelanin and the inhibition of PTEN function. Immune response escape via programmed cell death-1/programmed cell death ligand-1 interaction plays further roles in monitoring the spectrum. Here, we review the current literature on the molecular and immune mechanisms involving the transition from benign nevi to malignant melanoma.
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Tangthanapalakul A, Chaijitraruch N, Techavichit P, Sosothikul D, Chatproedprai S, Chongsrisawat V, Tempark T, Wananukul S. Dermatologic manifestations in pediatric patients after liver and HSCT: A 20-year retrospective cohort study. Pediatr Transplant 2021; 25:e13916. [PMID: 33142028 DOI: 10.1111/petr.13916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/22/2020] [Accepted: 10/17/2020] [Indexed: 11/30/2022]
Abstract
LT and HSCT are now potentially curative treatments for many medical conditions. Dermatologic manifestations are one of the sequelae after transplantation. To study the prevalence and associated risk factors of dermatologic manifestations after pediatric LT and HSCT. A 20-year retrospective cohort study was conducted in children, aged ≤15 years, who received LT or HSCT from January 1, 1997, to December 31, 2017. Medical records were reviewed for data collection until December 31, 2018. A total of 70 LT and 51 HSCT recipients were included. The percentages of overall dermatologic manifestations after LT and HSCT were 64.3% and 64.7%, respectively. Viral infection was the most common manifestation in both groups, with mucocutaneous HSV infection as the most prevalent. One HSCT recipient developed leukemia cutis. GVHD was revealed in 27.5% of HSCT recipients. Impetigo and xerosis were significantly observed in patients using azathioprine and prednisolone. Approximately two-thirds of pediatric LT and HSCT recipients experienced dermatologic manifestations, potentially associated with immunosuppressive agents. Thus, regular skin examination and optimized immunosuppression would be beneficial in these recipients.
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Affiliation(s)
- Amatanun Tangthanapalakul
- Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Nataruks Chaijitraruch
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Piti Techavichit
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Darintr Sosothikul
- Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Susheera Chatproedprai
- Division of Dermatology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Voranuch Chongsrisawat
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Therdpong Tempark
- Division of Dermatology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Siriwan Wananukul
- Division of Dermatology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
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6
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Li EB, Song JS, Huang JT, Hawryluk EB, London WB, Guo D, Sridharan M, Fisher DE, Rea CJ, Lehmann LE, Duncan CN. Sun exposure and protection practices in children after allogeneic hematopoietic stem cell transplantation: A Survey-Based Cross-Sectional Cohort Study. Pediatr Dermatol 2019; 36:882-886. [PMID: 31410910 PMCID: PMC6883116 DOI: 10.1111/pde.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVE Pediatric hematopoietic stem cell transplantation (HSCT) patients are at an increased risk for skin cancers. Sun exposure is a significant modifiable environmental risk factor. While patient education on sun protection and avoidance behaviors with regular dermatology evaluations are crucial for pediatric HSCT patients, the real-life practice of these sun-protection recommendations in this patient population compared to their peers is unknown. METHODS A survey-based cross-sectional cohort study was performed in pediatric HSCT patients seen at the Dana-Farber Cancer Institute and Boston Children's Hospital over a 1.5-year period compared with age/sex/Fitzpatrick skin phototype-matched healthy controls. Study participants were surveyed using the validated Glanz survey for pediatric sun protection behavioral research. RESULTS Eighty-five pediatric HSCT patients and 85 controls completed the study. Pediatric HSCT patients more frequently used sunscreen, hats, umbrellas, and sunglasses and obtained full-body skin exams compared to controls. No difference was observed in sun exposure during hours of peak sun intensity, frequency of purposeful tanning, tanning bed use, and the number of painful sunburns received between pediatric HSCT patients and controls. CONCLUSIONS Although pediatric HSCT patients practice more sun protection behaviors, they experienced harmful sunburns and intentional tanning behaviors at the same rate as their peers. Patient-directed counseling and strategies to improve patient adherence to optimal sun protection behaviors could have a significant impact on the dermatology quality of life in pediatric HSCT patients.
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Affiliation(s)
- Edward B Li
- Harvard Medical School, Boston, Massachusetts
| | - Johanna S Song
- Harvard Medical School, Boston, Massachusetts.,Dermatology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jennifer T Huang
- Harvard Medical School, Boston, Massachusetts.,Dermatology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elena B Hawryluk
- Harvard Medical School, Boston, Massachusetts.,Dermatology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Wendy B London
- Harvard Medical School, Boston, Massachusetts.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Dongjing Guo
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Madhumitha Sridharan
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - David E Fisher
- Harvard Medical School, Boston, Massachusetts.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Corinna J Rea
- Harvard Medical School, Boston, Massachusetts.,Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Leslie E Lehmann
- Harvard Medical School, Boston, Massachusetts.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Hematology/Oncology Division, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Christine N Duncan
- Harvard Medical School, Boston, Massachusetts.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.,Hematology/Oncology Division, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
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7
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Huang JT, Coughlin CC, Hawryluk EB, Hook K, Humphrey SR, Kruse L, Lawley L, AI-Sayegh H, London WB, Marghoob A, Phung TL, Pope E, Gerami P, Schmidt B, Robinson S, Bartenstein D, Bahrani E, Brahmbhatt M, Chen L, Haddock E, Mansour D, Nguyen J, Raisanen T, Tran G, Travis K, Wolner Z, Eichenfield LF. Risk Factors and Outcomes of Nonmelanoma Skin Cancer in Children and Young Adults. J Pediatr 2019; 211:152-158. [PMID: 31103258 PMCID: PMC7916541 DOI: 10.1016/j.jpeds.2019.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/27/2019] [Accepted: 04/09/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify risk factors associated with nonmelanoma skin cancer (NMSC) occurrence and survival in children. STUDY DESIGN This was a multicenter, retrospective, case-control study of patients <20 years of age diagnosed with NMSC between 1995 and 2015 from 11 academic medical centers. The primary outcome measure was frequency of cases and controls with predisposing genetic conditions and/or iatrogenic exposures, including chemotherapy, radiation, systemic immunosuppression, and voriconazole. RESULTS Of the 124 children with NMSC (40 with basal cell carcinoma, 90 with squamous cell carcinoma), 70% had at least 1 identifiable risk factor. Forty-four percent of the cases had a predisposing genetic condition or skin lesion, and 29% had 1 or more iatrogenic exposures of prolonged immunosuppression, radiation therapy, chemotherapy, and/or voriconazole use. Prolonged immunosuppression and voriconazole use were associated with squamous cell carcinoma occurrence (cases vs controls; 30% vs 0%, P = .0002, and 15% vs 0%, P = .03, respectively), and radiation therapy and chemotherapy were associated with basal cell carcinoma occurrence (both 20% vs 1%, P < .0001). Forty-eight percent of initial skin cancers had been present for >12 months prior to diagnosis and 49% of patients were diagnosed with ≥2 skin cancers. At last follow-up, 5% (6 of 124) of patients with NMSC died. Voriconazole exposure was noted in 7 cases and associated with worse 3-year overall survival (P = .001). CONCLUSIONS NMSC in children and young adults is often associated with a predisposing condition or iatrogenic exposure. High-risk patients should be identified early to provide appropriate counseling and management.
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Affiliation(s)
- Jennifer T. Huang
- Dermatology Program, Division of Immunology, Boston Children’s Hospital,Harvard Medical School,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Carrie C. Coughlin
- Division of Dermatology, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Elena B. Hawryluk
- Dermatology Program, Division of Immunology, Boston Children’s Hospital,Harvard Medical School,Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Kristen Hook
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | | | - Lacey Kruse
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Leslie Lawley
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Hasan AI-Sayegh
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA
| | - Wendy B. London
- Harvard Medical School,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA
| | - Ashfaq Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Thuy L. Phung
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Elena Pope
- Section of Dermatology, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Birgitta Schmidt
- Harvard Medical School,Department of Pathology, Boston Children’s Hospita, Boston, MA
| | - Sarah Robinson
- Dermatology Program, Division of Immunology, Boston Children’s Hospital
| | - Diana Bartenstein
- Department of Dermatology, Massachusetts General Hospital, Boston, MA
| | - Eman Bahrani
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Meera Brahmbhatt
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Lily Chen
- Division of Dermatology, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Ellen Haddock
- Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospita
| | - Danny Mansour
- Section of Dermatology, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Julie Nguyen
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Tom Raisanen
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Gary Tran
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kate Travis
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX
| | - Zachary Wolner
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lawrence F. Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospita,Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, San Diego, CA
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8
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Wei EX, Li X, Nan H. Extremity nevus count is an independent risk factor for basal cell carcinoma and melanoma, but not squamous cell carcinoma. J Am Acad Dermatol 2019; 80:970-978. [PMID: 30713015 DOI: 10.1016/j.jaad.2018.09.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The presence of nevi portends an increased risk for melanoma. OBJECTIVE We sought to examine the association between extremity nevus count and the risk of melanoma and keratinocyte cancers. METHODS We evaluated prospective cohorts of 176,317 women (the Nurses' Health Study, 1986-2012 and the Nurses' Health Study 2, 1989-2013) and 32,383 men (Health Professionals Follow-up Study, 1986-2012). Information on nevus count (none, 1-5, 6-14, ≥15) on the extremity was collected at baseline. RESULTS There were 1704 incident cases of melanoma, 2296 incident cases of squamous cell carcinoma, and 30,457 incident cases of basal cell carcinoma, with a total of 4,655,043 person-years for melanoma and 4,267,708 person-years for keratinocyte cancers. The presence of an extremity nevus was associated with an increased risk of melanoma in all anatomic areas and increased risk of basal cell carcinoma (BCC). Individuals with ≥15 nevi had the highest risk of melanoma and BCC compared to those without any extremity nevi (melanoma hazard ratio 2.79 [95% confidence interval 2.04-3.83]; BCC HR 1.40 [95% confidence interval 1.32-1.49]). No significant association was observed for squamous cell carcinoma. LIMITATIONS Limitations of our study included self-reported nevus count and detection bias. CONCLUSIONS Extremity nevus count is a helpful clinical marker in risk-stratifying individuals for BCC and melanoma on all body sites.
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Affiliation(s)
- Erin X Wei
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Indiana University Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana.
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9
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Coughlin CC, Siegel DH. Cutaneous findings in paediatric solid organ transplant recipients. Br J Dermatol 2018; 179:1235-1236. [PMID: 30508242 DOI: 10.1111/bjd.17112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C C Coughlin
- Division of Dermatology, Departments of Medicine and Pediatrics, Washington University School of Medicine, St Louis, MO, U.S.A
| | - D H Siegel
- Departments of Dermatology and Pediatrics, Medical College of Wisconsin, Milwaukee, WI, U.S.A
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10
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Nonmalignant late cutaneous changes after allogeneic hematopoietic stem cell transplant in children. J Am Acad Dermatol 2018; 79:230-237. [DOI: 10.1016/j.jaad.2018.03.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 03/13/2018] [Accepted: 03/18/2018] [Indexed: 12/24/2022]
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11
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Li AW, Lalor LE, Bellodi Schmidt F, Luu M. A pediatric case of squamous cell cancer in situ in the setting of sclerodermatous graft-versus-host disease and voriconazole treatment. Pediatr Dermatol 2018; 35:e165-e169. [PMID: 29570823 DOI: 10.1111/pde.13473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Sclerodermatous graft-versus-host disease is a subtype of cutaneous chronic graft-versus-host disease that is characterized by sclerosis of the skin and subcutaneous tissue, resulting in debilitating contractures, among other life-threatening complications. Children with sclerodermatous graft-versus-host disease are at high risk of developing nonmelanoma skin cancer because of several risk factors, including young age at transplantation, prolonged immunosuppression, and exposure to photosensitizing antimicrobial prophylaxis such as voriconazole. The immunosuppression required to treat sclerodermatous graft-versus-host disease makes effectively treating nonmelanoma skin cancer and sclerodermatous graft-versus-host disease in the same patient challenging. We describe a challenging case of a 6-year-old boy with a history of sclerodermatous graft-versus-host disease and voriconazole exposure presenting with squamous cell carcinoma in situ on the left temple and actinic keratoses on the scalp treated with topical chemotherapy agents.
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Affiliation(s)
- Alvin W Li
- School of Medicine, Yale University, New Haven, CT, USA
| | - Leah E Lalor
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Minnelly Luu
- Children's Hospital Los Angeles, Los Angeles, CA, USA
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12
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Gerring RC, Ott CT, Curry JM, Sargi ZB, Wester ST. Response to 'The importance of immunosuppression as risk and prognostic factor for periorbital non-melanoma skin cancers'. Eye (Lond) 2017; 32:160-161. [PMID: 28840856 DOI: 10.1038/eye.2017.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- R C Gerring
- Division of Oculoplastic Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - C T Ott
- Division of Oculoplastic Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J M Curry
- Division of Oculoplastic Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Z B Sargi
- Division of Oculoplastic Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S T Wester
- Division of Oculoplastic Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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