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de Andrade FAG, Cavalcanti CEDO, Isoldi FC, Ferreira LM. Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review. Indian J Dermatol Venereol Leprol 2021; 87:176-189. [PMID: 33769755 DOI: 10.25259/ijdvl_431_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 02/01/2020] [Indexed: 01/13/2023]
Abstract
Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; "xeroderma pigmentosum," "therapeutics" and "surgical procedures, operative" from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.
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Genetisch bedingte UV‑Empfindlichkeit. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-020-01115-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nguyen TT, Nguyen TTD, Ta QTH, Vo VG. Advances in non and minimal-invasive transcutaneous delivery of immunotherapy for cancer treatment. Biomed Pharmacother 2020; 131:110753. [PMID: 33152919 DOI: 10.1016/j.biopha.2020.110753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/20/2022] Open
Abstract
Cancer research has focused on figuring out what was the difference between cancer cells and the tissues within which cancer arose and developing targeted treatments for those differences. With FDA-approved treatments for more ten different cancers and more than thousand new clinical trials, immunotherapy has recently emerged as the most promising area of cancer research by improving efficacy and controlling the adverse effects. Transcutaneous delivery drug delivery offers a number of advantages for the patient because of not only its noninvasive and convenient nature but also factors such as avoidance of first-pass metabolism and prevention of gastrointestinal degradation. The purpose of this review was to highlight technological recent approaches to non and minimal-invasive delivery of immunotherapy for cancer treatment. Finally, some practical considerations and discussions for future studies in the field of transdermal immunomodulation are also included.
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Affiliation(s)
- Thuy Trang Nguyen
- Faculty of Pharmacy, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City 700000, Viet Nam
| | - Thi Thuy Dung Nguyen
- Faculty of Environmental and Food Engineering, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Viet Nam
| | - Qui Thanh Hoai Ta
- Institute of Research and Development, Duy Tan University, Danang 550000, Viet Nam
| | - Van Giau Vo
- Bionanotechnology Research Group, Ton Duc Thang University, Ho Chi Minh City 700000, Viet Nam; Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 700000, Viet Nam.
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Martens MC, Boeckmann L, Emmert S. Genetisch bedingte Hauterkrankungen – Xeroderma pigmentosum und das CEDNIK-Syndrom. AKTUELLE DERMATOLOGIE 2020. [DOI: 10.1055/a-1148-3867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungDie Rostocker Hautklinik ist Europäisches Referenznetzwerkzentrum für seltene Hauterkrankungen mit den besonderen Schwerpunkten Xeroderma pigmentosum und Ichthyosen. Diese Themen vertreten wir auch in der medizinischen Grundlagenforschung.Xeroderma pigmentosum (XP) ist eine seltene, autosomal-rezessive Erkrankung, die entsprechend der Gendefekte in 7 Komplementationsgruppen – XP-A bis XP-G sowie die sog. XP-Variante (XP-V) – eingeteilt wird. XP ist ein Nukleotid-Exzisions-Reparatur-Defektsyndrom und äußert sich v. a. durch vorzeitige Hautalterung und frühzeitige Entwicklung von Hauttumoren.Das seltene, neurokutane CEDNIK-Syndrom ist eine autosomal-rezessive Erkrankung, der eine Loss-of-Function-Mutation in SNAP29 zugrunde liegt. SNAP29 ist ein SNARE-Protein und an intrazellulären Membranfusionen beteiligt. CEDNIK ist ein Akronym für den mit dem Syndrom assoziierten Symptomkomplex aus zerebraler Dysgenese, Neuropathie, Ichthyose und Palmoplantarkeratosen. CEDNIK-Patienten weisen neben der Ichthyose zudem Gedeihstörungen, eine psychomotorische Retardierung und faziale Dysmorphien auf.
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Affiliation(s)
- M. C. Martens
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - L. Boeckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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Martens MC, Emmert S, Boeckmann L. Sunlight, Vitamin D, and Xeroderma Pigmentosum. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1268:319-331. [PMID: 32918226 DOI: 10.1007/978-3-030-46227-7_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sunlight, in particular UV-B radiation, is an important factor for endogenous vitamin D production as 80-90% of the required vitamin D needs to be photosynthesized in the skin. The active form of vitamin D, vitamin D3 or calcitriol, binds to the ligand-activated transcription factor vitamin D receptor (VDR) for genomic and non-genomic effects. Recently, calcitriol and analogs have been shown to have antiproliferative effects in mouse and human BCC and SCC cell lines in vitro. As UV radiation plays a critical role in the photosynthesis of vitamin D, stringent sun protection, as recommended for xeroderma pigmentosum (XP) patients, may impact their vitamin D levels.XP is a rare autosomal recessive disorder with a worldwide prevalence of 1 in 1,000,000. XP can be divided into seven different complementation groups: XP-A to XP-G. The complementation groups correspond with the underlying gene defect. Defects in these genes lead to a defective nucleotide excision repair (NER), which is necessary to remove UV-induced DNA damage such as the UV photoproducts cyclobutane pyrimidine dimers (CPD) and 6-4 pyrimidine-pyrimidone (6-4 PP) dimer. Additionally, a variant form with a mutation in the translational polymerase η gene (PolH), also called XP variant (XPV), exists. Patients with XPV show a defect in translesion synthesis. Due to their inability to repair UV-induced lesions, XP patients exhibit an increased risk for UV-induced nonmelanoma skin cancer (NMSC) such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) as well as melanoma. Although no curative therapy for XP exists today, numerous options for the treatment and prophylaxis of skin cancer have become available.
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Affiliation(s)
- Marie Christine Martens
- Clinic and Policlinic of Dermatology and Venerology, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Policlinic of Dermatology and Venerology, University Medical Center Rostock, Rostock, Germany
| | - Lars Boeckmann
- Clinic and Policlinic of Dermatology and Venerology, University Medical Center Rostock, Rostock, Germany.
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Nishigori C, Nakano E, Masaki T, Ono R, Takeuchi S, Tsujimoto M, Ueda T. Characteristics of Xeroderma Pigmentosum in Japan: Lessons From Two Clinical Surveys and Measures for Patient Care. Photochem Photobiol 2018; 95:140-153. [PMID: 30565713 DOI: 10.1111/php.13052] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/16/2018] [Indexed: 01/18/2023]
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive hereditary disease caused by deficiency in repair of DNA lesions generated by ultraviolet radiation and other compounds. Patients with XP display pigmentary change and numerous skin cancers in sun-exposed sites, and some patients show exaggerated severe sunburns even upon minimum sun exposure as well as neurological symptoms. We conducted a nationwide survey for XP since 1980. In Japan, the frequency of the XP complementation group A is the highest, followed by the variant type; while in the Western countries, those of groups C or D are the highest. Regarding skin cancers in XP, basal cell carcinoma was the most frequent cancer that afflicted patients with XP, followed by squamous cell carcinoma, and malignant melanoma. The frequency of these skin cancers in patients with XP has decreased in these 20 years, and the age of onset of developing skin cancers is higher than those previously observed, owing to early diagnosis and education to patients and care takers on strict prevention from sunlight for patients with XP. On the other hand, the effective therapy for neurological XP has not been established yet, and this needs to be done urgently.
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Affiliation(s)
- Chikako Nishigori
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Eiji Nakano
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Taro Masaki
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Ryusuke Ono
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Seiji Takeuchi
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Mariko Tsujimoto
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Takehiro Ueda
- Division of Neurology, Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
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Latour I, Hernández-Martín A, Ged C, Knöpfel N, Taïeb A, Torrelo A. Reversed actinic damage in two children with xeroderma pigmentosum treated with topical imiquimod. J Eur Acad Dermatol Venereol 2018; 32:e282-e284. [PMID: 29377344 DOI: 10.1111/jdv.14818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- I Latour
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - A Hernández-Martín
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - C Ged
- INSERUM U 1053, University of Bordeaux, 146 rue Léo Saignat FR-33000, Bordeaux, France
| | - N Knöpfel
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - A Taïeb
- INSERUM U 1053, University of Bordeaux, 146 rue Léo Saignat FR-33000, Bordeaux, France
| | - A Torrelo
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
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Moriwaki S, Kanda F, Hayashi M, Yamashita D, Sakai Y, Nishigori C. Xeroderma pigmentosum clinical practice guidelines. J Dermatol 2017; 44:1087-1096. [DOI: 10.1111/1346-8138.13907] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 04/02/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Fumio Kanda
- Division of Neurology; Kobe University Graduate School of Medicine; Kobe Japan
| | - Masaharu Hayashi
- Department of Brain Development and Neural Regeneration; Tokyo Metropolitan Institute of Medical Science; Tokyo Japan
| | - Daisuke Yamashita
- Division of Otolaryngology-Head and Neck Surgery; Kobe University Graduate School of Medicine; Kobe Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine; Kobe University Graduate School of Medicine; Kobe Japan
| | - Chikako Nishigori
- Division of Dermatology; Kobe University Graduate School of Medicine (Chairperson at Xeroderma pigmentosum clinical practice guidelines revision committee); Kobe Japan
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Lehmann J, Schubert S, Emmert S. Xeroderma pigmentosum: diagnostic procedures, interdisciplinary patient care, and novel therapeutic approaches. J Dtsch Dermatol Ges 2015; 12:867-72. [PMID: 25262888 DOI: 10.1111/ddg.12419] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Xeroderma pigmentosum (XP) is an autosomal recessive disease, caused by a gene defect in the nucleotide-excision-repair (NER) pathway or in translesional DNA synthesis. At the age of eight, patients already develop their first skin cancers due to this DNA repair defect. In contrast, in the Caucasian population the first tumor formation in UV exposed skin regions occurs at a mean age of 60. The clinical picture among patients suffering from XP is highly diverse and includes signs of accelerated skin aging, and UV-induced skin cancers, as well as ophthalmologic and neurological symptoms. Patients should therefore receive interdisciplinary care. This includes dermatologists, ophthalmologists, ENT specialists, neurologists, and human geneticists. Patients with XP are clinically diagnosed, but this may be supported by molecular-genetic and functional analyses. These analyses allow pinpointing the exact disease-causing gene defect (complementation group assignment, detection of the type and location of the mutation within the gene). The resulting information is already relevant to predict the course of disease and symptoms and probably will be utilized for individualized therapeutic approaches in the future. Recently, enhanced repair of UV photolesions in xeroderma pigmentosum group C cells induced by translational readthrough of premature termination codons by certain antibiotics could be demonstrated.
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Affiliation(s)
- Janin Lehmann
- Department of Dermatology, Venereology, and Allergology, University Hospital at the Georg August University Göttingen, Göttingen, Germany
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Yang JQ, Chen XY, Engle MY, Wang JY. Multiple facial basal cell carcinomas in xeroderma pigmentosum treated with topical imiquimod 5% cream. Dermatol Ther 2015; 28:243-7. [PMID: 25754701 DOI: 10.1111/dth.12217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jian-Qiang Yang
- Department of Dermatology; Second Affiliated Hospital; Zhejiang University School of Medicine; Hangzhou Zhejiang China
- Department of Dermatology; First Affiliated Hospital of Huzhou University; Huzhou Zhejiang China
| | - Xian-Yu Chen
- Department of Dermatology; Yongkang Hospital of Traditional Chinese Medicine; Yongkang Zhejiang China
| | | | - Jian-You Wang
- Department of Dermatology; Second Affiliated Hospital; Zhejiang University School of Medicine; Hangzhou Zhejiang China
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Lambert WC, Lambert MW. Development of effective skin cancer treatment and prevention in xeroderma pigmentosum. Photochem Photobiol 2015; 91:475-83. [PMID: 25382223 DOI: 10.1111/php.12385] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 10/29/2014] [Indexed: 11/29/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare, recessively transmitted genetic disease characterized by increasingly marked dyspigmentation and xerosis (dryness) of sun-exposed tissues, especially skin. Skin cancers characteristically develop in sun-exposed sites at very much earlier ages than in the general population; these are often multiple and hundreds or even thousands may develop. Eight complementation groups have been identified. Seven groups, XP-A…G, are associated with defective genes encoding proteins involved in the nucleotide excision DNA repair (NER) pathway that recognizes and excises mutagenic changes induced in DNA by sunlight; the eighth group, XP-V, is associated with defective translesion synthesis (TLS) bypassing such alterations. The dyspigmentation, xerosis and eventually carcinogenesis in XP patients appear to be due to their cells' failure to respond properly to these mutagenic DNA alterations, leading to mutations in skin cells. A subset of cases, especially those in some complementation groups, may develop neurological degeneration, which may be severe. However, in most XP patients, in the past the multiple skin cancers have led to death at an early age due to either metastases or sepsis. Using either topical 5-fluorouracil or imiquimod, we have developed a protocol that effectively prevents most skin cancer development in XP patients.
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Affiliation(s)
- W Clark Lambert
- Departments of Pathology and Laboratory Medicine and of Dermatology, Rutgers University - New Jersey Medical School, Newark, NJ
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Lehmann J, Schubert S, Emmert S. Xeroderma pigmentosum: diagnostisches Vorgehen, interdisziplinäre Patientenversorgung und neue Therapieansätze. J Dtsch Dermatol Ges 2014. [DOI: 10.1111/ddg.12419_suppl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Janin Lehmann
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin der Georg-August-Universität Göttingen
| | - Steffen Schubert
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin der Georg-August-Universität Göttingen
| | - Steffen Emmert
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin der Georg-August-Universität Göttingen
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ASAI M, KOIKE Y, TOMIMURA S, TAKENAKA M, UTANI A. Long-term Follow-up of a Case of Xeroderma Pigmentosum Complementation Group F. ACTA ACUST UNITED AC 2013. [DOI: 10.2336/nishinihonhifu.75.508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Segura S, Puig S, Carrera C, Lecha M, Borges V, Malvehy J. Non-invasive management of non-melanoma skin cancer in patients with cancer predisposition genodermatosis: a role for confocal microscopy and photodynamic therapy. J Eur Acad Dermatol Venereol 2010; 25:819-27. [DOI: 10.1111/j.1468-3083.2010.03871.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zghal M, Triki S, Elloumi-Jellouli A, Jbali A, Gargouri H, Benmously R, Souissi R, Chedly I, Brahim EB, Ayed MB, Fenniche S, Mokhtar I. [Contribution of the cryosurgery in the management of xeroderma pigmentosum]. Ann Dermatol Venereol 2010; 137:605-9. [PMID: 20932439 DOI: 10.1016/j.annder.2010.06.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 06/01/2010] [Accepted: 06/29/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) occurs frequently in young patients with xeroderma pigmentosum (XP). Because tumours are multiple and usually found on the face, alternatives to surgery are proposed. The purpose of this study was to evaluate the efficacy of cryosurgery for BCC in XP patients. PATIENTS AND METHODS This was a retrospective study that included all instances of BCC occurring in XP patients treated by cryosurgery between January 2002 and October 2008. RESULTS Forty-five cases of primary facial BCC and one case of relapsing BCC (16 on the cheeks, 11 on the nose, six on the face and five on the inner edge of the eye area) were treated by cryosurgery in 18 XP patients (average age: 18.7 years; sex ratio: 0.5). Mean carcinoma size was 10mm. Thirty-six tumours were nodular and 10 were nodular and ulcerated. Follow-up ranged from 16 to 60 months (mean: 30 months). Complications were rare. Cosmetic results were satisfactory. We noted 10 cases of hypopigmentation (21.7%) and one notch on the nose following treatment for recurrent BCC on a radiotherapy scar. Relapse occurred in one case (2.17%). CONCLUSION Because of its simplicity, its good safety, its sparing of skin and its reliability of oncological outcome, cryosurgery is the treatment of choice for CBC in XP patients.
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Affiliation(s)
- M Zghal
- Hôpital Habib Thameur, Tunis, Tunisie
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Sarasin A. Progress and Prospects of Xeroderma Pigmentosum Therapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2008; 637:144-51. [DOI: 10.1007/978-0-387-09599-8_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Malhotra AK, Gupta S, Khaitan BK, Verma KK. Multiple basal cell carcinomas in xeroderma pigmentosum treated with imiquimod 5% cream. Pediatr Dermatol 2008; 25:488-91. [PMID: 18789101 DOI: 10.1111/j.1525-1470.2008.00727.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report successful treatment of multiple basal cell carcinomas with imiquimod 5% cream in a 16-year-old boy with xeroderma pigmentosum and review the possibility of prophylactic role of imiquimod in the disease. Imiquimod cream was applied uniformly over all the basal cell carcinoma lesions and background pigmented skin, once at bedtime on every alternate day for 12 weeks. Besides the basal cell carcinomas, the background hyperpigmentation and keratotic papules also cleared, and the skin texture improved. The lesions did not recur at the treated sites during the follow up of 1 year.
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Affiliation(s)
- Amit Kumar Malhotra
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Mazereeuw-Hautier J, Durand F, Martin L, Cadet J, Thomas P. Réparatoses et poïkilodermies congénitales avec photosensibilité. Ann Dermatol Venereol 2007. [DOI: 10.1016/s0151-9638(07)89251-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rosón E, García-Doval I, de la Torre C, Feal C, Cruces M. [De Sanctis-Cacchione syndrome]. ACTAS DERMO-SIFILIOGRAFICAS 2006; 96:586-8. [PMID: 16476302 DOI: 10.1016/s0001-7310(05)73140-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We present a male patient with photosensitivity since the earliest months of his life, and pigmented macules in exposed areas, some showing clinical atypia, which increased in number over time. Molecular biology studies detected an alteration in DNA repair ability, so xeroderma pigmentosum was diagnosed. Shortly after birth, low weight, microcephaly and psychomotor retardation had been observed, but the cause was not established. The patient progressively showed neurological disorders that included perceptive deafness, hyporeflexia and areflexia, as well as choreoathetotic movements. Therefore, we felt that the patient's symptoms fit De Sanctis-Cacchione syndrome.
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Affiliation(s)
- Elena Rosón
- Servicio de Dermatología, Hospital Provincial, Complejo Hospitalario de Pontevedra, Spain.
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Donnelly RF, McCarron PA, Zawislak AA, Woolfson AD. Design and physicochemical characterisation of a bioadhesive patch for dose-controlled topical delivery of imiquimod. Int J Pharm 2006; 307:318-25. [PMID: 16300913 DOI: 10.1016/j.ijpharm.2005.10.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 10/18/2005] [Accepted: 10/20/2005] [Indexed: 11/19/2022]
Abstract
Clinical use of the imidazoquinoline immunomodulator imiquimod for the topical treatment of dysplastic and neoplastic lesions has increased markedly in recent years. However, despite guidance from the manufacturer of the proprietary imiquimod cream, there seems to be little consensus between clinicians as to the topically applied dose. Given that patients often apply the cream themselves at home, further dosing variability is expected and, consequently, accurate comparison of the results of different published studies is difficult. This paper describes, for the first time, the formulation and physicochemical characterisation of a bioadhesive patch for dose-controlled topical delivery of imiquimod as well as a new HPLC method for sensitive fluorescence determination of imiquimod released from such systems. Patches containing imiquimod loadings of 4.75, 9.50 and 12.50 mg cm(-2) all released significantly more drug across a model membrane than the proprietary cream over a period of 6h. Inclusion of imiquimod in patches did not adversely affect their physicochemical properties. Of major importance, patches contained defined drug loadings per unit area; therefore, their use could reduce inter-clinician variability. This would make critical comparison of clinical studies and determination of an appropriate imiquimod dose for successful treatment much simpler. Since bioadhesive formulations are capable of adhering to body tissues in moist environments, the use of a bioadhesive patch system may allow extension of the clinical uses of imiquimod to the treatment of neoplastic conditions of the oral cavity and cervix, as well as the vulva.
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Affiliation(s)
- Ryan F Donnelly
- School of Pharmacy, Queens University Belfast, Medical Biology Centre, Belfast BT9 7BL, UK.
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Nijsten T, Lapière K, Lambert J. A patient with xeroderma pigmentosum treated with imiquimod 5% cream. J Am Acad Dermatol 2005; 52:170-1. [PMID: 15627108 DOI: 10.1016/j.jaad.2004.04.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Further understanding of the pathogenesis of dermatologic conditions at a molecular level has led to targeted therapies. The topical immune response modifiers have contributed significantly to the treatment of cutaneous diseases. New topical remedies, particularly the Toll-like receptor agonists and calcineurin inhibitors, have added to the clinical armamentarium and have further advanced clinicians' ability to treat a wide variety of benign, premalignant, and malignant conditions. Furthermore, these agents have contributed to the understanding of the disease process. The next decade will witness even greater advances in targeted immunotherapies for dermatologic disease.
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Affiliation(s)
- Daniel N Sauder
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205-0900, USA.
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24
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Abstract
Imiquimod is a topically applied immunomodulator. Although initially approved for genital and perianal warts, dermatologists have prescribed this compound for many neoplastic and nonneoplastic skin conditions. The US Food and Drug Administration recently approved imiquimod for the treatment of actinic keratoses. This article reviews the literature on imiquimod in the treatment of cutaneous malignancies.
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Affiliation(s)
- Carrine A Burns
- Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 697, Rochester, NY 14642, USA
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25
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McGillis ST, Fein H. Topical treatment strategies for non-melanoma skin cancer and precursor lesions. ACTA ACUST UNITED AC 2004; 23:174-83. [PMID: 15584683 DOI: 10.1016/j.sder.2004.06.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The ability to manage non-melanoma skin cancers and pre-malignant lesions with topical pharmacologic agents is highly compelling. This article examines currently available products and discusses their emerging roles and limitations. These include fluorouracil, diclofenac sodium, imiquimod, and photodynamic therapy.
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Affiliation(s)
- S Teri McGillis
- Department of Dermatology, Section of Dermatologic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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