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Płatkowska A, Słowińska M, Zalewska J, Swacha Z, Szumera-Ciećkiewicz A, Wągrodzki M, Patera J, Łapieńska-Rey K, Lorent M, Ługowska I, Rutkowski P, Owczarek W. Minimally Invasive Plasma Device Management of Multiple Benign Skin Cancers Associated with Rare Genodermatoses-Case Series and Review of the Therapeutic Methods. J Clin Med 2024; 13:4377. [PMID: 39124644 PMCID: PMC11312861 DOI: 10.3390/jcm13154377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Non-melanocytic benign skin tumours encompass a diverse group of lesions, classified based on their cellular origin, such as epidermal, vascular, fibrous, neural, muscle, and adnexal tumours. Though they often reveal solitary lesions, multiple skin tumours focus on genodermatoses. Each syndrome exhibits distinct clinical characteristics and potential complications, including cutaneous and extra-cutaneous malignancies, some of which are potentially life-threatening. Diagnosing genetic syndromes is complex and requires numerous histopathological and immunohistochemistry tests due to similarities between the adnexal tumours and basal cell carcinoma upon pathology. Methods: To illustrate the clinical practice, we conducted a retrospective case study that included eleven patients with genodermatoses referred to a tertiary dermatology clinic from September 2018 to April 2024. We have also conducted a research study on available treatment modalities in this setting. Results: Five patients with excellent aesthetic results were treated using a recently approved FDA plasma device. After searching SCOPUS and PubMed database records, we assessed 96 original articles to present current knowledge regarding the dermato-surgical approach. Conclusions: Multiple skin tumours, especially on the face, may significantly affect patients' quality of life and have psychological consequences. An appropriate treatment selection tailored to the patient's needs should be provided. There is no standardised treatment for multiple benign tumours in genodermatoses, and selected methods with varying efficacy are employed. We presented the utility of a new plasma device in these settings.
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Affiliation(s)
- Anna Płatkowska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
- Anclara Health & Aesthetic lek. Anna Płatkowska, Anclara Ltd., Puławska 136/62, 02-511 Warsaw, Poland
| | - Monika Słowińska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Joanna Zalewska
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Zbigniew Swacha
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland; (A.S.-C.); (M.W.)
- Biobank, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland
| | - Michał Wągrodzki
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland; (A.S.-C.); (M.W.)
| | - Janusz Patera
- Department of Pathology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (J.P.); (K.Ł.-R.)
| | - Katarzyna Łapieńska-Rey
- Department of Pathology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (J.P.); (K.Ł.-R.)
| | - Małgorzata Lorent
- Department of Pathology, National Research Institute of Tuberculosis and Lung Diseases, Płocka 26, 01-138 Warsaw, Poland;
| | - Iwona Ługowska
- Department of Soft Tissue, Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland; (I.Ł.); (P.R.)
- Early Phase Clinical Trials Unit and Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue, Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 00-001 Warsaw, Poland; (I.Ł.); (P.R.)
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine—National Research Institute, Central Clinical Hospital Ministry of Defense, Szaserow 128, 04-141 Warsaw, Poland; (A.P.); (J.Z.); (Z.S.); (W.O.)
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2
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Shi L, Zhang F, Yan J, Luo M, Liu K, Liu P, Yan G, Li C, Yang Y, Zeng Q, Zhang G, Chen WR, Wang X. Photothermal therapy improves the efficacy of topical immunotherapy against melanoma. Photodiagnosis Photodyn Ther 2024; 49:104290. [PMID: 39067671 DOI: 10.1016/j.pdpdt.2024.104290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/03/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Melanoma is an aggressive cancer with poor response to traditional therapies. A combination of photothermal therapy and topical immunotherapy may enhance elimination of melanoma.. MATERIALS AND METHODS C57BL/6 mice with early stage and metastatic melanoma were treated with laser immunotherapy (LIT), combining near-infrared laser-based photothermal therapy (PTT) and topical imiquimod (IMQ)-based immunotherapy. The volume of primary and abscopal melanoma, animal survival, tissue temperature, transcriptome, and immune cell response were investigated to evaluate the effect of LIT. RESULTS LIT could eliminate primary tumors, inhibite abscopal tumors, and prolong animal survival. The tumor tissues were selectively destroyed under a photothermal gradient between 38.2 ± 3.7 °C and 73.0 ± 2.3 °C. Gene expression analysis showed a significant increase in the expression of damage associated molecular patterns. Additionally, the population of mature dendritic cells, CD4+ T cells, and CD8+ T cells were increased, while myeloid-derived suppressor cells were downregulated after LIT. CONCLUSION The study showed that LIT inhibited the growth of both primary and abscopal melanoma by activating systemic antitumor immune responses and reversing the immunosuppressive tumor microenvironment, making LIT a potential method for advanced melanoma treatment.
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Affiliation(s)
- Lei Shi
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Fuhe Zhang
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Jia Yan
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Min Luo
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Kaili Liu
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Pei Liu
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Guorong Yan
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Chunxiao Li
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Yutong Yang
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Qingyu Zeng
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Guolong Zhang
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China
| | - Wei R Chen
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK 73019, USA.
| | - Xiuli Wang
- Institute of Photomedicine, School of Medicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai 200092, PR China.
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3
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Fay CJ, Jakuboski S, Mclellan B, Allais BS, Semenov Y, Larocca CA, LeBoeuf NR. Diagnosis and Management of Dermatologic Adverse Events from Systemic Melanoma Therapies. Am J Clin Dermatol 2023; 24:765-785. [PMID: 37395930 PMCID: PMC10796164 DOI: 10.1007/s40257-023-00790-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 07/04/2023]
Abstract
The advent of protein kinase inhibitors and immunotherapy has profoundly improved the management of advanced melanoma. However, with these therapeutic advancements also come drug-related toxicities that have the potential to affect various organ systems. We review dermatologic adverse events from targeted (including BRAF and MEK inhibitor-related) and less commonly used melanoma treatments, with a focus on diagnosis and management. As immunotherapy-related toxicities have been extensively reviewed, herein, we discuss injectable talimogene laherparepvec and touch on recent breakthroughs in the immunotherapy space. Dermatologic adverse events may severely impact quality of life and are associated with response and survival. It is therefore essential that clinicians are aware of their diverse presentations and management strategies.
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Affiliation(s)
- Christopher J Fay
- Department of Dermatology, Brigham and Women's Hospital, and the Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | - Beth Mclellan
- Department of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Blair S Allais
- Department of Dermatology, Brigham and Women's Hospital, and the Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Yevgeniy Semenov
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cecilia A Larocca
- Department of Dermatology, Brigham and Women's Hospital, and the Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, Brigham and Women's Hospital, and the Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
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4
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Adan F, Nelemans PJ, Essers BAB, Brinkhuizen T, Dodemont SRP, Kessels JPHM, Quaedvlieg PJF, Dermont GJ, Winnepenninckx VJL, Abdul Hamid M, Kelleners-Smeets NWJ, Mosterd K. Optical coherence tomography versus punch biopsy for diagnosis of basal cell carcinoma: a multicentre, randomised, non-inferiority trial. Lancet Oncol 2022; 23:1087-1096. [DOI: 10.1016/s1470-2045(22)00347-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022]
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5
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6
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Botsali A, Caliskan E. Laser-assisted delivery of imiquimod in Brooke-Spiegler syndrome. An Bras Dermatol 2022; 97:541-543. [PMID: 35654650 PMCID: PMC9263671 DOI: 10.1016/j.abd.2020.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/13/2020] [Accepted: 12/31/2020] [Indexed: 12/04/2022] Open
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7
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Erbersdobler A, Dräger D. [Non-invasive precursor lesions of penile carcinoma : Differential diagnosis and treatment]. Urologe A 2021; 60:895-900. [PMID: 34142169 DOI: 10.1007/s00120-021-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 12/01/2022]
Abstract
Clinical diagnosis of preinvasive malignant lesions of the penis is difficult and there are numerous differential diagnoses. Recent decades have been witness to several changes in the terminology of histopathological diagnoses. In the current World Health Organization classification, penile intraepithelial neoplasia (PeIN) is defined, of which several subtypes exist. Just like in invasive carcinoma, the principal classification of PeIN subtypes corresponds with pathogenesis and includes human papilloma virus (HPV)-related and non-HPV-related forms. Subdivision is important for prognosis. Several therapeutic options exist, including surgical and nonsurgical procedures.
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Affiliation(s)
- A Erbersdobler
- Institut für Pathologie, Universitätsmedizin Rostock, Strempelstr. 14, 18057, Rostock, Deutschland.
| | - D Dräger
- Urologische Klinik, Universitätsmedizin Rostock, Rostock, Deutschland
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8
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Pereira TDSF, Castro LP, Menck CFM, Maia MHT, Souza LLD, Fonseca FP, Pontes HAR, Pontes FSC, Gomez RS. Xeroderma pigmentosum variant: squamous cell carcinoma of the lower lip harboring exon 11 mutation of POLH. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e97-e105. [PMID: 34030998 DOI: 10.1016/j.oooo.2021.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/09/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare inherited disease caused by deficiencies in DNA damage repair, which mainly results from the failure of nucleotide excision repair or defects in translesion DNA synthesis. The development of multiple malignancies is one of the most prominent features of this condition, which is clinically characterized by the occurrence of hyperpigmentation and lesions associated with sunlight exposure. Lip squamous cell carcinoma in patients with XP has rarely been reported, and information regarding the genetic analysis of these patients is limited. In this report, a case of a 20-year-old patient who developed squamous cell carcinoma in the lower lip is described. Although the tumor was surgically excised, the patient presented with recurrence a few months later. Targeted sequencing using a customized panel of DNA repair genes revealed a mutation in POLH, the gene encoding DNA polymerase eta. Therefore, molecular characterization is important to further improve the understanding of possible phenotype-genotype correlations and mechanisms involved in the pathogenesis of XP.
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Affiliation(s)
| | - Ligia Pereira Castro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Maria Helena Thomaz Maia
- Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Lucas Lacerda de Souza
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Helder Antônio Rebelo Pontes
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Flavia Sirotheau Correa Pontes
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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9
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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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10
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Salah A, Li Y, Wang H, Qi N, Wu Y. Macrophages as a Double-Edged Weapon: The Use of Macrophages in Cancer Immunotherapy and Understanding the Cross-Talk Between Macrophages and Cancer. DNA Cell Biol 2021; 40:429-440. [PMID: 33481665 DOI: 10.1089/dna.2020.6087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Macrophages (Mϕs) play an essential role in maintaining body homeostasis. They perform dual functions produced by different subtypes. Mϕs not only fight against pathogens and foreign bodies such as bacteria or cancer cells but also participate in healing and repairing damaged tissue since they maintain both proinflammatory and anti-inflammatory effects sequentially. Tumors possess the ability to polarize Mϕs from proinflammatory M1 subtype to anti-inflammatory M2-like Mϕs called tumor-associated macrophages, which, in turn, help the tumors to acquire cancer hallmarks. Consequently, this polarization allows tumors to grow and spread. In this light, Mϕs have been a subject of intense study, and researchers have developed protocols to derive different Mϕs subtypes either as a new state-of-the-art therapeutic approach or to understand the cross-talk between cancer and Mϕs. In this review, we present the use of primary Mϕs in adoptive immunotherapy for cancer, illustrate the reciprocating interplay between cancer and Mϕs, and the resulting structural and functional change on both cell types. Furthermore, we summarize the recent cutting-edge approaches of using Mϕs in cancer immunotherapy.
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Affiliation(s)
- Ahmed Salah
- Department of Biochemistry and Molecular Biology, College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, P.R. China
| | - Yanqin Li
- Department of Biochemistry and Molecular Biology, College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, P.R. China
| | - Hao Wang
- Hangzhou Biaomo Biosciences Co., Ltd., Hangzhou, P.R. China.,Asia Stem Cell Therapies Co., Limited, Shanghai, P.R. China
| | - Nianmin Qi
- Hangzhou Biaomo Biosciences Co., Ltd., Hangzhou, P.R. China.,Asia Stem Cell Therapies Co., Limited, Shanghai, P.R. China
| | - Yuehong Wu
- Department of Biochemistry and Molecular Biology, College of Life Science and Medicine, Zhejiang Sci-Tech University, Hangzhou, P.R. China
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11
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Lobo Y, Blake T, Wheller L. Management of multiple trichoepithelioma: A review of pharmacological therapies. Australas J Dermatol 2021; 62:e192-e200. [PMID: 33403677 DOI: 10.1111/ajd.13537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/17/2020] [Indexed: 12/01/2022]
Abstract
Trichoepithelioma is a rare benign adnexal neoplasm that can occur in various forms including solitary, multiple, familial or nonfamilial. Multiple facial trichoepithelioma can be associated with significant psychosocial burden. Conventional treatment modalities such as surgical excision and ablative laser have variable results and can be associated with unacceptable complications and tumour regrowth. Pharmacological interventions such as topical and systemic agents are potentially effective but clinical data are limited and treatments are poorly standardised. We review the available evidence to determine the role of pharmacological therapies in the management of multiple trichoepithelioma. Demographic and clinical data were retrospectively collected from the available English literature. Majority of cases treated with pharmacological therapies (93.75%) had a positive treatment outcome, achieving partial lesion response. Adverse effects associated with pharmacological therapies were generally well tolerated and did not interrupt treatment. There are limitations as to how our results can be interpreted owing to the paucity of good quality evidence, spectrum of disease severity, and diversity of study designs utilised in the included articles. Nonetheless, the results of our study indicate that while most pharmacological interventions for multiple trichoepithelioma produce a partial response, they can be employed as effective suppressive therapies, either alone or in conjunction with conventional treatments. The current evidence for pharmacological therapies remains largely anecdotal justifying the need for further clinical studies in this area.
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Affiliation(s)
- Yolanka Lobo
- Department of Dermatology, Mater Misericordiae Health Services, Brisbane, Queensland, Australia
| | - Tristan Blake
- Department of Dermatology, Mater Misericordiae Health Services, Brisbane, Queensland, Australia
| | - Laura Wheller
- Department of Dermatology, Mater Misericordiae Health Services, Brisbane, Queensland, Australia.,Department of Dermatology, Queensland Children's Hospital, Brisbane, Queensland, Australia
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12
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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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13
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Clinical, Histopathological, and Management Challenges of Multiple Familial Trichoepithelioma: A Case Report of a Patient Presenting with Multiple Facial Papules. Case Rep Dent 2020; 2020:5648647. [PMID: 32963838 PMCID: PMC7499335 DOI: 10.1155/2020/5648647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/22/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022] Open
Abstract
Trichoepitheliomas (TE) are benign skin tumours of the pilosebaceous apocrine unit with follicular differentiation. Multiple familial trichoepithelioma (MFT) is a considerably rare condition inherited in an autosomal dominant pattern. We present a case of a 15-year-old male who presented with multiple papulo-nodular lesions in the central face and a family history of a similar type of lesions from his mother. Significance of consideration of various clinical differential diagnoses with serious pathological outcomes, strategies followed in the diagnosis including histopathological evaluation aided by immunohistochemical investigations, and subsequent challenges that may be faced in the management of MFT in light of the presentation with multiple facial papules are documented in this case report.
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14
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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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15
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Juhasz MLW, Levin MK, Sharp A. Identifying and characterizing basal cell carcinomas in persons with albinism. Int J Dermatol 2020; 59:1082-1091. [DOI: 10.1111/ijd.15071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/20/2020] [Accepted: 06/21/2020] [Indexed: 12/01/2022]
Affiliation(s)
| | - Melissa K. Levin
- The Ronald O. Perelman Department of Dermatology New York University New York NY USA
- Entiere Dermatology New York NY USA
- Standing Voice London UK
| | - Andrew Sharp
- Standing Voice London UK
- Department of Dermatology University Hospitals of Leicester Leicester UK
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16
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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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Abstract
Although surgical intervention remains the standard of care for nonmelanoma skin cancer, other treatment modalities have been studied and used. Nonsurgical treatment methods include cryotherapy, topical medications, photodynamic therapy, radiation therapy, Hedgehog pathway inhibitors, programmed cell death protein 1 inhibitors, and active nonintervention. Despite the favorable efficacy of surgical treatment methods, many factors, including but not limited to patient age, preference, and severity of disease, must be taken into consideration when choosing the most appropriate, patient-centered treatment approach.
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Multiple Nonfamilial Unilateral Trichoepitheliomas: Report of a Case-Mini Review of the Literature. Case Rep Dermatol Med 2019; 2019:6821854. [PMID: 31380124 PMCID: PMC6662247 DOI: 10.1155/2019/6821854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 06/12/2019] [Accepted: 06/18/2019] [Indexed: 11/21/2022] Open
Abstract
Trichoepitheliomas are benign skin tumors with follicular differentiation that present most commonly as solitary lesions. They can also present as multiple centrofacial papules due to several mutations in the CYLD gene. Multiple unilateral trichoepitheliomas in a linear or dermatomal distribution may rarely be seen. Herein, we report a case of multiple unilateral trichoepitheliomas on the face of a healthy 34-year-old woman of Caucasian origin.
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19
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da Cruz Silva LL, de Oliveira WRP, Sotto MN. Epidermodysplasia verruciformis: revision of a model of carcinogenic disease. SURGICAL AND EXPERIMENTAL PATHOLOGY 2019. [DOI: 10.1186/s42047-019-0046-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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20
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Sreekantaswamy S, Endo J, Chen A, Butler D, Morrison L, Linos E. Aging and the treatment of basal cell carcinoma. Clin Dermatol 2019; 37:373-378. [PMID: 31345326 DOI: 10.1016/j.clindermatol.2019.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Basal cell carcinoma (BCC) is the most commonly diagnosed type of skin cancer. BCCs are especially prevalent in the elderly population, given their association with cumulative sun exposure and other risk factors. In this contribution, we outline geriatric concepts related to the care of older adults with BCCs. We describe how a patient's life expectancy can be estimated and combined with tumor characteristics to determine lag time to benefit, a concept to better understand whether patients will experience the efficacy of a treatment within their life span. We also review the possibility of current BCC overdiagnosis and summarize the effectiveness, benefits, and risks of common treatments for BCCs, noting that all treatment modalities have special considerations when administered to older adults. In particular, nonsurgical treatments might be preferable for older adults with a limited life expectancy. Ultimately, we argue that the decision of whether and how to treat a BCC should be the result of shared decision-making between the provider and the patient and take into account not only tumor characteristics, but also patient values and preferences.
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Affiliation(s)
| | - Justin Endo
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amy Chen
- University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Daniel Butler
- University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Lily Morrison
- Stanford University School of Medicine, Stanford, California, USA
| | - Eleni Linos
- Stanford University School of Medicine, Stanford, California, USA.
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21
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Lapteva M, Mignot M, Mondon K, Möller M, Gurny R, Kalia YN. Self-assembled mPEG-hexPLA polymeric nanocarriers for the targeted cutaneous delivery of imiquimod. Eur J Pharm Biopharm 2019; 142:553-562. [PMID: 30641138 DOI: 10.1016/j.ejpb.2019.01.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/18/2018] [Accepted: 01/10/2019] [Indexed: 11/18/2022]
Abstract
mPEG-hexPLA micelles have shown their ability to improve delivery and cutaneous bioavailability of a wide range of poorly water soluble and lipophilic molecules. Although poorly water soluble, imiquimod (IMQ) is only moderately lipophilic and it was decided to investigate whether mPEG-hexPLA polymeric micelles could be used as a drug delivery system for this "less than ideal" candidate for encapsulation. Nanosized IMQ micelles (dn = 27 nm) were formulated and characterized. Moreover, the innovative use of size exclusion chromatography allowed the exact drug localization inside the formulation to be determined; it appeared that the use of acetic acid to solubilize IMQ led to a higher IMQ content outside the micelle than inside. IMQ micelles (0.05%) were formulated in a gel using carboxymethyl cellulose (CMC). In vitro application of this formulation to porcine and human skin led to promising delivery results. IMQ deposition in human skin was 1.4 ± 0.4 µg/cm2 while transdermal permeation was only 79 ± 19 ng/cm2: the formulation displayed >17-fold selectivity for cutaneous deposition over transdermal permeation. The optimized 0.05% gel significantly outperformed Aldara® cream (containing 5% IMQ) formulation in terms of delivery efficiency to human skin (2.85 ± 0.74% vs 0.04 ± 0.01%). Despite IMQ being only partially incorporated in the micelles, the biodistribution profile showed that the optimized 0.05% gel delivered as much as 518.2 ± 173.3 ng/cm2 (1.04 ± 0.35% of the applied dose) to the viable epidermis and 236.4 ± 88.2 ng/cm2 (0.47 ± 0.18% of the applied dose) to the upper dermis where the target antigen presenting cells reside. In contrast, for Aldara® cream, the delivery efficiencies in those layers were less than 0.02%. The optimal 0.05% gel thus allowed therapeutically relevant drug levels to be achieved in target tissues despite a 100-fold dose reduction.
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Affiliation(s)
- Maria Lapteva
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland
| | - Margaux Mignot
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland
| | - Karine Mondon
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland
| | - Michael Möller
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland
| | - Robert Gurny
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland; Apidel SA, CH 1204 Geneva, Switzerland
| | - Yogeshvar N Kalia
- School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland.
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22
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23
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Sinha K, Mallipeddi R, Sheth N, Al-Niaimi F. Carbon dioxide laser ablation for trichoepitheliomas: The largest reported series. J COSMET LASER THER 2017; 20:9-11. [DOI: 10.1080/14764172.2017.1288257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Khushboo Sinha
- Department of Dermatologic Surgery and Laser Unit, St. John’s Institute of Dermatology, St Thomas’s Hospital, London, London, UK
| | - Raj Mallipeddi
- Department of Dermatologic Surgery and Laser Unit, St. John’s Institute of Dermatology, St Thomas’s Hospital, London, London, UK
| | - Nisith Sheth
- Department of Dermatologic Surgery and Laser Unit, Guy’s and St. Thomas’ Hospitals, London, UK
| | - Firas Al-Niaimi
- St. John’s Institute of Dermatology, St. Thomas’ Hospital, London, UK
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24
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Yu A, Tanizaki H, Kokunai Y, Kaneda K, Sugimoto A, Otsuka T, Kurokawa T, Moriwaki S. Association between the clinical and histopathological classifications of actinic keratosis and the efficacy of topical imiquimod treatment. J Dermatol 2017; 45:496-500. [DOI: 10.1111/1346-8138.14192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 11/17/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Akitoshi Yu
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Hideaki Tanizaki
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Yasuhito Kokunai
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Kazuma Kaneda
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Akira Sugimoto
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Toshihiro Otsuka
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
| | - Teruo Kurokawa
- Department of Dermatology; Osaka Medical College; Takatsuki Japan
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25
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Baumgarten AS, Fisher JS, Lawindy SM, Pavlinec JG, Carrion RE, Spiess PE. Penile sparing surgical approaches for primary penile tumors: preserving function and appearance. Transl Androl Urol 2017; 6:809-819. [PMID: 29184777 PMCID: PMC5673820 DOI: 10.21037/tau.2017.04.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Penile cancer is a rare and potentially disfiguring disease. There are multiple treatment options for primary penile lesions. Penile sparing approaches offer an attractive option as they can provide several quality of life benefits without detrimental oncologic outcomes. With appropriate diagnostic evaluation and staging, penile sparing techniques provide proper cancer control with improved cosmetic and functional results. Regardless of the chosen treatment modality, a commitment to close follow-up remains a critical component of all treatment considerations. The goal of this review is to provide an overview of the multiple treatment strategies for primary penile tumors with a focus on penile sparing surgical approaches.
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Affiliation(s)
| | - John S Fisher
- Division of Urology, University of Tennessee, Knoxville, USA
| | | | | | | | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA
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26
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Chen Q, Yang R, Gao A, Zhong D, Zhu H. Efficacy of fulguration combined with imiquimod cream on condyloma acuminatum, and the effect on immune functions and serums levels of IL-2 and IL-10. Exp Ther Med 2017; 14:131-134. [PMID: 28672903 PMCID: PMC5488597 DOI: 10.3892/etm.2017.4445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/01/2017] [Indexed: 01/19/2023] Open
Abstract
The objective of the present study was to investigate the clinical efficacy of high-frequency fulguration combined with 5% imiquimod cream for condyloma acuminatum (CA), and the effect on T cell immune function and serum levels of interleukin (IL)-2 and IL-10. We enrolled 112 patients with CA between January 2014 and January 2016. Patients were randomly divided into the control group (n=56) and observation group (n=56). The control group received high-frequency fulguration combined with intramuscular injection of Bacillus Calmette-Guérin polysaccharide nucleic acid, and the observation group received high-frequency fulguration combined with external application of 5% imiquimod cream. In both groups, the course of treatment lasted for 12 weeks, and the follow-up period was 6 months. Clinical efficacy was compared between the groups. The total effective rate in the observation group was higher than that in the control group (p<0.05), but no significant differences were identified in comparisons of effectiveness and recurrence rate between the two groups (p>0.05). After treatment, the levels of CD3+ and CD4+ cells, and CD4+/CD8+ ratio in both groups were increased compared with those before treatment (p<0.05), while no significant difference was identified in comparison of the levels of CD8+ cells in both groups before and after treatment (p>0.05); in both groups before and after treatment, there was no significant difference in the comparison of T cells (p>0.05). After treatment in both groups, the serum levels of IL-2 were increased, and the levels of IL-10 were decreased compared with those before treatment; the improvement in the observation group was superior to that in the control group (p<0.05). In conclusion, good efficacy can be achieved with the combined treatment of high-frequency fulguration and 5% imiquimod cream for CA, which is correlated with enhanced immune functions of T cells, and improvements in the serum levels of IL-2 and IL-10.
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Affiliation(s)
- Quan Chen
- Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Ridong Yang
- Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Aili Gao
- Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Daoqing Zhong
- Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Huilan Zhu
- Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
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27
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Otrofanowei E, Akinkugbe A, Ayanlowo O. Management challenges of epidermodysplasia verruciformis in a resource-limited setting: A retrospective review. JOURNAL OF CLINICAL SCIENCES 2017. [DOI: 10.4103/jcls.jcls_94_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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28
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Erythroplasia of Queyrat treated by laser and light modalities: a systematic review. Lasers Med Sci 2016; 31:1971-1976. [DOI: 10.1007/s10103-016-2005-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
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29
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Deen K, Burdon-Jones D. Imiquimod in the treatment of penile intraepithelial neoplasia: An update. Australas J Dermatol 2016; 58:86-92. [DOI: 10.1111/ajd.12466] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/03/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Kristyn Deen
- Department of Dermatology; Mater Misericordiae Hospital; Brisbane Queensland Australia
| | - David Burdon-Jones
- Department of Dermatology; Mater Misericordiae Hospital; Brisbane Queensland Australia
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30
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Russo I, Cona C, Saponeri A, Bassetto F, Baldo V, Alaibac M. Association between Toll-like receptor 7 Gln11Leu single-nucleotide polymorphism and basal cell carcinoma. Biomed Rep 2016; 4:459-462. [PMID: 27073632 DOI: 10.3892/br.2016.597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/19/2016] [Indexed: 12/12/2022] Open
Abstract
Non-melanoma skin cancers (NMSC) are the most common form of human skin cancer. The majority of NMSC are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) with a BCC:SCC incidence ratio of 4:1 in immunocompetent patients. Toll-like receptors (TLRs) are transmembrane glycoproteins that recognize pathogen-associated molecular patterns and damage-associated molecular patterns, against which they activate the innate immune response and initiate the adaptive immune response. Genetic variations of these receptors can alter the immune system and are involved in evolution and susceptibility of various diseases, including cancer. Imiquimod, an agonist of TLR7, is applied topically in the treatment of premalignant and malignant skin disorders, in particular BCC. The high efficacy of this TLR7 agonist toward BCC supports a possible role of this receptor in the induction of BCC and, consequently, polymorphisms of this receptor could be responsible for a greater or lesser susceptibility to BCC. The aim of the present study was to evaluate whether the presence of the functional TLR7 rs179008/Gln11Leu promoter polymorphism conferred an increased susceptibility to BCC. A case-control study with 177 BCC cases and 158 controls was performed to highlight the possible association between this polymorphism and the susceptibility to BCC. As the TLR7 gene is localized on chromosome X, the allelic frequency of this polymorphism was analyzed separately in males and females. The analysis of the distribution of frequencies of wild-type TLR7 and variant TLR7 carrying the single-nucleotide polymorphism (SNP) rs179008 in patients with BCC and healthy subjects did not reveal any statistically significant difference between cases and controls. This study does not suggest the involvement of the SNP rs179008 of TLR7 in the susceptibility to BCC, but cannot exclude a role for TLR7 in BCC carcinogenesis considering the high efficacy of the TLR7 agonist, imiquimod, in the treatment of this neoplastic disorder.
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Affiliation(s)
- Irene Russo
- Dermatology Unit, Department of Medicine, University of Padova, I-35121 Padova, Italy
| | - Camilla Cona
- Plastic Surgery Unit, University of Padova, I-35128 Padova, Italy
| | - Andrea Saponeri
- Dermatology Unit, Department of Medicine, University of Padova, I-35121 Padova, Italy
| | - Franco Bassetto
- Plastic Surgery Unit, University of Padova, I-35128 Padova, Italy
| | - Vincenzo Baldo
- Public Health Unit, University of Padova, I-35121 Padova, Italy
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine, University of Padova, I-35121 Padova, Italy
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31
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Hirschman D, Tacastacas J, Rady PL, Tyring SK, Cooper K, Honda K. Acquired Epidermodysplasia Verruciformis Associated with Human Papilloma Virus Type 14 in a Small Bowel Transplanted Child--A Case Report. Pediatr Dermatol 2016; 33:e1-5. [PMID: 26646304 DOI: 10.1111/pde.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 3-year-old African American girl taking sirolimus and tacrolimus for a small bowel transplantation presented with hypopigmented macules and papules throughout her trunk. A biopsy diagnosed epidermodysplasia verruciformis (EV) that was found to be associated with human papillomavirus (HPV) type 14 according to polymerase chain reaction analysis. There are few cases of acquired EV in the setting of organ transplantation. Although there is no standardized treatment for acquired EV, prevention and surveillance for transformation to squamous cell carcinoma are primary concerns.
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Affiliation(s)
- Derek Hirschman
- Graduate Medical Education Department, McLaren Bay Region, Bay City, Michigan
| | - Joselin Tacastacas
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Peter L Rady
- Center for Clinical Studies, University of Texas Health Science Center, Houston, Texas.,Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Stephen K Tyring
- Center for Clinical Studies, University of Texas Health Science Center, Houston, Texas.,Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Kevin Cooper
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Kord Honda
- Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
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32
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John AM, Schwartz RA. Basal cell naevus syndrome: an update on genetics and treatment. Br J Dermatol 2015; 174:68-76. [PMID: 26409035 DOI: 10.1111/bjd.14206] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 12/14/2022]
Abstract
Basal cell naevus syndrome is an autosomal dominant disorder that stems from mutations in multiple genes, most commonly patched 1 (PTCH1). The classic triad of symptoms consists of basal cell carcinomas, jaw keratocysts and cerebral calcifications, although there are many other systemic manifestations. Because of the broad range of symptoms and development of several types of tumours, early diagnosis and close monitoring are essential to preserve quality of life. Targeting treatment is often difficult because of tumour prevalence. Newer inhibitors of the hedgehog signalling pathway and proteins involved in proliferative growth have shown therapeutic promise. In addition, preventive medications are being devised. We propose a method for determining appropriate treatment for cutaneous tumours.
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Affiliation(s)
- A M John
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, NJ, 07103, U.S.A
| | - R A Schwartz
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, NJ, 07103, U.S.A.,Rutgers University School of Public Affairs and Administration, Newark, NJ, U.S.A
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33
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Takata Pontes L, Fantelli Stelini R, Cintra ML, Magalhães RF, Velho PENF, Moraes AM. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital. Clinics (Sao Paulo) 2015; 70:721-5. [PMID: 26602517 PMCID: PMC4642494 DOI: 10.6061/clinics/2015(11)01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. METHODS The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. RESULTS Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. CONCLUSION Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating "skip areas" and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.
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Affiliation(s)
- Luciana Takata Pontes
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Rafael Fantelli Stelini
- Patologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, SP, Brazil
| | - Maria Leticia Cintra
- Patologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, SP, Brazil
| | - Renata Ferreira Magalhães
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Paulo Eduardo N F Velho
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
| | - Aparecida Machado Moraes
- Clínica Médica, Divisão Dermatologia, Hospital das Clínicas da Universidade Estadual de Campinas, São Paulo, Brazil
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34
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Singh M, Overwijk WW. Intratumoral immunotherapy for melanoma. Cancer Immunol Immunother 2015; 64:911-21. [PMID: 26050024 PMCID: PMC11028428 DOI: 10.1007/s00262-015-1727-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 05/29/2015] [Indexed: 12/27/2022]
Abstract
Selection of suitable tumor-associated antigens is a major challenge in the development of effective cancer vaccines. Intratumoral (i.t.) immunotherapy empowers the immune system to mount T cell responses against tumor-associated antigens which are most immunogenic. To mediate systemic tumor regression, i.t. immunotherapy must generate systemic T cell responses that can target distant metastases beyond the initially treated tumor mass. Now that promising preclinical results and some initial success in clinical trials have been obtained, we here review i.t. immunotherapy-related preclinical and clinical studies, their mechanisms of action and future prospects.
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Affiliation(s)
- Manisha Singh
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, 7455 Fannin St., Unit 0904, Houston, TX 77030 USA
| | - Willem W. Overwijk
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, 7455 Fannin St., Unit 0904, Houston, TX 77030 USA
- The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX USA
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Kim JM, Lee HJ, Kim SH, Kim HS, Ko HC, Kim BS, Kim MB, Song M. Efficacy of 5% imiquimod cream on vulvar intraepithelial neoplasia in Korea: pilot study. Ann Dermatol 2015; 27:66-70. [PMID: 25673934 PMCID: PMC4323605 DOI: 10.5021/ad.2015.27.1.66] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 10/13/2014] [Accepted: 11/19/2014] [Indexed: 11/30/2022] Open
Abstract
Background Various therapeutic options, including surgery, electrocautery, cryotherapy, 5-fluorouracil treatment, laser therapy, radiotherapy, photodynamic therapy, and interferon-α/γ injection, have been employed to treat vulvar intraepithelial neoplasia (VIN) with varying degrees of success. To truly cure VIN, human papillomavirus elimination is considered important. Objective To investigate the efficacy of 5% imiquimod cream used to treat VIN in Korean patients Methods We performed a prospective, uncontrolled, observational study. Nine patients with histologically confirmed VIN applied 5% imiquimod cream to their vulvar lesions three to five times a week until a clinical response was apparent. All lesions were photo-documented, and therapeutic efficacy was assessed in terms of local adverse effects lesion number, size, and hyperpigmentation. Results The mean treatment duration was 30.2 months, and the median follow-up period after therapy completion was 30 months. Of the nine patients recruited, six (66.6%) experienced complete responses (CR) or partial responses (PR). Hyperpigmented patches in the VIN lesions were evident in five subjects (55.6%), and all experienced either CR or PR. Only three patients (33.3%) suffered from local adverse effects, which were relieved after temporary suspension of therapy, and better outcomes were attained ultimately. Conclusion The imiquimod cream was more efficacious when used to treat VIN of the hyperpigmented type compared with lesions lacking pigmentation. The unifocal nature of a lesion and the development of local adverse effects are useful factors when imiquimod cream is prescribed. However, although the cream is convenient and effective, regional resistance may develop, and close follow-up is essential because VIN may become malignant.
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Affiliation(s)
- Jeong-Min Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun-Joo Lee
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Su-Han Kim
- Goun Laser and Cosmetic Clinic, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Margaret Song
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Yamaguchi Y, Hata H, Imafuku K, Kitamura S, Shimizu H. A case of erythroplasia of Queyrat successfully treated with combination carbon dioxide laser vaporization and surgery. J Eur Acad Dermatol Venereol 2014; 30:497-8. [PMID: 25475424 DOI: 10.1111/jdv.12888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Y Yamaguchi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Imafuku
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Kitamura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Singh M, Khong H, Dai Z, Huang XF, Wargo JA, Cooper ZA, Vasilakos JP, Hwu P, Overwijk WW. Effective innate and adaptive antimelanoma immunity through localized TLR7/8 activation. THE JOURNAL OF IMMUNOLOGY 2014; 193:4722-31. [PMID: 25252955 DOI: 10.4049/jimmunol.1401160] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Intratumoral immune activation can induce local and systemic antitumor immunity. Imiquimod is a cream-formulated, TLR7 agonist that is Food and Drug Administration approved for the treatment of nonmelanoma skin cancers, but it has limited activity against melanoma. We studied the antitumor activity and mechanism of action of a novel, injectable, tissue-retained TLR7/8 agonist, 3M-052, which avoids systemic distribution. Intratumoral administration of 3M-052 generated systemic antitumor immunity and suppressed both injected and distant, uninjected wild-type B16.F10 melanomas. Treated tumors showed that an increased level of CCL2 chemokines and infiltration of M1 phenotype-shifted macrophages, which could kill tumor cells directly through production of NO and CCL2, were essential for the antitumor activity of 3M-052. CD8(+) T cells, B cells, type I IFN, IFN-γ, and plasmacytoid dendritic cells were contributed to efficient tumor suppression, whereas perforin, NK cells, and CD4 T cells were not required. Finally, 3M-052 therapy potentiated checkpoint blockade therapy with anti-CTLA-4 and anti-programmed death ligand 1 Abs, even when checkpoint blockade alone was ineffective. Our findings suggest that intratumoral treatment with 3M-052 is a promising approach for the treatment of cancer and establish a rational strategy and mechanistic understanding for combination therapy with intratumoral, tissue-retained TLR7/8 agonist and checkpoint blockade in metastatic cancer.
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Affiliation(s)
- Manisha Singh
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Hiep Khong
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030
| | - Zhimin Dai
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Xue-Fei Huang
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Jennifer A Wargo
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; and
| | - Zachary A Cooper
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; and
| | - John P Vasilakos
- 3M Drug Delivery Systems Division, 3M Company, St. Paul, MN 55144
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030
| | - Willem W Overwijk
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030; University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030;
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Mohammadi AA, Seyed Jafari SM. Trichoepithelioma: a rare but crucial dermatologic issue. World J Plast Surg 2014; 3:142-5. [PMID: 25489539 PMCID: PMC4236999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/01/2014] [Indexed: 11/26/2022] Open
Abstract
Trichoepithelioma is a rare benign skin lesion that originates from hair follicles. Trichoepitheliomas are mostly seen in the scalp, nose, forehead, and upper lip. We present a large family of Iranian origin with 15 individuals affected with multiple familial trichoepithelioma in four generations, and treated with three different methods. Trichoepithelioma is histologically similar to basal cell carcinoma and has a rare risk of malignant transformation. In addition, most frequent incidence of this disease in young to elderly women may lead to social and psychological issues. Precise diagnosis and management of this rare disease seem necessary.
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Affiliation(s)
- Ali Akbar Mohammadi
- Correspondence Author: Ali Akbar Mohammadi, MD; Shiraz Burn Research Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran, Tel: +98-711-8219640, Fax: +98-711-8217090, E-mail:
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Bahner JD, Bordeaux JS. Non-melanoma skin cancers: photodynamic therapy, cryotherapy, 5-fluorouracil, imiquimod, diclofenac, or what? Facts and controversies. Clin Dermatol 2014; 31:792-8. [PMID: 24160289 DOI: 10.1016/j.clindermatol.2013.08.020] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Surgical modalities-excision, Mohs micrographic surgery, and electrodesiccation with curettage-are the preferred treatments for nonmelanoma skin cancer (NMSC). When used within guidelines, they have cure rates greater than 90%. Despite this, many other treatments have been studied and utilized for NMSC. We present a comprehensive review of the literature on these topical treatments. Photodynamic therapy (PDT) is administered under numerous and significantly varied regimens, and there are a wide range of cure rates reported. Even with aggressive regimens, PDT is not as effective as surgery is, and it is not a first-line therapy for NMSC. The cryotherapy regimen aggressive enough to adequately treat NMSC carries adverse effects and cosmetic outcomes poor enough to negate its usefulness. Topical 5-fluorouracil and imiquimod are efficacious and safe for the treatment of superficial basal cell carcinoma (BCC) but not other BCC subtypes or squamous cell carcinoma. They are self-administered twice daily for several weeks; therefore, patient and tumor selection are vital to ensuring adherence. There are currently insufficient data to support the use of topical diclofenac and ingenol mebutate for NMSC.
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Affiliation(s)
- Jennifer D Bahner
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Morton CA, Birnie AJ, Eedy DJ. British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014. Br J Dermatol 2014; 170:245-60. [PMID: 24313974 DOI: 10.1111/bjd.12766] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 01/14/2023]
Affiliation(s)
- C A Morton
- Stirling Community Hospital, Stirling, FK8 2AU, U.K
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Schmitz L, Bierhoff E, Dirschka T. Optical Coherence Tomography Imaging of Erythroplasia of Queyrat and Treatment with Imiquimod 5% Cream: A Case Report. Dermatology 2013; 228:24-6. [DOI: 10.1159/000354652] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/27/2013] [Indexed: 11/19/2022] Open
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Maruyama H, Fujisawa Y, Nakamura Y, Kawachi Y, Otsuka F. Penile preservation surgery in a case of erythroplasia of Queyrat involving the glans penis and distal urethra. Int J Dermatol 2013; 53:e177-80. [PMID: 23675865 DOI: 10.1111/ijd.12103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hiroshi Maruyama
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan.
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Duparc A, Lasek-Duriez A, Wiart T, Duban-Bedu B, Gosset P, Modiano P. Trichoépithéliomes multiples familiaux : nouvelle mutation du gène CYLD. Ann Dermatol Venereol 2013; 140:274-7. [DOI: 10.1016/j.annder.2013.01.441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 12/16/2012] [Accepted: 01/11/2013] [Indexed: 10/27/2022]
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Werthmann PG, Sträter G, Friesland H, Kienle GS. Durable response of cutaneous squamous cell carcinoma following high-dose peri-lesional injections of Viscum album extracts--a case report. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2013; 20:324-327. [PMID: 23394841 DOI: 10.1016/j.phymed.2012.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (CSCC) is a common locally invasive skin cancer which rarely metastasises. First-line treatment is surgical excision, which is curative in most cases. Viscum album extract (VAE) is a widely used herbal cancer treatment with cytotoxic, apoptogenic and immunological effects, but has not been investigated in CSCC. CASE PRESENTATION A 78-year-old patient with histologically diagnosed CSCC refused surgical excision and was treated with peri-lesional high-dose VAE. After 10 months of treatment the CSCC had disappeared clinically. The patient has been recurrence-free for 4 years. CONCLUSION The presented case shows clinical response of a CSCC to high-dose peri-lesional VAE injections. Further research on VAE in CSCC is warranted.
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Affiliation(s)
- Paul Georg Werthmann
- Institute for Applied Epistemology and Medical Methodology at the University of Witten/Herdecke, Freiburg, Germany.
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Overall treatment success after treatment of primary superficial basal cell carcinoma: a systematic review and meta-analysis of randomized and nonrandomized trials. Br J Dermatol 2012; 167:733-56. [DOI: 10.1111/j.1365-2133.2012.11061.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Osiecka B, Jurczyszyn K, Ziółkowski P. The application of Levulan-based photodynamic therapy with imiquimod in the treatment of recurrent basal cell carcinoma. Med Sci Monit 2012; 18:PI5-9. [PMID: 22293891 PMCID: PMC3560595 DOI: 10.12659/msm.882449] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Common skin tumors like basal- and squamous-cell carcinoma present a serious problem in modern medicine. Exposure to ultraviolet solar radiation is the main cause of these lesions. Since application of Aldara and PDT separately is well documented, we decided to use both methods together. The aim of our study was to evaluate the effectiveness of local photodynamic therapy supplemented with topical application of Aldara in basal-cell carcinoma. MATERIAL/METHODS Thirty-four patients ages 50 to 68 years were enrolled to the trial and underwent PDT treatment. Each case of BCC was histopathologically confirmed. Ten patients were subjected to local Levulan-PDT and placebo (Eucerin as vehicle cream), and 24 patients were subjected to Levulan-PDT and imiquimod. Photodynamic diagnosis (PDD) was used to detect and visualize suspicious foci (including cancer lesions). RESULTS In the group of patients who were treated using Levulan-PDT and placebo, 6 patients (60%) were totally cured and 4 lesions (40%) significantly decreased in size. In the group of patients treated with Levulan-PDT and imiquimod, 18 lesions totally disappeared (75%), 6 lesions significantly diminished, and in 1 patient small foci of previously excised BCC developed again in scar tissue 10 month after the first control examination. CONCLUSIONS Cure was achieved without any scarring and with very good cosmetic effects. Although this is the preliminary report, the presented modification of PDT seems to be reasonable and promising in treating basal-cell carcinoma.
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Affiliation(s)
- Beata Osiecka
- Photodynamic Therapy Laboratory, Department of Pathology, Wroclaw Medical University, Wroclaw, Poland.
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Alnajjar HM, Lam W, Bolgeri M, Rees RW, Perry MJA, Watkin NA. Treatment of carcinoma in situ of the glans penis with topical chemotherapy agents. Eur Urol 2012; 62:923-8. [PMID: 22421082 DOI: 10.1016/j.eururo.2012.02.052] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 02/29/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of topical agents in the treatment of carcinoma in situ (CIS) of the penis has been well described in the literature. Previous studies have been limited by small sample size and imprecise end points. OBJECTIVE Establish the response rate of 5-fluorouracil (5-FU) and imiquimod (IQ) in the treatment of penile CIS in a large contemporary series in a supranetwork centre. DESIGN, SETTING, AND PARTICIPANTS Retrospective review of all primary and recurrent cases of penile CIS treated with 5-FU and IQ identified from a prospective database over a 10-yr period. Therapy was standardised in all cases with application to the lesion for 12h every 48 h for 28 d. INTERVENTION 5-FU was the first-line therapy, and IQ was the second-line topical agent. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary end point was defined as complete response (CR; i.e., resolution of lesion), partial response (PR; i.e., lesion reduced in size and or visibility), or no response (NR; ie, no improvement in lesion size and or visibility). The secondary end points included local toxicity and adverse events. No statistical analysis or software was used. RESULTS AND LIMITATIONS A total of 86 patients were diagnosed with CIS of the penis over the 10-yr period. Forty-four (51%) received topical chemotherapy. The mean follow-up was 34 mo. CR to topical chemotherapy was seen in 25 (57%), PR was seen in 6 (13.6%), and NR was seen in the remaining 13 (29.5%) patients. Local toxicity was experienced by 10% of patients, and 12% had an adverse event following application of 5-FU. The retrospective design and short follow-up were the major limitations of this study. CONCLUSIONS Topical chemotherapy agents are moderately effective first-line therapy in the treatment of penile CIS. Toxicity and adverse events were few with our treatment protocol. The issues of long-term surveillance and assessment of partial responders remain a challenge. Topical chemotherapy should remain a first-line treatment option for penile CIS.
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Micali G, Lacarrubba F, Dinotta F, Massimino D, Nasca MR. Treating skin cancer with topical cream. Expert Opin Pharmacother 2010; 11:1515-27. [DOI: 10.1517/14656566.2010.481284] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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