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Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, Bataille V, Brochez L, Del Marmol V, Dummer R, Forsea AM, Gaudy-Marqueste C, Harwood CA, Hauschild A, Höller C, Kandolf L, Kellerners-Smeets NWJ, Lallas A, Leiter U, Malvehy J, Marinović B, Mijuskovic Z, Moreno-Ramirez D, Nagore E, Nathan P, Stratigos AJ, Stockfleth E, Tagliaferri L, Trakatelli M, Vieira R, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023; 192:113254. [PMID: 37604067 DOI: 10.1016/j.ejca.2023.113254] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
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Affiliation(s)
- Ketty Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | | | - Veronique Bataille
- Twin Research and Genetic Epidemiology Unit, School of Basic & Medical Biosciences, King's College London, London SE1 7EH, UK
| | - Lieve Brochez
- Department of Dermatology, University Hospital Ghent, Ghent, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich and University Zurich, Switzerland
| | - Ana-Marie Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | | | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - Christoph Höller
- Department of Dermatology, Medical University of Vienna, Austria
| | - Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Nicole W J Kellerners-Smeets
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands; Department of Dermatology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, Croatia
| | - Zeljko Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - David Moreno-Ramirez
- Dermatology. Medicine School, University of Seville, University Hospital Virgen Macarena, Seville-Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Eggert Stockfleth
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Rome, Italy
| | - Myrto Trakatelli
- Second Department of Dermatology, Aristotle University Medical School, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ricardo Vieira
- Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard-Karls University, Tuebingen, Germany
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Arenbergerova M, Lallas A, Nagore E, Rudnicka L, Forsea AM, Pasek M, Meier F, Peris K, Olah J, Posch C. Position statement of the EADV Melanoma Task Force on recommendations for the management of cutaneous melanoma patients during COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e427-e428. [PMID: 33780557 PMCID: PMC8251426 DOI: 10.1111/jdv.17252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - A Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - A M Forsea
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.,Oncologic Dermatology Department, Elias University Hospital Bucharest, Bucharest, Romania
| | - M Pasek
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - F Meier
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany.,Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - K Peris
- UOC di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - J Olah
- Department of Oncotherapy, Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - C Posch
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Garbe C, Peris K, Soura E, Forsea AM, Hauschild A, Arenbergerova M, Bylaite M, Del Marmol V, Bataille V, Samimi M, Gandini S, Saiag P, Eigentler TK, Lallas A, Zalaudek I, Lebbe C, Grob JJ, Hoeller C, Robert C, Dréno B, Arenberger P, Kandolf-Sekulovic L, Kaufmann R, Malvehy J, Puig S, Leiter U, Ribero S, Papadavid E, Quaglino P, Bagot M, John SM, Richard MA, Trakatelli M, Salavastru C, Borradori L, Marinovic B, Enk A, Pincelli C, Ioannides D, Paul C, Stratigos AJ. The evolving field of Dermato-oncology and the role of dermatologists: Position Paper of the EADO, EADV and Task Forces, EDF, IDS, EBDV-UEMS and EORTC Cutaneous Lymphoma Task Force. J Eur Acad Dermatol Venereol 2020; 34:2183-2197. [PMID: 32840022 DOI: 10.1111/jdv.16849] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The incidence of skin cancers has been increasing steadily over the last decades. Although there have been significant breakthroughs in the management of skin cancers with the introduction of novel diagnostic tools and innovative therapies, skin cancer mortality, morbidity and costs heavily burden the society. OBJECTIVE Members of the European Association of Dermato-Oncology, European Academy of Dermatology and Venereology, International Dermoscopy Society, European Dermatology Forum, European Board of Dermatovenereology of the European Union of Medical Specialists and EORTC Cutaneous Lymphoma Task Force have joined this effort to emphasize the fundamental role that the specialist in Dermatology-Venereology has in the diagnosis and management of different types of skin cancer. We review the role of dermatologists in the prevention, diagnosis, treatment and follow-up of patients with melanoma, non-melanoma skin cancers and cutaneous lymphomas, and discuss approaches to optimize their involvement in effectively addressing the current needs and priorities of dermato-oncology. DISCUSSION Dermatologists play a crucial role in virtually all aspects of skin cancer management including the implementation of primary and secondary prevention, the formation of standardized pathways of care for patients, the establishment of specialized skin cancer treatment centres, the coordination of an efficient multidisciplinary team and the setting up of specific follow-up plans for patients. CONCLUSION Skin cancers represent an important health issue for modern societies. The role of dermatologists is central to improving patient care and outcomes. In view of the emerging diagnostic methods and treatments for early and advanced skin cancer, and considering the increasingly diverse skills, knowledge and expertise needed for managing this heterogeneous group of diseases, dermato-oncology should be considered as a specific subspecialty of Dermatology-Venereology.
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Affiliation(s)
- C Garbe
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - K Peris
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Soura
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodestrian University of Athens, Athens, Greece
| | - A M Forsea
- Department of Oncologic Dermatology, University Hospital Elias, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - A Hauschild
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - M Bylaite
- Faculty of Medicine, Centre of Dermatovenereology, Clinic of Infectious Diseases and Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - V Del Marmol
- Dermatology Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - V Bataille
- Dermatology Department, West Herts NHS Trust, London, UK.,Twin Research and Genetic Epidemiology Department, Kings College London, London, UK
| | - M Samimi
- Departments of Dermatology, University Hospital of Tours, Tours, France
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - P Saiag
- Department of General and Oncologic Dermatology, Ambroise-Paré Hospital, APHP, & EA 4340, 'Biomarkers in Cancerology and Hemato-Oncology', UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - T K Eigentler
- Departments of Dermatology, University Hospital Tübingen, Tubingen, Germany
| | - A Lallas
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - C Lebbe
- Department of Dermatology, AP-HP Saint Louis Hospital, Paris, France
| | - J-J Grob
- Timone Hospital, Aix-Marseille University, Marseille, France
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Robert
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France.,Paris-Saclay University, Le Kremlin Bicêtre, France
| | - B Dréno
- Department of Dermatolo-Cancerology, CHU Nantes, CIC 1413, CRCINA, University Nantes, Nantes, France
| | - P Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - L Kandolf-Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, University of Defense, Belgrade, Serbia
| | - R Kaufmann
- Department of Dermatology, Venerology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J Malvehy
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Spain.,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Biomedical Research Networking Centre on rarae disease (CIBERER), ISCIII, Barcelona, Spain
| | - S Puig
- Dermatology Department, Hospital Clinic of Barcelona, University of Barcelona, Spain.,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Biomedical Research Networking Centre on rarae disease (CIBERER), ISCIII, Barcelona, Spain
| | - U Leiter
- Center for Dermato-oncology, Department of Dermatology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - S Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - E Papadavid
- 2nd Department of Dermatology-Venereology, ATTIKON Hospital, National and Kapodistrian Univeristy of Athens, Athens, Greece
| | - P Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Bagot
- Department of Dermatology, AP-HP Saint Louis Hospital, Paris, France
| | - S M John
- Department Dermatology, Environmental Medicine, Health Theory, University of Osnabrueck, Osnabrueck, Germany
| | - M-A Richard
- Timone Hospital, Aix-Marseille University, Marseille, France
| | - M Trakatelli
- 2nd Department of Dermatology-Venerology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Salavastru
- Pediatric Dermatology Discipline, Dermato-oncology Research Facility, Colentina Clinical Hospital, Bucharest, Romania
| | - L Borradori
- Department of Dermatology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - B Marinovic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - A Enk
- Department of Dermatology, University Hospital of Heidelberg, Heidelberg, Germany
| | - C Pincelli
- DermoLab, Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - D Ioannides
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Paul
- Department of Dermatology, Toulouse University, Toulouse, France
| | - A J Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodestrian University of Athens, Athens, Greece
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Suppa M, Gandini S, Bulliard JL, Daxhelet M, Zamagni M, Forsea AM, Longo MI, Del Marmol V. Who, why, where: an overview of determinants of sunbed use in Europe. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:6-12. [PMID: 30811690 DOI: 10.1111/jdv.15318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J L Bulliard
- Cancer Epidemiology Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - M Daxhelet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Zamagni
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - M I Longo
- Department of Dermatology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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Chernyshov PV, Lallas A, Tomas-Aragones L, Arenbergerova M, Samimi M, Manolache L, Svensson A, Marron SE, Sampogna F, Spillekom-vanKoulil S, Bewley A, Forsea AM, Jemec GB, Szepietowski JC, Augustin M, Finlay AY. Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer. J Eur Acad Dermatol Venereol 2019; 33:816-827. [PMID: 30963614 DOI: 10.1111/jdv.15487] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer (NMSC) present a review of the literature and position statement on health-related (HR) QoL assessment in skin cancer patients. A literature search was carried out to identify publications since 1980 that included information about the impact of SC on QoL. Generic, dermatology-specific, cancer-specific, SC-specific, facial SC-specific, NMSC-specific, basal cell carcinoma-specific and melanoma-specific QoL questionnaires have been used to assess HRQoL in SC patients. HRQoL was assessed in the context of creation and validation of the HRQoL instruments, clinical trials, comparison of QoL in SC and other cancers, other diseases or controls, HRQoL assessment after treatment, comorbidities, behaviour modification, predictors of QoL and survival, supportive care needs, coping strategies and fear of cancer recurrence. The most widely used instruments for HRQoL assessment in SC patients are the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), the Functional Assessment of Cancer Therapy-Melanoma (FACT-M), Skin Cancer Index (SCI), Short Form 36 Item Health Survey (SF-36) and the Dermatology Life Quality Index (DLQI). The TFs recommend the use of the cancer-specific EORTC QLQ-C30, especially in late stages of disease, and the melanoma-specific FACT-M and SC-specific SCI questionnaires. These instruments have been well validated and used in several studies. Other HRQoL instruments, also with good basic validation, are not currently recommended because the experience of their use is too limited. Dermatology-specific HRQoL instruments can be used to assess the impact of skin-related problems in SC. The TFs encourage further studies to validate HRQoL instruments for use in different stages of SC, in order to allow more detailed practical recommendations on HRQoL assessment in SC.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Samimi
- Dermatology Department, University of Tours, Tours, France
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM, Rome, Italy
| | - S Spillekom-vanKoulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - A M Forsea
- Department of Oncologic Dermatology and Allergology, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Forsea AM, Mihai C, Predescu T, Tudose I, Margaritescu I, Giurcaneanu C. POLYGLANDULAR AUTOIMMUNE SYNDROME ASSOCIATED WITH MULTIPLE AUTOIMMUNE CONDITIONS AND ATOPIC DERMATITIS - AN UNUSUAL MANIFESTATION OF A POLYAUTOIMMUNITY PHENOTYPE. Acta Endocrinol (Buchar) 2017; 13:106-110. [PMID: 31149156 DOI: 10.4183/aeb.2017.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction The polyglandular autoimmune syndrome (PAS) type III is a rare condition defined as the coexistence of autoimmune thyroid disorder with other endocrine autoimmune diseases, including type 1 diabetes, without adrenal dysfunction. PAS may associate with other non-endocrine autoimmune diseases, overlapping with the multiple autoimmune syndromes (MAS). We present a case of PAS III/ MAS type 3, including autoimmune thyroiditis, autoimmune diabetes, vitiligo, lupus erythematosus, associated with adult-onset atopic dermatitis, a combination not reported previously. Case report A 40 years old woman, registered as nurse working in dialysis unit, previously diagnosed with vitiligo, euthyroid autoimmune thyroiditis and disseminated granuloma annulare, with personal and familial history of atopic disorders, presented in our clinic for disseminated eczematous and lichenoid cutaneous rashes. She was tested positive for antinuclear, anti-double stranded DNA and anti-histone antibodies, with inflammatory syndrome and marginal lymphopenia and she was diagnosed with systemic lupus erythematosus (SLE). Subsequently, moderate hyperglycemia, positive anti-glutamic acid decarboxylase antibodies and low C-peptide level prompted the diagnosis of autoimmune diabetes. Recurrent flexural eczematous rashes, with negative epicutaneous tests but positive specific IgE tests for common allergens fulfilled the clinical criteria for the diagnosis of atopic dermatitis. The clinical, immunological and glycemic status were controlled with low doses of oral prednisone (<0.5 mg/kg), methotrexate (10mg/week), antimalarials, metformin, emollients and photoprotection. After changing her workplace, the immunosuppressive treatment could be discontinued, and the patient maintained normal immunological and biochemical profile at 6 months follow-up.This case brings a unique perspective on the evolution, associations spectrum and the management challenges of endocrine polyautoimmunity associated with atopic diathesis.
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Affiliation(s)
- A M Forsea
- "Carol Davila" University of Medicine and Pharmacy, Dept. of Dermatology, Elias University Hospital, Bucharest, Romania.,Dept. of Oncologic Dermatology and Allergology, Bucharest, Romania
| | - C Mihai
- "Carol Davila" University of Medicine and Pharmacy, Dept. of Dermatology, Elias University Hospital, Bucharest, Romania.,"Dr. I. Cantacuzino" Hospital, Bucharest, Romania
| | - T Predescu
- Dept. of Oncologic Dermatology and Allergology, Bucharest, Romania
| | - I Tudose
- Dept. of Pathology, Bucharest, Romania
| | - I Margaritescu
- Monza Hospital, Dept. of Oncoteam Pathology, Bucharest, Romania
| | - C Giurcaneanu
- "Carol Davila" University of Medicine and Pharmacy, Dept. of Dermatology, Elias University Hospital, Bucharest, Romania.,Dept. of Oncologic Dermatology and Allergology, Bucharest, Romania
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Forsea AM, Tschandl P, Del Marmol V, Zalaudek I, Soyer HP, Geller AC, Argenziano G. Factors driving the use of dermoscopy in Europe: a pan-European survey. Br J Dermatol 2016; 175:1329-1337. [PMID: 27469990 DOI: 10.1111/bjd.14895] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND When used correctly, dermoscopy is an essential tool for helping clinicians in the diagnosis of skin diseases and the early detection of skin cancers. Despite its proven benefits, there is a lack of data about how European dermatologists use dermoscopy in everyday practice. OBJECTIVES To identify the motivations, obstacles and modifiable factors influencing the use of dermoscopy in daily dermatology practice across Europe. METHODS All registered dermatologists in 32 European countries were invited to complete an online survey of 20 questions regarding demographic and practice characteristics, dermoscopy training and self-confidence in dermoscopic skills, patterns of dermoscopy use, reasons for not using dermoscopy and attitudes relating to dermoscopy utility. RESULTS We collected 7480 valid answers, of which 89% reported use of dermoscopy. The main reasons for not using dermoscopy were lack of equipment (58% of nonusers) and lack of training (42%). Dermoscopy training during residency was reported by 41% of dermoscopy users and by 12% of nonusers (P < 0·001). Dermatologists working in public hospitals were the least likely to use dermoscopy. High use of dermoscopy across the spectrum of skin diseases was reported by 62% of dermoscopy users and was associated with dermoscopy training during residency, the use of polarized light and digital dermoscopy devices, longer dermoscopy practice, younger age and female gender. CONCLUSIONS Expanding access to dermoscopy equipment, especially in public healthcare facilities and establishing dermoscopy training during dermatology residency would further enhance the substantially high dermoscopy use across European countries.
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Affiliation(s)
- A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Del Marmol
- Dermatology Department, Universite Libre de Bruxelles, Hopital Erasme, Brussels, Belgium
| | - I Zalaudek
- Department of Dermatology and Venereology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia
| | | | - A C Geller
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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Forsea AM, del Marmol V. Impact, challenges and perspectives of Euromelanoma, a pan-European campaign of skin cancer prevention. J Eur Acad Dermatol Venereol 2013; 27:1317-9. [PMID: 23294192 DOI: 10.1111/jdv.12060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy Bucharest, Romania Euromelanoma Europe Chair. Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Belgium
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Abstract
BACKGROUND Melanoma incidence and mortality in Europe are high but there are significant gaps in the epidemiological information available across the continent. OBJECTIVES With the aim of enhancing the planning of educational programmes for reducing the melanoma burden in Europe, we analysed the most recent incidence and mortality data for Europe with a new focus on the regional disparities of melanoma reporting. METHODS GLOBOCAN 2008, the standard set of worldwide estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer for 2008, was used to provide the estimated age-standardized rates (world standard population) of melanoma incidence and mortality in European countries and regions. RESULTS The estimated age-standardized incidence of melanoma (measured per 100 000 person-years) varies widely from 19·2 in Switzerland to 2·2 in Greece. The incidence rate of 4·3 of Central and Eastern Europe (CEE) is less than half of that of Western Europe. Melanoma mortality rates of 1·5 are similar in CEE and Western Europe, although rates vary with a high of 3·2 in Norway and a low of 0·9 in Greece. Over 20 000 deaths from melanoma were estimated in Europe in 2008, with CEE having the largest share (35·5%) among the four geographical European regions. Population-based data are lacking for significant parts of CEE, which must rely on estimates. CONCLUSIONS The most recent estimates of melanoma incidence and mortality in Europe reveal sharp differences between European countries, possibly related to missed opportunities for early diagnosis and incomplete reporting of melanoma in Eastern Europe.
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Affiliation(s)
- A M Forsea
- Department of Society, Human Development and Health, Harvard School of Public Health, Kresge Building, Room 718, 677 Huntington Avenue, Boston, MA 02115, USA.
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Forsea AM, Carstea EM, Ghervase L, Giurcaneanu C, Pavelescu G. Clinical application of optical coherence tomography for the imaging of non-melanocytic cutaneous tumors: a pilot multi-modal study. J Med Life 2010; 3:381-9. [PMID: 21254735 PMCID: PMC3019059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Optical coherence tomography (OCT) is an emergent imaging technique, based on the interference of infrared radiation and living tissues, that allows the in vivo visualization of the skin structures, at high resolution and up to 1.6 mm depth. As such, there is mounting evidence that OCT may be an interesting technique for the diagnosis of skin diseases, including the noninvasive early detection of cutaneous tumors. OBJECTIVE We aimed to investigate the utility of OCT for the diagnosis of non-melanocytic, non-pigmented cutaneous tumors. METHODS Preliminary results are presented from an initiated study. Fifteen consecutive patients with clinical suspicion of epithelial cancers and precancers registered over one week in a university dermatologic department were included. As control were selected 7 patients with inflammatory skin diseases (psoriasis, lichen planus, cutaneous lupus erythematosus). In all study and control patients, the lesions and samples of normal, perilesional skin were documented by clinical digital photography, contact dermoscopy with digital image capture and OCT with central wavelength of 930 nm. Final diagnosis was certified by histopathological analysis. RESULTS We could identify morphological features in OCT examination that distinguished between normal and lesional skin, and between neoplastic vs. inflammatory lesions. In the same time, combining OCT and dermatoscopical evaluation of a lesion improved the performance of diagnosis when compared to clinical diagnosis alone and with either OCT or dermoscopy imaging used alone. CONCLUSIONS OCT appears as a promising method of in vivo diagnosis of early neoplastic cutaneous lesions with equivocal clinical and/or dermoscopic aspect. Continuation of our study as well as other larger investigation will be able to contribute with new insights in the role of OCT in the non-invasive diagnosis of skin disease.
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Affiliation(s)
- AM Forsea
- Dermatology Department Elias University Hospital,
Carol Davila University of Medicine and Pharmacy, Bucharest
Romania
| | - EM Carstea
- National Institute for Optoelectronics INOE 2000, MagureleRomania
| | - L Ghervase
- National Institute for Optoelectronics INOE 2000, MagureleRomania
| | - C Giurcaneanu
- Dermatology Department Elias University Hospital,
Carol Davila University of Medicine and Pharmacy, Bucharest
Romania
| | - G Pavelescu
- National Institute for Optoelectronics INOE 2000, MagureleRomania
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