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Sharp O, Garioch J, Moncrieff M. Seasonal variation in high-risk phenotypes of cutaneous malignant melanoma diagnosed in Eastern England: An observational study. J Plast Reconstr Aesthet Surg 2022; 75:1923-1930. [PMID: 35153165 DOI: 10.1016/j.bjps.2022.01.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2021] [Accepted: 01/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite seasonal variation in malignant melanoma diagnosis being well described, data on the annual variation in high-risk melanomas are scarce. OBJECTIVES We set out to investigate the relationship between seasonality, the incidence of melanoma, and the distribution of melanoma characteristics, including Breslow thickness, ulceration, mitotic rate, lymphovascular and perineural invasion, and the presence of microsatellites. METHODS Primary cutaneous malignant melanomas diagnosed between 2011 and 2019 in Eastern England were identified from our prospectively maintained melanoma database (n = 2199). These were analysed by year and season of diagnosis, patient demographics, and melanoma characteristics. RESULTS There was a variation in rates of melanoma diagnosis across the year, with Summer having the highest incidence (p < 0.0001). There was a significant trend towards more male than female diagnosis in Winter (p = 0.0354). There were no significant seasonal trends in Breslow thickness, ulceration, tumour infiltrating lymphocytes, or mitotic rate. Multivariate analysis showed that microsatellites were more likely to be diagnosed in the Winter (OR=2.00 (1.19-3.43), p = 0.010), lymphovascular invasion significantly more likely to be diagnosed in Autumn (OR=1.78 (1.16-2.76), p = 0.009), and perineural invasion was more likely to be diagnosed in the Summer (OR=0.44 (0.23-0.79), p = 0.007). CONCLUSIONS These data confirm that high-risk phenotypes are associated with increasing Breslow thickness and mitotic rate. However, season variability as an independent risk factor for the phenotypes is a novel finding.
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Affiliation(s)
- O Sharp
- Department of Plastic Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, Norfolk, England NR4 7UY, UK.
| | - J Garioch
- Department of Dermatology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, Norfolk, England NR4 7UY, UK
| | - M Moncrieff
- Department of Plastic Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, Norfolk, England NR4 7UY, UK
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Swanson D, Venneugues R, Vicencio S, Garioch J, Biryulina M, Ryzhikov G, Hamre B, Zhao L, Castellana F, Stamnes K, Stamnes J. 在模拟初级护理实践中用于区分良性和恶性色素病灶的光学传递诊断. Br J Dermatol 2018. [DOI: 10.1111/bjd.16300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Swanson D, Venneugues R, Vicencio S, Garioch J, Biryulina M, Ryzhikov G, Hamre B, Zhao L, Castellana F, Stamnes K, Stamnes J. Optical transfer diagnosis differentiating benign and malignant pigmented lesions in a simulated primary care practice. Br J Dermatol 2018. [DOI: 10.1111/bjd.16282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Swanson D, Venneugues R, Vicencio S, Garioch J, Biryulina M, Ryzhikov G, Hamre B, Zhao L, Castellana F, Stamnes K, Stamnes J. Optical transfer diagnosis differentiating benign and malignant pigmented lesions in a simulated primary care practice. Br J Dermatol 2018; 178:541-546. [DOI: 10.1111/bjd.15898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 11/28/2022]
Affiliation(s)
- D.L. Swanson
- Division of Clinical Dermatology (Dr Swanson); Mayo Clinic; Scottsdale AZ U.S.A
| | - R.V. Venneugues
- Department of Dermatology; Buckinghamshire Healthcare NHS Trust; Buckinghamshire U.K
| | - S.Q. Vicencio
- Department of Dermatology; Buckinghamshire Healthcare NHS Trust; Buckinghamshire U.K
| | - J. Garioch
- Department of Dermatology; Buckinghamshire Healthcare NHS Trust; Buckinghamshire U.K
| | | | | | - B. Hamre
- Balter Medical AS; Bergen Norway
- Department of Physics and Technology; University of Bergen; Bergen Norway
| | - L. Zhao
- Balter Medical AS; Bergen Norway
| | | | - K. Stamnes
- Balter Medical AS; Bergen Norway
- Department of Physics and Engineering Physics; Stevens Institute of Technology; Hoboken NJ U.S.A
| | - J.J. Stamnes
- Balter Medical AS; Bergen Norway
- Department of Physics and Technology; University of Bergen; Bergen Norway
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Lo M, Maraka J, Garioch J, John W, Moncrieff M. Monitoring vitamin D in the patient with melanoma: impact of sun avoidance on vitamin D levels of patients with melanoma at a U.K. tertiary-referral melanoma service. Br J Dermatol 2017; 177:282-283. [DOI: 10.1111/bjd.15062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M.C.I. Lo
- Department of Plastic and Reconstructive Surgery; Norfolk and Norwich University Hospitals; Colney Lane Norwich NR4 7UY U.K
| | - J. Maraka
- Department of Plastic and Reconstructive Surgery; Norfolk and Norwich University Hospitals; Colney Lane Norwich NR4 7UY U.K
| | - J. Garioch
- Department of Dermatology; Norfolk and Norwich University Hospitals; Colney Lane Norwich NR4 7UY U.K
- Norwich Medical School; University of East Anglia; Norwich U.K
| | - W.G. John
- Norwich Medical School; University of East Anglia; Norwich U.K
- Department of Clinical Biochemistry; Norfolk and Norwich University Hospitals; Colney Lane Norwich NR4 7UY U.K
| | - M. Moncrieff
- Department of Plastic and Reconstructive Surgery; Norfolk and Norwich University Hospitals; Colney Lane Norwich NR4 7UY U.K
- Norwich Medical School; University of East Anglia; Norwich U.K
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Moncrieff M, Fadhil M, Garioch J. Topical diphencyprone for the treatment of locoregional intralymphatic melanoma metastases of the skin; the 5-year Norwich experience. Br J Dermatol 2016; 174:1141-2. [PMID: 26598951 DOI: 10.1111/bjd.14314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Moncrieff
- Skin Tumour Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, U.K
| | - M Fadhil
- Skin Tumour Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, U.K
| | - J Garioch
- Skin Tumour Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, U.K
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Affiliation(s)
- M. Moncrieff
- Plastic and Reconstructive Surgery Department Norfolk and Norwich University Hospital Colney Lane Norwich Norfolk NR4 7UY U.K
| | - J. Garioch
- Department of Dermatology Norfolk and Norwich University Hospital Colney Lane Norwich Norfolk NR4 7UY U.K
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Kok K, Moncrieff M, Garioch J, Ramaiya A. The inking brush in Mohs micrographic surgery: a potential source of malignant cell contamination. Clin Exp Dermatol 2014; 39:650-1. [PMID: 24766031 DOI: 10.1111/ced.12321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2014] [Indexed: 11/30/2022]
Affiliation(s)
- K Kok
- Department of Plastic Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
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Skellett A, Swift L, Tan E, Garioch J. A randomized, double-blind, negatively controlled pilot study to determine whether the use of emollients or calcipotriol alters the sensitivity of the skin to ultraviolet radiation during phototherapy with narrowband ultraviolet B. Br J Dermatol 2011; 164:402-6. [PMID: 20969563 DOI: 10.1111/j.1365-2133.2010.10103.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is contradictory evidence suggesting that emollients increase, decrease or have no effect on minimal erythema dose (MED) or minimal phototoxic dose values prior to phototherapy. Few studies have looked at the in vivo use of emollients or calcipotriol prior to narrowband ultraviolet (UV) B (NB-UVB) treatment. OBJECTIVES To investigate whether emollients or calcipotriol alter MED readings of skin on the back of healthy subjects prior to NB-UVB irradiation. METHODS Topical agents were applied to the backs of 20 healthy volunteers for 30 min prior to MED testing. These agents were aqueous cream, 50:50 white soft paraffin and liquid paraffin, Diprobase(®) (Schering-Plough, Welwyn Garden City, U.K.), Epaderm(®) (Medlock, Oldham, U.K.) and calcipotriol ointment and cream. A control MED strip was used with no topical agent applied prior to testing. MED readings were recoded as integer steps between 1 and 9 (one is lowest MED dose for skin type; eight is highest; nine is no response, i.e. a higher MED). RESULTS The median MED was between step 5 and 6 for all treatments and control. There was no significant difference at the 5% level between control and each topical agent. The study was powered to detect a median difference of approximately 0·4-0·6 steps. CONCLUSIONS This has important implications at a practical level when advising patients not to apply creams prior to treatment with NB-UVB. Studies where agents are applied immediately prior to phototherapy have been more likely to show that emollients block transmission of UV radiation. If they are applied at least 30 min prior to treatment, they have no effect.
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Affiliation(s)
- A Skellett
- Dermatology Department, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich NR4 7UY, UK.
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Patel NG, Shah AK, Barker T, Garioch J, Moncrieff MDS. Malignant melanoma re-excision specimens: the need for analysis. J Plast Reconstr Aesthet Surg 2010; 63:e653-4. [PMID: 20227359 DOI: 10.1016/j.bjps.2010.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Accepted: 02/02/2010] [Indexed: 11/30/2022]
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Affiliation(s)
- E Tan
- Department of Dermatology, Norfolk and Norwich University Hospital NHS Trust, Colney Lane, Norwich, UK.
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Todd P, Garioch J, Lamey PJ, Lewis M, Forsyth A, Rademaker M. Patch testing in lichenoid reactions of the mouth and oral lichen planus. Contact Dermatitis 2006. [DOI: 10.1111/j.1600-0536.1990.tb05155.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
T helper cell type 1 (Th1) response to gluten has been implicated in the pathogenesis of coeliac disease (CD). To characterize immunological activation and mild inflammations leading to overt CD in potential coeliac patients, jejunal biopsies were obtained from family members of patients with CD or dermatitis herpetiformis (DH). Nine family members and one latent CD, eight CD patients and eight normal controls furnished jejunal biopsy specimens. Immunohistochemical staining of sections for interleukin-1alpha (IL-1alpha), IL-2, IL-4, interferon-gamma (IFN-gamma), tumour necrosis factor alpha (TNF-alpha), CD3, gammadelta-T cell receptor (gammadelta-TCR), and alphabeta-TCR was carried out with monoclonal antibodies. Further, expression of IL-4 and IFN-gamma messenger RNA was detected by radioactive in situ hybridization in these same samples. In lamina propria, CD patients and potential CD patients had higher densities of IL-2 (P = 0.028, P = 0.043), IL-4 (P = 0.021, P = 0.034) and IFN-gamma positive cells (P = 0.000, P = 0.009) than did controls. Moreover, CD patients showed a higher density of TNF-alpha positive cells (P = 0.012, P = 0.001) than the other two groups, and expression of IFN-gamma mRNA (P = 0.035) was higher in them than in the other two study groups. Additionally, higher densities of TNF-alpha and IFN-gamma positive cells occurred in potential CD patients with high gammadelta-TCR+ intraepithelial lymphocytes (IELs). Our findings support the hypothesis that lamina propria T cells and macrophages, through their secretion of cytokines, play a central role in the pathogenesis of coeliac disease. The inflammatory cytokines found in potential CD specimens strongly suggest that these inflammatory markers can be identified long before visible villous changes have occurred.
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Affiliation(s)
- M Westerholm-Ormio
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
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Abstract
We report 12 cases of contact sensitivity to the flavouring agents menthol and peppermint oil in patients presenting with intra-oral symptoms in association with burning mouth syndrome, recurrent oral ulceration or a lichenoid reaction. The patients were referred from the Glasgow Dental Hospital over a 4-year period for assessment of the possible contribution of contact sensitivity to their complaints. 5 patients with burning mouth syndrome demonstrated contact sensitivity to menthol and/or peppermint, with 1 patient sensitive to both agents, 3 positive to menthol only and 1 to peppermint only. 4 cases with recurrent intra-oral ulceration were sensitive to both menthol and peppermint. 3 patients with an oral lichenoid reaction were positive to menthol on patch testing, with 2 also sensitive to peppermint. 9 of the 12 cases demonstrated additional positive patch test results. After a mean follow-up of 32.7 months (range 9-48 months), of the 9 patients that could be contacted, 6 patients described clearance or improvement of their symptoms as a consequence of avoidance of menthol/peppermint.
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Affiliation(s)
- C A Morton
- Contact Dermatitis Investigation Unit, Glasgow Royal Infirmary, UK
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Abstract
Lymphoproliferative and myeloproliferative malignancies have been noted in patients with systemic mastocytosis and urticaria pigmentosa. However, to our knowledge an association between mastocytosis and malignant melanoma has not been reported previously.
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Affiliation(s)
- P Todd
- Department of Dermatology, Glasgow Royal Infirmary, UK
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Abstract
A family is described in which five of the six members with the Jackson-Lawler type of pachyonychia congenita also had varying degrees of hidradenitis suppurativa. We suggest an association between this type of pachyonychia congenita and hidradenitis suppurativa.
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Affiliation(s)
- P Todd
- Department of Dermatology, Glasgow Royal Infirmary
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Garioch J, Todd P, Rademaker M, Forsyth A. Allergic contact dermatitis reactions to latex examination gloves. Br J Dermatol 1990. [DOI: 10.1111/j.1365-2133.1990.tb04420.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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