1
|
Meyer SR, Rudzki-Senet A, Emde NL, Imhof L, Dummer R, Barysch MJ. Results of a 10-year web-based health promotion campaign against skin cancer in Switzerland. Eur J Dermatol 2021; 31:ejd.2021.4094. [PMID: 34405807 DOI: 10.1684/ejd.2021.4094] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Skin cancer is the most common malignancy with rising incidence. Although early detection can be lifesaving, prevention programmes are under-utilized. In 2008, a group of board-certified dermatologists in Switzerland established a website aimed at educating about skin cancer risk factors and providing guidance on self-assessment. To present the data of this programme over the last 10 years with regards to representation of the targeted groups and sustained impact on primary skin cancer prevention. A comprehensive web-based health promotion campaign was established for education and guidance on self-assessment. Teledermatological evaluation was offered and participants were then interviewed. In total, 11,171 digital photos were evaluated during 2008-2018; 54.3% (n = 6,067) from females and 45.7% (n = 5,104) from males. In 26.7% (n = 2,983), clinical examination was recommended. Of the participants, 1,874 replied revealing 103 malignancies (9.2% of the lesions were presented to a physician): 34 melanomas in situ, six squamous cell carcinomas, 53 basal cell carcinomas and 10 malignant lesions (not further specified). Of the participants, 40.5% (n = 683) changed their attitude towards sun exposure, 48.7% (n = 820) used more sunscreen, and 57.5% (n = 966) improved sunscreen measures. Web-based educational programmes raise public awareness, enhance prevention, and support early diagnosis of skin cancer. Teledermatology might contribute to reducing skin cancer mortality rates.
Collapse
Affiliation(s)
| | - Agnes Rudzki-Senet
- La Roche-Posay, L'Oréal Active Cosmetics, 10 chemin de Blandonnet, CH-1214 Vernier, Switzerland
| | - Nastia-Lara Emde
- La Roche-Posay, L'Oréal Active Cosmetics, 10 chemin de Blandonnet, CH-1214 Vernier, Switzerland
| | - Laurence Imhof
- University Hospital Zürich, Department of Dermatology, Switzerland
| | - Reinhard Dummer
- University Hospital Zürich, Department of Dermatology, Switzerland
| | - Marjam J Barysch
- University Hospital Zürich, Department of Dermatology, Switzerland
| |
Collapse
|
2
|
Dimitriou F, Staeger R, Ak M, Maissen M, Kudura K, Barysch MJ, Levesque MP, Cheng PF, Dummer R, Mangana J. Frequency, Treatment and Outcome of Immune-Related Toxicities in Patients with Immune-Checkpoint Inhibitors for Advanced Melanoma: Results from an Institutional Database Analysis. Cancers (Basel) 2021; 13:2931. [PMID: 34208218 PMCID: PMC8230729 DOI: 10.3390/cancers13122931] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) can induce immune-related adverse events (irAEs), which may result in treatment discontinuation. We sought to describe the onset, frequency, and kinetics of irAEs in melanoma patients in a real-life setting and to further investigate the prognostic role of irAEs in treatment outcomes. In this retrospective single-center cohort study, we included 249 melanoma patients. Onset, grade, and resolution of irAEs and their treatment were analyzed. A total of 191 (74.6%) patients in the non-adjuvant and 65 (25.3%) in the adjuvant treatment setting were identified. In the non-adjuvant setting, 29 patients (59.2%) with anti-CTLA4, 43 (58.1%) with anti-PD1, and 54 (79.4%) with anti-PD1/anti-CTLA4 experienced some grade of irAE and these had an improved outcome. In the adjuvant setting, the frequency of irAEs was 84.6% in anti-CTLA4 and 63.5% in anti-PD1, but no correlation with disease relapse was observed. Patients with underlying autoimmune conditions have a risk of disease exacerbation. Immunomodulatory agents had no impact on treatment efficacy. IrAEs are correlated with increased treatment efficacy in the non-adjuvant setting. Application of steroids and immunomodulatory agents, such as anti-TNF-alpha or anti-IL6, did not affect ICI efficacy. These data support irAEs as possible prognostic markers for ICI treatment.
Collapse
Affiliation(s)
- Florentia Dimitriou
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Ramon Staeger
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Melike Ak
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Matias Maissen
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Ken Kudura
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Marjam J. Barysch
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Mitchell P. Levesque
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Phil F. Cheng
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Reinhard Dummer
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| | - Joanna Mangana
- Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland; (F.D.); (R.S.); (M.A.); (M.J.B.); (M.P.L.); (P.F.C.); (J.M.)
- Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland;
| |
Collapse
|
3
|
Peil N, Varga Z, Barysch MJ, Brüssow C, Dedes KJ. Ectopic axillary breast cancer in a male patient. Clin Case Rep 2020; 8:2324-2325. [PMID: 33235795 PMCID: PMC7669415 DOI: 10.1002/ccr3.3336] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 12/03/2022] Open
Abstract
Ectopic breast tissue can persist in the axilla due to lack of involution of mammary glands along the mammary lines. It is rare in men, and the malignant transformation to breast cancer has occasionally been described. Differential diagnosis of any axillary tumor should include breast cancer arising at ectopic sites.
Collapse
Affiliation(s)
- Nils Peil
- Breast Cancer Center Comprehensive Cancer Center Zürich University Hospital of Zurich Zurich Switzerland.,Department of Gynecology University Hospital of Zurich Zurich Switzerland
| | - Zsuzsanna Varga
- Breast Cancer Center Comprehensive Cancer Center Zürich University Hospital of Zurich Zurich Switzerland.,Institute of Pathology and Molecular Pathology University Hospital Zurich Zurich Switzerland
| | - Marjam J Barysch
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - Cornelia Brüssow
- Breast Cancer Center Comprehensive Cancer Center Zürich University Hospital of Zurich Zurich Switzerland.,Department of Oncology University Hospital Zurich Zurich Switzerland
| | - Konstantin J Dedes
- Breast Cancer Center Comprehensive Cancer Center Zürich University Hospital of Zurich Zurich Switzerland.,Department of Gynecology University Hospital of Zurich Zurich Switzerland
| |
Collapse
|
4
|
Burla J, Bluemel S, Biedermann L, Barysch MJ, Dummer R, Levesque MP, Gubler C, Morell B, Rogler G, Scharl M. Retrospective Analysis of Treatment and Complications of Immune Checkpoint Inhibitor-Associated Colitis: Histological Ulcerations as Potential Predictor for a Steroid-Refractory Disease Course. Inflamm Intest Dis 2020; 5:109-116. [PMID: 32999883 DOI: 10.1159/000507579] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022] Open
Abstract
Background/Aims Among the severe immune-related adverse events (irAEs) that occur with immune checkpoint inhibitor (ICI) therapy, colitis is the most frequent one. This study aimed at describing the experience from the largest gastroenterology unit in Switzerland with immune checkpoint inhibitor-associated colitis (ICIAC), its clinical presentation, management, and outcomes. Methods We performed a retrospective review of patients who were referred for the evaluation of ICIAC between January 2011 and October 2018 to the Division of Gastroenterology and Hepatology, University Hospital Zurich. Results Thirty-three patients with immune-related colitis grade 3 or 4 met the inclusion criteria and were analyzed in detail: All patients had diarrhea, 64% had abdominal pain, 42% had bloody stool, 27% had emesis, and 18% developed fever. In total, 33% were successfully treated with corticosteroids alone; 66% were steroid-refractory and treated with infliximab or vedolizumab. Two of these patients developed severe complications requiring surgery. All patients reached complete remission of ICIAC and its symptoms. At colonoscopy, ulcerations were seen in 37% of steroid-refractory versus 63% of steroid-responsive cases. Deep histological ulcerations invading the submucosa were only present in steroid-refractory cases. Conclusion ICIAC is a severe irAE which frequently requires high-dose steroids and a close follow-up due to deleterious complications. The detection of histologically diagnosed deep ulcerations may predict a steroid-refractory course and may warrant early application of infliximab. However, larger studies are required to confirm our findings.
Collapse
Affiliation(s)
- Julian Burla
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sena Bluemel
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Luc Biedermann
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marjam J Barysch
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mitchell P Levesque
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christoph Gubler
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bernhard Morell
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gerhard Rogler
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Scharl
- Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
5
|
Dummer R, Mangana J, Frauchiger AL, Lang C, Micaletto S, Barysch MJ. How I treat metastatic melanoma. ESMO Open 2019; 4:e000509. [PMID: 31423341 PMCID: PMC6677980 DOI: 10.1136/esmoopen-2019-000509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 01/08/2023] Open
Abstract
Tremendous progress in basic and clinical research has completely revolutionised the management of advanced melanoma, and this dramatic development is still ongoing. In this environment, state-of-the-art patient care is a major challenge. We describe how patient-centred medicine is organised in a leading referral centre that is also involved in early and late clinical trials and is part of a worldwide network for translational research.
Collapse
Affiliation(s)
- Reinhard Dummer
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
| | - Joanna Mangana
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Claudia Lang
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Sara Micaletto
- Department of Dermatology, University Hospital, Zurich, Switzerland
| | - Marjam J Barysch
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Dimitriou F, Krattinger R, Ramelyte E, Barysch MJ, Micaletto S, Dummer R, Goldinger SM. The World of Melanoma: Epidemiologic, Genetic, and Anatomic Differences of Melanoma Across the Globe. Curr Oncol Rep 2018; 20:87. [PMID: 30250984 DOI: 10.1007/s11912-018-0732-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [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] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW As cancer remains an increasing problem in industrial countries, the incidence of melanoma has risen rapidly in many populations during the last decades and still continues to rise. Current strategies aiming to control the disease have largely focused on improving the understanding of the interplay of causal factors for this cancer. RECENT FINDINGS Cutaneous melanoma shows clear differences in incidence, mortality, genomic profile, and anatomic presentation, depending on the country of residence, ethnicity, and socioeconomic status. Known risk factors are multiple atypical nevi, positive family and/or personal history, immune suppressive diseases or treatments, and fair skin phenotype. Besides new adjuvant therapeutic options, changed attitude toward leisure and sun exposure, primary prevention, and early detection are major contributors to disease control. Melanoma is a disease of multifactorial causality and heterogeneous presentation. Its subtypes differ in origin, anatomical site, role of UV radiation, and mutational profile. Better understanding of these differences may improve prevention strategies and therapeutic developments.
Collapse
Affiliation(s)
- Florentia Dimitriou
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Regina Krattinger
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Egle Ramelyte
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Marjam J Barysch
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Sara Micaletto
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - Simone M Goldinger
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland.
| |
Collapse
|
7
|
Weibel L, Barysch MJ, Scheer HS, Königs I, Neuhaus K, Schiestl C, Rentsch K, Müller DM, Theiler M. Topical Timolol for Infantile Hemangiomas: Evidence for Efficacy and Degree of Systemic Absorption. Pediatr Dermatol 2016; 33:184-90. [PMID: 26840644 DOI: 10.1111/pde.12767] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Topical use of timolol for infantile hemangiomas has recently emerged with promising results. It is unknown whether topical β-blockers act locally or if their effect is partly due to systemic absorption. This study investigates whether topically applied timolol is absorbed and reports on the efficacy of this treatment. METHODS We treated 40 infants with small proliferating hemangiomas with topical timolol gel 0.5% twice daily and assessed urinary excretion and serum levels in a proportion of patients. Clinical response was evaluated on a visual analog scale of standardized photographs after 1, 2, 3, and 5 months. RESULTS Forty infants with a median age of 18 weeks (range 2-35 wks) were included; 23 (58%) had superficial and 17 (42%) mixed-type hemangiomas. The median size was 3 cm(2) (range 0.1-15 cm(2) ) and nine hemangiomas were ulcerated. The hemangiomas improved significantly during treatment, with a median increase in visual analog scale of 7 points after 5 months (p < 0.001). Urinalysis for timolol was performed in 24 patients and was positive in 20 patients (83%). In three infants, serum levels of timolol were also measured and were all positive (median 0.16 ng/mL [range 0.1-0.18 ng/mL]). No significant side effects were recorded. CONCLUSION Topical therapy with timolol is effective for infantile hemangiomas, but systemic absorption occurs. Serum levels in our patients were low, suggesting that using timolol for small hemangiomas is safe, but caution is advised when treating ulcerated or large hemangiomas, very young infants, or concomitantly using systemic propranolol.
Collapse
Affiliation(s)
- Lisa Weibel
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Marjam J Barysch
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Helene S Scheer
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Ingo Königs
- Department of Pediatric Surgery, Pediatric Burn Unit and Plastic and Reconstructive Surgery in Children, Altonaer Kinderkrankenhaus & University Medical Center, Hamburg-Eppendorf, Germany
| | - Kathrin Neuhaus
- Department of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Zurich, Switzerland.,Pediatric Burn Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Clemens Schiestl
- Department of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Zurich, Switzerland.,Pediatric Burn Center, University Children's Hospital Zurich, Zurich, Switzerland
| | | | - Daniel M Müller
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
| | - Martin Theiler
- Department of Pediatric Dermatology, University Children's Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
8
|
Urosevic-Maiwald M, Barysch MJ, Cheng PF, Karpova MB, Steinert H, Okoniewski MJ, Dummer R. In vivo profiling reveals immunomodulatory effects of sorafenib and dacarbazine on melanoma. Oncoimmunology 2015; 4:e988458. [PMID: 25949886 DOI: 10.4161/2162402x.2014.988458] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 11/12/2014] [Indexed: 12/21/2022] Open
Abstract
Sorafenib is a multi-kinase inhibitor used alone or in combination with dacarbazine to treat metastasized melanoma. Our study investigated the relationship between metabolic response assessed by PET-CT and global transcriptome changes during sorafenib and dacarbazine therapy in patients with advanced melanoma. We conducted an open-label, investigator-initiated study that enrolled 13 sorafenib-naïve Stage IV melanoma patients, whose metastases were accessible for repeated biopsies. Treatment regimen included orally administered sorafenib and intravenous dacarbazine. Biopsies of skin or superficial lymph node metastases were taken before treatment (baseline), during sorafenib and after dacarbazine therapy and used for transcriptional profiling and validation experiments. Serum samples were evaluated for cytokine production. Metabolic response to therapy was observed in 45.5% of patients. The study drugs were well tolerated. We observed a clear upregulation of interferon (IFN)-stimulated immune response genes in profiled metastases. The IFNγ-induced gene signature seemed to be enhanced after addition of dacarbazine to sorafenib. Serum IFNγ also increased during therapy, particularly after addition of dacarbazine. Induction of IFNγ stimulated genes correlating with increased serum IFNγ was predictive of better clinical outcome and responders who had significantly higher serum IFNγ levels lived longer. Our data reveal in situ changes in melanoma metastases during treatment with sorafenib and dacarbazine and suggest an additional mechanism of action through immunomodulation.
Collapse
Affiliation(s)
| | - Marjam J Barysch
- Department of Dermatology; University Hospital Zurich ; Zurich, Switzerland
| | - Phil F Cheng
- Department of Dermatology; University Hospital Zurich ; Zurich, Switzerland
| | - Maria B Karpova
- Department of Dermatology; University Hospital Zurich ; Zurich, Switzerland
| | - Hans Steinert
- Department of Nuclear Medicine; University Hospital Zurich ; Zurich, Switzerland
| | | | - Reinhard Dummer
- Department of Dermatology; University Hospital Zurich ; Zurich, Switzerland
| |
Collapse
|
9
|
Barysch MJ, Levesque MP, Cheng P, Karpova MB, Mihic-Probst D, Civenni G, Shakhova O, Sommer L, Biedermann T, Schiestl C, Dummer R. Coexpression of SOX10/CD271 (p75(NTR)) and β-Galactosidase in Large to Giant Congenital Melanocytic Nevi of Pediatric Patients. Dermatopathology (Basel) 2014; 1:35-46. [PMID: 27047921 PMCID: PMC4772933 DOI: 10.1159/000362490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Congenital melanocytic nevi (CMNs) are melanocytic neoplasms that can transform into melanoma. However, this development is impeded in the majority of cases and mostly affects patients with large or giant CMNs. Methods To elucidate mechanisms that keep CMNs from malignant transformation, CMN tissue biopsies were investigated for p-ERK and senescence markers by immunohistochemistry and for SOX10/CD271 (p75NTR) by immunofluorescence. CMN cells were cultivated, and MTT assays were performed for evaluating cell viability. Mutation status for NRAS and BRAF was performed by real-time PCR. Results 13 CMNs (from patients aged 0.5-11.8 years, mean: 2.7) showed immunoreactivity for SOX10/CD271 (p75NTR) in 34.2%. p-ERK was immunoreactive in 80% (4/5); β-galactosidase was significantly stronger expressed in CMNs compared to melanocytic nevi of patients over 70 years (p = 0.0085). The 5 CMN cultures were immunoreactive for SOX10/CD271 (p75NTR) in 36.7%. By silencing SOX10 by siRNA in 2 CMN cell cultures, cell viability decreased significantly. NRASQ61K mutation was found in 91.7% (11/12) and BRAFV600E in 6.3% of all analyzable CMNs (1/16). Conclusions Oncogene-induced senescence might prevent malignant transformation through activation of the mitogen-activated protein kinase pathway. SOX10 is necessary for the viability of human CMN cell cultures and may be responsible for clinical changes during aging.
Collapse
Affiliation(s)
- Marjam J Barysch
- Department of Dermatology, University Hospital Zurich, Switzerland
| | | | - Phil Cheng
- Department of Dermatology, University Hospital Zurich, Switzerland
| | - Maria B Karpova
- Department of Dermatology, University Hospital Zurich, Switzerland
| | | | - Gianluca Civenni
- Laboratories of Experimental Oncology, Department of Anatomy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Olga Shakhova
- Institute of Anatomy, University Zurich, Switzerland
| | - Lukas Sommer
- Institute of Anatomy, University Zurich, Switzerland
| | - Thomas Biedermann
- Pediatric Burn Centre, Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Switzerland; Children's Research Center, Zurich, Department of Anatomy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Clemens Schiestl
- Pediatric Burn Centre, Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital Zurich, Switzerland; Children's Research Center, Zurich, Department of Anatomy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Switzerland
| |
Collapse
|
10
|
Dummer R, Karpova MB, Barysch MJ. Basal cell carcinomas: molecular abnormalities and molecularly targeted therapies. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.09.30] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
11
|
Barysch MJ, Weibel L, Neuhaus K, Subotic U, Schärer L, Donghi D, Hafner J, Braun R, Läuchli S, Dummer R, Schiestl C. Dermatofibrosarcoma protuberans in childhood treated with slow Mohs micrographic surgery. Pediatr Dermatol 2013; 30:462-8. [PMID: 23432099 DOI: 10.1111/pde.12039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dermatofibrosarcoma protuberans (DFSP) in childhood is a rare tumor with high recurrence rates. Wide local excision can result in disfiguring mutilation, whereas Mohs micrographic surgery (MMS) reduces surgical margins. MMS in children is not performed routinely, as the required infrastructures such as a histopathology lab in close proximity to the operating room is often lacking. We retrospectively reviewed children diagnosed with DFSP treated at our hospital over 2 years. We recorded surgical treatment details, including margins, duration of inpatient stay, outcome, follow-up, and molecular genetic tumor tissue analysis. Four children with a median age of 6.8 years (range 6.0-8.8 years) were identified who had a diagnostic delay of a median of 2.5 years (range 0.5-4.0 years); all underwent complete tumor excision using the slow MMS technique using vacuum-assisted closure systems between repeated excisions and before wound closure. The median maximal safety margins were 1.5 cm (range 1.0-3.0 cm). By using vacuum-assisted closure systems, no dressing changes were needed, pain was limited, and full mobility was maintained in all children. The median total time in the hospital was 11 days (range 10-14 days). No relapses occurred during a median follow-up of 25.8 months (range 11.3-32.6 months). Collagen 1A1/platelet-derived growth factor B (COL1A1/PDGFB) translocation on chromosomes 17 and 22 was detected in all three analyzable specimens. Lesions suspected of being DFSP warrant prompt histologic evaluation; interdisciplinary management is mandatory in particular for children. Micrographic surgery allows smaller surgical margins than wide excision and should be considered as the treatment of choice in children with DFSP. The interim usage of vacuum-assisted closure systems increases patient comfort. Translocations in the COL1A1/PDGFB gene imply susceptibility to targeted treatment modalities for therapy-resistant cases.
Collapse
Affiliation(s)
- Marjam J Barysch
- Department of Plastic and Reconstructive Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Läuchli S, Hafner J, Ostheeren S, Mayer D, Barysch MJ, French LE. Management of Split-Thickness Skin Graft Donor Sites: A Randomized Controlled Trial of Calcium Alginate versus Polyurethane Film Dressing. Dermatology 2013; 227:361-6. [DOI: 10.1159/000356122] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/24/2013] [Indexed: 11/19/2022] Open
|
13
|
Barysch MJ, Eggmann N, Beyeler M, Panizzon RG, Seifert B, Dummer R. Long-term recurrence rate of large and difficult to treat cutaneous squamous cell carcinomas after superficial radiotherapy. Dermatology 2012; 224:59-65. [PMID: 22433440 DOI: 10.1159/000337027] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 01/31/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Surgical excision is the gold standard for cutaneous squamous cell carcinoma (cSCC), however its application is limited in specific cases. Superficial radiotherapy (RTx) is an alternative treatment option, but long-term follow-up data are limited. OBJECTIVE To determine the outcome of superficial RTx of cSCC in correlation to histological differentiation grade and tumor localization. METHODS The outcome of 180 large cSCCs after superficial RTx between 1960 and 2004 was retrospectively reviewed. RESULTS Mean tumor size was 3.5 cm(2) (SD 7.5) and mean follow-up period was 4.9 years (SD 4.7). Relapse-free survival was 95.8 and 80.4% after 1 and 10 years. Two-year relapse-free survival was 94.8% for good, 88.9% for moderate and 85.7% for poor differentiated tumors. Five-year relapse-free survival was highest in cSCCs located around the eyes (100%) and cheeks (90.9%). CONCLUSION Superficial RTx is an effective alternative for cSCC if surgery is difficult due to localization or concomitant disease.
Collapse
Affiliation(s)
- Marjam J Barysch
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | | | | | | | | | | |
Collapse
|
14
|
Abstract
In addition to lasers, intense pulsed light (IPL) sources are widely used in medicine to treat various indications, such as vascular lesions, irregular pigmentation and hypertrichosis. In contrast to lasers, IPL systems are broadband flash lamps that emit polychromatic incoherent light ranging from visible to infrared (500-1,300 nm). Optical filters are used to tailor the polychromatic light to specific needs. As a broad range of wavelengths are delivered, treatment of multiple chromophores--including melanin, hemoglobin, water and collagen--within the same exposure is possible.
Collapse
|
15
|
Karpova MB, Barysch MJ, Zipser MC, Schönewolf N, French LE, Dummer R. Changing pathology with changing drugs: skin cancer. Pathobiology 2011; 78:61-75. [PMID: 21677470 DOI: 10.1159/000314576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Today skin cancer is mainly treated by surgical interventions. New findings concerning molecular biology and the signaling pathways in epithelial skin cancers such as basal cell carcinoma, squamous cell carcinoma or melanoma, and mesenchymal skin cancers such as angiosarcoma and dermatofibrosarcoma protuberans (DFSP) have identified new molecular targets for a systemic or local treatment approach. For DFSP there is an opportunity already today to reduce the intensity of surgical procedures by pretreatment with targeted therapy. This article highlights important aspects in several skin cancer types.
Collapse
Affiliation(s)
- M B Karpova
- Department of Dermatology, University Hospital of Zürich, Switzerland.
| | | | | | | | | | | |
Collapse
|
16
|
Frey K, Fiechter M, Schwager K, Belloni B, Barysch MJ, Neri D, Dummer R. Different patterns of fibronectin and tenascin-C splice variants expression in primary and metastatic melanoma lesions. Exp Dermatol 2011; 20:685-8. [PMID: 21649738 DOI: 10.1111/j.1600-0625.2011.01314.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have investigated the staining patterns of primary and metastatic melanoma lesions using F8, L19 and F16. These three clinical-stage antibodies are currently being studied in clinical trials for the pharmacodelivery of cytokines or therapeutic radionuclides to neoplastic sites in patients with cancer. Frozen sections of 24 primary and 29 metastatic melanoma lesions were stained, using immunofluorescence procedures, with biotinylated preparations of the F8, L19 and F16 antibodies, which are specific to the alternatively spliced extra domain A and extra domain B domains of fibronectin and A1 domain of tenascin-C, respectively. Blood vessels were costained using von Willebrand factor-specific antibodies. In primary cutaneous melanoma lesions, F16 and F8 (but not L19) strongly stained the basal lamina at the interface between epidermis and dermis, with a strikingly complementary pattern. By contrast, metastatic melanoma lesions displayed a strong and diffuse pattern of immunoreactivity with all three antibodies. It was found that the extracellular matrix in melanoma undergoes extensive remodelling during the transition from primary to metastatic lesions. The intense staining of metastatic melanoma lesions by the F8, L19 and F16 antibodies provides a strong rationale for the use of these antibodies and their derivatives for the treatment of melanoma patients and possibly for the personalized choice of the best performing antibody in individual patients.
Collapse
Affiliation(s)
- Katharina Frey
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | | | | | | | | | | | | |
Collapse
|
17
|
Imhof L, Kerl K, Barysch MJ, Dummer R, French LE, Hofbauer GFL. Facial blaschkitis: case and review. Dermatology 2011; 223:1-3. [PMID: 21625075 DOI: 10.1159/000328136] [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] [Received: 12/21/2010] [Accepted: 04/02/2011] [Indexed: 11/19/2022] Open
Abstract
We report on a 15-year-old female with a 3-month history of a pruritic, erythematous cutaneous eruption on the right cheek and perioral area. The lesion had a linear distribution following the lines of Blaschko. Histopathological findings and direct immunofluorescence were compatible with chronic cutaneous lupus erythematosus (LE). Treatment with topical steroids and systemic antimalarial agents over 2 months showed hardly any improvement contrary to similar cases reported in the literature in the past. Histological findings move this case close to LE. However, the unusual clinical presentation as well as the resistance to antimalarial drugs do not fully allow to confirm this suspicion. Therefore, we recommend to call this new entity LE-like facial Blaschkitis of the adult.
Collapse
Affiliation(s)
- Laurence Imhof
- Department of Dermatology, University Hospital, Zurich, Switzerland.
| | | | | | | | | | | |
Collapse
|
18
|
Walter A, Barysch MJ, Behnke S, Dziunycz P, Schmid B, Ritter E, Gnjatic S, Kristiansen G, Moch H, Knuth A, Dummer R, van den Broek M. Cancer-Testis Antigens and Immunosurveillance in Human Cutaneous Squamous Cell and Basal Cell Carcinomas. Clin Cancer Res 2010; 16:3562-70. [DOI: 10.1158/1078-0432.ccr-09-3136] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Binner C, Selinski S, Barysch MJ, Pölcher C, Schormann W, Hermes M, Brulport M, Bauer A, Rudolph C, Bedawy E, Schug M, Golka K, Hasenclever D, Trauer H, Lessig R, Bolt HM, Ickstadt K, Hengstler JG. Munich Oktoberfest experience: remarkable impact of sex and age in ethanol intoxication. Arch Toxicol 2008; 82:933-9. [PMID: 18987847 DOI: 10.1007/s00204-008-0373-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 10/02/2008] [Indexed: 11/26/2022]
Abstract
Approximately 5,000 of 6 million annual visitors of the Oktoberfest in Munich have to undergo medical treatment. Patients with alcohol intoxication without trauma or further complications are all treated in a specialized medical camp. We studied these patients in order to identify risk factors and to assess the relevance of the Glasgow Coma Score (GCS) and of ethanol blood concentrations for patient management. In 2004 totally 405 patients suffering from ethanol intoxication without trauma were treated in the medical camp. A complete set of the following data was obtained from all 405 patients: GCS, ethanol blood concentration, age, sex, blood pressure (mean, systolic and diastolic), body temperature, heart rate, blood sugar, GOT, gamma-GT, and CK. A multivariate logistic regression model was applied to identify risk factors predicting patients at increased risk of hospitalization. Low GCS (< or =8 vs. >8, OR: 4.18, CI: 1.96-8.65) low age (20-29 vs. > or =30 years, OR: 2.35, CI: 1.05-5.65) and male gender (male vs. female, OR: 3.58, CI: 1.36-9.34) independently predicted patients that had to be hospitalized. All other parameters including ethanol blood concentrations were not explanatory. Patients with GCS < or = 8 (n = 66) had a lower median blood pressure (P = 0.0312) and showed a smaller increase in blood pressure during the observation period compared to patients with GCS > 8 (P < 0.001), suggesting that this subgroup may require longer recovery periods. Men aged 20-29 years were at highest risk for hospital admission. Increased risk could not be explained by higher ethanol blood concentrations in this subgroup. Importantly, GCS < 6 does not justify endotracheal intubation in ethanol intoxicated patients, when further complications, such as trauma, can be excluded.
Collapse
Affiliation(s)
- C Binner
- Division of Thoracic and Cardiovascular Surgery, Heart Center Leipzig of the University of Leipzig, Leipzig, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|