1
|
Lai C, Chundangayil R, Shapanis A, Sommerlad M, Al-Shamkhani A, Healy E. 449 Identification of tertiary lymphoid structures in primary cutaneous squamous cell carcinoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.463] [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: 11/19/2022]
|
2
|
Abstract
Skin bleaching, also known as skin lightening, is the deliberate lightening of an individual's skin tone outside of medical supervision. The causes are complex, multifactorial and often intertwined although the unifying themes centre around a belief that lighter skin denotes an individual of higher status, be that economic or physical beauty, than their darker skinned counterpart. Skin lightening is achieved using agents that block the production of melanin and often contain drugs such as Hydroquinone, super potent topical steroid and Mercury. These drugs can cause serious local and systemic complication. Skin lightening compounds are illegal in most countries throughout the world however the industry is worth billions of dollars annually and the agents can be easily obtained by individuals seeking to lightening their skin. Dermatologists are in a unique position to identify those at risk of using skin bleaching agents, manage complications and give advice on how to avoid using skin lightening agents to treat dermatological conditions and physiological variation in pigmentation. In order to manage the belief that lighter skin is better, societal level change is required in order to ensure that people of all skin tones are represented in the media.
Collapse
Affiliation(s)
- M Sommerlad
- Department of Dermatology, Homerton University Hospital, London, UK
| |
Collapse
|
3
|
Shapanis A, Lai C, Smith S, Coltart G, Sommerlad M, Schofield J, Parkinson E, Skipp P, Healy E. Identification of proteins associated with development of metastasis from cutaneous squamous cell carcinomas (cSCCs) via proteomic analysis of primary cSCCs. Br J Dermatol 2020; 184:709-721. [PMID: 32794257 DOI: 10.1111/bjd.19485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers capable of metastasizing. Proteomic analysis of cSCCs can provide insight into the biological processes responsible for metastasis, as well as future therapeutic targets and prognostic biomarkers. OBJECTIVES To identify proteins associated with development of metastasis in cSCC. METHODS A proteomic-based approach was employed on 105 completely excised, primary cSCCs, comprising 52 that had metastasized (P-M) and 53 that had not metastasized at 5 years post-surgery (P-NM). Formalin-fixed, paraffin-embedded cSCCs were microdissected and subjected to proteomic profiling after one-dimensional (1D), and separately two-dimensional (2D), liquid chromatography fractionation. RESULTS A discovery set of 24 P-Ms and 24 P-NMs showed 144 significantly differentially expressed proteins, including 33 proteins identified via both 1D and 2D separation, between P-Ms and P-NMs. Several differentially expressed proteins were also associated with survival in SCCs of other organs. The findings were verified by multiple reaction monitoring on six peptides from two proteins, annexin A5 (ANXA5) and dolichyl-diphosphooligosaccharide-protein glycosyltransferase noncatalytic subunit (DDOST), in the discovery group and validated on a separate cohort (n = 57). Increased expression of ANXA5 and DDOST was associated with reduced time to metastasis in cSCC and decreased survival in cervical and oropharyngeal cancer. A prediction model using ANXA5 and DDOST had an area under the curve of 0·93 (confidence interval 0·83-1·00), an accuracy of 91·2% and higher sensitivity and specificity than cSCC staging systems currently in clinical use. CONCLUSIONS This study highlights that increased expression of two proteins, ANXA5 and DDOST, is significantly associated with poorer clinical outcomes in cSCC.
Collapse
Affiliation(s)
- A Shapanis
- Dermatopharmacology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - C Lai
- Dermatopharmacology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S Smith
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - G Coltart
- Dermatopharmacology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Sommerlad
- Histopathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J Schofield
- Centre for Proteomic Research, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - E Parkinson
- Centre for Proteomic Research, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - P Skipp
- Centre for Proteomic Research, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - E Healy
- Dermatopharmacology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Dermatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
4
|
Purdie KJ, Proby CM, Rizvi H, Griffin H, Doorbar J, Sommerlad M, Feltkamp MC, der Meijden EV, Inman GJ, South AP, Leigh IM, Harwood CA. The Role of Human Papillomaviruses and Polyomaviruses in BRAF-Inhibitor Induced Cutaneous Squamous Cell Carcinoma and Benign Squamoproliferative Lesions. Front Microbiol 2018; 9:1806. [PMID: 30154763 PMCID: PMC6102365 DOI: 10.3389/fmicb.2018.01806] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 03/19/2018] [Accepted: 07/18/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Human papillomavirus (HPV) has long been proposed as a cofactor in the pathogenesis of cutaneous squamous cell carcinoma (cSCC). More recently, the striking clinico-pathological features of cSCCs that complicate treatment of metastatic melanoma with inhibitors targeting BRAF mutations (BRAFi) has prompted speculation concerning a pathogenic role for oncogenic viruses. Here, we investigate HPV and human polyomaviruses (HPyV) and correlate with clinical, histologic, and genetic features in BRAFi-associated cSCC. Materials and Methods: Patients receiving BRAFi treatment were recruited at Barts Health NHS Trust. HPV DNA was detected in microdissected frozen samples using reverse line probe technology and degenerate and nested PCR. HPV immunohistochemistry was performed in a subset of samples. Quantitative PCR was performed to determine the presence and viral load of HPyVs with affinity for the skin (HPyV6, HPyV7, HPyV9, MCPyV, and TSPyV). These data were correlated with previous genetic mutational analysis of H, K and NRAS, NOTCH1/2, TP53, CDKN2A, CARD11, CREBBP, TGFBR1/2. Chromosomal aberrations were profiled using single nucleotide polymorphism (SNP) arrays. Results: Forty-five skin lesions from seven patients treated with single agent vemurafenib in 2012–2013 were analyzed: 12 cSCC, 19 viral warts (VW), 2 actinic keratosis (AK), 5 verrucous keratosis/other squamoproliferative (VK/SP) lesions, one melanocytic lesion and 6 normal skin samples. Significant histologic features of viral infection were seen in 10/12 (83%) cSCC. HPV DNA was detected in 18/19 (95%) VW/SP, 9/12 (75%) cSCC, 4/5 (80%) SP, and 3/6 (50%) normal skin samples and in 1/12 cases assessed by immunohistochemistry. HPyV was co-detected in 22/30 (73%) of samples, usually at low viral load, with MCPyV and HPyV7 the most common. SNP arrays confirmed low levels of chromosomal abnormality and there was no significant correlation between HPV or HPyV detection and individual gene mutations or overall mutational burden. Conclusion: Despite supportive clinicopathologic evidence, the role for HPV and HPyV infection in the pathogenesis of BRAFi-induced squamoproliferative lesions remains uncertain. Synergistic oncogenic mechanisms are plausible although speculative. Nonetheless, with the prospect of a significant increase in the adjuvant use of these drugs, further research is justified and may provide insight into the pathogenesis of other BRAFi-associated malignancies.
Collapse
Affiliation(s)
- Karin J Purdie
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Charlotte M Proby
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Hasan Rizvi
- Department of Pathology, Barts Health NHS Trust, London, United Kingdom
| | - Heather Griffin
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - John Doorbar
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Mary Sommerlad
- Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
| | - Mariet C Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Els Van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Gareth J Inman
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Andrew P South
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Irene M Leigh
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - 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, United Kingdom.,Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
| |
Collapse
|
5
|
Sommerlad M, Lock A, Moir G, McGregor J, Bull R, Cerio R, Harwood C. Linear porokeratosis with multiple squamous cell carcinomas successfully treated by electrochemotherapy. Br J Dermatol 2016; 175:1342-1345. [DOI: 10.1111/bjd.14669] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- M. Sommerlad
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| | - A. Lock
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| | - G. Moir
- Department of Plastic Surgery; Royal London Hospital; Whitechapel London U.K
| | - J. McGregor
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| | - R. Bull
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| | - R. Cerio
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| | - C. Harwood
- Department of Dermatology; Royal London Hospital; Whitechapel London U.K
| |
Collapse
|
6
|
Turner CE, Sommerlad M, McGregor K, Davies FJ, Pichon B, Chong DLW, Farzaneh L, Holden MTG, Spratt BG, Efstratiou A, Sriskandan S. Superantigenic activity of emm3 Streptococcus pyogenes is abrogated by a conserved, naturally occurring smeZ mutation. PLoS One 2012; 7:e46376. [PMID: 23049698 PMCID: PMC3462185 DOI: 10.1371/journal.pone.0046376] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 08/29/2012] [Indexed: 11/18/2022] Open
Abstract
Streptococcus pyogenes M/emm3 strains have been epidemiologically linked with enhanced infection severity and risk of streptococcal toxic shock syndrome (STSS), a syndrome triggered by superantigenic stimulation of T cells. Comparison of S. pyogenes strains causing STSS demonstrated that emm3 strains were surprisingly less mitogenic than other emm-types (emm1, emm12, emm18, emm28, emm87, emm89) both in vitro and in vivo, indicating poor superantigenic activity. We identified a 13 bp deletion in the superantigen smeZ gene of all emm3 strains tested. The deletion led to a premature stop codon in smeZ, and was not present in other major emm-types tested. Expression of a functional non-M3-smeZ gene successfully enhanced mitogenic activity in emm3 S. pyogenes and also restored mitogenic activity to emm1 and emm89 S. pyogenes strains where the smeZ gene had been disrupted. In contrast, the M3-smeZ gene with the 13 bp deletion could not enhance or restore mitogenicity in any of these S. pyogenes strains, confirming that M3-smeZ is non-functional regardless of strain background. The mutation in M3-smeZ reduced the potential for M3 S. pyogenes to induce cytokines in human tonsil, but not during invasive infection of superantigen-sensitive mice. Notwithstanding epidemiological associations with STSS and disease severity, emm3 strains have inherently poor superantigenicity that is explained by a conserved mutation in smeZ.
Collapse
Affiliation(s)
- Claire E. Turner
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
| | - Mary Sommerlad
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
| | - Karen McGregor
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Frances J. Davies
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
| | - Bruno Pichon
- Respiratory and Systemic Infection Laboratory, The Health Protection Agency Centre for Infections, London, United Kingdom
| | - Deborah L. W. Chong
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
| | - Leili Farzaneh
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
| | - Matthew T. G. Holden
- Pathogen Genomics, The Wellcome Trust Sanger Institute, Cambridge, United Kingdom
| | - Brian G. Spratt
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Androulla Efstratiou
- Respiratory and Systemic Infection Laboratory, The Health Protection Agency Centre for Infections, London, United Kingdom
| | - Shiranee Sriskandan
- Department of Infectious Diseases & Immunity, Imperial College London, London, United Kingdom
- * E-mail:
| |
Collapse
|
7
|
Sommerlad M, Patel N, Vijayalakshmi B, Morris P, Hall P, Ahmad T, Campbell S, Lees C. Detection of lip, alveolar ridge and hard palate abnormalities using two-dimensional ultrasound enhanced with the three-dimensional reverse-face view. Ultrasound Obstet Gynecol 2010; 36:596-600. [PMID: 20617510 DOI: 10.1002/uog.7739] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The aim of this study was to assess conventional two-dimensional (2D) ultrasound enhanced with a three-dimensional (3D) ultrasound technique, the 'reverse-face' view (3D-RF) in prenatal evaluation of the involvement of the lips, alveolar ridge and secondary palate in suspected isolated orofacial clefting. METHODS One hundred and twenty-four cases of suspected orofacial clefting diagnosed by a routine 2D ultrasound scan were referred for specialist ultrasound at 20-34 weeks' gestation for a detailed assessment of the lips and palate using both 2D and 3D ultrasound. For the 3D examination the lips and alveolar ridges were examined both in profile and in the frontal plane. The palate was then assessed in the reverse coronal view by rotating the face through 180° on the vertical axis to produce the 3D-RF view. Antenatal diagnoses were compared with postnatal findings. Left and right lip and alveolar ridge defects were counted separately according to the Kernohan 'striped Y' classification. RESULTS Of 124 patients, 110 had isolated facial clefts and were available for follow-up; in 10, 3D-RF views were not successfully obtained, leaving 100 cases for assessment. The sensitivity of the 2D enhanced with 3D-RF technique for the diagnosis of cleft of the lip was 116/122 (95%), false-positive rate (FPR) 7.7%; for alveolar ridge was 87/103 (84.5%), FPR 7.2%; and for hard palate was 61/68 (89.7%), FPR 15.6%. CONCLUSION The data reported represent the largest series of orofacial abnormalities diagnosed by 2D ultrasound and enhanced with 3D imaging to refine the detection of clefts of the hard palate. The technique is feasible in 90% of patients in whom almost 90% have a correct classification of clefts of the lip, alveolar ridge and palate.
Collapse
Affiliation(s)
- M Sommerlad
- Cleft Net East, Addenbrookes Hospital, Cambridge, UK
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Sommerlad M, Beier C, Kaufmann R. Dermatitis artefacta unter dem Bild einer Lichtdermatose. Hautarzt 2007; 58:153-5. [PMID: 16705461 DOI: 10.1007/s00105-006-1133-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dermatitis artefacta is a form of a self-injury due to psychiatric disorders or internal conflicts. Delayed diagnosis often leads to unnecessary treatments. A 17-year old girl was referred with a putative photodermatosis presenting with erosions on an erythematous base on the face and forearms. The unusual rapid onset of new lesions following phototesting and in particular a reaction induced after a simulated light exposure substantiated the diagnosis of dermatitis artefacta. Faced with the diagnosed the patient admitted she had induced the lesions and was referred for psychiatric care.
Collapse
Affiliation(s)
- M Sommerlad
- Zentrum der Dermatologie und Venerologie, Klinikum der J.W. Goethe-Universität, Theodor-Stern-Kai 7, 60596 Frankfurt am Main.
| | | | | |
Collapse
|
9
|
Abstract
This is a prospective study to find out whether an interactive large-group case-based teaching approach combined with small-group bedside teaching improves student satisfaction and learning outcome in a practical dermatology course. During two consecutive terms a rotating system of large-group interactive case-study-method teaching with two tutors (one content expert, one process facilitator) and bedside teaching with randomly appointed tutors was evaluated with a nine-item questionnaire and multiple-choice test performed at the beginning and the end of the course (n = 204/231 students evaluable). The results of three different didactic approaches utilized over the prior year served as a control. The interactive course was rated significantly better (p < 0.0001) than the standard course with regard to all items. The aggregate mark given by the students for the whole course was 1.58-0.61 (mean +/- SD, range 1 (good)-5 (poor)). This was significantly better than the standard course (p < 0.0001) and not different from small-group teaching approaches. The mean test results in the final examination improved significantly (p < 0.01). The combination of large-group interactive teaching and small-group bedside teaching was well accepted, improved the learning outcome, was rated as good as a small-group didactic approach and needed fewer resources in terms of personnel.
Collapse
Affiliation(s)
- F R Ochsendorf
- Klinikum d. J.W. Goethe-Universität, Frankfurt am Main, Germany.
| | | | | | | |
Collapse
|