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Kostaki M, Plaka M, Befon A, Dessinioti C, Kypraiou K, Chardalia V, Christofidou E, Polydorou D, Stratigos A. Simultaneous melanomas in the setting of multiple primary melanomas. Melanoma Res 2024; 34:198-201. [PMID: 38224405 DOI: 10.1097/cmr.0000000000000954] [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: 01/16/2024]
Abstract
It is estimated that about 1-13% of melanoma patients will develop multiple primary melanomas. Although the occurrence of subsequent tumors has been described during the last few years, the development of simultaneous melanomas has not yet been extensively studied. We reviewed our registries to identify patients with multiple primary melanomas. We studied epidemiological, clinical, and histological characteristics of patients who were diagnosed with simultaneous melanomas and compared them with those of patients who developed non-synchronous multiple primary melanomas. As simultaneous were defined subsequent melanomas that were diagnosed either at the same visit or within a time-period of maximum of 1 month. Between 2000 and 2020, 2500 patients were diagnosed with melanoma at Andreas Syggros Hospital. 86 (3.4%) patients presented multiple primary melanomas and among them, 35 (40.7%) developed simultaneous melanomas. Patients with simultaneous melanomas developed more frequently more than 2 tumors. First tumors of patients with non-synchronous melanomas were significantly thicker than second tumors while those of patients with simultaneous melanomas did not differ significantly. Slight differences in the tumor localization, staging and histologic type were observed between the two groups. However significant differences were ascertained between first and second tumors in both groups. Simultaneous melanomas occupy an important proportion of multiple primary melanomas, affecting a non-negligible number of patients. Slight differences between simultaneous and non-synchronous multiple primary melanomas seem to define a distinct subcategory of multiple primary melanomas.
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Affiliation(s)
- Maria Kostaki
- Department of Plastic Surgery, Microsurgery, Burns and Melanoma Reference Center, General Hospital of Athens G.Gennimatas
| | - Michaela Plaka
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Aggeliki Befon
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Clio Dessinioti
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Katerina Kypraiou
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Vasiliki Chardalia
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Eleftheria Christofidou
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Doris Polydorou
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology-Venereology, Medical School of Athens University, Andreas Syggros Hospital, Athens, Greece
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Kypreou K, Stergiopoulou A, Plaka M, Befon A, Chardalia V, Stratigos IA, Stratigos AJ, Stefanaki I. Targeted sequencing analysis of loci implicated in familial melanoma in a Greek cohort. J Eur Acad Dermatol Venereol 2023. [PMID: 38100224 DOI: 10.1111/jdv.19728] [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] [Received: 09/05/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024]
Affiliation(s)
- K Kypreou
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Stergiopoulou
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - M Plaka
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Befon
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - V Chardalia
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - I A Stratigos
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A J Stratigos
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - I Stefanaki
- 1st University Clinic of Dermatological and Venereal Diseases, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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3
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Kostaki M, Plaka M, Moustaki M, Befon A, Champsas G, Kypreou K, Chardalia V, Chasapi V, Polydorou D, Stratigos A. Cutaneous melanoma metastases: Clinical and dermoscopic findings. J Eur Acad Dermatol Venereol 2022; 37:941-944. [PMID: 36310344 DOI: 10.1111/jdv.18701] [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] [Received: 02/23/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND About 2%-20% of melanoma patients will develop cutaneous melanoma metastases (CMM). Their clinical diagnosis still remains challenging because of the variation of clinical and dermoscopic characteristics. Until today, few studies exist concerning the dermoscopic image of CMM but no one has focused on its possible association with clinicopathological melanoma characteristics. METHODS Between 2002 and 2019, 42 patients diagnosed with melanoma at Andreas Syggros Hospital developed CMM. We studied the dermoscopic presentation of these metastases and its possible association with the clinical and histologic characteristics of the underlying melanoma. RESULTS There were 20 male and 22 female patients with a mean age of 64.02 years. Nineteen patients developed satellites and 23 in transit metastases. Mean Breslow index was estimated at 2.93 mm and ulceration was observed in half of the tumours (50%). Almost half of the patients developed cutaneous metastases on the lower limbs (45.24%). We identified 5 dermoscopic patterns of CMM: saccular, amelanotic, homogenous, vascular and polymorphic. Homogenous (30.95%) and amelanotic (28.57%) were the most common patterns. Homogenous pattern was the most common in satellite metastases while amelanotic was mostly observed in in-transit metastases. Homogenous pattern was more frequent among superficial spreading melanomas. Patients with thin (<1 mm) and medium depth (1-2 mm) melanomas mostly developed metastases with saccular pattern. Vascular pattern was only present in metastases of tumours with Breslow index 2-4 mm. Homogenous and amelanotic were the only patterns found in tumours with Breslow index >4 mm. CONCLUSIONS We observed that vascular structures were more frequent in metastases of deeper tumours while nevus-like structures were more common in metastases of thinner tumours. CMM occasionally may constitute the first clinical sign of melanoma disease. Therefore, it is important for clinicians to recognize their dermoscopic patterns which seem to be associated with some of the clinical and histological characteristics of cutaneous melanomas.
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Affiliation(s)
- Maria Kostaki
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Michaela Plaka
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Margarita Moustaki
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Aggeliki Befon
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Grigoris Champsas
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Katerina Kypreou
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Vasiliki Chardalia
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Vasiliki Chasapi
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Dorothea Polydorou
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology-Venereology, Andreas Syggros Hospital, Medical School of Athens University, Athens, Greece
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Kostaki M, Plaka M, Stergiopoulou A, Kypreou K, Chardalia V, Befon A, Kostopoulos E, Theologi V, Christofidou E, Chasapi V, Polydorou D, Rigopoulos D, Stratigos A. Subungual melanoma: the experience of a Greek melanoma reference centre from 2003 to 2018. J Eur Acad Dermatol Venereol 2020; 34:e231-e234. [PMID: 31944385 DOI: 10.1111/jdv.16193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Kostaki
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - M Plaka
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stergiopoulou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - K Kypreou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chardalia
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Befon
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - E Kostopoulos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Theologi
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - E Christofidou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chasapi
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - D Polydorou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - D Rigopoulos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stratigos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
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5
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Kostaki M, Plaka M, Stergiopoulou A, Kypreou K, Chardalia V, Chasapi V, Polydorou D, Stratigos A. Trends in epidemiology of melanoma in situ in Greece: data from a melanoma reference centre during the period 2000-2018. Br J Dermatol 2019; 182:811-813. [PMID: 31549388 DOI: 10.1111/bjd.18551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Kostaki
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - M Plaka
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stergiopoulou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - K Kypreou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chardalia
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - V Chasapi
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - D Polydorou
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
| | - A Stratigos
- First Department of Dermatology-Venereology of Athens University, Andreas Syggros Hospital, Athens, Greece
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6
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Bokotas C, Gregoriou S, Polydorou D, Plaka M, Kontochristopoulos G, Chasapi V, Stratigos A, Rigopoulos D. Herpetic whitlow mimicking squamous cell carcinoma in an immunocompromised patient. J Eur Acad Dermatol Venereol 2019; 34:e51-e53. [DOI: 10.1111/jdv.15898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- C. Bokotas
- Department of Dermatology “A. Sygros” Hospital Athens Greece
| | - S. Gregoriou
- 1st Department of Dermatology and Venereology, National and Kapodistrian University of Athens “A. Sygros” Hospital Athens Greece
| | - D. Polydorou
- Department of Dermatology “A. Sygros” Hospital Athens Greece
| | - M. Plaka
- Department of Dermatology “A. Sygros” Hospital Athens Greece
| | | | - V. Chasapi
- Department of Dermatology “A. Sygros” Hospital Athens Greece
| | - A. Stratigos
- 1st Department of Dermatology and Venereology, National and Kapodistrian University of Athens “A. Sygros” Hospital Athens Greece
| | - D. Rigopoulos
- 1st Department of Dermatology and Venereology, National and Kapodistrian University of Athens “A. Sygros” Hospital Athens Greece
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7
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Kostaki M, Stathopoulou A, Plaka M, Zaras A, Chatzidimitriou E, Dimitrakopoulou A, Christofidou E, Polydorou D, Stratigos A. Pazopanib induced pigmented lesions of the scrotum and the face in a patient with metastatic renal cancer. J Eur Acad Dermatol Venereol 2019; 33:e361-e362. [PMID: 31066082 DOI: 10.1111/jdv.15657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- M Kostaki
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - A Stathopoulou
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - M Plaka
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - A Zaras
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - E Chatzidimitriou
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - A Dimitrakopoulou
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - E Christofidou
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - D Polydorou
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
| | - A Stratigos
- First Department of Dermatology-Venereology of Medical School of Athens University, Andreas Syggros Hospital, Athens 16121, Greece
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8
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Dessinioti C, Plaka M, Dimitrakopoulou A, Stratigos AJ. Complete response is reversible upon vismodegib withdrawal and re-inducible upon vismodegib rechallenge in a patient with locally advanced basal cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33:e187-e188. [PMID: 30653740 DOI: 10.1111/jdv.15428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- C Dessinioti
- Dermato-Oncology Unit, 1st Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, I. Dragoumi Street, Athens, 16121, Greece
| | - M Plaka
- Dermato-Oncology Unit, 1st Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, I. Dragoumi Street, Athens, 16121, Greece
| | - A Dimitrakopoulou
- Department of Histopathology, Andreas Sygros Hospital, 5, I. Dragoumi street, Athens 16121, Greece
| | - A J Stratigos
- Dermato-Oncology Unit, 1st Department of Dermatology, Andreas Sygros Hospital, University of Athens, 5, I. Dragoumi Street, Athens, 16121, Greece
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9
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Soura E, Plaka M, Dessinioti C, Chasapi V, Stefanaki C, Antoniou C, Stratigos A. Use of vismodegib for the treatment of multiple basal cell carcinomas in a patient with xeroderma pigmentosum. Pediatr Dermatol 2018; 35:e334-e336. [PMID: 30178564 DOI: 10.1111/pde.13610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 11/28/2022]
Abstract
A female patient with xeroderma pigmentosum and multiple basal cell carcinomas was treated with a hedgehog pathway inhibitor (vismodegib), which successfully treated the majority of her basal cell carcinomas while preventing the appearance of new lesions. The sum diameter of lesions showed a 61% decrease after 16.5 months of treatment, although after 18.5 months of treatment, a persistent lesion showed progression and metatypical characteristics; adverse events included persistent alopecia muscle cramps, dysgeusia, and amenorrhea. Despite these limitations, vismodegib may have a role in the treatment of some patients with xeroderma pigmentosum.
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Affiliation(s)
- Efthymia Soura
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Michaela Plaka
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Clio Dessinioti
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vassiliki Chasapi
- State Clinic of Dermatology - Venereology, Andreas Sygros Hospital, Athens, Greece
| | - Christina Stefanaki
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Christina Antoniou
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alexander Stratigos
- 1st University Department of Dermatology - Venereology, "Andreas Sygros" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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10
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Karagianni F, Njauw CN, Kypreou KP, Stergiopoulou A, Plaka M, Polydorou D, Chasapi V, Pappas L, Stratigos IA, Champsas G, Panagiotou P, Gogas H, Evangelou E, Tsao H, Stratigos AJ, Stefanaki I. CDKN2A/CDK4 Status in Greek Patients with Familial Melanoma and Association with Clinico-epidemiological Parameters. Acta Derm Venereol 2018; 98:862-866. [PMID: 29774366 PMCID: PMC6572781 DOI: 10.2340/00015555-2969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Approximately 5–10% of melanoma cases occur in a familial context. CDKN2A/CDK4 were the first high- penetrance melanoma genes identified. The aims of this study were to evaluate CDKN2A/CDK4 variants in Greek familial melanoma patients and to correlate the mutational status with specific clinico-epidemiological characteristics. A cross-sectional study was conducted by genotyping CDKN2A/CDK4 variants and selected MC1R polymorphisms in 52 melanoma-prone families. Descriptive statistics were calculated and comparisons were made using the X2 test, Fisher’s exact test and Student’s t-test for statistical analysis, as appropriate. CDKN2A variants were detected in 46.2% of melanoma-prone families, while a CDK4 variant was found in only one family. This study confirmed that, in the Greek population, the age at melanoma diagnosis was lower in patients carrying a variant in CDKN2A compared with wild-type patients. No statistically significant associations were found between CDKN2A mutational status and MC1R polymorphisms.
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Affiliation(s)
- Fani Karagianni
- 1st Department of Dermatology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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11
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Soura E, Plaka M, Chasapi V, Antoniou C, Stratigos A. Vismodegib persistence and discontinuation patterns in Greek patients from a real world setting. Dermatol Ther 2017; 31. [DOI: 10.1111/dth.12553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Efthymia Soura
- 1 University Department of Dermatology - Venereology; “Andreas Sygros” Hospital, National and Kapodistrian University of Athens Medical School; Athens Greece
| | - Michaela Plaka
- 1 University Department of Dermatology - Venereology; “Andreas Sygros” Hospital, National and Kapodistrian University of Athens Medical School; Athens Greece
| | - Vasiliki Chasapi
- State Clinic of Dermatology - Venereology, Andreas Sygros Hospital; Athens Greece
| | - Christina Antoniou
- 1 University Department of Dermatology - Venereology; “Andreas Sygros” Hospital, National and Kapodistrian University of Athens Medical School; Athens Greece
| | - Alexander Stratigos
- 1 University Department of Dermatology - Venereology; “Andreas Sygros” Hospital, National and Kapodistrian University of Athens Medical School; Athens Greece
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12
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Dessinioti C, Plaka M, Zisimou C, Christofidou E, Antoniou C, Stratigos A. Advanced squamous cell carcinoma of the axillae mimicking hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2017; 31:e421-e423. [DOI: 10.1111/jdv.14235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C. Dessinioti
- Hidradenitis Clinic; Department of Dermatology; Andreas Syggros Hospital; University of Athens; Athens Greece
| | - M. Plaka
- Dermato-Oncology Unit; Department of Dermatology; Andreas Syggros Hospital; University of Athens; Athens Greece
| | - C. Zisimou
- Hidradenitis Clinic; Department of Dermatology; Andreas Syggros Hospital; University of Athens; Athens Greece
| | - E. Christofidou
- Histopathology Department; Andreas Syggros Hospital; Athens Greece
| | - C. Antoniou
- Hidradenitis Clinic; Department of Dermatology; Andreas Syggros Hospital; University of Athens; Athens Greece
| | - A.J. Stratigos
- Dermato-Oncology Unit; Department of Dermatology; Andreas Syggros Hospital; University of Athens; Athens Greece
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13
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Soura E, Plaka M, Stefanaki C, Chasapi V, Christofidou E, Antoniou C, Stratigos A. Characteristics of Spitz nevi, Atypical Spitz nevi and Melanomas in patients younger than 20 years. J Eur Acad Dermatol Venereol 2017; 31:e384-e385. [PMID: 28295655 DOI: 10.1111/jdv.14208] [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] [Indexed: 01/14/2023]
Affiliation(s)
- E Soura
- 1st University Department of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
| | - M Plaka
- 1st University Department of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
| | - C Stefanaki
- 1st University Department of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
| | - V Chasapi
- State Clinic of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
| | - E Christofidou
- Histopathology Department of 'Andreas Sygros' Hospital, Athens, Greece
| | - C Antoniou
- 1st University Department of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
| | - A Stratigos
- 1st University Department of Dermatology - Venereology, 'Andreas Sygros' Hospital, Athens, Greece
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14
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Soura E, Plaka M, Dessinioti C, Syrigos K, Stratigos AJ. Can hair re-growth be considered an early clinical marker of treatment resistance to Hedgehog inhibitors in patients with advanced basal cell carcinoma? A report of two cases. J Eur Acad Dermatol Venereol 2016; 30:1726-1729. [PMID: 27461144 DOI: 10.1111/jdv.13754] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Basal cell carcinomas (BCCs) are the most common skin cancers in the Caucasian population. BCCs are in the majority of cases adequately managed with surgical excision, however a small subset of these tumours exhibit resistance to conventional therapies and progress to become locally advanced or even metastatic. Although Hedgehog inhibitors have been successfully used during the last few years in the treatment of locally advanced or metastatic BCCs, resistance to treatment remains an issue. Until this point, no biomarkers or clinical markers of drug resistance for Hedgehog inhibitors have been identified. METHODS AND RESULTS We report two patients, a female patient with Gorlin syndrome and a male patient with locally advanced BCC, which received treatment with the Hedgehog inhibitor Vismodegib. These patients responded adequately to treatment and they both developed Hedgehog inhibitor-induced alopecia as an adverse event. However, after 2.5 and 1.5 years of treatment, respectively, the patients exhibited progressive disease that was accompanied by reversal of the Hedgehog inhibitor-induced alopecia, although still under treatment with Vismodegib. CONCLUSION Although alopecia is a well-known adverse event associated with the administration of Hh inhibitors, data associated with the appearance and/or clinical severity of alopecia and the treatment efficacy of Hedgehog inhibitors are limited. The Hedgehog pathway plays an important role in the normal cycling of the hair follicles in adults and, therefore, the pathomechanism of Hedgehog inhibitor-induced alopecia is considered unique for this drug class. Based on the fact that Hh inhibitor resistance is associated with partial reactivation of the Hh pathway, it would not be illogical to suggest that reversal of Hh inhibitor-induced alopecia in patients under treatment with Hh inhibitors could serve as a clinical marker of drug resistance. However, this observation, as reported in this paper, is only limited in two patients and therefore more information is needed in order to assess its actual clinical importance.
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Affiliation(s)
- E Soura
- 1st Department of Dermatology, School of Medicine, "Andreas Sygros" Hospital, University of Athens, Athens, Greece.
| | - M Plaka
- 1st Department of Dermatology, School of Medicine, "Andreas Sygros" Hospital, University of Athens, Athens, Greece
| | - C Dessinioti
- 1st Department of Dermatology, School of Medicine, "Andreas Sygros" Hospital, University of Athens, Athens, Greece
| | - K Syrigos
- 3rd Department of Medicine, School of Medicine, "Sotiria" General Hospital, University of Athens, Athens, Greece
| | - A J Stratigos
- 1st Department of Dermatology, School of Medicine, "Andreas Sygros" Hospital, University of Athens, Athens, Greece
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Dessinioti C, Plaka M, Stratigos AJ. Vismodegib for the treatment of basal cell carcinoma: results and implications of the ERIVANCE BCC trial. Future Oncol 2014; 10:927-36. [DOI: 10.2217/fon.14.50] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT: The need for effective treatment of patients with locally advanced or metastatic basal cell carcinoma (BCC), in conjunction with major advances in the elucidation of the molecular basis of this tumor has led to the advent of new targeted therapies – namely, hedgehog inhibitors. The rationale for their use in patients with advanced BCC is based on their inhibitory effect on the hedgehog pathway, which is aberrantly activated in BCCs due to mutations of its primary components, PTCH1 and SMO genes. Vismodegib (GDC-0449) is an orally bioavailable hedgehog pathway inhibitor that selectively inhibits SMO. The ERIVANCE BCC study is a Phase II, international, multicenter clinical trial evaluating the efficacy and safety of vismodegib 150 mg once daily in patients with locally advanced or metastatic BCC. Vismodegib has been approved for the treatment of adult patients with metastatic BCC, or with locally advanced BCC that has recurred following surgery or who are not candidates for surgery or radiation therapy. This article will outline the rationale, design and available results from the ERIVANCE BCC study and discuss the clinical implications of vismodegib in the management of patients with BCC. Challenges regarding vismodegib use include the recurrence of BCC after drug discontinuation, the development of acquired resistance, the dramatic efficacy in patients with Gorlin syndrome, and class-related drug toxicity. Ongoing clinical trials aim to explore the role of vismodegib in the neoadjuvant setting prior to surgery, the potential use of alternate dosing regimens in order to limit chronic adverse events, as well as the identification of patients with BCC that are more likely to respond to this targeted therapy based on genotypic and/or phenotypic characteristics.
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Affiliation(s)
- Clio Dessinioti
- Dermato–Oncology Unit, First Department of Dermatology Venereology, University of Athens, Andreas Sygros Hospital, 5 Dragoumi Str, 16 121, Kaisariani, Athens, Greece
| | - Michaela Plaka
- Dermato–Oncology Unit, First Department of Dermatology Venereology, University of Athens, Andreas Sygros Hospital, 5 Dragoumi Str, 16 121, Kaisariani, Athens, Greece
| | - Alexander J Stratigos
- Dermato–Oncology Unit, First Department of Dermatology Venereology, University of Athens, Andreas Sygros Hospital, 5 Dragoumi Str, 16 121, Kaisariani, Athens, Greece
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Talaganis JA, Biello K, Plaka M, Polydorou D, Papadopoulos O, Trakatelli M, Sotiriadis D, Tsoutsos D, Kechagias G, Gogas H, Antoniou C, Swetter SM, Geller AC, Stratigos AJ. Demographic, behavioural and physician-related determinants of early melanoma detection in a low-incidence population. Br J Dermatol 2014; 171:832-8. [PMID: 24749902 DOI: 10.1111/bjd.13068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Knowledge of the factors that influence early detection of melanoma is important in developing strategies to reduce associated mortality. OBJECTIVES To identify sociodemographic, behavioural and medical care-related factors associated with melanoma thickness in a low-incidence population but with a high case fatality. PATIENTS AND METHODS In a multicentre, retrospective, survey-based study of 202 patients with a recent diagnosis of invasive melanoma (< 1 year), we collected data on demographic and behavioural factors, attitudes towards prevention, access to medical care, frequency of skin self-examination (SSE) and physician skin examination (PSE) in relation to melanoma thickness. RESULTS Thinner tumours (≤ 1 mm, 80 melanomas) were associated with female sex (P ≤ 0.049), nonnodular (superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma) histological subtypes (P < 0.001), absence of ulceration (P ≤ 0.001), and location other than lower extremity or trunk location (P ≤ 0.004). Patients married at the time of diagnosis or who performed SSE during the year prior to diagnosis were more likely to have thinner tumours than those who did not [odds ratio (OR) 3.45, 95% confidence interval (CI) 1.48-8.04 and OR 2.43, 95% CI 1.10-5.34, respectively]. Full-body skin examination by a physician was not significantly associated with thinner melanoma (OR 1.99, 95% CI 0.66-6.07). CONCLUSIONS SSE was shown to be an important factor in the detection of thin melanoma, in contrast to partial or full-body PSE, which did not show any statistically significant effect on tumour thickness.
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Affiliation(s)
- J A Talaganis
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Dragoumi 5, 161 21, Athens, Greece
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Stefanaki I, Panagiotou OA, Kodela E, Gogas H, Kypreou KP, Chatzinasiou F, Nikolaou V, Plaka M, Kalfa I, Antoniou C, Ioannidis JPA, Evangelou E, Stratigos AJ. Replication and predictive value of SNPs associated with melanoma and pigmentation traits in a Southern European case-control study. PLoS One 2013; 8:e55712. [PMID: 23393597 PMCID: PMC3564929 DOI: 10.1371/journal.pone.0055712] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 12/29/2012] [Indexed: 11/18/2022] Open
Abstract
Background Genetic association studies have revealed numerous polymorphisms conferring susceptibility to melanoma. We aimed to replicate previously discovered melanoma-associated single-nucleotide polymorphisms (SNPs) in a Greek case-control population, and examine their predictive value. Methods Based on a field synopsis of genetic variants of melanoma (MelGene), we genotyped 284 patients and 284 controls at 34 melanoma-associated SNPs of which 19 derived from GWAS. We tested each one of the 33 SNPs passing quality control for association with melanoma both with and without accounting for the presence of well-established phenotypic risk factors. We compared the risk allele frequencies between the Greek population and the HapMap CEU sample. Finally, we evaluated the predictive ability of the replicated SNPs. Results Risk allele frequencies were significantly lower compared to the HapMap CEU for eight SNPs (rs16891982 – SLC45A2, rs12203592 – IRF4, rs258322 – CDK10, rs1805007 – MC1R, rs1805008 - MC1R, rs910873 - PIGU, rs17305573- PIGU, and rs1885120 - MTAP) and higher for one SNP (rs6001027 – PLA2G6) indicating a different profile of genetic susceptibility in the studied population. Previously identified effect estimates modestly correlated with those found in our population (r = 0.72, P<0.0001). The strongest associations were observed for rs401681-T in CLPTM1L (odds ratio [OR] 1.60, 95% CI 1.22–2.10; P = 0.001), rs16891982-C in SCL45A2 (OR 0.51, 95% CI 0.34–0.76; P = 0.001), and rs1805007-T in MC1R (OR 4.38, 95% CI 2.03–9.43; P = 2×10−5). Nominally statistically significant associations were seen also for another 5 variants (rs258322-T in CDK10, rs1805005-T in MC1R, rs1885120-C in MYH7B, rs2218220-T in MTAP and rs4911442-G in the ASIP region). The addition of all SNPs with nominal significance to a clinical non-genetic model did not substantially improve melanoma risk prediction (AUC for clinical model 83.3% versus 83.9%, p = 0.66). Conclusion Overall, our study has validated genetic variants that are likely to contribute to melanoma susceptibility in the Greek population.
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Affiliation(s)
- Irene Stefanaki
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Orestis A. Panagiotou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Elisavet Kodela
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Helen Gogas
- Department of Internal Medicine, University of Athens, Laikon Hospital, Athens, Greece
| | - Katerina P. Kypreou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Foteini Chatzinasiou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Vasiliki Nikolaou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Michaela Plaka
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - Iro Kalfa
- Blood Donation Unit, Laikon Hospital, Athens, Greece
| | - Christina Antoniou
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
| | - John P. A. Ioannidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, and Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California, United States of America
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Alexander J. Stratigos
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece
- * E-mail:
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Nikolaou V, Kang X, Stratigos A, Gogas H, Latorre MC, Gabree M, Plaka M, Njauw CN, Kypreou K, Mirmigi I, Stefanaki I, Tsao H. Comprehensive mutational analysis of CDKN2A and CDK4 in Greek patients with cutaneous melanoma. Br J Dermatol 2011; 165:1219-22. [PMID: 21801156 PMCID: PMC3225501 DOI: 10.1111/j.1365-2133.2011.10551.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The penetrance of CDKN2A mutations is subject to geographical and latitudinal variation and is presumably dictated by ultraviolet radiation exposure and possibly other co-inherited genetic factors. The frequency of mutations increases with the number of family members affected and the number of primary tumours, and also fluctuates with geography. To date, little is known about the prevalence of CDKN2A mutations in patients with melanoma from Greece. OBJECTIVE To characterize the frequency of CDKN2A and CDK4 mutations in a hospital-based population of Greek patients with melanoma. METHODS Three hundred and four consecutive single primary melanoma (SPM), nine familial melanoma (FM) and seven multiple primary melanoma cases (MPM) were assessed for sequence variants in exons 1α, 1β and 2 of CDKN2A and exon 2 of CDK4. RESULTS Germline CDKN2A mutations were detected in 10 of 304 SPM (3·3%), in four of seven MPM (57%) and in two of nine FM (22%) cases. The most common mutation was a Northern European allele (p16 p.R24P) detected in eight individuals. Five previously unreported CDKN2A variants were also identified: -34G>C, c.41_43delins20bp, c.301G>C (p.G101R), c.301G>A (p.G101E) and c.296_297insGACC. We also describe the first report of a CDK4 p.R24H substitution in a Greek family. CONCLUSIONS The Greek population appears to harbour a higher prevalence of the CDKN2A mutation than other reported cohorts. This supports the notion that genetic susceptibility may play a stronger influence in a country with a relatively low incidence of melanoma. Furthermore, the identification of Northern European alleles suggests that gene migration may be responsible, in part, for the observed cases in Greece.
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Affiliation(s)
- V Nikolaou
- Department of Dermatology, University of Athens Medical School, 'A. Sygros' Hospital, I Dragoumi 5, 16121 Athens, Greece
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Daskalaki MA, Frangoulis M, Papadopoulos O, Plaka M, Stravigos A. Case of a malignant melanoma developing on an underlying cavernous hemangioma. J Eur Acad Dermatol Venereol 2009; 23:1327-8. [PMID: 19250327 DOI: 10.1111/j.1468-3083.2009.03130.x] [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] [Indexed: 11/28/2022]
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Nikolaou VA, Sypsa V, Stefanaki I, Gogas H, Papadopoulos O, Polydorou D, Plaka M, Tsoutsos D, Dimou A, Mourtzoukou E, Korfitis V, Hatziolou E, Antoniou C, Hatzakis A, Katsambas A, Stratigos AJ. Risk associations of melanoma in a Southern European population: results of a case/control study. Cancer Causes Control 2008; 19:671-9. [DOI: 10.1007/s10552-008-9130-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 01/29/2008] [Indexed: 10/22/2022]
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Stratigos AJ, Dimisianos G, Nikolaou V, Poulou M, Sypsa V, Stefanaki I, Papadopoulos O, Polydorou D, Plaka M, Christofidou E, Gogas H, Tsoutsos D, Kastana O, Antoniou C, Hatzakis A, Kanavakis E, Katsambas AD. Melanocortin Receptor-1 Gene Polymorphisms and the Risk of Cutaneous Melanoma in a Low-Risk Southern European Population. J Invest Dermatol 2006; 126:1842-9. [PMID: 16601669 DOI: 10.1038/sj.jid.5700292] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Individuals with melanocortin 1 receptor (MC1R) gene variants have been shown to carry an increased risk for the development of melanoma. In this study, we investigated the relationship of MC1R gene variants and the risk of melanoma in 123 melanoma patients and 155 control subjects from Greece. The entire MC1R gene was sequenced for polymorphisms and the results were correlated with host factors and pigmentary characteristics. MC1R polymorphisms were present in 59.4% of melanoma patients compared to 37.5% of controls, yielding an odds ratio (OR) of 2.43 (95% confidence interval (CI) = 1.50-3.96, P < 0.001) for melanoma among MC1R carriers. The risk of melanoma was enhanced in individuals carrying multiple variant alleles (OR = 6.97; 95% CI = 1.86-26.12, P = 0.004). Only the Val60Leu, Arg142His, and Arg151Cys variants were significantly associated with melanoma risk. In stratified analysis, the risk of melanoma among MC1R carriers was not influenced by skin phototype, skin color, or hair color. No association was found between MC1R genotype and the age of onset of melanoma, the tumor location, or the tumor thickness. In conclusion, MC1R polymorphisms are a predisposing factor of melanoma in a southern European population with a relatively low incidence of the disease.
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Affiliation(s)
- Alexander J Stratigos
- Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece.
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