ABSTRACT
Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.
Subject(s)
Humans , Asian People , Foreign Bodies , Hematoma , Hutchinson's Melanotic Freckle , Melanoma , Mortality , Rare Diseases , Skin Neoplasms , Ulcer , WartsABSTRACT
Malignant melanoma is a rare disease in Asians but potentially the most aggressive form of skin cancer worldwide. It can occur in any melanocyte-containing anatomic site. Four main cutaneous melanoma subtypes are recognized: lentigo maligna melanoma, superficial spreading melanoma, acral lentiginous melanoma (ALM), and nodular melanoma. Generally, excessive exposure to ultraviolet (UV) radiation increases the risk of melanoma. The exception is ALM, which is the most common melanoma subtype in Asians and is not associated with UV radiation. ALM presents as dark brownish to black, irregular maculopatches, nodules, or ulcers on the palms, soles, and nails. The lesions may be misdiagnosed as more benign lesions, such as warts, ulcers, hematomas, foreign bodies, or fungal infections, especially in amelanotic acral melanomas where black pigments are absent. The aim of this brief review is to improve understanding and the rate of early detection thereby reducing mortality, especially regarding cutaneous melanoma in Asians.
Subject(s)
Humans , Asian People , Foreign Bodies , Hematoma , Hutchinson's Melanotic Freckle , Melanoma , Mortality , Rare Diseases , Skin Neoplasms , Ulcer , WartsABSTRACT
BACKGROUND: Recent studies indicate that light-emitting diodes (LED) may represent a novel and effective anti-aging light source for the skin. Among many candidate molecules known to control collagens, caveolin-1 (Cav-1) is known to play an inhibitory role in cutaneous collagen metabolism. OBJECTIVE: This study aimed to evaluate the effects of LED irradiation on the expression levels of Cav-1 and procollagens (proCOLs) in human dermal fibroblasts (HDFs). METHODS: Cultured HDFs were irradiated with 630 nm LED at different doses, and the mRNA and protein expression levels of Cav-1 and proCOLs I/III were analyzed. RESULTS: In LED-irradiated HDFs, mRNA and protein levels of Cav-1 were found to be down-regulated, whereas those of proCOLs I/III were up-regulated in a dose-dependent manner. A negative correlation between Cav-1 and proCOLs was verified in Cav-1 siRNA transfected HDFs. LED was moreover found to result in up-regulation of transforming growth factor (TGF)-beta1 and its receptors (TbetaRI, TbetaRII), SMAD1, and SMAD2 mRNA levels, indicating that LED may activate the TGF-1/TbetaR/SMAD pathway in HDFs. CONCLUSION: The anti-aging effects of 630 nm LED on human skin are likely mediated by up-regulation of proCOLs I/III and inhibition of Cav-1 expression levels in HDFs.
Subject(s)
Humans , Caveolin 1 , Collagen , Fibroblasts , Metabolism , Procollagen , RNA, Messenger , RNA, Small Interfering , Skin , Transforming Growth Factors , Up-RegulationABSTRACT
BACKGROUND: Psoriasis is a chronic inflammatory dermatosis and various topical or systemic drugs should be selected depending on severity. OBJECTIVE: The purpose of this study was to compare the efficacy and adverse reactions of methotrexate (MTX) and cyclosporine A (CsA) in the treatment of moderate-to-severe plaque psoriasis. METHODS: A retrospective analysis of the therapeutic efficacy of MTX and CsA was performed on 81 patients (MTX 30, CsA; 51) with moderate-to-severe plaque psoriasis. The MTX treatment was administered in weekly doses of 2.5 mg-7.5 mg up to 3 times every 12 hours. The CsA treatment was administered at daily doses of 1.5-5 mg/kg. Regular follow-up and laboratory tests were performed to evaluate the efficacy and adverse reactions of MTX and CsA. RESULTS: Reach to PASI 50 was observed in 93% of patients in the MTX-treated group with an average-time of 4.8 weeks, and in 70% of patients in the CsA-treated group with an average-time of 7.1 weeks. Among nine patients who were switched from MTX to CsA, 55.6% had improved with CsA treatment in 6.6 weeks. In contrast, among the 22 patients who were switched from CsA to MTX, 77.3% had improved with MTX treatment in 5.4 weeks. Adverse reactions to MTX and CsA were observed in 40% and 25% of the treated patients, respectively, most of which were mild and transient. Average relapse-time in patients improved by the drugs was 20.4 weeks in the MTX group and 15.4 weeks in the CsA group. CONCLUSION: Treatment with MTX is found to be a more effective systemic agent than CsA in both therapeutic response and length of relapse-free periods.
Subject(s)
Humans , Cyclosporine , Follow-Up Studies , Methotrexate , Psoriasis , Retrospective Studies , Skin DiseasesABSTRACT
BACKGROUND AND OBJECTIVES: The spinal accessory nerve dysfunction is a serious sequela following selective neck dissections despite preservation of the spinal accessory nerve. The incidence of this complication is known to be 20%-30% and the primary cause of nerve dysfunction is known as significant traction during resection of level IIb lymph node group. To try to answer whether level IIb could be preserved, we evaluated the incidence of metastasis to level IIb lymph node from various types of the head and neck cancer. MATERIALS AND METHODS: Sixty patients who underwent surgery for their head and neck cancer as an initial treatment from February 1999 to July 2000 were prospectively evaluated. Histopathological evaluations for 106 neck dissection specimens were performed in 60 patients with the head and neck cancer. RESULTS: A total of 7 patients (11.7%) had metastasis to level IIb lymph node. All but one case had ipsilateral level IIb metastasis. All seven cases had multiple lymph node metastases to other levels, including level I, IIa, III, IV, or V. Occult metastasis to level IIb was noted in one case of 25 clinically proven N0 head and neck cancer patients (4%). Primary sites and pathologies with level IIb metastasis were varied, including such sites as upper eyelid, parotid gland, or thyroid gland. CONCLUSIONS: This preliminary report reveals low incidence of level IIb metastasis in some of clinically proven N0 head and neck cancer. Contralateral level IIb lymph node could be preserved in clinically proven N0 heasd and neck cases. Multiple lymph node metastases increase the probability of metastasis to level IIb. Level IIb resection is necessary in clinically proven N+ cases with multiple nodes or multiple levels of metastases. Also, Level IIb metastasis may tend to increase in some of the primary sites, which drain into the jugular chain via level IIb lymph node.