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1.
Hautarzt ; 73(3): 212-215, 2022 Mar.
Article in German | MEDLINE | ID: covidwho-1838290

ABSTRACT

BACKGROUND: The advantages and disadvantages of the nationwide skin cancer screening which was introduced in 2008 are regularly discussed. OBJECTIVES: Do missed skin cancer screenings change the tumor depths? METHODS: Evaluation and analysis of office data from the second quarters of 2019, 2020 and 2021 were compared using the one-way analysis of variance (ANOVA) with Welch's F test. RESULTS: There was a significant increase in the tumor thickness in squamous cell carcinoma and basal cell carcinoma, while there was only a tendency due to the small amount of data available for malignant melanoma. CONCLUSIONS: The results of the analysis emphasize the importance of the skin cancer screening as a method of early detection and reduction of mutilating operations and expensive immunotherapies by the prompt detection of malignant tumors.


Subject(s)
COVID-19 , Carcinoma, Basal Cell , Dermatology , Skin Neoplasms , COVID-19/epidemiology , Carcinoma, Basal Cell/diagnosis , Dermatology/methods , Early Detection of Cancer , Humans , Pandemics , SARS-CoV-2 , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology
2.
J Drugs Dermatol ; 21(5): 545-547, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1836610

ABSTRACT

BACKGROUND: At the onset of the COVID-19 pandemic, many Mohs micrographic surgeries (MMS) were delayed over concerns for propagating further infectious spread and scarcity of medical resources. OBJECTIVE: To assess the impact of the pandemic on MMS and the treatment of skin cancer Methods and Materials: An electronic survey was sent to fellowship trained Mohs surgeons to assess patient outcomes, practice viability, and physician sentiment related to performing MMS during the COVID-19 pandemic. RESULTS: Of the 303 respondents, 82% reported declines in case volume for at least 3 months, and average case difficulty increased for 69% of surgeons following these delays. Instances of local tumor spread following delays were seen by 69% of respondents, and 20% noted cases of regional or systemic metastasis. Only 8 cases of staff testing positive (and 7 cases of patients) were reported, and 97% of respondents felt comfortable performing MMS during the pandemic. Private practice surgeons more often viewed practice restriction recommendations negatively initially (42% vs 26% in academics, P=0.03) and in hindsight (63% vs 36% in academics, P<0.001). CONCLUSIONS: Mohs surgeon’s ability to minimize spread of COVID-19 during routine patient care, alongside potential risks of delaying treatment of skin cancers, should be considered in future recommendations for patient care. J Drugs Dermatol. 2022;21(5):545-547. doi:10.36849/JDD.6189.


Subject(s)
COVID-19 , Skin Neoplasms , Surgeons , COVID-19/epidemiology , Humans , Mohs Surgery/methods , Pandemics/prevention & control , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Surveys and Questionnaires
3.
Pathol Res Pract ; 233: 153805, 2022 May.
Article in English | MEDLINE | ID: covidwho-1829375

ABSTRACT

BACKGROUND: The diagnosis of nodal nevi (NN) is challenging as they mimic melanoma metastases (MM), with a detection rate mostly ranging between 1% and 11% in sentinel lymph node biopsy (SLNB). Herein, we assessed the incidence of NN and the association with the clinical-pathological features of primary melanoma, adopting the updated European Organisation for Research and Treatment of Cancer (EORTC) protocol for SLNB. METHODS: All cases of paired melanoma and SLNB were retrospectively evaluated (April 2019-May 2020). Appropriate statistical tests were adopted, with significant variables included in the logistic regression model. RESULTS: 81 patients and a total of 186 lymph nodes (LNs) were included. Eleven patients had only NN and 4 had both NN and MM (18.5%); 29 LNs (15.6%) showed at least one NN and 12 (6.5%) showed more than one NN (a total amount of 43 NN was detected). All NN and none MM stained for p16. NN were associated with age < 60 years (p: 0.042), no ulceration (p: 0.025) and nevus-associated melanoma (NAM) (p: 0.018), with this latter being the only predictor at the logistic regression model (p: 0.022). CONCLUSIONS: The updated EORTC protocol shows a high number of NN and highlights a strong association with NAM.


Subject(s)
Melanoma , Nevus , Skin Neoplasms , Humans , Lymph Nodes/pathology , Melanoma/pathology , Middle Aged , Nevus/diagnosis , Retrospective Studies , Sentinel Lymph Node Biopsy , Skin Neoplasms/pathology
4.
Medicina (Kaunas) ; 58(4)2022 Apr 03.
Article in English | MEDLINE | ID: covidwho-1810018

ABSTRACT

Dabrafenib and trametinib are two available molecules that have been approved for the treatment of metastatic melanoma with BRAF-V600E or V600K mutations. Their combined therapy has led to long-lasting survival benefits and substantially improved outcomes. Until now, only a few cases of severe hypersensitivity reactions to dabrafenib and vemurafenib have been reported, and even fewer desensitization protocols to these molecules have been documented. We report the case of a 71-year-old female patient with metastatic melanoma harboring a BRAF-V600E mutation undergoing targeted therapy with dabrafenib and trametinib. Two weeks after the initiation of the combined treatment, she developed a hypersensitivity reaction. The cause-effect relationship between dabrafenib and the hypersensitivity reaction was demonstrated twice, when symptoms recurred upon dabrafenib reintroduction. We started a rapid 3-day dabrafenib desensitization protocol, which was well tolerated. When the patient discontinued the drug administration, we decided on a longer protocol that included more steps and more days in order to prevent the occurrence of other hypersensitivity reactions. Our patient tolerated both rapid and slow-going schedules, the first one reaching the final dose within 3 days and the second one reaching the total daily dose within 14 days. Depending on the patient's needs, the severity of the hypersensitivity reaction and the hospital's availability, the doctor may choose either the rapid or slow-going desensitization protocol.


Subject(s)
Melanoma , Neoplasms, Second Primary , Skin Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Imidazoles , Melanoma/drug therapy , Melanoma/genetics , Mutation , Neoplasm Recurrence, Local/drug therapy , Neoplasms, Second Primary/etiology , Oximes , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/pathology
5.
Oxid Med Cell Longev ; 2022: 9366494, 2022.
Article in English | MEDLINE | ID: covidwho-1807713

ABSTRACT

Trehalose, a natural disaccharide, is synthesized by many organisms when cells are exposed to stressful stimuli. On the basis of its ability to modulate autophagy, trehalose has been considered an innovative drug for ameliorating many diseases, but its molecular mechanism is not well described. Previous findings demonstrated that trehalose plays a photoprotective role against ultraviolet (UV) B-induced damage through autophagy induction in keratinocytes. In this study, coimmunoprecipitation, label-free quantitative proteomic and parallel reaction monitoring, and western blot analysis demonstrated that trehalose promotes the interaction between tissue inhibitor of metalloproteinase (TIMP) 3 and Beclin1. Western blot and immunofluorescence staining analysis suggested that trehalose increases ATG9A localization in lysosomes and decreases its localization in the endoplasmic reticulum. Furthermore, in the presence or absence of UVB radiation, we evaluated the influence of TIMP3 and ATG9A small interfering RNA (siRNA) on the effect of trehalose on autophagy, cell death, migration, or interleukin-8 expression in keratinocytes, including HaCaT, A431, and human epidermal keratinocytes. The results revealed that in HaCaT cells, TIMP3 and ATG9A siRNA resulted in attenuation of trehalose-induced autophagy and inhibited cell death. In A431 cells, TIMP3 and ATG9A siRNA led to attenuation of trehalose-induced autophagy and cell death and inhibited migration. In human epidermal keratinocytes, trehalose-induced autophagy and inhibition of the interleukin-8 expression were blocked by ATG9A but not TIMP3 siRNA. In addition, the results of quantitative real-time PCR and immunohistochemistry analysis demonstrated the abnormal expression of TIMP3 and ATG9A in actinic keratosis and cutaneous squamous cell carcinoma skin tissues. These findings suggest the protective effects of trehalose in normal keratinocytes and its inhibitory effects on cancerous keratinocytes, possibly mediated by activation of autophagy and regulation of TIMP3 and ATG9A, providing the mechanistic basis for the potential use of trehalose in the prevention or treatment of UVB-induced skin diseases.


Subject(s)
Carcinoma, Squamous Cell , Skin Neoplasms , Autophagy , Autophagy-Related Proteins/metabolism , Carcinoma, Squamous Cell/pathology , Humans , Interleukin-8/metabolism , Keratinocytes/metabolism , Membrane Proteins/metabolism , Proteomics , RNA, Small Interfering/metabolism , Skin Neoplasms/metabolism , Tissue Inhibitor of Metalloproteinase-3/genetics , Tissue Inhibitor of Metalloproteinase-3/metabolism , Tissue Inhibitor of Metalloproteinase-3/pharmacology , Trehalose/pharmacology , Ultraviolet Rays/adverse effects , Vesicular Transport Proteins/metabolism
7.
Dermatol Online J ; 27(12)2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1789588

ABSTRACT

Primary cutaneous diffuse large B-cell lymphoma, leg type is a rare entity accounting for 4% of all primary cutaneous lymphomas whose clinical presentation encompasses a range of possibilities. COVID-19 has caused a delay in diagnosis of malignant neoplasms and consequently, this has resulted in poorer prognoses. A 62-year-old woman presented with two smooth-surfaced, mobile, well-circumscribed, oval, skin-colored nodules approximately one-cm in diameter with nonerythematous borders on the lower third of the left leg. Two months later, eleven nodules measuring between one and 1.5cm with erythematous halo, slight scaling, central erosion, and crusting had appeared. Histological study showed moderate pericapillary lymphocytic infiltration in the papillary and reticular dermis and prominent diffuse proliferation of medium to large cells in the subcutis. These exhibited irregular vesicular nuclei, a conspicuous solitary nucleolus of two to three small nucleoli, and three mitoses per high power field. Adipocytes were consistently encircled by neoplastic lymphocytes. Primary cutaneous diffuse large B-cell lymphoma, leg type is a high-grade lymphoma that can manifest as a diagnostic challenge and requires adequate immunohistochemistry and in situ hybridization studies for proper diagnosis, treatment, and prognosis.


Subject(s)
COVID-19 , Lymphoma, Large B-Cell, Diffuse , Panniculitis , Skin Neoplasms , COVID-19/diagnosis , Female , Humans , Leg/pathology , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, T-Cell , Middle Aged , Panniculitis/diagnosis , Panniculitis/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology
9.
Int J Environ Res Public Health ; 19(5)2022 02 25.
Article in English | MEDLINE | ID: covidwho-1715339

ABSTRACT

BACKGROUND: After the outbreak of the corona virus disease-19 (COVID-19) pandemic, teledermatology was implemented in the Hungarian public healthcare system for the first time. Our objective was to assess aggregated diagnostic agreements and to determine the effectiveness of an asynchronous teledermatology system for skin cancer screening. METHODS: This retrospective single-center study included cases submitted for teledermatology consultation during the first wave of the COVID-19 pandemic. Follow-up of the patients was performed to collect the results of any subsequent personal examination. RESULTS: 749 patients with 779 lesions were involved. 15 malignant melanomas (9.9%), 78 basal cell carcinomas (51.3%), 21 squamous cell carcinomas (13.8%), 7 other malignancies (4.6%) and 31 actinic keratoses (20.4%) were confirmed. 87 malignancies were diagnosed in the high-urgency group (42.2%), 49 malignancies in the moderate-urgency group (21.6%) and 16 malignancies in the low-urgency group (4.6%) (p < 0.0001). Agreement of malignancies was substantial for primary (86.3%; κ = 0.647) and aggregated diagnoses (85.3%; κ = 0.644). Agreement of total lesions was also substantial for primary (81.2%; κ = 0.769) and aggregated diagnoses (87.9%; κ = 0.754). CONCLUSIONS: Our findings showed that asynchronous teledermatology using a mobile phone application served as an accurate skin cancer screening system during the first wave of the COVID-19 pandemic.


Subject(s)
COVID-19 , Dermatology , Skin Neoplasms , Telemedicine , COVID-19/diagnosis , COVID-19/epidemiology , Early Detection of Cancer , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Telemedicine/methods
10.
Clin Imaging ; 85: 78-82, 2022 May.
Article in English | MEDLINE | ID: covidwho-1708841

ABSTRACT

Metastatic melanoma of the breast is rare, and demonstrates nonspecific imaging findings which may overlap with both benign and malignant pathology.1-3 Immunohistochemical stains are important to confirm the diagnosis, particularly combining S100, a sensitive marker for melanoma, with more specific tumor markers such as Melan-A and HMB-45, and lack of cytokeratin staining.4-7 We present a case of a 64-year-old female who presented for diagnostic imaging of a palpable abnormality in her right breast, with medical history notable for previously excised cutaneous melanoma, recent COVID-19 vaccination, and significant family history of breast cancer. Diagnostic mammogram of the right breast demonstrated a circumscribed mass in the lower inner quadrant corresponding to the area of palpable concern, as well as an additional non-palpable circumscribed mass in the lower inner quadrant. Targeted right breast ultrasound demonstrated corresponding circumscribed cystic versus solid masses as well as a morphologically abnormal right axillary lymph node. Pathologic results after tissue sampling of the two right breast masses and right axillary lymph node all yielded metastatic melanoma.


Subject(s)
Breast Neoplasms , COVID-19 , Melanoma , Skin Neoplasms , Axilla/pathology , Breast Neoplasms/pathology , COVID-19 Vaccines , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Melanoma/diagnostic imaging , Melanoma/pathology , Middle Aged , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology
11.
Clin Dermatol ; 40(1): 93-99, 2022.
Article in English | MEDLINE | ID: covidwho-1708471

ABSTRACT

During the Italian first wave of the COVID-19 pandemic, social restrictions and bad news spread daily by mass media inevitably had a huge influence on the mental state of the population. To assess how much the COVID-19 outbreak impacted the psychologic state of patients referring to our Skin Cancer Unit from March 9 to May 31, 2020, we administered to them a self-report questionnaire, the Impact of Event Scale-Revised (IES-R). To evaluate the trend of the IES-R score over time, we set a temporal cutoff of March 27 (the day with the highest number of deaths for COVID-19 in Italy during the first wave). Three hundred fifty-five patients completed the questionnaire, reporting an average IES-R score of 25.5 (±16.4); 32.4% of participants reached a total IES-R score >32. Patients who visited after March 27, 2020 reported a higher psychologic impact, since the IES-R score significantly increased from 23.6 (±15.6) to 28.3 (±17.2). A group reported higher scores (of participants reaching an IES-R score >32, 57.4% were women and 33.9% were men). We gathered that, at an early stage of events of this magnitude, it could be useful to submit the IES-R questionnaire in high-risk and oncologic patients: we could potentially identify individuals at risk of developing post-traumatic stress disorders, who might be tempted to postpone necessary medical consultations. This could be also the basis for increasing targeted psychologic support in selected patients.


Subject(s)
COVID-19 , Skin Neoplasms , Female , Humans , Male , Pandemics , Referral and Consultation , SARS-CoV-2 , Self Report , Skin Neoplasms/epidemiology
12.
Skeletal Radiol ; 51(3): 681-685, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1669771

ABSTRACT

A nuchal-type fibroma is a rare, benign fibrous tumour that typically occurs in the posterior neck along the midline, but can occur in extra-nuchal locations, most commonly in the back, shoulder and face. We present a biopsy-proven case that arose as a result of heavy gym-related activities. In particular, a heavy barbell was rested on his vertebral prominence at the level of C7/T1 during leg squatting. Repetitive trauma as a cause for extra-nuchal-type fibromas has been sparsely reported, but we suggest that sustained high pressure is an additional required feature. Although this lesion was in the posterior neck, it was contained entirely within the subcutaneous tissues without involvement of the nuchal ligament. Hence, it was considered an extra-nuchal fibroma. A description of key ultrasound and MRI imaging characteristics are provided to assist in making the diagnosis, along with a review of the current literature and a discussion of differential diagnoses.


Subject(s)
Fibroma , Head and Neck Neoplasms , Skin Neoplasms , Soft Tissue Neoplasms , Fibroma/diagnostic imaging , Humans , Neck
15.
World J Surg Oncol ; 19(1): 350, 2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1637517

ABSTRACT

BACKGROUND: The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period. METHODS: A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019. RESULTS: Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap. CONCLUSION: These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided. TRIAL REGISTRATION: The study adhered to the STROBE statement for case-control studies.


Subject(s)
COVID-19 , Carcinoma, Basal Cell , Skin Neoplasms , Carcinoma, Basal Cell/epidemiology , Carcinoma, Basal Cell/surgery , Case-Control Studies , Communicable Disease Control , Humans , Neoplasm Recurrence, Local , Pandemics , SARS-CoV-2 , Skin Neoplasms/epidemiology , Skin Neoplasms/surgery , Time-to-Treatment
18.
Cancer Imaging ; 22(1): 3, 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1603334

ABSTRACT

18F-FDG PET/CT plays an increasingly pivotal role in the staging and post-treatment monitoring of high-risk melanoma patients, augmented by the introduction of therapies, including tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICIs), that have novel modes of action that challenge conventional response assessment. Simultaneously, technological advances have been regularly released, including advanced reconstruction algorithms, digital PET and motion correction, which have allowed the PET community to detect ever-smaller cancer lesions, improving diagnostic performance in the context of indications previously viewed as limitations, such as detection of in-transit disease and confirmation of the nature of small pulmonary metastases apparent on CT.This review will provide advice regarding melanoma-related PET protocols and will focus on variants encountered during the imaging of melanoma patients. Emphasis will be made on pitfalls related to non-malignant diseases and treatment-related findings that may confound accurate interpretation unless recognized. The latter include signs of immune activation and immune-related adverse events (irAEs). Technology-related pitfalls are also discussed, since while new PET technologies improve detection of small lesions, these may also induce false-positive cases and require a learning curve to be observed. In these times of the COVID 19 pandemic, cases illustrating lessons learned from COVID 19 or vaccination-related pitfalls will also be described.


Subject(s)
COVID-19 , Melanoma , Skin Neoplasms , Fluorodeoxyglucose F18 , Humans , Melanoma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiopharmaceuticals , SARS-CoV-2 , Skin Neoplasms/diagnostic imaging
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