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1.
Dermatol Ther ; 35(3): e15276, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1583589

ABSTRACT

In the context of the SARS-CoV-2 pandemic, it is important to ensure the quality of cancer treatment as well as patients and health professionals' safety. Individual-based treatment options should be considered in patients with advanced epithelial skin cancer, who are typically elderly and frail. Aim of this study was to assess feasibility and safety of Contact Skin Radiation Therapy (CSRT) to treat basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) during SARS-CoV-2 pandemic. Patients with advanced and difficult-to-treat BCC or SCC were discussed at skin multidisciplinary tumor board (S-MDTB) from February the 21st to May the 4th (phase 1 Italian Pandemic) and retrospectively analyzed. Patient's triage following internal recommendations was daily performed. CSRT was delivered in 8 fractions of 5 Gy each, twice a day. Beyond the clinical outcomes, treatment success indicators, such as the completion of CSRT without SARS-CoV-2 occurrence, were identified to evaluate the feasibility of CSRT during pandemic. A post-treatment psychological assessment regarding patient's safety perception was performed. Six male patients (median age 80 years; range 62-92) with histologically confirmed BCC or SCC were treated with CSRT. Complete clinical remission was achieved in 5/6 patients (83.4%). No high-grade acute toxicities occurred during treatment. No patients or healthcare personnel developed SARS-CoV-2 infection. All the treatment success indicators were achieved. CSRT represents a safe, and feasible treatment option even during the pandemic emergency period. Hypofractionation could be an option to reduce total number of fractions and, consequently, infective risk exposition.


Subject(s)
Brachytherapy , COVID-19 , Skin Neoplasms , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Skin Neoplasms/therapy
3.
Melanoma Res ; 31(4): 389-392, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1434530

ABSTRACT

The Novel Coronavirus disease (COVID-19) first emerged in Wuhan province, China, in late November 2019 and changed public healthcare perception. It has caused a significant decline in attendance to outpatient clinics. However, other diseases have not stopped, including malignant melanoma. Survey of the number of visits to plastic surgery outpatient clinic during the first lockdown in Israel concerning malignant melanoma was compared to the same months in the previous years. We assessed the number of visits to the oncology department during 2020 compared to the number of visits and treatment protocols for malignant melanoma. During the first lockdown, the attendance at the plastic surgery outpatient clinic and ambulatory surgery decreased significantly (P = 0.002), both in excisions of suspected malignant melanoma and malignant melanoma follow-ups (P = 0.019 and P = 0.035, respectively). The last third of 2020 (from September to December) had shown a significant rise in new protocols commenced (P < 0.001). This rise in the final third of the year was not noted in 2018 or 2019. These data clearly show the rise in advanced and metastatic malignant melanoma cases due to refraining from medical follow-ups and treatments during the COVID-19 pandemic. Diseases other than COVID-19 have not vanished, and continue to treat those diseases. Ignoring malignant melanoma treatment because of COVID-19 and vice-versa will not benefit our patients.


Subject(s)
Appointments and Schedules , COVID-19/prevention & control , Melanoma/epidemiology , Patient Acceptance of Health Care , Skin Neoplasms/epidemiology , COVID-19/epidemiology , COVID-19/transmission , Humans , Israel/epidemiology , Melanoma/diagnosis , Melanoma/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/therapy , Time Factors , Workload
4.
Clin Exp Dermatol ; 47(1): 114-116, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1301463

ABSTRACT

The impact of the COVID-19 pandemic upon care of malignant melanoma (MM) remains as yet poorly understood. We undertook a UK-wide national survey, in conjunction with a patient support group (Melanoma UK), to explore patient perceptions of the impact of the pandemic upon treatment and outpatient care of their MM. Our findings suggest that following the onset of COVID-19, a significant minority of treatments and appointments have been delayed, there has been a shift from face-to-face to virtual outpatient consultations and there may be a rise in psychological comorbidities in patients with MM. We would urge clinicians to consider mental health interventions as part of a holistic care package.


Subject(s)
Anxiety/etiology , COVID-19/prevention & control , Melanoma/therapy , Skin Neoplasms/therapy , Stress, Psychological/etiology , Adult , Aged , Aged, 80 and over , Ambulatory Care , Appointments and Schedules , Communicable Disease Control/methods , Cross-Sectional Studies , Female , Health Care Surveys , Health Services Accessibility , Humans , Male , Melanoma/psychology , Middle Aged , SARS-CoV-2 , Skin Neoplasms/psychology , Telemedicine , United Kingdom , Young Adult
5.
Clin Dermatol ; 39(1): 64-75, 2021.
Article in English | MEDLINE | ID: covidwho-1300692

ABSTRACT

Primary cutaneous lymphomas are defined as a heterogenic group of T- and B-cell non-Hodgkin lymphomas that present initially in the skin. Patients with primary cutaneous lymphomas are at a higher risk for developing complications in case of infection with the novel coronavirus severe acute respiratory syndrome coronavirus 2. The coronavirus disease 2019 (COVID-19) pandemic has affected the established diagnostic approach, staging, and therapeutic guidelines in patients with primary cutaneous lymphomas. In the light of the current global health crisis, management of primary cutaneous lymphomas needs to be adjusted. The key to achieving this is to balance the optimal control of the lymphoma, with a minimal increase of the personal risk for COVID-19 exposure and complications.


Subject(s)
COVID-19/epidemiology , Lymphoma, B-Cell/therapy , Lymphoma, T-Cell, Cutaneous/therapy , Skin Neoplasms/therapy , COVID-19/prevention & control , Humans , Lymphoma, B-Cell/classification , Lymphoma, B-Cell/diagnosis , Lymphoma, T-Cell, Cutaneous/classification , Lymphoma, T-Cell, Cutaneous/diagnosis , Risk Assessment , SARS-CoV-2 , Skin Neoplasms/classification , Skin Neoplasms/diagnosis
6.
Dermatol Clin ; 39(4): 627-637, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1252656

ABSTRACT

The COVID-19 pandemic has presented a unique set of challenges to cancer care centers around the world. Diagnostic and treatment delays associated with lockdown periods may be expected to increase the total number of avoidable skin cancer deaths. During this unprecedented time, dermatologists have been pressed to balance early surgical interventions for skin cancer with the risk of viral transmission. This article summarizes evidenced-based recommendations for the surgical management of cutaneous melanoma, keratinocyte cancer, and Merkel cell carcinoma during the COVID-19 pandemic. Additional long-term studies are required to determine the effect of COVID-19 on skin cancer outcomes.


Subject(s)
Clinical Decision-Making/methods , Delayed Diagnosis/trends , Skin Neoplasms/epidemiology , Skin Neoplasms/therapy , Time-to-Treatment/trends , Health Services Accessibility/trends , Humans , Patient Acceptance of Health Care/statistics & numerical data , Time Factors
13.
J Biol Regul Homeost Agents ; 34(6): 1977-1982, 2020.
Article in English | MEDLINE | ID: covidwho-1027415

ABSTRACT

COVID-19 pandemic emerged as a condition that changed our entire life and led us to develop new perspectives on diseases. Cancers are generally additional risk factors for COVID-19, and this has implications also for skin cancer patients. Those patients require special attention, due to situations such as an increased risk of infection as a result of visiting the hospital for treatment. It is imperative that the diagnosis and treatment of patients who have a cancer that progresses rapidly, such as malignant melanoma, high-risk squamous cell carcinoma and a high risk of metastasis, are delayed. Due to the relatively long-lasting nature of basal cell carcinoma and, as almost no metastasis would be expected, its treatment may be postponed, except for those that occur in areas such as the eyes and mouth. Diagnosis and treatment of skin cancers is a process that requires many procedures. Throughout this process, physicians should take appropriate precautions that are sufficient to protect both the patient and themselves in the best way without leading to any delay in the procedures.


Subject(s)
COVID-19 , Melanoma , Skin Neoplasms , Humans , Melanoma/diagnosis , Melanoma/epidemiology , Melanoma/therapy , Pandemics , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/therapy
14.
Clin Cancer Res ; 27(10): 2678-2697, 2021 05 15.
Article in English | MEDLINE | ID: covidwho-1015729

ABSTRACT

Five years ago, the Melanoma Research Foundation (MRF) conducted an assessment of the challenges and opportunities facing the melanoma research community and patients with melanoma. Since then, remarkable progress has been made on both the basic and clinical research fronts. However, the incidence, recurrence, and death rates for melanoma remain unacceptably high and significant challenges remain. Hence, the MRF Scientific Advisory Council and Breakthrough Consortium, a group that includes clinicians and scientists, reconvened to facilitate intensive discussions on thematic areas essential to melanoma researchers and patients alike, prevention, detection, diagnosis, metastatic dormancy and progression, response and resistance to targeted and immune-based therapy, and the clinical consequences of COVID-19 for patients with melanoma and providers. These extensive discussions helped to crystalize our understanding of the challenges and opportunities facing the broader melanoma community today. In this report, we discuss the progress made since the last MRF assessment, comment on what remains to be overcome, and offer recommendations for the best path forward.


Subject(s)
COVID-19/prevention & control , Medical Oncology/methods , Melanoma/therapy , Practice Guidelines as Topic , SARS-CoV-2/isolation & purification , Skin Neoplasms/therapy , Biomedical Research/methods , Biomedical Research/trends , COVID-19/epidemiology , COVID-19/virology , Humans , Medical Oncology/organization & administration , Medical Oncology/trends , Melanoma/diagnosis , SARS-CoV-2/physiology , Skin Neoplasms/diagnosis
16.
Dermatol Ther ; 34(1): e14463, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-894743

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic spreads quickly all over the world. There are no sufficient data in the literature about COVID-19 infection and cutaneous lymphomas. This review sheds the light on what is known so far about COVID-19 with a cutaneous lymphoma perspective. Cutaneous T-cell lymphoma (CTCL) diagnosis does not represent a predisposing factor to viral infections and most of CTCL patients have indolent disease. However, physicians should be cautious with patients with aggressive primary cutaneous lymphomas and advanced CTCL. Different treatment strategies for cutaneous lymphomas should be taken into consideration during the COVID-19 pandemic. Thus, it is highly needed to estimate the benefit-to-risk ratio on a case-by-case basis.


Subject(s)
COVID-19 , Lymphoma, T-Cell, Cutaneous , Skin Neoplasms , Humans , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/epidemiology , Lymphoma, T-Cell, Cutaneous/therapy , Pandemics , SARS-CoV-2 , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/therapy
17.
Immunotherapy ; 12(15): 1133-1138, 2020 10.
Article in English | MEDLINE | ID: covidwho-750791

ABSTRACT

Background: Little is known about the 2019 novel coronavirus disease (COVID-19) course and outcomes in patients receiving immunotherapy. Here we describe a metastatic Merkel cell carcinoma patient with a severe acute respiratory syndrome coronavirus 2 infection while receiving pembrolizumab. Case presentation: A 66-year-old man, with a metastatic Merkel cell carcinoma receiving pembrolizumab, presented with fever. Chest computed tomography (CT) showed pulmonary ground-glass opacities, suggesting viral or immuno-related etiology. On day 7, the patient was hospitalized due to dyspnea and worsening of the radiological findings. Real time polymerase chain reaction (RT-PCR) testing confirmed COVID-19. The patient developed acute respiratory distress syndrome and acute kidney injury. Hydroxychloroquine was administered for 5 days, but discontinued after supraventricular extrasystoles. Clinical improvement allowed the patient's discharge after 81 days of hospitalization. Conclusion: A careful evaluation of oncologic patients receiving immunotherapy during the COVID-19 pandemic is of utmost importance.


Subject(s)
Carcinoma, Merkel Cell/therapy , Coronavirus Infections/diagnosis , Immunotherapy , Pneumonia, Viral/diagnosis , Skin Neoplasms/therapy , Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Betacoronavirus , COVID-19 , Carcinoma, Merkel Cell/complications , Carcinoma, Merkel Cell/pathology , Coronavirus Infections/complications , Coronavirus Infections/pathology , Coronavirus Infections/therapy , Humans , Immunotherapy/adverse effects , Lung/diagnostic imaging , Lung/pathology , Male , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/pathology , Pneumonia, Viral/therapy , Programmed Cell Death 1 Receptor/antagonists & inhibitors , SARS-CoV-2 , Skin Neoplasms/complications , Skin Neoplasms/pathology , Tomography, X-Ray Computed , Treatment Outcome
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