ABSTRACT
Locoregional cutaneous metastases of melanoma (LCMM) represent a therapeutic challenge. Many treatment options are available with varying results. The combination of cryotherapy and imiquimod, two treatments with a possible synergistic effect, has not yet been described for treating this disease. In this paper, we aimed to show the response of LCMM to cryotherapy combined with topical imiquimod 5%. A retrospective review of 20 patients diagnosed with LCMM and treated with cryotherapy combined with topical imiquimod 5% between November 2000 and May 2014 at three institutions was performed. The locoregional cutaneous response was evaluated. After a mean of five sessions, 13 patients (65%) responded to treatment, eight (40%) of these completely and five (25%) partially. Systemic disease progressed in 16 (80%) patients. Cryotherapy followed by topical imiquimod 5% is simple to apply, has minimal adverse effects and provides response rates similar to other, more complex treatment options.
Subject(s)
Aminoquinolines/therapeutic use , Antineoplastic Agents/therapeutic use , Cryosurgery , Melanoma/therapy , Skin Neoplasms/therapy , Administration, Cutaneous , Aged , Aged, 80 and over , Aminoquinolines/administration & dosage , Antineoplastic Agents/administration & dosage , Combined Modality Therapy , Female , Humans , Imiquimod , Male , Melanoma/drug therapy , Melanoma/pathology , Melanoma/surgery , Middle Aged , Neoplasm Metastasis , Retrospective Studies , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Skin Neoplasms/surgerySubject(s)
Carcinoma, Squamous Cell/pathology , Nevus, Sebaceous of Jadassohn/pathology , Skin Neoplasms/pathology , Adult , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/surgery , Humans , Male , Nevus, Sebaceous of Jadassohn/complications , Nevus, Sebaceous of Jadassohn/surgery , Skin Neoplasms/etiology , Skin Neoplasms/surgeryABSTRACT
Standard antineoplastic treatment for metastatic melanoma is ineffective in the large majority of patients. Therefore, alternative approaches need to be investigated. STI571 is a new antineoplastic compound, which selectively inhibits the tyrosine kinase activity of ABL, c-Kit and platelet-derived growth factor receptor (PDGFR). Melanoma may express all of these proteins. The aim of this study was to investigate whether STI571 inhibits the in-vitro growth of melanoma cells. Nineteen cell lines were obtained from four primary and 15 metastatic melanomas of cutaneous origin. The percentages of positive cells for the putative targets of STI571 were as follows: ABL, 41-100%; c-Kit, 8-97%; PDGFR-alpha, 41-98%; PDGFR-beta, 51-99%. 3-(4,5-Dimethylthiazol-yl)-2,5-diphenyltetrazolium (MTT) and viability assays showed that STI571 clearly inhibits the proliferation of eight of the 19 (42.1%) cell lines. No relationship could be established between the expression of c-Kit, ABL, PDGFR-alpha or PDGFR-beta and the response of cell lines to STI571. Our study shows, for the first time, an antiproliferative effect of STI571 on human melanoma cell lines of cutaneous origin, raising the possibility of the future clinical use of STI571. The identification of the target of STI571 in human cutaneous melanoma cells would allow the selection of patients who could benefit from this treatment.
Subject(s)
Antineoplastic Agents/pharmacology , Cell Proliferation/drug effects , Melanoma/metabolism , Piperazines/pharmacology , Pyrimidines/pharmacology , Benzamides , Blotting, Western , Cell Line, Tumor , DNA Mutational Analysis , Flow Cytometry , Humans , Imatinib Mesylate , Immunohistochemistry , Oncogene Proteins v-abl/metabolism , Polymerase Chain Reaction , Proto-Oncogene Proteins c-kit/metabolism , Receptor, Platelet-Derived Growth Factor alpha/metabolismABSTRACT
Paraneoplastic pemphigus is a life-threatening autoimmune bullous disease associated with neoplasia, generally of lymphoid origin. Immunosuppressive therapy is often disappointing and there are only a few reports of patients surviving more than 2 years. These cases were generally associated with benign neoplasms. We report here the case of a patient with paraneoplastic pemphigus associated with non-Hodgkin B-cell lymphoma who had a surprisingly good response to systemic corticosteroids and remains free of lesions more than 3 years later despite progression of her neoplasm.
Subject(s)
Lymphoma, B-Cell/diagnosis , Paraneoplastic Syndromes/diagnosis , Pemphigus/diagnosis , Aged , Diagnosis, Differential , Drug Administration Schedule , Female , Glucocorticoids/administration & dosage , Humans , Lymphoma, B-Cell/complications , Lymphoma, B-Cell/drug therapy , Oral Ulcer/pathology , Paraneoplastic Syndromes/complications , Paraneoplastic Syndromes/drug therapy , Paraneoplastic Syndromes/pathology , Pemphigus/complications , Pemphigus/drug therapy , Pemphigus/pathology , Prednisone/administration & dosageABSTRACT
Se presenta el caso de un síndrome de Sweet con lesiones atípicas, caracterizadas por placas eritematosas, vesículas y lesiones ampollosas. Las lesiones cutáneas en pacientes con malignidad subyacente son más frecuentemente atípicas y con características vesiculosas, ampollosas o incluso ulcerativas, además de las típicas placas y nódulos. Sin embargo, el caso presentado no se asocia a malignidad a pesar de que el índice de sospecha de estos procesos en particular los hematológicos, debe ser alto
We present a case of Sweet's syndrome with atypical lesions, characterized by erythematous plaques, vesicles and bullous lesions. Skin lesions in patients with an underlying malignancy are more frequently atypical and with vesicular, bullous or even ulcerative characteristics, in addition to the typical plaques and nodules. However, the case presented is not associated with malignancy, despite the fact that these processes, particularly hematologic ones, should be suspected
Subject(s)
Female , Adult , Humans , Sweet Syndrome/diagnosis , Sweet Syndrome/etiology , Papilledema/etiology , Papilledema/microbiology , Prednisone , Erythema/physiopathology , Sweet Syndrome/pathology , Papilledema/pathology , BiopsyABSTRACT
We present a case of Sweet's syndrome with atypical lesions, characterized by erythematous plaques, vesicles and bullous lesions. Skin lesions in patients with an underlying malignancy are more frequently atypical and with vesicular, bullous or even ulcerative characteristics, in addition to the typical plaques and nodules. However, the case presented is not associated with malignancy, despite the fact that these processes, particularly hematologic ones, should be suspected.
