ABSTRACT
The management of melanoma is a typical example of a pluridisciplinary approach, in order to provide the patient with a rapid and adequate treatment plan after the initial diagnosis. Both in the domains of dermatology, pathology and oncology, enormous progress has been made. Recent advances permit a rapid access to diagnostic techniques using teledermoscopy, an improved diagnostic accuracy using dermoscopy, pre-interventional high-frequency ultrasound and optical coherence tomography, a determination of risk factors using immunohistochemistry and genetic analyses on the pathology samples. Furthermore, the development of immunotherapies, in particular the anti-PD1 antibodies, and the directed therapies, therapies permitting an increased number of patients to experience an increased survival with an acceptable tolerance profile in the event of metastatic lesions. This article describes the patient's care pathway, from the initial diagnosis, staging, to an eventual treatment and follow-up.
Le traitement du mélanome est un exemple type de collaboration multidisciplinaire, afin de pouvoir garantir au patient une prise en charge rapide dès le moment de la détection de la lésion. Tant au niveau dermatologique, anatomopathologique et oncologique, d'énormes progrès ont eu lieu ces dernières années. Ils permettent un accès au diagnostic de plus en rapide par la télédermoscopie, une précision diagnostique accrue par la dermoscopie, l'ultrason à haute fréquence et la tomographie par cohérence optique, une détermination des facteurs de risque immunohistochimiques et génétiques sur les analyses anatomo-pathologiques ainsi que le recours à des immunothérapies, notamment les anti-PD1, et à des traitements ciblés. Ces nouveaux traitements permettent souvent une plus longue survie du patient, avec un profil de tolérance acceptable en cas de lésions métastatiques. Cet article reprend le trajet de soins du patient, du diagnostic initial et du staging au traitement éventuel avec son suivi.
Subject(s)
Melanoma , Skin Neoplasms , Dermoscopy , Humans , Immunohistochemistry , Immunotherapy , Melanoma/diagnosis , Melanoma/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/therapyABSTRACT
Drug eruptions are frequently encountered. Their putative diagnosis is based on a set of imputability arguments. The histopathological aspect is often evocative of the nature of the dermatosis. It varies according to the type of drug reaction. Some drug eruptions follow a benign course, but others are life-threatening.
Subject(s)
Drug Eruptions , Medical History Taking , HumansABSTRACT
Mammary Paget's disease is an intraepithelial carcinoma present on the nipple and its areola. The tumor typically develops in middle aged women. It is frequently associated or contiguous to an underlying galactophoric adenocarcinoma. The histopathologic and immunopathologic aspects are typical and linked to the presence of Paget's cells. Early diagnosis is required searching for a possible underlying carcinoma. The surgical treatment is directed by the characteristics of the deep mammary carcinoma.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Paget's Disease, Mammary/diagnosis , Paget's Disease, Mammary/therapy , Female , HumansABSTRACT
Ichthyoses are hereditary and sometimes acquired diseases of keratinisation. They are heterogeneous according to their clinical and histopathological presentations, as well as to the nature of their molecular and genetic alterations. We present the most frequent types of hereditary ichthyoses.
Subject(s)
Ichthyosis/classification , Humans , Ichthyosis/complications , Ichthyosis/genetics , IncidenceABSTRACT
Immunosuppressive therapy associated with organ transplant leads to an increased risk to develop skin cancers. In such circumstances, squamous cell carcinomas and basal cell carcinomas represent the most frequent tumors. Other neoplasms include malignant melanoma, Merkel cell carcinoma and Kaposi disease. Histopathology is primordial in the establishment of the diagnosis. In addition, bioengineering devices and skin imaging methods are useful in establishing the risk of cancers and for detecting incipient tumoral lesions.
