ABSTRACT
Population-based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009-2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of pathology reports that mentioned the essential pathological features required for T staging was 93%, ranging across geographic areas from 81% to 98% (p < 0.001). The percentage of low-risk patients who underwent no imaging studies, as proposed by guidelines, or only chest imaging ranged among areas from 0.6% to 84% (p < 0.001). Of the patients with clinically node-negative melanoma >1 mm thick and no distant metastases, 68% underwent SLNB, varying by area from 61% to 78% (p = 0.017). This study revealed wide geographic variation in different aspects of melanoma care. The use of a standardised structured pathology report could strengthen the completeness of reporting. Improvement strategies should also include efforts to reduce overuse of imaging in low-risk patients and to increase the adherence to guidelines recommendations on the use of SLNB.
Subject(s)
Healthcare Disparities , Melanoma/surgery , Skin Neoplasms/surgery , Adult , Aged , Diagnostic Imaging/standards , Diagnostic Imaging/statistics & numerical data , Female , Guideline Adherence , Humans , Lymph Node Excision/standards , Lymph Node Excision/statistics & numerical data , Lymphatic Metastasis , Male , Melanoma/pathology , Middle Aged , Practice Guidelines as Topic/standards , Retrospective Studies , Sentinel Lymph Node Biopsy/standards , Sentinel Lymph Node Biopsy/statistics & numerical data , Skin Neoplasms/pathology , Spain , Melanoma, Cutaneous MalignantABSTRACT
No disponible
Subject(s)
Humans , Female , Adolescent , Biopsy , Granuloma/complications , Granuloma/diagnosis , Granuloma/drug therapy , Leprosy, Multibacillary/diagnosis , Leprosy, Multibacillary/drug therapy , Dapsone/therapeutic use , Rifampin/therapeutic use , Leprostatic Agents/therapeutic use , Erythema Infectiosum/complications , Mycobacterium leprae , Mycobacterium leprae/isolation & purification , Dermis , Dermis/pathology , Leprosy, Multibacillary/microbiology , Leprosy, Multibacillary/physiopathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/pathology , HIV Infections/diagnosis , HIV Infections/drug therapy , Antiretroviral Therapy, Highly Active , Dermatitis, Exfoliative/diagnosis , Alopecia/diagnosisSubject(s)
Anti-HIV Agents/therapeutic use , Lymphoma, AIDS-Related/drug therapy , Lymphoma, T-Cell, Cutaneous/drug therapy , Alopecia/drug therapy , Alopecia/etiology , Antiretroviral Therapy, Highly Active , Atazanavir Sulfate/therapeutic use , CD8-Positive T-Lymphocytes/pathology , Clone Cells , Dideoxynucleosides/therapeutic use , Drug Therapy, Combination , Humans , Immunophenotyping , Lamivudine/therapeutic use , Lymphoma, AIDS-Related/etiology , Lymphoma, T-Cell, Cutaneous/etiology , Male , Middle Aged , Remission Induction , Ritonavir/therapeutic useABSTRACT
Epidermal nevi are benign proliferations of the epidermis for which different treatments have been used with disappointing results due to their recurrences and anesthetic scars. Topical therapies have generally been ineffective and surgical treatment provides more definitive results, but with high risk of scarring. In recent years, multiple laser modalities have been described for the treatment of these lesions. In the literature, there are no reported cases of treatment of these lesions with Neodymium-doped Yttrium aluminum garnet (Nd:YAG) laser. We present the case of a 3-year-old patient with a hemicorporal epidermal nevus treated with Nd:YAG laser at an early stage with good results.
Subject(s)
Lasers, Solid-State/therapeutic use , Nevus/surgery , Skin Neoplasms/surgery , Child, Preschool , Female , HumansABSTRACT
No disponible
