RESUMO
(1) Introduction: The association between melanoma (MM) and the occurrence of second primary neoplasms (SPNs) has been extensively studied, with reported incidence rates ranging from 1.5% to 20%. This study aims to evaluate the occurrence of SPNs in patients with a history of primary MM and to describe the factors that make the risk higher in our population. (2) Material and Methods: We conducted a prospective cohort study and calculated the incidence rates and relative risks (RR) for the development of different SPNs in 529 MM survivors from 1 January 2005 to 1 August 2021. Survival and mortality rates were obtained, and the Cox proportional hazards model was used to determine the demographic and MM-related factors that influence the overall risk. (3) Results: Among the 529 patients included, 89 were diagnosed with SPNs (29 prior to MM diagnosis, 11 synchronous, and 49 after MM), resulting in 62 skin tumors and 37 solid organ tumors. The estimated probability of developing SPNs after MM diagnosis was 4.1% at 1 year, 11% at 5 years, and 19% at 10 years. Older age, primary MM location on the face or neck, and histologic subtype of lentigo maligna mm were significantly associated with a higher risk of SPNs. (4) Conclusions: In our population, the risk of developing SPNs was higher in patients with primary MM located on the face and neck and with the histological subtype of lentigo maligna-MM. Age also independently influences the risk. Understanding these hazard factors can aid in the development of MM guidelines with specific follow-up recommendations for individuals with the highest risk.
Assuntos
Acitretina/administração & dosagem , Ceratoacantoma/patologia , Lúpus Eritematoso Cutâneo/tratamento farmacológico , Lúpus Eritematoso Cutâneo/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Biópsia por Agulha , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Ceratoacantoma/diagnóstico , Ceratoacantoma/tratamento farmacológico , Dermatoses da Perna/diagnóstico , Lúpus Eritematoso Cutâneo/diagnóstico , Prognóstico , Medição de Risco , Neoplasias Cutâneas/diagnóstico , Resultado do TratamentoRESUMO
Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. The emergence of new molecular targets has enabled the development of drugs such as alemtuzumab, an anti-CD52 monoclonal antibody, which has shown promising results in the treatment of this entity. We report the case of a 70-year-old male with refractory Sézary syndrome in whom treatment with alemtuzumab achieved an 80% skin lesion clearance with complete haematologic and radiologic response. The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Síndrome de Sézary/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Alemtuzumab , Antígenos de Diferenciação de Linfócitos T/metabolismo , Contagem de Células Sanguíneas , Humanos , Masculino , Síndrome de Sézary/sangue , Neoplasias Cutâneas/sangue , Resultado do TratamentoRESUMO
Abstract: Sézary syndrome is a primary cutaneous T-cell lymphoma characterized by the triad of erythroderma, lymphadenopathy and circulating atypical cells. The emergence of new molecular targets has enabled the development of drugs such as alemtuzumab, an anti-CD52 monoclonal antibody, which has shown promising results in the treatment of this entity. We report the case of a 70-year-old male with refractory Sézary syndrome in whom treatment with alemtuzumab achieved an 80% skin lesion clearance with complete haematologic and radiologic response. The treatment was discontinued after 4 months due to adverse effects, with the patient showing a sustained response without disease progression after 13 months of follow-up.
Assuntos
Humanos , Masculino , Idoso , Neoplasias Cutâneas/tratamento farmacológico , Síndrome de Sézary/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias Cutâneas/sangue , Contagem de Células Sanguíneas , Antígenos de Diferenciação de Linfócitos T/metabolismo , Síndrome de Sézary/sangue , Resultado do Tratamento , AlemtuzumabAssuntos
Antineoplásicos/administração & dosagem , Sarcoma de Kaposi/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Timolol/administração & dosagem , Administração Cutânea , Idoso de 80 Anos ou mais , Géis , Humanos , Masculino , Indução de Remissão , Sarcoma de Kaposi/patologia , Neoplasias Cutâneas/patologia , Resultado do Tratamento , Ultrassonografia Doppler em CoresRESUMO
Eccrine hidrocystoma is a benign tumor derived from eccrine sudoriparous glands. Most eccrine hidrocystomas are solitary and asymptomatic lesions. Multiple hidrocystomas are unusual and have been associated with Graves' disease, Parkinson's disease, and idiopathic craniofacial hyperhidrosis. This report describes the successful treatment of multiple center facial eccrine hidrocystomas associated with craniofacial hyperhidrosis with 0.5% glycopyrrolate aqueous solution applied locally for 1 week. The present authors obtained a very significant improvement without leaving any trace of clinical examination. Multiple eccrine hidrocystomas are a rare condition and, to date, no effective treatment has been reported. Topical glycopyrrolate is a very good first-line treatment option.