The gut microbiome and melanoma: A review.

Disturbances in the microbial ecosystem have been implemented in chronic inflammation, immune evasion and carcinogenesis, with certain microbes associated with the development of specific cancers. In recent times, the gut microbiome has been recognised as a potential novel player in the pathogenesis and treatment of malignant melanoma. It has been shown that the composition of gut microbiota in early-stage melanoma changes from in situ to invasive and then to metastatic disease. The gut bacterial and fungal profile has also been found to be significantly different in melanoma patients compared to controls. Multiple studies of immune checkpoint inhibitor (ICI) therapies have shown that the commensal microbiota may have an impact on anti-tumor immunity and therefore ICI response in cancer patients. When it comes to chemotherapy and radiotherapy treatments, studies demonstrate that gut microbiota are invaluable in the repair of radiation and chemotherapy-induced damage and therapeutic manipulation of gut microbiota can be an effective strategy to deal with side effects. Studies demonstrate the oncogenic and tumor-suppressive properties of the gut microbiome, which may play a role in the pathogenesis of melanoma. Despite this, investigations into specific interactions are still in its infancy, but starting to gain momentum as more significant and clinically relevant effects are emerging.

The Impact of the COVID-19 Pandemic on Diagnosis of Skin Cancer Cases in North Cancer Alliance and Scotland.

The coronavirus disease 2019 (COVID-19) pandemic has dramatically impacted healthcare provision in the UK and skin cancer services have had to adapt to ensure continuity of safe care. As we return to "normality" we reflect on lessons learned and the impact of the pandemic on skin cancer services. We looked at data on Public Health Scotland Dashboard, which compiles data from 14 local health boards across Scotland, comparing melanoma and non-melanoma skin cancer diagnoses during the years 2020 and 2019 (pre-COVID-19 pandemic). We looked at skin cancer cases within the North Cancer Alliance (NCA) and all of Scotland. Within the NCA, 518 cases of melanoma were diagnosed in 2019, compared to 429 in 2020. Within Scotland, 1950 cases of melanoma were diagnosed in 2019, compared to 1605 in 2020. In 2019, 5103 non-melanoma skin cancer cases were diagnosed in NCA, compared to 4071 in 2020. In Scotland, 21,626 non-melanoma skin cancer cases were diagnosed in 2019, compared to 16,193 in 2020. The COVID-19 pandemic has had a significant impact on skin cancer care within the NCA and the whole of Scotland. A significantly lower number of melanoma and non-melanoma skin cancer cases have been diagnosed within the NCA and in Scotland in 2020 compared to 2019. The trend is similar between NCA and other areas of Scotland. We must raise awareness of melanoma and non-melanoma skin cancer to improve timely presentation of patients during a global health crisis and a multidisciplinary approach is needed to address this problem.

Bilateral Anteverted Conchal Bowls: Surgical Correction of a Rare Anomaly.

Anteverted conchal bowl is a rare auricular anomaly in which a convexity of the conchal bowl is seen. The condition may pose both aesthetic and functional implications for affected patients. Most cases are benign and require minimal or no intervention. In severe cases, the external acoustic meatus can be occluded, giving rise to a host of complications. Correction of anteverted conchal bowls is achieved by either conservative or surgical modalities, with the latter commonly undertaken in the post-neonatal stage. Reconstructive surgery can be performed using relatively simple techniques and yields desirable results. Here, we present a case of a patient surgically treated in our Plastic Surgery Unit in the North East of Scotland, along with a description of the operative methods utilised.