Risk of skin cancers in mycosis fungoides patients receiving PUVA therapy: A real-life experience from a single tertiary center.

BACKGROUND: Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. Skin-directed therapies, including phototherapy, are the first-line treatment modalities. Psoralen plus ultraviolet A light photochemotherapy (PUVA) is quite effective in controlling the disease; however, long-term adverse effects, particularly carcinogenesis, are the cons of this treatment. OBJECTIVE: There are various studies on the negative impact of PUVA on skin cancer in patients with autoimmune skin diseases. The data on the long-term effects of phototherapy on MF patients are scarce. METHODS: All MF cases that received PUVA alone or combined with other treatments at a single tertiary center were analyzed. This study compared the development of non-melanoma skin cancers, melanoma, and solid organ tumors in MF patients with at least 5-year follow-up data with age- and sex-matched controls. RESULTS: A total of 104 patients were included in the study. Ninety-two malignancies were detected in 16 (15.4%) patients, and six developed multiple malignancies. Skin cancers consisted of 56 basal cell carcinomas, 16 Bowen's disease, four squamous cell carcinomas, three melanomas, two basosquamous cell carcinomas, one Kaposi sarcoma, and one keratoacanthoma were found in nine (8.7%) patients. Eight patients developed three solid cancers and six lymphomas. The risk of developing skin cancer was associated with the total number of PUVA sessions (<250 vs ≥250 sessions; hazard ratio (HR) 4.44, 95% confidence interval (CI) 1.033-19.068; p = .045). 9 (13.2%) of 68 patients who had follow-ups for at least 5 years developed skin cancer. Compared to an age- and sex-matched cohort, the prevalence of new skin cancer was considerably greater (p = .009). CONCLUSIONS: Patients with MF are predisposed to develop secondary malignancies, and continual exposure to PUVA may potentiate this risk. Annual digital dermoscopic follow-up in MF patients treated with UVA is advised for early diagnosis and treatment of secondary cutaneous malignancies.

Dermoscopic findings of Kaposi sarcoma and dermatopathological correlations.

BACKGROUND/OBJECTIVE: There are a limited number of studies regarding the dermoscopic features and dermatopathological correlations of Kaposi sarcoma. The primary objective of this study was to evaluate dermoscopic features of Kaposi sarcoma, and the secondary objective was to investigate their dermatopathological correlates. METHODS: Dermoscopic and clinical analysis of 222 lesions from 38 patients with histologically confirmed Kaposi darcoma were assessed by two investigators. A total of 83 biopsies were available from different clinical stages. Additionally, 3 mm punch biopsy was performed where newly defined dermoscopic findings were observed. Modified pattern analysis algorithm was used for the dermoscopic evaluation. RESULTS: The most common dermoscopic features of Kaposi sarcoma were white lines (55.9%) and white clods (37.8%) followed by surface scale (32.9%) and polychromatic colour change (22.1%). Four dot clods, white lines, white clods, collarette sign, serpentine vessels, dotted, curved and coiled vessels were the new dermoscopic findings of our study. Polychromatic colour change is correlated with the presence of hyaline globules probably with their birefringence properties, whereas we found no significant correlation between polychromatic colour change and honeycomb-like pattern of vascular spaces. CONCLUSIONS: White lines, white clods, four dot clods, collarette sign, serpentine vessels, dotted, curved and coiled vessels are the new dermoscopic features of Kaposi sarcoma, and polychromatic colour change is correlated with the presence of hyaline globules.

Polymerization and biosensor application of water soluble peptide-SNS type monomer conjugates.

A simple and efficient approach for the preparation of a biosensing platform was developed based on newly designed peptide-SNS type monomer conjugates. The approach involves the electrochemical polymerization of the peptide-SNS type monomer on the electrode surface. To synthesize the peptide bearing monomers, the SNS-type monomer having a carboxylic acid functional group was anchored to the C-terminal of the peptide by solid phase peptide synthesis via coupling reagents. Utilization of peptides to increase the solubility of the monomers was first investigated in this report. The obtained monomers, soluble in water, were fully characterized by spectral analyses and utilized as matrices for biomolecule attachment. Polymerization of monomers in water has the potential to provide an alternative process for the electrochemical preparation of the polymers in aqueous media, without using any organic solvent. Under the optimized conditions, the biosensor responded to the target analyte, glucose, in a strikingly selective and sensitive manner, and showed promising feasibility for the quantitative analysis of glucose in beverages.