1
|
Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T224-T230. [PMID: 38185206 DOI: 10.1016/j.ad.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
Collapse
Affiliation(s)
- P Díaz-Calvillo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| |
Collapse
|
2
|
Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:224-230. [PMID: 37858857 DOI: 10.1016/j.ad.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
Collapse
Affiliation(s)
- P Díaz-Calvillo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
| | - A Martínez-López
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
| |
Collapse
|
3
|
Benedetti S, Frosolini A, Catarzi L, Marsiglio A, Gennaro P, Gabriele G. Impact of the COVID-19 Pandemic on the Diagnosis and Management of Non-Melanoma Skin Cancer in the Head and Neck Region: A Retrospective Cohort Study. Healthcare (Basel) 2024; 12:501. [PMID: 38391876 PMCID: PMC10888473 DOI: 10.3390/healthcare12040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital "Le Scotte" in Siena, Italy, the research includes 111 patients treated from 2018 to 2021. The study aims to understand how pandemic-related healthcare changes affected NMSC treatment, focusing on differences in diagnosis and management before and during the pandemic. Methods involved retrospective analysis of patient demographics, clinical characteristics, lesion details, and treatment modalities, using Jamovi software (version 1.6) for statistical analysis. Results revealed the scalp as the most common NMSC site, with Squamous Cell Carcinoma (SCC) being the predominant histotype. A significant rise in Basal Cell Carcinoma (BCC) cases and a reduction in surgery duration were noted during the pandemic. The shift to local anesthesia was more pronounced, reflecting the necessity to adapt to healthcare limitations. Despite the disruptions caused by the pandemic, there was no significant drop in NMSC cases, which is attributed to the noticeable nature of head and neck lesions. In conclusion, this study highlights that the COVID-19 pandemic significantly influenced surgical practices in NMSC management, emphasizing the need for effective healthcare strategies that balance quality patient care with public health safety measures.
Collapse
Affiliation(s)
- Simone Benedetti
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Andrea Frosolini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lisa Catarzi
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Agnese Marsiglio
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Guido Gabriele
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| |
Collapse
|
4
|
Lai J, Bao A, McCaffrey T, Salman R, Gelderen EV, Rizk E, Thompson KG, Epstein JA, Bibee K, Scott J. Predictor Variables Associated With Dermatology Referral Completion and the Impact on Surgical Treatment: A Retrospective Cohort Study. Dermatol Surg 2024; 50:28-34. [PMID: 37962110 DOI: 10.1097/dss.0000000000003989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Delays or failure to complete a dermatologic referral may affect health care outcomes. Factors associated with these delays remain understudied. OBJECTIVE This study investigated socioeconomic and demographic factors associated with delays or failure to complete dermatology referrals and potential impact on surgical outcomes. METHODS A retrospective chart review was performed for 400 patients internally referred to an academic dermatology center from 19 primary-care clinics from July 2018 to June 2019. Only patients referred after an in-person primary-care visit in which the provider documented a specific concerning lesion were included. Multivariate analyses were performed to explore variables associated with delays or failure to complete dermatology referrals. RESULTS Patients were more likely to complete their referral if they had a personal history (adjusted odds ratio [aOR] = 7.843, 95% CI 1.383-14.304) or family history (aOR = 11.307, 95% CI 2.344-20.27) of skin cancer. Patients were more likely to delay referral completion past 30 days if they were ages 18 to 34 (aOR = 6.665, 95% CI 1.285-12.044) and less likely to delay referral past 30 days if they had a previous history of skin cancer (aOR = 0.531, 95% CI 0.181-0.882). LIMITATIONS Single institution, retrospective study, limited surgical patients. CONCLUSION Understanding factors associated with delays in dermatology referral completion can help identify at-risk patient populations.
Collapse
Affiliation(s)
- Jonathan Lai
- Johns Hopkins Department of Medicine, Baltimore, Maryland
| | - Aaron Bao
- Johns Hopkins Department of Medicine, Baltimore, Maryland
| | - Tara McCaffrey
- Johns Hopkins Department of Medicine, Baltimore, Maryland
| | - Rumsha Salman
- Johns Hopkins Department of Medicine, Baltimore, Maryland
| | | | - Emanuelle Rizk
- Johns Hopkins Department of Medicine, Baltimore, Maryland
| | | | | | - Kristin Bibee
- Johns Hopkins Department of Medicine, Baltimore, Maryland
- Johns Hopkins Department of Dermatology, Baltimore, Maryland
| | - Jeffrey Scott
- Clinical Skin Center of Northern Virginia, Fairfax, Virginia
| |
Collapse
|
5
|
Meraya AM, Kashan Syed N, Syed MH, Yasmeen A, Alfaifi MH, Alfaifi AJ, Hurubi KY, Khobrani MA, Alhossan A. Impact of COVID-19 related movement restrictions on the follow-up care visits of adults with chronic conditions: A Saudi arabian survey study. Saudi Pharm J 2023; 31:101846. [PMID: 38033751 PMCID: PMC10682654 DOI: 10.1016/j.jsps.2023.101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Aims Lockdown measures implemented during the initial phase of the pandemic resulted in the delay and disruption of healthcare utilization for individuals with chronic conditions. We aimed to evaluate the impact of COVID-19 movement restrictions on the follow-up care visits of individuals with chronic illnesses. We also assessed the possible reasons patients missed their follow-ups and the potential barriers impeding follow-up during the pandemic. Methods A total of 397 adults with pre-existing medical conditions participated in an online cross-sectional survey from October to December 2022. The study sample comprised 57 % females and 43 % males, with a mean age of 43 years. A 36-item online self-report survey was used for data collection.Results: Fifty-five percent of participants reported missing their follow-up during COVID-19 pandemic, and 14 % made emergency department visits due to their missed follow-up appointments. In addition, 24 % experienced complications due to their missed appointments. The mean score on the fear of COVID-19 scale was 17.8 ± 6.5 (SD). For the majority of participants (60 %), pandemic-related restrictions were the predominant barrier to their follow-up visits. Additionally, we found that as individuals' COVID-19 fear scores increased, the likelihood of missing a follow-up care visit also increased (AOR: 1.067; p-value = 0.001). However, participants who did not perceive COVID-19 pandemic-related restrictions as a barrier were less likely to miss their follow-up visits (AOR: 0.581; p-value = 0.031). Furthermore, those who understood the significance of follow-up care were less likely to miss any of their follow-up visits (AOR: 0.224; p-value < 0.001) than those who had limited understanding of its importance. Conclusion The results showed that pandemic-related movement restrictions negatively affected attendance at follow-up visits for people with pre-existing health conditions. Initiatives should therefore be undertaken during global public health emergencies to provide medical and psychological support to vulnerable and high-risk groups.
Collapse
Affiliation(s)
- Abdulkarim M. Meraya
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Nabeel Kashan Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Mamoon H. Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Ayesha Yasmeen
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Mohammed H. Alfaifi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Aseel J. Alfaifi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Khalid Y. Hurubi
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan P.O Box 114-45124, Saudi Arabia
| | - Moteb A. Khobrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Saudi Arabia
| | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Saudi Arabia
| |
Collapse
|
6
|
Rehman U, Sarwar MS, Abualnaja SY, Amy Johanna Freer F, Brennan PA. Are foundation doctors equipped with the skills necessary for the assessment and referral of a patient presenting with a suspected facial skin malignancy? Clin Exp Dermatol 2023; 48:1328-1332. [PMID: 37466281 DOI: 10.1093/ced/llad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/01/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The incidence of skin cancer (SC) has increased in recent years with it being the most common cancer within the UK. The management of SC requires a multidisciplinary approach involving dermatologists and surgical specialities. OBJECTIVES To assess the confidence of current foundation trainees (FTs) in the assessment of facial SC and referral for surgical management and reconstruction. METHODS An online survey was distributed via social media and completed by 142 FTs across 13 deaneries. Two higher training respondents were excluded. RESULTS We found that 50% (71/142) of trainees had only examined one or two patients with SC and 25.3% (36/142) had no experience in SC assessment. Most FTs were not confident in performing a full skin examination (90.2%, 119/132), formulating differential diagnoses for a pigmented facial lesion (45.3%, 64/141) or investigating a facial SC (87.9%, 124/141). Facial defects requiring reconstruction (87.3%, 124/142) were more likely to be referred to plastic surgery. CONCLUSIONS FTs were not confident in performing full skin examinations nor formulating diagnoses for pigmented lesions. This is concerning given that the majority of FTs will enter general practice and therefore exposure to SC will be common. This may in turn place greater burden on secondary care services such as dermatology and allied surgical specialities resulting in a greater caseload in an already stretched service in the UK. The integration of the British Association of Dermatology undergraduate syllabus into the medical school curriculum should improve confidence in the detection and management of SC at both undergraduate and postgraduate levels.
Collapse
Affiliation(s)
- Umar Rehman
- School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | | | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| |
Collapse
|
7
|
Ganko AG, Copertino N. Late diagnosis of a giant, pedunculated, cutaneous melanoma: a rare case study in an Australian tertiary centre. J Surg Case Rep 2023; 2023:rjad594. [PMID: 37942344 PMCID: PMC10629865 DOI: 10.1093/jscr/rjad594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/08/2023] [Indexed: 11/10/2023] Open
Abstract
Giant melanomas are uncommon tumours that still occur in Australia despite extensive public health messaging on the importance of early detection of skin cancers. We present the case of a 49-year-old female with a giant melanoma of her left arm measuring 101 × 71 × 22 mm, which had been growing for over 1 year and was metastatic on presentation. In this interesting case, we identify reasons for delayed presentation and highlight the importance of multi-disciplinary care in the management of such large tumours, with reference to other cases in the literature.
Collapse
Affiliation(s)
- Annabelle G Ganko
- Department of General Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia
| | - Nicolas Copertino
- Department of General Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia
| |
Collapse
|
8
|
Aichholzer M, Schiweck C, Uckermark C, Hamzehloiya T, Reif-Leonhard C, Golbach R, Reif A, Edwin Thanarajah S. Impact of COVID-19 on the treatment of depressive patients in Germany-a gap in care for the mentally ill? Front Psychiatry 2023; 14:1198632. [PMID: 37840810 PMCID: PMC10569605 DOI: 10.3389/fpsyt.2023.1198632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Background The COVID-19 pandemic led to a higher incidence of depression and a worsening of psychiatric conditions, while pre-existing constraints of the healthcare system and safety regulations limited psychiatric care. Aims We investigated the impact of the pandemic on the clinical care of patients with a single episode (SE-MDD) or major depressive disorder (MDD) in Germany. Methods Nationwide inpatient data were extracted from the German Institute for Hospital Remuneration System for 2020 and 2021 (depression data) and the Robert Koch Institute (COVID-19 incidence). Changes in inpatients were tested with linear regression models. Local cases of depression in our department compared to 2019 were explored with one-way ANOVA and Dunnett's test. Results Across Germany, the inpatient numbers with both SE-MDD and MDD declined by more than 50% during three out of four COVID-19 waves. Higher COVID-19 incidence correlated with decreased inpatient numbers. In our department, fewer MDD inpatients were treated in 2020 (adj. p < 0.001) and 2021 (adj. p < 0.001) compared to 2019, while the number of SE-MDD inpatients remained stable. During this period fewer elective and more emergency inpatients were admitted. In parallel, MDD outpatient admissions increased in 2021 compared to 2019 (adj. p = 0.002) and 2020 (adj. p = 0.003). Conclusion During high COVID-19 infection rates, MDD patients received less inpatient care, which might cause poor outcomes in the near future. These data highlight the necessity for improved infrastructure in the in- and outpatient domains to facilitate accessibility to adequate care.
Collapse
Affiliation(s)
- Mareike Aichholzer
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Carmen Schiweck
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Carmen Uckermark
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Tirage Hamzehloiya
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Christine Reif-Leonhard
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Rejane Golbach
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Sharmili Edwin Thanarajah
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| |
Collapse
|
9
|
Jović M, Marinković M, Suđecki B, Jurišić M, Bukumirić Z, Jovanović M, Stojičić M, Jeremić J. COVID-19 and Cutaneous Squamous Cell Carcinoma-Impact of the Pandemic on Unequal Access to Healthcare. Healthcare (Basel) 2023; 11:1994. [PMID: 37510435 PMCID: PMC10378852 DOI: 10.3390/healthcare11141994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Most skin tumors are not fatal, but if not treated in a timely manner, they can lead to significant morbidity. Due to the COVID-19 pandemic and in order to create more capacities for the treatment of COVID-19-positive patients as well as to contain the spread of the virus, the healthcare system was reorganized worldwide, leading to decreased access to preventive screening programs. The aim of this study was to evaluate the impact of the pandemic on healthcare accessibility to cutaneous squamous cell carcinoma patients in Serbia. This retrospective study was conducted at the Clinic for Burns, Plastic, and Reconstructive Surgery, University Clinical Center of Serbia in Belgrade. Patient demographics and pathohistological findings of tumors of patients living in and outside the capital in the period before, during, and after the pandemic were compared. The two groups did not show any differences regarding the largest tumor diameter prior and during the pandemic; however, this difference became extremely noticeable after the pandemic (15 mm vs. 27 mm; p < 0.001). While cSCCs are commonly slow-growing tumors, the impact of the COVID-19 pandemic is not negligible. This study found a population at a significant risk of cSCC metastasis, with additional evidence likely to emerge in the upcoming years.
Collapse
Affiliation(s)
- Marko Jović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milana Marinković
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Branko Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milana Jurišić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Zoran Bukumirić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute for Medical Statistics and Informatics, 11000 Belgrade, Serbia
| | - Milan Jovanović
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milan Stojičić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena Jeremić
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| |
Collapse
|
10
|
Ruggiero A, Martora F, Fabbrocini G, Villani A, Marasca C, Megna M, Fornaro L, Comune R, Potestio L. The Role of Teledermatology During the COVID-19 Pandemic: A Narrative Review. Clin Cosmet Investig Dermatol 2022; 15:2785-2793. [PMID: 36569420 PMCID: PMC9783831 DOI: 10.2147/ccid.s377029] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Teledermatology represented one of the most important and useful tools during the COVID-19 pandemic era. Indeed, due to the severe restriction, and to reduce the spread of the infection, different measures were applied among different countries and hospitals to ensure a continuity of care for patients. In this scenario, teledermatology played a central role, especially in the management of patients suffering from chronic inflammatory skin diseases. The aim of this narrative review is to describe the role of teledermatology during the COVID-19 pandemic to analyze main strengths and limitations of this tool, as well as to provide future perspectives in clinical applications.
Collapse
Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy,Correspondence: Angelo Ruggiero, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rosita Comune
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| |
Collapse
|
11
|
Jeremić J, Suđecki B, Radenović K, Mihaljević J, Radosavljević I, Jovanović M, Milić N, Pavlović V, Brašanac D, Jović M. Impact of the COVID-19 Pandemic on Melanoma Diagnosis: Increased Breslow Thickness in Primary Melanomas-A Single Center Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16806. [PMID: 36554683 PMCID: PMC9779520 DOI: 10.3390/ijerph192416806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Early melanoma diagnosis plays a key role in ensuring best prognosis with good survival rates. The ongoing global COVID-19 pandemic has greatly impacted global and national healthcare systems, thus making it a real challenge. The aim of this study was to evaluate the impact of the pandemic on diagnostic delay in melanoma patients in Serbia. In this retrospective study, we included patients treated at the university hospital in Serbia's capitol over a period of five years and three months. We compared the prepandemic (01/JAN/17-14/MAR/20) and pandemic periods (15/MAR/20-31/MAR/22) by evaluating patient demographic data, melanoma subtype, Breslow thickness, Clark level, ulceration status, mitotic index rate and pT staging. We observed a significant reduction in the number of diagnosed patients (86.3 vs. 13.7%; p = 0.036), with melanomas having an increased median Breslow thickness (1.80 vs. 3.00; p = 0.010), a higher percentage of Clark IV-V level lesions (44.0% vs. 63.0%; p = 0.009), an increase in median mitotic index rate (2 vs. 5; p < 0.001) and a trend of increase in lesions thicker than 2 mm (37.8% vs. 53.7%; p = 0.026). We believe that this study can be a useful scenario guide for future similar events, highlighting the importance of preventive measures and timely diagnosis for the best patient outcomes.
Collapse
Affiliation(s)
- Jelena Jeremić
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Branko Suđecki
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Kristina Radenović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Jovan Mihaljević
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivan Radosavljević
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milan Jovanović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nataša Milić
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vedrana Pavlović
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dimitrije Brašanac
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Jović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| |
Collapse
|
12
|
Lee C, Witkowski A, Żychowska M, Ludzik J. The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic. Indian J Dermatol Venereol Leprol 2022; 89:347-352. [PMID: 36688890 DOI: 10.25259/ijdvl_118_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/01/2022] [Indexed: 12/13/2022]
Abstract
The unprecedented onset of the COVID-19 crisis poses a significant challenge to all fields of medicine, including dermatology. Since the start of the coronavirus outbreak, a stark decline in new skin cancer diagnoses has been reported by countries worldwide. One of the greatest challenges during the pandemic has been the reduced access to face-to-face dermatologic evaluation and non-urgent procedures, such as biopsies or surgical excisions. Teledermatology is a well-integrated alternative when face-to-face dermatological assistance is not available. Teledermoscopy, an extension of teledermatology, comprises consulting dermoscopic images to improve the remote assessment of pigmented and non-pigmented lesions when direct visualisation of lesions is difficult. One of teledermoscopy's greatest strengths may be its utility as a triage and monitoring tool, which is critical in the early detection of skin cancer, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. Mobile teledermoscopy may act as a communication tool between medical practitioners and patients. By using their smartphone (mobile phone) patients can monitor a suspicious skin lesion identified by their medical practitioner, or alternatively self-detect concerning lesions and forward valuable dermoscopic images for remote medical evaluation. Several mobile applications that allow users to photograph suspicious lesions with their smartphones and have them evaluated using artificial intelligence technology have recently emerged. With the growing popularity of mobile apps and consumer-involved healthcare, this will likely be a key component of skin cancer screening in the years to come. However, most of these applications apply artificial intelligence technology to assess clinical images rather than dermoscopic images, which may lead to lower diagnostic accuracy. Incorporating the direct-to-consumer mobile dermoscopy model in combination with mole-scanning artificial intelligence as a mobile app may be the future of skin cancer detection.
Collapse
Affiliation(s)
- Claudia Lee
- Department of Medicine, University of California Riverside, Riverside, California, United States
| | - Alexander Witkowski
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Joanna Ludzik
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
| |
Collapse
|
13
|
Ungureanu L, Apostu AP, Vesa ȘC, Cășeriu AE, Frățilă S, Iancu G, Bejinariu N, Munteanu M, Șenilă SC, Vasilovici A. Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania-Data from Two University Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15129. [PMID: 36429847 PMCID: PMC9690697 DOI: 10.3390/ijerph192215129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic affected the healthcare system in our country and led non-COVID patients to postpone medical visits that were not urgent. The purpose of this study was to investigate the impact of the first year of the COVID-19 pandemic on the trends in melanoma diagnosis and to compare the pathological characteristics of melanoma patients before and during the pandemic. The number of primary cutaneous melanomas diagnosed each month between 1 March 2019 and 29 February 2020 (pre-COVID-19) and between 1 March 2020 and 28 February 2021 (COVID-19) in the North-Western Region of Romania (Cluj and Bihor counties) was determined. The pathological characteristics of melanomas diagnosed in the two intervals were compared. The number of melanoma diagnoses substantially decreased during the pandemic, with 66 (-19.3%) fewer cutaneous melanomas being diagnosed in the first year of the pandemic when compared with the previous year. The tumor thickness and mitotic rate were significantly higher in cases found during the COVID-19 pandemic. Our study suggests that COVID-19 has delayed diagnosis in patients with melanoma, leading to the detection of thicker melanomas that may increase morbidity and mortality. Further studies are needed to determine the consequences of this delay on outcomes.
Collapse
Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Alexandra Elena Cășeriu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania
- Clinical Emergency County Hospital, 410039 Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, 550245 Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, 400350 Cluj-Napoca, Romania
| | - Maximilian Munteanu
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| |
Collapse
|
14
|
Kleemann J, Meissner M, Özistanbullu D, Balaban Ü, Old O, Kippenberger S, Kloka J, Kaufmann R, Zacharowski K, Friedrichson B. Impact of the Covid-19 pandemic on melanoma and non-melanoma skin cancer inpatient treatment in Germany - a nationwide analysis. J Eur Acad Dermatol Venereol 2022; 36:1766-1773. [PMID: 35570468 PMCID: PMC9347564 DOI: 10.1111/jdv.18217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND SARS-CoV-2 has massively changed the care situation in hospitals worldwide. Although tumour care should not be affected, initial reports from European countries were suggestive for a decrease in skin cancer during the first pandemic wave and only limited data are available thereafter. OBJECTIVES The aim of this study was to investigate skin cancer cases and surgeries in a nationwide inpatient dataset in Germany. METHODS Comparative analyses were performed in a prepandemic (18 March 2019 until 17 March 2020) and a pandemic cohort (18 March 2020 until 17 March 2021). Cases were identified and analysed using the WHO international classification of diseases codes (ICDs) and process key codes (OPSs). RESULTS Comparing the first year of the pandemic with the same period 1 year before, a persistent decrease of 14% in skin cancer cases (n = 19 063) was observed. The largest decrease of 24% was seen in non-invasive in situ tumours (n = 1665), followed by non-melanoma skin cancer (NMSC) with a decrease of 16% (n = 15 310) and malignant melanoma (MM) with a reduction of 7% (n = 2088). Subgroup analysis showed significant differences in the distribution of sex, age, hospital carrier type and hospital volume. There was a decrease of 17% in surgical procedures (n = 22 548), which was more pronounced in minor surgical procedures with a decrease of 24.6% compared to extended skin surgery including micrographic surgery with a decrease of 15.9%. CONCLUSIONS Hospital admissions and surgical procedures decreased persistently since the beginning of the pandemic in Germany for skin cancer patients. The higher decrease in NMSC cases compared to MM might reflect a prioritization effect. Further evidence from tumour registries is needed to investigate the consequences of the therapy delay and identify the upcoming challenges in skin cancer care.
Collapse
Affiliation(s)
- J. Kleemann
- Department of Dermatology, Venereology and AllergologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - M. Meissner
- Department of Dermatology, Venereology and AllergologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - D. Özistanbullu
- Department of Dermatology, Venereology and AllergologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - Ü. Balaban
- Department of Biostatistics and Mathematical ModellingGoethe‐University FrankfurtFrankfurtGermany
| | - O. Old
- Department of Anaesthesiology, Intensive Care Medicine and Pain TherapyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - S. Kippenberger
- Department of Dermatology, Venereology and AllergologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - J. Kloka
- Department of Anaesthesiology, Intensive Care Medicine and Pain TherapyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - R. Kaufmann
- Department of Dermatology, Venereology and AllergologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - K. Zacharowski
- Department of Anaesthesiology, Intensive Care Medicine and Pain TherapyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| | - B. Friedrichson
- Department of Anaesthesiology, Intensive Care Medicine and Pain TherapyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
| |
Collapse
|
15
|
Advanced-Stage Melanoma at Presentation Following the Peak of the Pandemic: A COVID-19 Cancer Canary in a Coal Mine. World J Surg 2022; 46:1820-1825. [PMID: 35691970 PMCID: PMC9188812 DOI: 10.1007/s00268-022-06623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 11/06/2022]
Abstract
Background For melanoma patients, timely identification and tumor thickness are directly correlated with outcomes. COVID-19 impacted both patients’ ability and desire to see physicians. We sought to identify whether the pandemic correlated with changes in melanoma thickness at presentation and subsequent treatment timeline. Methods Retrospective chart review was performed on patients who underwent surgery for melanoma in an academic center surgical oncology practice from May 2019 to September 2021. Patients were split into two cohorts: “pre-pandemic” from May 2019 to May 2020 and “pandemic,” after May 2020, representing when these patients received their initial diagnostic biopsy. Demographic and melanoma-specific variables were recorded and analyzed. Results A total of 112 patients were identified: 51 patients from the “pre-pandemic” and 61 from the “pandemic” time period. The pandemic cohort more frequently presented with lesions greater than 1 mm thickness compared to pre-pandemic (68.8% v 49%, p = 0.033) and were found to have significantly more advanced T stage (p = 0.02) and overall stage disease (p = 0.022). Additionally, trends show that for pandemic patients more time passed from patient-reported lesion appearance/change to diagnostic biopsy (5.7 ± 2.0 v 7.1 ± 1.5 months, p = 0.581), but less time from biopsy to operation (42.9 ± 2.4 v 52.9 ± 5.0 days, p = 0.06). Conclusions “Pandemic” patients presented with thicker melanoma lesions and more advanced-stage disease. These results may portend a dangerous trend toward later stage at presentation, for melanoma and other cancers with rapid growth patterns, that will emerge as the prolonged effects of the pandemic continue to impact patients’ presentation for medical care.
Collapse
|
16
|
Rok J, Rzepka Z, Kowalska J, Banach K, Beberok A, Wrześniok D. The Anticancer Potential of Doxycycline and Minocycline-A Comparative Study on Amelanotic Melanoma Cell Lines. Int J Mol Sci 2022; 23:ijms23020831. [PMID: 35055021 PMCID: PMC8775630 DOI: 10.3390/ijms23020831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022] Open
Abstract
Malignant melanoma is still a serious medical problem. Relatively high mortality, a still-growing number of newly diagnosed cases, and insufficiently effective methods of therapy necessitate melanoma research. Tetracyclines are compounds with pleiotropic pharmacological properties. Previously published studies on melanotic melanoma cells ascertained that minocycline and doxycycline exerted an anti-melanoma effect. The purpose of the study was to assess the anti-melanoma potential and mechanisms of action of minocycline and doxycycline using A375 and C32 human amelanotic melanoma cell lines. The obtained results indicate that the tested drugs inhibited proliferation, decreased cell viability, and induced apoptosis in amelanotic melanoma cells. The treatment caused changes in the cell cycle profile and decreased the intracellular level of reduced thiols and mitochondrial membrane potential. The exposure of A375 and C32 cells to minocycline and doxycycline triggered the release of cytochrome c and activated initiator and effector caspases. The anti-melanoma effect of analyzed drugs appeared to be related to the up-regulation of ERK1/2 and MITF. Moreover, it was noticed that minocycline and doxycycline increased the level of LC3A/B, an autophagy marker, in A375 cells. In summary, the study showed the pleiotropic anti-cancer action of minocycline and doxycycline against amelanotic melanoma cells. Considering all results, it could be concluded that doxycycline was a more potent drug than minocycline.
Collapse
Affiliation(s)
- Jakub Rok
- Correspondence: ; Tel.: +48-32-364-15-47
| | | | | | | | | | | |
Collapse
|
17
|
Hussain A, Livesey A, Murray CS. Response to "Bare necessities? The utility of full skin examination in the COVID-19 era". Clin Exp Dermatol 2021; 47:972-973. [PMID: 34939213 DOI: 10.1111/ced.15074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Alizeh Hussain
- Faculty of Medicine, University of Southampton, Southampton
| | - Amy Livesey
- Department of Dermatology, Dermatology Department, Royal South Hants Hospital, Southampton
| | - Caroline S Murray
- Department of Dermatology, Dermatology Department, Royal South Hants Hospital, Southampton
| |
Collapse
|
18
|
The Impact of the COVID-19 Pandemic on Oncology Care and Clinical Trials. Cancers (Basel) 2021; 13:cancers13235924. [PMID: 34885038 PMCID: PMC8656780 DOI: 10.3390/cancers13235924] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/08/2023] Open
Abstract
Simple Summary The coronavirus pandemic has had a considerable impact on all parts of society. Unsurprisingly, healthcare has been particularly affected, including cancer care and trials of new drugs. This article will summarize the impact the pandemic has had on cancer healthcare taking into consideration how the pandemic affected potential cancer patients and stopped them seeking medical advice for new symptoms. The pandemic also affected the ability of people to access healthcare services and undergo the tests necessary to diagnose cancer. This article will also discuss the impact of the pandemic on existing treatments and the trials of new drugs. In light of the unprecedented speed of development of new treatments and vaccines for the virus itself, it will also review whether some of these adaptations could be used to accelerate the development of novel cancer therapies. Abstract The coronavirus disease 2019 (COVID-19) pandemic has caused considerable global disruption to clinical practice. This article will review the impact that the pandemic has had on oncology clinical trials. It will assess the effect of the COVID-19 situation on the initial presentation and investigation of patients with suspected cancer. It will also review the impact of the pandemic on the subsequent management of cancer patients, and how clinical trial approval, recruitment, and conduct were affected during the pandemic. An intriguing aspect of the pandemic is that clinical trials investigating treatments for COVID-19 and vaccinations against the causative virus, SARS-CoV-2, have been approved and conducted at an unprecedented speed. In light of this, this review will also discuss the potential that this enhanced regulatory environment could have on the running of oncology clinical trials in the future.
Collapse
|