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Wang W, Wang H, Luo Y, Li Z, Li J. Discovery of petroleum ether extract of eclipta targeting p53/Fas pathway for the treatment of chemotherapy-induced alopecia: Network pharmacology and experimental validation. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118405. [PMID: 38844249 DOI: 10.1016/j.jep.2024.118405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/19/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ecliptea herba, a traditional Chinese herbal medicine for hair loss, was first recorded in the Tang Dynasty's 'Qian Jin Yue Ling', of which the active ingredients and mechanisms of action in the treatment of chemotherapy-induced hair loss remain poorly investigated. AIM OF THE STUDY To investigate the effects of the petroleum ether extract of Eclipta (PEE) on alopecia and follicle damage and elucidate its potential therapeutic mechanisms using the integration of network pharmacology, bioinformatics, and experimental validation. MATERIALS AND METHODS UPLC-MS was used to analyse the chemical composition of PEE. A network pharmacology approach was employed to establish the 'components-targets-pathways' network of PEE to explore potential therapeutic pathways and targets. Molecular docking was used for validation, and the mechanism of PEE in treating chemotherapy-induced alopecia (CIA) was elucidated using in vitro and in vivo on CIA models. RESULTS UPLC-MS analysis of PEE revealed 185 components, while network pharmacology and molecular docking analyses revealed potential active compounds and their target molecules, suggesting the involvement of core genes, such as TP53, ESR1, AKT1, IL6, TNF, and EGFR. The key components included wedelolactone, dimethyl-wedelolactone, luteoloside, linarin, and hispidulin. In vivo, PEE promoted hair growth, restored the number of hair follicles, and reduced follicle apoptosis. Conversely, in vitro, PEE enhanced cell viability, reduced apoptosis, and protected HaCaT cells from damage induced by 4-hydroperoxycyclophosphamide (4-HC). CONCLUSIONS PEE alleviated hair follicle damage in CIA mice by inhibiting the P53/Fas pathway, which may be associated with inhibiting hair follicle cell apoptosis. This study provides a novel therapeutic strategy for treating cyclophosphamide-induced hair loss.
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Affiliation(s)
- Wuji Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China.
| | - Honglan Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Yang Luo
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Zheng Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | - Jingjie Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, 563006, China; Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi, 563006, China; Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China.
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Lambert KA, Albright BB, Anastasio MK, Kaplan SJ, McNally L. Scalp hypothermia to reduce chemotherapy-induced alopecia: A systematic review and meta-analysis. Gynecol Oncol 2024; 188:71-80. [PMID: 38936283 DOI: 10.1016/j.ygyno.2024.06.012] [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: 02/22/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Chemotherapy-induced alopecia (CIA) is a common and emotionally-taxing side effect of chemotherapy, including taxane agents used frequently in treatment of gynecologic cancers. Scalp hypothermia, also known as "cold caps", is a possible method to prevent severe CIA, studied primarily in the breast cancer population. OBJECTIVES To compile existing data on scalp hypothermia in cancer patients receiving taxane chemotherapy in order to investigate its application to the gynecologic cancer population. SEARCH STRATEGY MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and Cochrane were searched through January 31, 2023. SELECTION CRITERIA Full-text manuscripts reporting on the results of scalp hypothermia in patients receiving taxane-based chemotherapy. DATA COLLECTION AND ANALYSIS Binomial proportions were summed, and random-effects meta-analyses performed. MAIN RESULTS From 1424 records, we included 31 studies, representing 14 different countries. Only 5 studies included gynecologic cancer patients. We extracted the outcome of the proportion of patients with <50% hair loss. Among 2179 included patients, 60.7% were reported to have <50% hair loss (meta-analysis: 60.6%, 95% confidence interval [CI] 54.9-66.1%). Among the 28 studies reporting only on taxane-based chemotherapy, the rate of <50% hair loss was 60.0% (meta-analysis: 60.9%, (95% CI: 54.9-66.7%). In comparative studies, hair loss was significantly less in patients who received scalp hypothermia versus those who did not (49.3% versus 0% with <50% hair loss; OR 40.3, 95% CI: 10.5-154.8). Scalp cooling achieved <50% hair loss in patients receiving paclitaxel (67.7%; meta-analysis 69.9%, 95% CI 64.1-75.4%) and docetaxel (57.1%; meta-analysis 60.5%, 95% CI 50.0-71.6%). Meta-analysis on patient satisfaction in regard to scalp cooling found a satisfaction rate of 78.9% (95% CI 69.1-87.4%). CONCLUSION Scalp hypothermia may be an effective method to reduce some cases of CIA due to taxane chemotherapy, especially paclitaxel. More trials need to be done to determine the precise effects of scalp hypothermia in gynecologic cancer patients.
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Affiliation(s)
- Katherine A Lambert
- Duke University, School of Medicine, Durham, NC, United States of America; The Ohio State University, Department of Obstetrics and Gynecology, Columbus, OH, United States of America.
| | - Benjamin B Albright
- University of North Carolina, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States of America
| | | | - Samantha J Kaplan
- Duke University, School of Medicine, Durham, NC, United States of America
| | - Leah McNally
- Duke University, Department of Obstetrics and Gynecology, Durham, NC, United States of America
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Kuo AMS, Reingold RE, Ketosugbo KF, Pan A, Kraehenbuehl L, Dusza S, Gajria D, Lake DE, Bromberg JF, Traina TA, Fornier MN, Gucalp A, D'Alessandro BM, Rotemberg V, Dauscher M, Shapiro J, Goldfarb SB, Markova A, Lacouture ME. Oral minoxidil for late alopecia in cancer survivors. Breast Cancer Res Treat 2024:10.1007/s10549-024-07440-5. [PMID: 39097564 DOI: 10.1007/s10549-024-07440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/16/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Late alopecia, defined as incomplete hair regrowth > 6 months following cytotoxic chemotherapy or > 6 months from initiation of endocrine therapy, negatively impacts quality of life and may affect dose intensity of adjuvant therapy. This study investigates the effect of oral minoxidil in women with chemotherapy and/or endocrine therapy-induced late alopecia. METHODS The rate of clinical response was assessed by standardized photography and quantitated with trichoscopy. RESULTS Two hundred and sixteen patients (mean age 57.8 ± 13.7) were included. The most common cancer diagnosis was breast, in 170 patients (79.1%). Alopecia developed after chemotherapy in 31 (14.4%) patients, endocrine monotherapy in 65 (30.1%) patients, and chemotherapy followed by endocrine therapy in 120 (55.6%) patients. In 119 patients, standardized photography assessments were used to determine clinical change in alopecia after a median of 105 (IQR = 70) days on oral minoxidil and revealed improvement in 88 (74%) patients. Forty-two patients received quantitative trichoscopic assessments at baseline and at follow-up after a median of 91 (IQR = 126) days on oral minoxidil. Patients had clinically and statistically significant increases in frontal hair shaft density (from 124.2 hairs/cm2 at initial to 153.2 hairs/cm2 at follow-up assessment, p = 0.008) and occipital shaft density (from 100.3 hairs/cm2 at initial to 123.5 hairs/cm2 at follow-up assessment. p = 0.004). No patients discontinued oral minoxidil due to adverse events. CONCLUSIONS Overall, oral minoxidil was well tolerated by patients and may benefit both frontal and occipital late alopecia in cancer survivors treated with cytotoxic and/or endocrine therapy by increasing hair shaft and follicle density.
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Affiliation(s)
- Alyce Mei-Shiuan Kuo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rachel E Reingold
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kwami F Ketosugbo
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander Pan
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lukas Kraehenbuehl
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Ludwig Collaborative and Swim Across America Laboratory, Human Oncology and Pathogenesis Program, Department of Medicine, MSKCC, Parker Institute for Cancer Immunotherapy, New York, NY, USA
| | - Stephen Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Devika Gajria
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Diana E Lake
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jacqueline F Bromberg
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiffany A Traina
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica N Fornier
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ayca Gucalp
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Veronica Rotemberg
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Megan Dauscher
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Shari B Goldfarb
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alina Markova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Dermatology Division, Department of Medicine, NYU Grossman Long Island School of Medicine, Mineola, New York, USA.
- Symptom Management Program, Perlmutter Cancer Center, NYU Langone Hospital - Long Island, Mineola, New York, USA.
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Melo RR, Cortez de Almeida RF, Lemes LR, Frattini Junior S, Müller Ramos P, Melo DF. Low-dose oral minoxidil for persistent chemotherapy and radiotherapy-induced alopecia in a pediatric female patient. An Bras Dermatol 2024; 99:635-637. [PMID: 38653611 PMCID: PMC11221154 DOI: 10.1016/j.abd.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 04/25/2024] Open
Affiliation(s)
- Raíssa Rodriguez Melo
- Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Luciana Rodino Lemes
- Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Paulo Müller Ramos
- Department of Infectious Diseases, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Daniel Fernandes Melo
- Dermatology Department, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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Novice M, Novice T, Powers M, Lo Sicco KI. The financial burden of scalp cooling therapy: A nonprofit organization data analysis. J Am Acad Dermatol 2024; 91:127-129. [PMID: 38467304 DOI: 10.1016/j.jaad.2024.02.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Madison Novice
- University of Michigan Medical School, Ann Arbor, Michigan.
| | - Taylor Novice
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Molly Powers
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Kristen I Lo Sicco
- The Ronald O Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
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Kraehenbuehl L, Kang D, Bang AS, Ketosugbo KF, Hay J, Patil S, Goldfarb S, Cho J, Lacouture ME. Validation and responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in breast cancer patients. Support Care Cancer 2024; 32:369. [PMID: 38773008 PMCID: PMC11108899 DOI: 10.1007/s00520-024-08564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/10/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE This study aimed to validate the Chemotherapy-Induced Alopecia Distress Scale (CADS) in a diverse English-speaking population and patients with endocrine treatment-induced alopecia (EIA). OBJECTIVE Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation. METHODS Data from the CHANCE study (NCT02530177), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, 6 months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size. RESULTS The CADS exhibited good reliability, with Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively. CONCLUSION The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.
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Affiliation(s)
- L Kraehenbuehl
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Dermatology, University Hospital Zurich (USZ), University of Zurich (UZH), Raemistrasse 100, 8091, Zurich, Switzerland.
- Department of Pharmacology and Meyer Cancer Center, Weill Cornell Medicine, New York, NY, 10021, USA.
| | - D Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Ro, Gangnam, Seoul, 06351, Republic of Korea
| | - A S Bang
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K F Ketosugbo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - S Goldfarb
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Ro, Gangnam, Seoul, 06351, Republic of Korea.
| | - M E Lacouture
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Dermatology Division, Department of Medicine, NYU Grossman Long Island School of Medicine, NYU Langone Hospital - Long Island, Mineola, NY, 11501, USA
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Fernández-Sánchez J, Trujillo-Colmena D, Rodríguez-Castaño A, Lavín-Pérez AM, Del Coso J, Casado A, Collado-Mateo D. Effects of exercise on life satisfaction of people diagnosed with cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:297. [PMID: 38637349 PMCID: PMC11026230 DOI: 10.1007/s00520-024-08486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE A cancer diagnosis is commonly associated with a decline in patient's life satisfaction and more pessimistic expectations about the future. The identification of strategies to improve life satisfaction in patients with cancer is of great interest to health practitioners since it may be associated with a better prognosis of cancer and higher survival rates. Previous meta-analyses and reviews concluded that exercise could significantly improve health-related quality of life in this population, but the effects of exercise on life satisfaction are still not well-known. This review aims to analyse the effects of exercise programs on life satisfaction in people with cancer and individuals who have overcome cancer. METHODS The present systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A thorough search of databases including Web of Science and PubMed/MEDLINE was carried out. Six studies (535 participants) in which the effect of an exercise program was compared to a non-exercise program control condition in patients with cancer were considered eligible. A subsequent meta-analysis was performed using the random effects model to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI). RESULTS Exercise intervention improved satisfaction with life compared with a control condition (SMD = 1.28; p = 0.02 with a 95% CI of 0.22 to 2.34). CONCLUSION Exercise could be considered an effective tool to improve life satisfaction in patients with cancer. Hence, professionals might consider the possibility of integrating physical exercise into strategies aimed at enhancing the low life satisfaction often experienced by patients. PROSPERO CRD42023438146.
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Affiliation(s)
| | | | | | - Ana Myriam Lavín-Pérez
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain.
- GO fitLAB, Ingesport, Madrid, Spain.
| | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Arturo Casado
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
| | - Daniel Collado-Mateo
- Sport Sciences Research Centre, Rey Juan Carlos University, Fuenlabrada, Madrid, Spain
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Lairedj K, Klausner G, Robijns J, Arany PR, Bensadoun RJ. [Photobiomodulation in the prevention and the management of side effects of cancer treatments: Bases, results and perspectives]. Bull Cancer 2024; 111:314-326. [PMID: 37858427 DOI: 10.1016/j.bulcan.2023.08.011] [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: 04/06/2023] [Revised: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Assess the current and potential indications of photobiomodulation (PBM) therapy and their level of evidence in the prevention or treatment of side effects related to oncology treatments (radiation therapy, and to a minimal extent favored and hematopoietic stem cell transplants). And report on the recommended modalities (parameters and doses) of PBM therapy. MATERIALS AND METHODS The Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, and LILACS databases were systematically reviewed to include and analyze publications of clinical studies that evaluated PBM in the prevention or management side effects related to cancer treatments. The keywords used were "photobiomodulation"; "low level laser therapy"; "acute oral mucositis"; "acute dysphagia"; "acute radiation dermatitis"; "lymphedema"; "xerostomia"; "dysgeusia"; "hyposalivation"; "lockjaw"; "bone necrosis"; "osteoradionecrosis"; "radiation induced fibrosis"; "voice and speech alterations"; "palmar-plantar erythrodysesthesia"; "graft versus host disease"; "peripheral neuropathy"; "chemotherapy induced alopecia". Prospective studies were included, while retrospective cohorts and non-original articles were excluded from the analysis. RESULTS PBM in the red or infrared spectrum has been shown to be effective in randomized controlled trials in the prevention and management of certain complications related to radiotherapy, in particular acute mucositis, epitheliitis and upper limb lymphedema. The level of evidence associated with PBM was heterogeneous, but overall remained moderate. The main limitations were the diversity and the lack of precision of the treatment protocols which could compromise the efficiency and the reproducibility of the results of the PBM. For other effects related to chemo/radiation therapy (dysgeusia, osteonecrosis, peripheral neuropathy, alopecia, palmar-plantar erythrodysaesthesia) and haematopoietic stem cell transplantation (graft versus host disease), treatment with PBM suffers from a lack of studies or limited studies at the origin of a weakened level of proof. However, based on these results, it was possible to establish safe practice parameters and doses of PBM. CONCLUSION Published data suggest that PBM could therefore be considered as supportive care in its own right for patients treated with radiation, chemotherapy, immunotherapy, hormone therapy or targeted therapies, whether in clinical practice or clinical trials. therapies. However, until solid data have been published on its long-term safety, the use of PBM should be considered with caution and within the recommended parameters and doses, particularly when practiced in areas of known or possible tumours. In this case, the patient should be informed of the theoretical benefits and risks of PBM in order to obtain informed consent before treatment.
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Affiliation(s)
- Kamel Lairedj
- Médecine générale, centre de santé Saint-Paul, 32, Delmas rue Louverture # 44, Delmas, Haïti; Université républicaine d'Haïti, # 22, Delmas 55, Lalue Ave John-Brown # 293 Bis, 1640 Port-au-Prince, Haïti
| | - Guillaume Klausner
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Polyclinique Maymard, 13, rue Marcel-Paul, 20200 Bastia, France
| | - Julien Robijns
- Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, 3500 Hasselt, Belgique
| | - Praveen R Arany
- University at Buffalo, Oral Biology, Surgery and Biomedical Engineering, Buffalo, New York, États-Unis
| | - René-Jean Bensadoun
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Département d'oncologie-radiothérapie, Gustave-Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
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Ben Kridis W, Boudawara O, Khanfir A. Chemotherapy induced alopecia in breast cancer patients: A monocentric prospective study. Breast Dis 2024; 43:251-255. [PMID: 39213044 PMCID: PMC11380241 DOI: 10.3233/bd-240019] [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] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Alopecia is one of the main adverse events of chemotherapy in breast cancer. However, its impact is often ignored and underestimated by clinicians. Our aim was to evaluate the quality of life of breast cancer patients with chemotherapy induced alopecia. METHODS We conducted a prospective study including 72 breast cancer patients who developed alopecia on or after stopping chemotherapy in the last 6 months. Clinical information and characteristics of alopecia were assessed using a self-prepared questionnaire. DLQI score was used to evaluate patients' quality of life. RESULTS We interviewed a total of 72 women with a mean age of 53.5 ± 6 years. Alopecia appeared soon after the first course in 62.5%. All patients actively tried to hide induced hair fall (either by a hat in 6.9% or by a headscarf in 93.1%). Quality of life was impacted in 97.2% of patients with a median DLQI score of 6.5. Women who did not underwent mastectomy were significantly more bothered by hair loss than those who had radical surgery (78.1% vs 55%, p = 0.04). Working status was a significant predictor factor of a bad quality of life due to alopecia (100% in working women vs 58.3% in homemaker or retired patients, p = 0.006). CONCLUSION Chemotherapy induced alopecia had a negative impact on quality of life of patients with breast cancer, especially in working women and those who did not have radical surgery. Prior wearing of headscarves did not impact significantly the DLQI score.
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Affiliation(s)
- Wala Ben Kridis
- Department of Medical Oncology, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Olfa Boudawara
- Department of Medical Oncology, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Afef Khanfir
- Department of Medical Oncology, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
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Wang W, Wang H, Long Y, Li Z, Li J. Controlling Hair Loss by Regulating Apoptosis in Hair Follicles: A Comprehensive Overview. Biomolecules 2023; 14:20. [PMID: 38254620 PMCID: PMC10813359 DOI: 10.3390/biom14010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Apoptosis is a physiological process that occurs in all cell types of the human body, and it profoundly changes the fate of hair by affecting hair follicle cells. This review outlines the cellular changes, intrinsic biochemical characteristics, and mechanisms underlying apoptosis and summarizes the hair follicle life cycle, including development, cycle stages, and corresponding cellular changes. Finally, the relationship between apoptosis and the hair cycle is discussed and the significance of apoptosis in hair loss conditions and drug treatments is highlighted. Apoptosis induces cellular changes and exhibits distinctive properties through intricate signaling pathways. Hair follicles undergo cyclic periods of growth, regression, and dormancy. Apoptosis is closely correlated with the regression phase by triggering hair follicle cell death and shedding. Regulation of apoptosis in hair follicles plays an essential role in hair loss due to maladies and drug treatments. Mitigating apoptosis can enhance hair growth and minimize hair loss. A comprehensive understanding of the correlation between apoptosis and the hair cycle can facilitate the development of novel treatments to prevent hair loss and stimulate hair regeneration.
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Affiliation(s)
- Wuji Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China; (W.W.); (H.W.); (Y.L.); (Z.L.)
- Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi 563006, China
- Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
| | - Honglan Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China; (W.W.); (H.W.); (Y.L.); (Z.L.)
- Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi 563006, China
- Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
| | - Yunluan Long
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China; (W.W.); (H.W.); (Y.L.); (Z.L.)
- Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi 563006, China
- Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
| | - Zheng Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China; (W.W.); (H.W.); (Y.L.); (Z.L.)
- Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi 563006, China
- Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
| | - Jingjie Li
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, China; (W.W.); (H.W.); (Y.L.); (Z.L.)
- Key Laboratory of Basic Pharmacology of Guizhou Province, Zunyi Medical University, Zunyi 563006, China
- Department of Pharmacology, School of Pharmacy, Zunyi Medical University, Zunyi 563006, China
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11
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Yue Z, Lin J, Lu X, Gao Q, Pan M, Zhang Y, Shen S, Zhu WG, Paus R. Keratin 17 Impacts Global Gene Expression and Controls G2/M Cell Cycle Transition in Ionizing Radiation-Induced Skin Damage. J Invest Dermatol 2023; 143:2436-2446.e13. [PMID: 37414246 DOI: 10.1016/j.jid.2023.02.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 01/30/2023] [Accepted: 02/08/2023] [Indexed: 07/08/2023]
Abstract
Keratin 17 (K17) is a cytoskeletal protein that is part of the intermediate filaments in epidermal keratinocytes. In K17-/- mice, ionizing radiation induced more severe hair follicle damage, whereas the epidermal inflammatory response was attenuated compared with that in wild-type mice. Both p53 and K17 have a major impact on global gene expression because over 70% of the differentially expressed genes in the skin of wild-type mice showed no expression change in p53-/- or K17-/- skin after ionizing radiation. K17 does not interfere with the dynamics of p53 activation; rather, global p53 binding in the genome is altered in K17-/- mice. The absence of K17 leads to aberrant cell cycle progression and mitotic catastrophe in epidermal keratinocytes, which is due to nuclear retention, thus reducing the degradation of B-Myb, a key regulator of the G2/M cell cycle transition. These results expand our understanding of the role of K17 in regulating global gene expression and ionizing radiation-induced skin damage.
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Affiliation(s)
- ZhiCao Yue
- Department of Cell Biology & Medical Genetics, Shenzhen University Medical School, Shenzhen, China; International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China.
| | - JianQiong Lin
- Department of Cell Biology & Medical Genetics, Shenzhen University Medical School, Shenzhen, China; International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China
| | - XiaoPeng Lu
- International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China; Department of Biochemistry & Molecular Biology, Shenzhen University Medical School, Shenzhen, China
| | - QingXiang Gao
- Institute of Life Sciences, Fuzhou University, Fuzhou, China
| | - MeiPing Pan
- Institute of Life Sciences, Fuzhou University, Fuzhou, China
| | - YaFei Zhang
- Department of Cell Biology & Medical Genetics, Shenzhen University Medical School, Shenzhen, China; International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China
| | - SiTing Shen
- Department of Cell Biology & Medical Genetics, Shenzhen University Medical School, Shenzhen, China; International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China
| | - Wei-Guo Zhu
- International Cancer Center, Shenzhen University Medical School, Shenzhen, China; Guangdong Key Laboratory of Genome Instability and Human Disease Prevention, Shenzhen University Medical School, Shenzhen, China; Department of Biochemistry & Molecular Biology, Shenzhen University Medical School, Shenzhen, China
| | - Ralf Paus
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA; Center for Dermatology Research, School of Biological Sciences, The University of Manchester and NIHR Biomedical Research Center, Manchester, United Kingdom
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12
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Liu Q, Wang L, He D, Wu Y, Liu X, Yang Y, Chen Z, Dong Z, Luo Y, Song Y. Application Value of Antimicrobial Peptides in Gastrointestinal Tumors. Int J Mol Sci 2023; 24:16718. [PMID: 38069041 PMCID: PMC10706433 DOI: 10.3390/ijms242316718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Gastrointestinal cancer is a common clinical malignant tumor disease that seriously endangers human health and lacks effective treatment methods. As part of the innate immune defense of many organisms, antimicrobial peptides not only have broad-spectrum antibacterial activity but also can specifically kill tumor cells. The positive charge of antimicrobial peptides under neutral conditions determines their high selectivity to tumor cells. In addition, antimicrobial peptides also have unique anticancer mechanisms, such as inducing apoptosis, autophagy, cell cycle arrest, membrane destruction, and inhibition of metastasis, which highlights the low drug resistance and high specificity of antimicrobial peptides. In this review, we summarize the related studies on antimicrobial peptides in the treatment of digestive tract tumors, mainly oral cancer, esophageal cancer, gastric cancer, liver cancer, pancreatic cancer, and colorectal cancer. This paper describes the therapeutic advantages of antimicrobial peptides due to their unique anticancer mechanisms. The length, net charge, and secondary structure of antimicrobial peptides can be modified by design or modification to further enhance their anticancer effects. In summary, as an emerging cancer treatment drug, antimicrobial peptides need to be further studied to realize their application in gastrointestinal cancer diseases.
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Affiliation(s)
- Qi Liu
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Lei Wang
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Dongxia He
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Yuewei Wu
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Xian Liu
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Yahan Yang
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhizhi Chen
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhan Dong
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Ying Luo
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Yuzhu Song
- College of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
- Medical College, Kunming University of Science and Technology, Kunming 650500, China
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13
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Minta A, Rose L, Park C, Ramaswamy B, Stover D, Gatti-Mays M, Cherian M, Williams N, Sudheendra P, Wesolowski R, Sardesai S, Lustberg M, Loprinzi CL, Ruddy KJ, Cathcart-Rake E, Trovato S, Dulmage B. Retrospective cohort study of CDK4/6-inhibitor-induced alopecia in breast cancer patients. Support Care Cancer 2023; 31:717. [PMID: 37991653 DOI: 10.1007/s00520-023-08160-0] [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: 04/16/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Dermatologic adverse events commonly result in the interruption of oncologic treatment, and targeted therapies are the most frequently interrupted class of anticancer agents. Alopecia is a common cutaneous adverse event reported with CK4/6i therapy. Though the clinical characteristics and therapeutic response of EIA have been well documented, few studies have characterized alopecia in patients treated with CDK4/6i. METHODS This study analyzed a retrospective cohort of 28 breast cancer patients diagnosed with endocrine-induced alopecia (EIA) or CDKiA. Comparative analysis of the clinical characteristics of alopecia and therapeutic response to minoxidil was conducted. Therapeutic response to minoxidil (LDOM or topical [5%] solution or foam) was assessed by both Dean Scale and qualitative clinical improvement by comparison of pretreatment and posttreatment clinical images by single-blinded, board-certified academic dermatologists (ST and BD). RESULTS CDKiA was clinically similar to androgenetic alopecia and specific vertex involvement was more common in patients treated with CDK4/6i + ET than endocrine monotherapy (n = 7 [70.0%] vs n = 4 [36.4%]; p = 0.04), respectively. After 4-6 months of minoxidil, there was a moderate to significant qualitative alopecia improvement in 80% of CDKiA patients versus 94.4% of EIA patients. Additionally, superior improvement of mean Dean Score grade was observed in EIA (with change from pre- to posttreatment - 0.44; p = 0.0002). CONCLUSION Compared to endocrine monotherapy, patients on combination CDK4/6i + ET had greater extent of vertex involvement and were more recalcitrant to minoxidil. The preferential vertex involvement observed in CDKiA suggests that combination therapy with minoxidil and topical antiandrogens with poor systemic absorption should be studied in this setting.
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Affiliation(s)
- Abena Minta
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Candice Park
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Bhuvaneswari Ramaswamy
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Stover
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Margaret Gatti-Mays
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Mathew Cherian
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nicole Williams
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Preeti Sudheendra
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Robert Wesolowski
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sagar Sardesai
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Maryam Lustberg
- Department of Medical Oncology, Yale Cancer Center, New Haven, CT, USA
| | | | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Stephanie Trovato
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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14
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Cheret J, Samra T, Verling SD, Gherardini J, Rodriguez-Feliz J, Bauman AJ, Sanchez CA, Wikramanayake TC, Xu XX, Paus R. Low-Intensity Ultrasound as a Potential Intervention Strategy to Protect Human Scalp Hair Follicles from Taxane-Induced Toxicity. J Invest Dermatol 2023; 143:1809-1813.e2. [PMID: 36990174 DOI: 10.1016/j.jid.2023.02.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/09/2023] [Accepted: 02/22/2023] [Indexed: 03/30/2023]
Affiliation(s)
- Jeremy Cheret
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA
| | - Tara Samra
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA
| | - Samantha D Verling
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA
| | - Jennifer Gherardini
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA
| | | | - Alan J Bauman
- Bauman Medical Hair Transplant & Hair Loss Treatment Center, Boca Raton, Florida, USA
| | - Celina Amaya Sanchez
- Department of Radiation Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Tongyu C Wikramanayake
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA
| | - Xiang-Xi Xu
- Department of Radiation Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ralf Paus
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Florida, USA; Monasterium Laboratory, Münster, Germany; CUTANEON, Hamburg, Germany.
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15
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Alhanshali L, Buontempo M, Shapiro J, Lo Sicco K. Medication-induced hair loss: An update. J Am Acad Dermatol 2023; 89:S20-S28. [PMID: 37591561 DOI: 10.1016/j.jaad.2023.04.022] [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: 12/31/2022] [Revised: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 08/19/2023]
Abstract
This article discusses drug-induced hair loss, which can occur with many drugs including cytotoxic agents, biologics, and immunomodulating agents, among others. It outlines the diagnosis and management of drug-induced alopecia, with a focus on recently implicated drugs.
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Affiliation(s)
- Lina Alhanshali
- Department of Dermatology, SUNY Downstate College of Medicine, Brooklyn, New York
| | - Michael Buontempo
- Department of Dermatology, Hackensack Meridian School of Medicine, Nutley, New Jersey
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
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16
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Wikramanayake TC, Haberland NI, Akhundlu A, Laboy Nieves A, Miteva M. Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming? Curr Oncol 2023; 30:3609-3626. [PMID: 37185388 PMCID: PMC10137043 DOI: 10.3390/curroncol30040275] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Millions of new cancer patients receive chemotherapy each year. In addition to killing cancer cells, chemotherapy is likely to damage rapidly proliferating healthy cells, including the hair follicle keratinocytes. Chemotherapy causes substantial thinning or loss of hair, termed chemotherapy-induced alopecia (CIA), in approximately 65% of patients. CIA is often ranked as one of the most distressing adverse effects of chemotherapy, but interventional options have been limited. To date, only scalp cooling has been cleared by the US Food and Drug Administration (FDA) to prevent CIA. However, several factors, including the high costs not always covered by insurance, preclude its broader use. Here we review the current options for CIA prevention and treatment and discuss new approaches being tested. CIA interventions include scalp cooling systems (both non-portable and portable) and topical agents to prevent hair loss, versus topical and oral minoxidil, photobiomodulation therapy (PBMT), and platelet-rich plasma (PRP) injections, among others, to stimulate hair regrowth after hair loss. Evidence-based studies are needed to develop and validate methods to prevent hair loss and/or accelerate hair regrowth in cancer patients receiving chemotherapy, which could significantly improve cancer patients’ quality of life and may help improve compliance and consequently the outcome of cancer treatment.
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17
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Recuero JK, Fitz JR, Pereira AA, Bonamigo RR. EGFR inhibitors: clinical aspects, risk factors and biomarkers for acneiform eruptions and other mucosal and cutaneous adverse effects. An Bras Dermatol 2023:S0365-0596(23)00051-X. [PMID: 36990917 DOI: 10.1016/j.abd.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/20/2022] [Accepted: 10/01/2022] [Indexed: 03/29/2023] Open
Abstract
The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article.
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Affiliation(s)
- Júlia Kanaan Recuero
- Postgraduate program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Dermatology Service, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Joana Roberta Fitz
- Dermatology Service, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Andrea Abe Pereira
- Postgraduate program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Renan Rangel Bonamigo
- Postgraduate program in Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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18
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Aiba T, Kono Y, Etoh T, Kawano Y, Oshima Y, Inomata M. Efficacy of cooling therapy and α-lipoic acid derivative against chemotherapy-induced alopecia in an animal model. Cancer Sci 2023; 114:1007-1014. [PMID: 36337052 PMCID: PMC9986063 DOI: 10.1111/cas.15639] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
Chemotherapy-induced alopecia is frequently induced by various regimens of chemotherapy and has a significant impact on mental health and quality of life. However, the effect of available current treatment for chemotherapy-induced alopecia is not sufficient. This study aimed to clarify the therapeutic effects and mechanism of skin cooling and the antioxidant α-lipoic acid derivative on chemotherapy-induced alopecia. We developed a chemotherapy-induced alopecia model of cyclophosphamide (120 μg/g) using Institute of Cancer Research mice. We used cooling therapy and α-lipoic acid derivative application as the treatments. We compared the alopecia score, hair bulb diameter, insulin-like growth factor-1 level, vascular permeability, and apoptosis between the control and treatment groups. The alopecia score significantly improved in each treatment group compared with that in the cyclophosphamide group. Hair bulb diameter significantly improved in the cyclophosphamide + cooling group compared with that in the cyclophosphamide group. The insulin-like growth factor-1 level and vascular permeability level was significantly retained and suppressed, respectively, in each treatment group compared with that in the cyclophosphamide group. The number of apoptotic cells in the vascular endothelium significantly decreased in the cyclophosphamide + α-lipoic acid derivative group compared with that in the cyclophosphamide group. In conclusion, cooling therapy and α-lipoic acid derivative facilitated recovery from chemotherapy-induced alopecia caused by cyclophosphamide through decreasing vascular permeability.
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Affiliation(s)
- Takayuki Aiba
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yohei Kono
- Department of Advanced Medical Research and Development for Cancer and Hair [Aderans], Oita University Faculty of Medicine, Yufu, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yoko Kawano
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yusuke Oshima
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.,Faculty of Engineering, University of Toyama, Toyama, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.,Department of Advanced Medical Research and Development for Cancer and Hair [Aderans], Oita University Faculty of Medicine, Yufu, Japan
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19
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Rose L, Lustberg M, Ruddy KJ, Cathcart-Rake E, Loprinzi C, Dulmage B. Hair loss during and after breast cancer therapy. Support Care Cancer 2023; 31:186. [PMID: 36826602 DOI: 10.1007/s00520-023-07634-5] [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: 11/04/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
For patients diagnosed with breast cancer, alopecia can be a distressing side effect of treatment. Major surgeries, cytotoxic chemotherapy, and endocrine therapy may result in several different types of alopecia. This article reviews the underlying mechanisms, etiology, prevention strategies, and treatment options for chemotherapy-induced alopecia, telogen effluvium, and endocrine-induced alopecia. Here, we aim to provide breast oncologists with a review of the types of hair loss related to cancer therapy and current preventative and treatment options to facilitate informative patient counseling.
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Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | | | | | | | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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20
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Chemotherapy: how to reduce its adverse effects while maintaining the potency? Med Oncol 2023; 40:88. [PMID: 36735206 DOI: 10.1007/s12032-023-01954-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
Chemotherapy is one of the widely used anticancer treatments that involves the use of powerful cytotoxic drugs to stop tumor growth by targeting rapidly dividing cells through various mechanisms, which will be elucidated in this review. Introduced during the early twentieth century, chemotherapy has since lengthened the longevity of innumerable cancer patients. However, the increase in lifespan is at the expense of quality of life as patients are at risk of developing short-term and long-term side effects following chemotherapy, such as alopecia (hair loss), chemotherapy-induced peripheral neuropathy, chemotherapy-induced nausea and vomiting, cardiotoxicity, diarrhea, infertility, and chemo brain. Currently, a number of these chemotherapy-induced adverse effects are managed through supportive care and approved treatments, while the rest of the side effects are unavoidable. Hence, chemotherapeutic drugs associated with inevitable side effects are only administered when their therapeutic role outweighs their chemotoxicity, thus severely limiting the potency of chemotherapy in treating malignancy. Therein, the potential approaches to alleviating side effects of chemotherapy ranging from pharmaceutical drugs to alternative therapies will be discussed in this review in hopes of increasing the tolerance and effectiveness of future chemotherapeutic treatments.
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21
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Yin L, Klein EJ, Svigos K, Novice T, Gutierrez D, Oratz R, Lacouture ME, Powers M, Senna M, Shapiro J, Lo Sicco K. Dermatologist awareness of scalp cooling for chemotherapy-induced alopecia. J Am Acad Dermatol 2023; 88:176-179. [PMID: 35278488 DOI: 10.1016/j.jaad.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/09/2022] [Accepted: 03/01/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Lu Yin
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Elizabeth J Klein
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Katerina Svigos
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Taylor Novice
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Daniel Gutierrez
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Ruth Oratz
- Department of Medicine, New York University Grossman School of Medicine, New York, New York
| | | | - Molly Powers
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Maryanne Senna
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jerry Shapiro
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Kristen Lo Sicco
- Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
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22
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The Chemical and Pharmacological Research Progress on a Kind of Chinese Herbal Medicine, Fructus Malvae. Molecules 2022; 27:molecules27175678. [PMID: 36080446 PMCID: PMC9458057 DOI: 10.3390/molecules27175678] [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: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022] Open
Abstract
Since the outbreak of the COVID-19 pandemic, traditional Chinese medicine has played an important role in the treatment process. Furthermore, the discovery of artemisinin in Artemisia annua has reduced the incidence of malaria all over the world. Therefore, it is becoming urgent and important to establish a novel method of conducting systematic research on Chinese herbal medicine, improving the medicinal utilization value of traditional Chinese medicine and bringing great benefits to human health all over the world. Fructus Malvae, a kind of Chinese herbal medicine which has been recorded in the “Chinese Pharmacopoeia” (2020 edition), refers to the dry, ripe fruits of Malva verticillata L. Recently, some studies have shown that Fructus Malvae exhibits some special pharmacological activities; for example, it has diuretic, anti-diabetes, antioxidant and anti-tumor properties, and it alleviates hair loss. Furthermore, according to the reports, the active ingredients separated and identified from Fructus Malvae contain some very novel compounds such as nortangeretin-8-O-β-d-glucuronopyranoside and 1-O-(6-deoxy-6-sulfo)-glucopyranosyl-2-O-linolenoyl-3-O-palmitoyl glyceride, which could be screened as important candidate compounds for diabetes- or tumor-treatment drugs, respectively. Therefore, in this research, we take Fructus Malvae as an example and systematically summarize the chemical constituents and pharmacological activity research progress of it. This review will be helpful in promoting the development and application of Fructus Malvae and will also provide an example for other investigations of traditional Chinese medicine.
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Gu H, Liang L, Zhu Z, Mao X. Preparation and identification of anti-breast cancer cells peptides released from yak milk casein. Front Nutr 2022; 9:997514. [PMID: 36091230 PMCID: PMC9462664 DOI: 10.3389/fnut.2022.997514] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Yak milk casein (YMC) is the main protein in the yak milk. Peptides released from Yak milk casein (YMC) have multiple bioactivities, including anti-inflammation and immune-regulation, suggesting that these peptides might be able to inhibit cancer theoretically. However, the anti-cancer peptides from YMC have only been sparsely studied. Breast carcinoma is the most common carcinoma in women worldwide. Thus, the paper herein was to identify yak milk casein (YMC)-derived anti-breast cancer peptides via gel filtration, reversed phase high-performance liquid chromatography (RP-HPLC) and liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI MS/MS) for the first time. The inhibitory effects of the hydrolysates on the cell viabilities, cell cycles and apoptosis of breast cancer cells were evaluated with a cck8 kit and a flow cytometry. The result showed that YMC hydrolysates (YMCH) obtained by united hydrolyzation with trypsin (3 h) and alkaline protease (3 h) displayed the highest cell viability inhibition rate for MCF7 (20.74 ± 1.39%) and MDA-MB-231 (26.73 ± 2.87%) cells. Three peptides were identified in the RP-HPLC subfraction F3-4, and a nonapeptide (TPVVVPPFL) showed the most potent inhibitory effects on both cancer cells and displayed good gastrointestinal stability. TPVVVPPFL could induce G2-M cell cycle arrest in MCF7 cells and S cell arrest in MDA-MB-231 cells and induce apoptosis in both cancer cells. Moreover, in silico analysis indicated that the peptide had non-toxic and no inhibitory roles on P4502D6-enzyme. Together, this study shows that YMC is a good source of anti-breast cancer cells peptides.
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Affiliation(s)
- Haofeng Gu
- School of Modern Agriculture and Biotechnology, Ankang University, Ankang, China
- College of Food Science and Nutritional Engineering, Key Laboratory of Functional Dairy, Ministry of Education, China Agricultural University, Beijing, China
- Haofeng Gu,
| | - Lei Liang
- School of Modern Agriculture and Biotechnology, Ankang University, Ankang, China
| | - Ziwei Zhu
- College of Food Science and Nutritional Engineering, Key Laboratory of Functional Dairy, Ministry of Education, China Agricultural University, Beijing, China
| | - Xueying Mao
- College of Food Science and Nutritional Engineering, Key Laboratory of Functional Dairy, Ministry of Education, China Agricultural University, Beijing, China
- *Correspondence: Xueying Mao,
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Clinical and sociodemographic determinants of disease-specific health-related quality of life in long-term breast cancer survivors. J Cancer Res Clin Oncol 2022; 148:3461-3473. [PMID: 35879433 DOI: 10.1007/s00432-022-04204-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/09/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE It is important to monitor disease-specific health-related quality of life (HRQoL) in breast cancer (BC) survivors to identify potential unmet supportive care needs. However, previous studies were characterized by small samples of mostly short-term survivors and were limited to certain age ranges, stages and/or treatments. METHODS We used data from 3045 long-term BC survivors (5-15 years post-diagnosis) recruited in a German multi-regional population-based study. We assessed disease-specific HRQoL with the EORTC QLQ-BR23, scoring from 0 to 100. Differences in functioning and symptoms according to age at survey, self-reported treatments, stage, and disease status (disease-free vs. active disease) were assessed with multiple regression. Active disease was defined as any self-report of recurrence, metastasis or second primary cancer after the index cancer. RESULTS Older BC survivors reported a higher body image and a better future perspective, but lower sexual functioning. Survivors aged 30-49 years who had breast-conserving therapy or mastectomy with breast reconstruction reported a better body image compared to those who had mastectomy only. We also found differences in symptoms according to treatments in some age groups. Stage at diagnosis was not associated with HRQoL overall and in most age subgroups. Disease-free BC survivors aged 30-79 years reported a better future perspective and less systemic therapy side effects than those with active disease. CONCLUSION Several treatment-associated symptoms and functioning detriments were found 5-15 years after diagnosis. The results emphasize the need of a comprehensive, individualized survivorship care, recognizing differential needs of long-term BC survivors according to age, treatment modalities, and disease status.
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Dufner V, Kessler AF, Just L, Hau P, Bumes E, Pels HJ, Grauer OM, Wiese B, Löhr M, Jordan K, Strik H. The Emesis Trial: Depressive Glioma Patients Are More Affected by Chemotherapy-Induced Nausea and Vomiting. Front Neurol 2022; 13:773265. [PMID: 35242096 PMCID: PMC8886159 DOI: 10.3389/fneur.2022.773265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Glioma patients face a limited life expectancy and at the same time, they suffer from afflicting symptoms and undesired effects of tumor treatment. Apart from bone marrow suppression, standard chemotherapy with temozolomide causes nausea, emesis and loss of appetite. In this pilot study, we investigated how chemotherapy-induced nausea and vomiting (CINV) affects the patients' levels of depression and their quality of life. METHODS In this prospective observational multicentre study (n = 87), nausea, emesis and loss of appetite were evaluated with an expanded MASCC questionnaire, covering 10 days during the first and the second cycle of chemotherapy. Quality of life was assessed with the EORTC QLQ-C30 and BN 20 questionnaire and levels of depression with the PHQ-9 inventory before and after the first and second cycle of chemotherapy. RESULTS CINV affected a minor part of patients. If present, it reached its maximum at day 3 and decreased to baseline level not before day 8. Levels of depression increased significantly after the first cycle of chemotherapy, but decreased during the further course of treatment. Patients with higher levels of depression were more severely affected by CINV and showed a lower quality of life through all time-points. CONCLUSION We conclude that symptoms of depression should be perceived in advance and treated in order to avoid more severe side effects of tumor treatment. Additionally, in affected patients, delayed nausea was most prominent, pointing toward an activation of the NK1 receptor. We conclude that long acting antiemetics are necessary totreat temozolomide-induced nausea.
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Affiliation(s)
- Vera Dufner
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | | | - Larissa Just
- Department of Neurology, University Medical Center, Marburg, Germany
| | - Peter Hau
- Wilhelm Sander Neuroonkologische Therapieeinheit, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Elisabeth Bumes
- Wilhelm Sander Neuroonkologische Therapieeinheit, Universitätsklinikum Regensburg, Regensburg, Germany
| | | | | | - Bettina Wiese
- Department of Hematology, University Medical Center, Heidelberg, Germany
| | - Mario Löhr
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Karin Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Herwig Strik
- Department of Neurology, Sozialstiftung Bamberg, Bamberg, Germany
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Hein MJA, Kvansakul M, Lay FT, Phan TK, Hulett MD. Defensin-lipid interactions in membrane targeting: mechanisms of action and opportunities for the development of antimicrobial and anticancer therapeutics. Biochem Soc Trans 2022; 50:423-437. [PMID: 35015081 PMCID: PMC9022979 DOI: 10.1042/bst20200884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/29/2021] [Accepted: 12/21/2021] [Indexed: 12/21/2022]
Abstract
Defensins are a class of host defence peptides (HDPs) that often harbour antimicrobial and anticancer activities, making them attractive candidates as novel therapeutics. In comparison with current antimicrobial and cancer treatments, defensins uniquely target specific membrane lipids via mechanisms distinct from other HDPs. Therefore, defensins could be potentially developed as therapeutics with increased selectivity and reduced susceptibility to the resistance mechanisms of tumour cells and infectious pathogens. In this review, we highlight recent advances in defensin research with a particular focus on membrane lipid-targeting in cancer and infection settings. In doing so, we discuss strategies to harness lipid-binding defensins for anticancer and anti-infective therapies.
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Affiliation(s)
- Matthew J. A. Hein
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne 3086, Australia
| | - Marc Kvansakul
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne 3086, Australia
| | - Fung T. Lay
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne 3086, Australia
| | - Thanh Kha Phan
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne 3086, Australia
| | - Mark D. Hulett
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne 3086, Australia
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Art of prevention: The importance of dermatologic care when using aromatase inhibitors. Int J Womens Dermatol 2022; 7:769-773. [PMID: 35028380 PMCID: PMC8714559 DOI: 10.1016/j.ijwd.2021.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
As of January 2021, there are more than 3.8 million women in the United States with a history of breast cancer. The current standard of care for breast cancer involves surgical resection, radiation therapy, adjuvant endocrine therapy, and/or adjuvant chemotherapy. Aromatase inhibitors (AIs) are the gold standard for endocrine therapy in postmenopausal women. Dermatologic adverse events (dAEs) associated with AIs are rare but have been reported in the literature. Commonly reported dAEs include unspecified rash, pruritus, alopecia, vulvovaginal atrophy, vasculitis, and autoimmune/connective tissue disorders. Appropriate preventative strategies and careful management considerations have the potential to optimize the comprehensive care of patients with cancer and improve quality of life. Furthermore, prevention of dAEs can lead to a reduction in cancer treatment interruptions and discontinuations. Herein, we characterize dAEs of AIs and discuss preventative management to reduce the incidence of AI therapy interruption.
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The european particle therapy network (EPTN) consensus on the follow-up of adult patients with brain and skull base tumours treated with photon or proton irradiation. Radiother Oncol 2022; 168:241-249. [DOI: 10.1016/j.radonc.2022.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/19/2022] [Indexed: 12/25/2022]
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Yue Z, Lei M, Paus R, Chuong CM. The global regulatory logic of organ regeneration: circuitry lessons from skin and its appendages. Biol Rev Camb Philos Soc 2021; 96:2573-2583. [PMID: 34145718 PMCID: PMC10874616 DOI: 10.1111/brv.12767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/17/2022]
Abstract
In organ regeneration, the regulatory logic at a systems level remains largely unclear. For example, what defines the quantitative threshold to initiate regeneration, and when does the regeneration process come to an end? What leads to the qualitatively different responses of regeneration, which restore the original structure, or to repair which only heals a wound? Here we discuss three examples in skin regeneration: epidermal recovery after radiation damage, hair follicle fate choice after chemotherapy damage, and wound-induced feather regeneration. We propose that the molecular regulatory circuitry is of paramount significance in organ regeneration. It is conceivable that defects in these controlling pathways may lead to failed regeneration and/or organ renewal, and understanding the underlying logic could help to identify novel therapeutic strategies.
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Affiliation(s)
- ZhiCao Yue
- Department of Cell Biology and Medical Genetics, Carson International Cancer Center, Guangdong Key Laboratory for Genome Stability and Disease Prevention, Shenzhen University School of Medicine, Shenzhen, Guangdong, 518060, China
| | - Mingxing Lei
- 111 Project Laboratory of Biomechanics and Tissue Repair, College of Bioengineering, Chongqing University, Chongqing, 400038, China
| | - Ralf Paus
- Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, U.S.A
| | - Cheng-Ming Chuong
- Department of Pathology, University of Southern California, Los Angeles, CA, 90033, U.S.A
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Cancer-Related Alopecia: From Etiologies to Global Management. Cancers (Basel) 2021; 13:cancers13215556. [PMID: 34771716 PMCID: PMC8583126 DOI: 10.3390/cancers13215556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Although it does not represent a condition that threatens the life of patients, alopecia nevertheless has an essential impact on the quality of life of patients, particularly in terms of the psychological and social aspects. Indeed, while it has long been considered an acceptable side effect in the management of patients, the progressive emergence of a patient-centered approach coupled with a better knowledge of the pathophysiological processes involved has led to a better consideration of alopecia, both on the preventive and palliative sides. Thus, cancerous alopecia can be multifactorial: iatrogenic (in particular via conventional chemotherapy), induced by a vitamin/nutritional deficiency, or even caused by the disease itself. In this state-of-the-art review, we therefore cover alopecia in an exhaustive manner by considering the different mechanisms involved and their frequency as well as the various therapies offered. Abstract Alopecia represents a multifaceted challenge with distinct etiologies and consequences. Transposed to the world of oncology, different types of alopecia and molecular pathways have been characterized, allowing a better understanding of the underlying mechanisms. In patients with cancer, alopecia can be iatrogenic (i.e., due to conventional chemotherapies, endocrine therapies, targeted therapies, immunotherapies, radiotherapy and surgery) or a direct consequence of the disease itself (e.g., malnutrition, scalp metastases and paraneoplastic syndromes). Identification of the actual incriminated mechanism(s) is therefore essential in order to deliver appropriate supportive care, whether preventive or curative. On the preventive side, the last few years have seen the advent of the automated cooling cap, a prophylactic approach supported by several randomized clinical trials. On the curative side, although the treatments currently available are limited, several promising therapeutic approaches are under development. Appropriate alopecia management is essential, particularly regarding its psychological repercussions with significant consequences on the quality of life of patients and their family and with a potential impact on treatment compliance.
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Bhoyrul B, Asfour L, Lutz G, Mitchell L, Jerjen R, Sinclair RD, Holmes S, Chaudhry IH, Harries MJ. Clinicopathologic Characteristics and Response to Treatment of Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors. JAMA Dermatol 2021; 157:1335-1342. [PMID: 34586345 DOI: 10.1001/jamadermatol.2021.3676] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Alopecia induced by classic chemotherapy affects up to 65% of patients and is usually reversible. However, there are increasing reports of persistent chemotherapy-induced alopecia (pCIA), especially for patients treated with taxane-containing chemotherapy regimens. Objective To analyze the clinicopathologic characteristics and response to treatment of patients with pCIA after chemotherapy for breast cancer. Design, Setting, and Participants In this case series, a retrospective evaluation was performed of patients with a diagnosis of pCIA after chemotherapy for breast cancer in 4 specialist hair clinics from November 1, 2011, to February 29, 2020. Main Outcomes and Measures Clinical, trichoscopic, and histopathologic characteristics and treatment outcomes were analyzed. For patients who presented with diffuse alopecia or diffuse rarefaction of hair over the midfrontal scalp with widening of the central part line and preservation of the frontal hairline, the Sinclair scale (grades 1-5, where 1 indicates normal hair density and 5 indicates the most severe stage of hair loss, with little or no hair in the centroparietal region) was used to assess severity. Results One hundred patients (99 women [99%]; mean age at presentation, 54.0 years [range, 29.0-74.1 years]) were included. Most patients had diffuse nonscarring alopecia (n = 39), female pattern hair loss (n = 55), or male pattern hair loss (n = 6). Six patients developed cicatricial alopecia. Taxane-containing regimens were used for most patients (92 [92%]) and were associated with more severe alopecia than regimens that did not contain taxanes (median Sinclair grade, 4 [IQR, 3-5] vs 2 [IQR, 2-2.5]; P < .001). A total of 76 of 86 patients (88%) had trichoscopic signs indistinguishable from those of androgenetic alopecia. Of 18 patients who had biopsies, 14 had androgenetic alopecia-like features, 2 had cicatricial alopecia, and 2 had features of both. Both topical and oral minoxidil, sometimes combined with antiandrogen therapy, were associated with an improvement in hair density (median Sinclair grade, 4 [IQR, 3-5] before treatment vs 3 [IQR, 2-4] after treatment; P < .001). Conclusions and Relevance This case series outlines previously unreported features of pCIA in patients with breast cancer, including a trichoscopic description. Cosmetically significant regrowth was achieved for a significant proportion of patients with topical or systemic treatments, suggesting that pCIA may be at least partly reversible.
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Affiliation(s)
| | - Leila Asfour
- The Dermatology Centre, Salford Royal National Health Service Foundation Trust, Salford, Greater Manchester, United Kingdom
| | - Gerhard Lutz
- Hair and Nail Medicine, Bonn, Germany.,Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - Lorne Mitchell
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - Rodney D Sinclair
- Sinclair Dermatology, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Iskander H Chaudhry
- Department of Histopathology, Royal Liverpool and Broadgreen University Hospitals National Health Service Trust, Liverpool, United Kingdom
| | - Matthew J Harries
- The Dermatology Centre, Salford Royal National Health Service Foundation Trust, Salford, Greater Manchester, United Kingdom.,Centre for Dermatology Research, University of Manchester, Manchester Academic Health Science Centre and National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom
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Reply to "Presentation, diagnosis, and management options of lipedematous alopecia". JAAD Case Rep 2021; 16:22-23. [PMID: 34504929 PMCID: PMC8417389 DOI: 10.1016/j.jdcr.2021.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lavín-Pérez AM, Collado-Mateo D, Mayo X, Liguori G, Humphreys L, Copeland RJ, Jiménez A. Effects of high-intensity training on the quality of life of cancer patients and survivors: a systematic review with meta-analysis. Sci Rep 2021; 11:15089. [PMID: 34301995 PMCID: PMC8302720 DOI: 10.1038/s41598-021-94476-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/07/2021] [Indexed: 12/12/2022] Open
Abstract
Cancer and associated medical treatments affect patients' health-related quality of life (HRQoL) by decreasing functional dimensions of physical, social, cognitive, and emotional well-being, while increasing short and late-term symptoms. Exercise, however, is demonstrated to be a useful therapy to improve cancer patients' and survivors' HRQoL, yet the effectiveness of high-intensity training (HIT) exercise is uncertain. This systematic review and meta-analysis aimed to analyse the effects of HIT on HRQoL dimensions in cancer patients and survivors as well as evaluate the optimal prescription of HIT. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and examined Web of Science and PubMed (Medline) databases. Data were analysed utilizing Review Manager Software. Twenty-two articles were included in the systematic review and 17 in the meta-analysis. Results showed HIT improved global quality of life, physical functioning, role functioning, social functioning, cognitive functioning, fatigue, pain, dyspnea, and insomnia, compared to an inactive control group, yet no differences were found between HIT and low to moderate-intensity exercise interventions. Particular improvements in HRQoL were observed during cancer treatment and with a training duration of more than eight weeks, a frequency of 2 days/week, and a volume of at least 120 min/week, including 15 min or more of HIT. Our findings whilst encouraging, highlight the infancy of the extant evidence base for the role of HIT in the HRQoL of cancer patients and survivors.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- PhD International School, Program of Epidemiology and Public Health (Interuniversity), Rey Juan Carlos University, 28933, Móstoles, Spain
- Centre for Sport Studies, Rey Juan Carlos University, 28943, Fuenlabrada, Spain
- GO fitLAB, Ingesport, 28003, Madrid, Spain
| | - Daniel Collado-Mateo
- Centre for Sport Studies, Rey Juan Carlos University, 28943, Fuenlabrada, Spain.
| | - Xián Mayo
- Centre for Sport Studies, Rey Juan Carlos University, 28943, Fuenlabrada, Spain
| | - Gary Liguori
- University of Rhode Island, Kingston, 02881, USA
| | - Liam Humphreys
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, S9 3TU, UK
| | - Robert James Copeland
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, S9 3TU, UK
| | - Alfonso Jiménez
- Centre for Sport Studies, Rey Juan Carlos University, 28943, Fuenlabrada, Spain
- GO fitLAB, Ingesport, 28003, Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, S9 3TU, UK
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[Alopecia and cancers: From basics to clinical practice]. Bull Cancer 2021; 108:963-980. [PMID: 34304865 DOI: 10.1016/j.bulcan.2021.04.011] [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: 12/20/2020] [Revised: 03/30/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022]
Abstract
Alopecia, although long considered an unavoidable consequence of cancer therapy, currently presents a multifaceted challenge. The knowledge of the physiology of the hair and consequently of the pathophysiology of alopecia has led to show that there is not one but several types of alopecia. Transposed to the world of oncology, different types of alopecia and subsequently molecular pathways have been characterized, allowing a better understanding of the underlying mechanisms. Thus, in patients with cancer, alopecia can be iatrogenic (chemotherapies, endocrine therapies, targeted therapies, immunotherapies, radiotherapy, surgery) or directly the consequence of the disease itself (malnutrition, scalp metastases, paraneoplastic syndromes). Knowledge of the incriminated mechanism(s) could thus make it possible to deploy an appropriate care component, whether on the preventive or curative sides or in terms of supportive care. These are particularly essential regarding the psychological repercussions caused by alopecia, with significant consequences on the quality of life of patients and with a potential impact on treatment compliance. On the preventive side, the last few years have seen the advent of the automated scalp cooling therapy, supported by several randomized clinical trials. On the curative side, several therapeutic proposals are currently deployed or under development in order to provide relevant treatments.
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Wang S, Yang T, Shen A, Qiang W, Zhao Z, Zhang F. The scalp cooling therapy for hair loss in breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis. Support Care Cancer 2021; 29:6943-6956. [PMID: 33847828 DOI: 10.1007/s00520-021-06188-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/28/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically assess the efficacy and side effects of scalp cooling in patients with breast cancer. METHODS A systematic literature search was conducted in October 2020 across Cochrane Library, PubMed, Embase, CINAHL, Web of Science, Scopus, and four Chinese databases (CNKI, Wanfang, SinoMed, and VIP database). Our review included all randomized controlled trials, cohort studies, and cross-sectional studies. Two authors independently searched databases, screened studies, extracted data, and evaluated each included study's methodological quality and risk bias. Meta-analysis was performed using Stata 15.1 software package and Revman 5.3 software, with estimates of scalp cooling effect and its side effects from pooled using a random-effects model. This study has been registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020216224). RESULTS In total, 755 articles were screened and data from 27 studies involving 2202 participants were used in the meta-analysis. Studies meeting inclusion and exclusion criteria were three randomized clinical trials, 12 cohort studies, and 12 cross-sectional studies. The effectiveness rate of using a scalp cooling device to protect hair was 61% (95% CI: 55 to 67%, I2 = 88%, P = 0.000). However, scalp cooling therapy's side effects are not be ignored, such as headache, dizziness, scalp pain, neck pain, feeling cold, heaviness of the head, skin rash, nausea, and overtightened strap. CONCLUSIONS This review shows that scalp cooling devices can significantly improve the patients with breast cancer chemotherapy-induced alopecia, but the implications of its side effects provide guide for the implementation of this technology.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Aomei Shen
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
| | - Zihan Zhao
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Fangyuan Zhang
- Nursing Department, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
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Breneman DL, Breneman A, Ballman E, Breneman JC. Long-term effects of total skin electron beam therapy for mycosis fungoides on hair and nail loss and regrowth. J DERMATOL TREAT 2021; 33:1975-1978. [PMID: 33755504 DOI: 10.1080/09546634.2021.1906398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To better document the risk of permanent hair and nail loss after total skin electron beam therapy (TSEBT) for mycosis fungoides (MF). METHODS Interviews and evaluations were conducted in 13 patients with MF treated with TSEBT alone and two patients treated with concomitant TSEBT and chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). Evaluated parameters included time to hair and nail loss and regrowth, the density of hair regrowth, and quality of hair and nail regrowth. RESULTS Most patients had complete loss of scalp hair during treatment, and new growth appeared about 2 months following treatment completion. After 18 months, most patients felt their hair had regrown to about 70% of baseline thickness without cosmetically obvious alopecia. The patients treated with TSEBT and concomitant chemotherapy had substantially less scalp hair regrowth with persistent cosmetically obvious alopecia. Some lost eyebrows and eyelashes, but complete or near-complete regrowth generally occurred. Most patients lost their nails following TSEBT, with complete regrowth noted by most patients 5 months after treatment. New nails were most often normal, but a few patients developed post-therapy nail dystrophies. CONCLUSION This data can be used to better inform patients of likely long-term changes of hair and nails following TSEBT.
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Affiliation(s)
- Debra L Breneman
- Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alyssa Breneman
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Elaine Ballman
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - John C Breneman
- Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Lima ABS, Rocha FT, Perecin FAMC, Simão JCL, Westin AT, Frade MAC. Flame Hair: Auxiliary Trichoscopic Finding in Radiotherapy-Induced Alopecia. Skin Appendage Disord 2021; 7:224-226. [PMID: 34055913 PMCID: PMC8138194 DOI: 10.1159/000513578] [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: 08/11/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022] Open
Abstract
Radiotherapy-induced alopecia is characterized by an anagen effluvium (AE). It may be temporary or permanent, depending on the radiation dose. The diagnosis is based on clinical history and dermatologic exam with trichoscopy being auxiliary the presence of flame hair. We describe a case of an AE induced by radiotherapy, emphasizing the trichoscopic findings.
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Affiliation(s)
- Ana Beatriz Silva Lima
- Division of Dermatology, Department of Internal Medicine, Hospital of the clinics of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Brook I. Early side effects of radiation treatment for head and neck cancer. Cancer Radiother 2021; 25:507-513. [PMID: 33685809 DOI: 10.1016/j.canrad.2021.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/04/2021] [Indexed: 12/28/2022]
Abstract
Purpose of this review of medical literature is to present the immediate side effects of radiation therapy for head and neck cancer and their treatment. The likelihood and severity of these immediate side effects depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Early side effects include: inflammation of the oropharyngeal mucosa (mucositis), painful swallowing (odynophagia), difficulty swallowing (dysphagia), hoarseness, lack of saliva (xerostomia), orofacial pain, laryngeal radionecrosis, dermatitis, hair loss, nausea, vomiting, inadequate nutrition and hydration, and weight loss. These complications can interfere with, and delay treatment. Most of these side effects generally dissipate over time. In conclusion, radiation treatment for the head and neck cancer causes significant early side effects. Many of these side effects present difficult challenges to the patients. Their recognition and treatment can significantly improve the patients' health, long-term survival and quality of life. The review provides information that can assist head and cancer survivors deal with radiation side effects.
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Affiliation(s)
- I Brook
- Department of Pediatrics, Georgetown University School of Medicine, Washington DC, USA.
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39
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Haslam IS, Zhou G, Xie G, Teng X, Ao X, Yan Z, Smart E, Rutkowski D, Wierzbicka J, Zhou Y, Huang Z, Zhang Y, Farjo N, Farjo B, Paus R, Yue Z. Inhibition of Shh Signaling through MAPK Activation Controls Chemotherapy-Induced Alopecia. J Invest Dermatol 2021; 141:334-344. [DOI: 10.1016/j.jid.2020.05.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/16/2020] [Accepted: 05/11/2020] [Indexed: 01/09/2023]
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Lacouture ME, Sibaud V, Gerber PA, van den Hurk C, Fernández-Peñas P, Santini D, Jahn F, Jordan K. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines ☆. Ann Oncol 2021; 32:157-170. [PMID: 33248228 DOI: 10.1016/j.annonc.2020.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- M E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - V Sibaud
- Department of Oncodermatology, Claudius Regaud Institute, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - P A Gerber
- Department of Dermatology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - C van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - P Fernández-Peñas
- Department of Dermatology, The University of Sydney, Westmead Hospital, Sydney, Australia
| | - D Santini
- Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy; Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy
| | - F Jahn
- Department of Internal Medicine IV, Hematology, Oncology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
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41
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Carlesimo M, Pigliacelli F, D'Arino A, Caro G, Fortuna MC, Rossi A. Dermatologic management of oncotherapy side effects: A proposed algorithm. J Cosmet Dermatol 2020; 20:429-436. [PMID: 32585724 DOI: 10.1111/jocd.13566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 01/20/2023]
Abstract
Since the introduction of the first chemotherapeutic regimens for the treatment of oncological disease, hundreds of drugs have been approved for cancer treatment and many more are under investigation. The development of newer drugs such as target therapies, immuno-oncotherapies, and hormonal therapies has increased in specificity with the development of smaller molecules and more selective targets. Cutaneous side effects are now well known for both standard chemotherapy and targeted therapies. The correct diagnosis and management of these effects are of vital importance both to optimize therapeutic success rates and to reduce the patient's suffering. In fact, the appearance of a cutaneous adverse event can be responsible for a reduction in drug dosage or worse its suspension. In order to achieve this objective, we propose a management algorithm, based on three different steps, before, during, and after the oncological treatments, respectively. Our proposal underlines the importance of correct skin care measures to limit or reduce the severity of side effects.
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Affiliation(s)
- Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
| | - Flavia Pigliacelli
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
| | - Andrea D'Arino
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
| | - Maria Caterina Fortuna
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, Sapienza University of Rome, Rome, Italy
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Abstract
Drug reactions resulting from chemotherapy agents are common and frequently affect the skin. Although often benign, a select few of these cutaneous reactions may necessitate immediate changes to the antineoplastic regimens. Given the diversity of chemotherapeutic skin reactions and their complex implications on patient management, an organized conceptual schema is imperative for proper patient care. We evaluate a number of commonly seen chemotherapy-induced skin toxicities organized by pathogenic mechanism and drug class, providing a framework for the identification and categorization of adverse events to prevent unrecognition. Groupings of these reactions include direct cytotoxicity and/or drug accumulation, immunologic hypersensitivity, and aberrant molecular signaling.
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Affiliation(s)
- Dylan Haynes
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA.
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43
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Silva GDB, Ciccolini K, Donati A, Hurk CVD. Scalp cooling to prevent chemotherapy-induced alopecia. An Bras Dermatol 2020; 95:631-637. [PMID: 32622629 PMCID: PMC7563013 DOI: 10.1016/j.abd.2020.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/20/2020] [Indexed: 02/07/2023] Open
Abstract
Chemotherapy-induced alopecia causes an important impact on cancer patients and its risk of persistence is currently a considerable issue in cancer survivors. Of the various interventions proposed for the prevention of chemotherapy-induced alopecia, scalp cooling has emerged as an effective and safe strategy. This paper aims to provide an overview on scalp cooling and chemotherapy-induced alopecia prevention.
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Affiliation(s)
| | - Kathryn Ciccolini
- Department of Hematology/Oncology, Mount Sinai Hospital, New York, NY, United States of America
| | - Aline Donati
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| | - Corina van den Hurk
- R & D Department, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
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44
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Deutsch A, McLellan BN. Severe onycholysis and eyelash trichomegaly in a patient treated with erdafitinib. JAAD Case Rep 2020; 6:569-571. [PMID: 32509951 PMCID: PMC7265062 DOI: 10.1016/j.jdcr.2020.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Beth N. McLellan
- Correspondence to: Beth N. McLellan, MD, 111 East 210 Street, Bronx, NY 10467.
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45
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Scoccianti S, Simontacchi G, Greto D, Perna M, Terziani F, Talamonti C, Teriaca MA, Caramia G, Lo Russo M, Olmetto E, Delli Paoli C, Grassi R, Carfora V, Saieva C, Bonomo P, Detti B, Mangoni M, Desideri I, Francolini G, Di Cataldo V, Marrazzo L, Pallotta S, Livi L. Dosimetric Predictors of Acute and Chronic Alopecia in Primary Brain Cancer Patients Treated With Volumetric Modulated Arc Therapy. Front Oncol 2020; 10:467. [PMID: 32322558 PMCID: PMC7156544 DOI: 10.3389/fonc.2020.00467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/16/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose: To determine dose constraints that correlate with alopecia in patients treated with photon-based Volumetric Modulated Arc Therapy (VMAT) for primary brain tumors. Methods: During the treatment planning process, the scalp was drawn as a region of interest. Dose received by 0.1 cc (D0.1cc), mean dose (Dmean), absolute volumes receiving different doses (V16Gy, V20Gy, V25Gy, V30Gy, V35Gy, V40Gy, and V43Gy) were registered for the scalp. Alopecia was assessed according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Receiver operating characteristics (ROC) curve analysis was used to identify parameters associated with hair-loss. Results: One-hundred and one patients were included in this observational study. At the end of radiotherapy (RT), 5 patients did not develop alopecia (Dmean scalp 3.1 Gy). The scalp of the patients with G1 (n = 11) and G2 (n = 85) alopecia received Dmean of 10.6 Gy and 11.8 Gy, respectively. At ROC analysis, V16Gy20Gy ≥ 5.2 cc were the strongest predictors of acute alopecia risk. Chronic hair-loss assessment was available for 74 patients: median time to recovery from G2 alopecia was 5, 9 months. The actuarial rate of hair regrowth was 98.1% at 18 months after the end of RT. At ROC analysis, V40Gy43Gy ≥2.2 cc were the strongest predictors of chronic G2-alopecia risk. V20Gy, V40Gy, and D0,1cc were shown to be independent variables according to correlation coefficient r. Conclusions: V20Gy and V40Gy were the strongest predictors for acute and chronic G2 hair-loss, respectively. The low-dose bath typical of VMAT corresponds to large areas of acute but transient alopecia. However, the steep dose gradient of VMAT allows to reduce the areas of the scalp that receive higher doses, minimizing the risk of permanent alopecia. The application of our dosimetric findings for the scalp may help in reducing the alopecia risk and also in estimating the probability of hair-loss during patient counseling before starting radiotherapy.
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Affiliation(s)
- Silvia Scoccianti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Gabriele Simontacchi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Daniela Greto
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Marco Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesca Terziani
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Cinzia Talamonti
- Medical Physics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Maria Ausilia Teriaca
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Giorgio Caramia
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Monica Lo Russo
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Emanuela Olmetto
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Camilla Delli Paoli
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Roberta Grassi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Vincenzo Carfora
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Calogero Saieva
- SC Epidemiology of Risk Factors and Lifestyles, Institute for Study, Prevention, and Oncology Network (ISPRO), Florence, Italy
| | - Pierluigi Bonomo
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Beatrice Detti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Monica Mangoni
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Vanessa Di Cataldo
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Livia Marrazzo
- Medical Physics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Stefania Pallotta
- Medical Physics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Lorenzo Livi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
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Management of dermatologic adverse events from cancer therapies: recommendations of an expert panel. An Bras Dermatol 2020; 95:221-237. [PMID: 32165025 PMCID: PMC7175407 DOI: 10.1016/j.abd.2020.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/12/2020] [Indexed: 12/15/2022] Open
Abstract
With the development of new cancer therapies, systemic toxicity profile and effects on survival achieved an important improvement. However, a constellation of toxicities has emerged, even more remarkably, cutaneous adverse events. This report, developed by a board of Brazilian experts in oncodermatology, aims to establish a guideline for the dermatological care of oncologic patients. When possible, evidence-based recommendations were made, but in many cases, when strong evidence was not available, a consensus was reached, based on some data supporting therapies combined with personal experiences.
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Novice T, Novice M, Shapiro J, Lo Sicco K. Chemotherapy-induced alopecia—A potentially preventable side effect with scalp cooling. J Am Acad Dermatol 2020; 82:e57-e59. [DOI: 10.1016/j.jaad.2019.09.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 11/27/2022]
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Ferreira MN, Ramseier JY, Leventhal JS. Dermatologic conditions in women receiving systemic cancer therapy. Int J Womens Dermatol 2019; 5:285-307. [PMID: 31909148 PMCID: PMC6938835 DOI: 10.1016/j.ijwd.2019.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/12/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt cancer therapy and can therefore affect overall survival and treatment response. In this article, we review the dermatologic adverse effects from traditional chemotherapy, targeted therapy, immune checkpoint inhibitors, and endocrine therapy that disproportionately affect women. The timely diagnosis and management of these dermatologic conditions is crucial in the multidisciplinary care of women with cancer.
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49
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Melanoma and Vitiligo: In Good Company. Int J Mol Sci 2019; 20:ijms20225731. [PMID: 31731645 PMCID: PMC6888090 DOI: 10.3390/ijms20225731] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
Cutaneous melanoma represents the most aggressive form of skin cancer, whereas vitiligo is an autoimmune disorder that leads to progressive destruction of skin melanocytes. However, vitiligo has been associated with cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by both melanoma cells and normal melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. In this review, we discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, as well as the significance of occurrence of leukoderma during immunotherapy, with special attention to check-point inhibitors.
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50
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Asz-Sigall D, Iñigo-Gomez K, Ortega-Springall MF, Vega-Memije ME, Arenas R, Tosti A. Alopecia Secondary to Hyaluronic Acid Embolization: Trichoscopic Findings. Skin Appendage Disord 2019; 5:396-400. [PMID: 31799272 PMCID: PMC6883453 DOI: 10.1159/000502262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/21/2019] [Indexed: 11/19/2022] Open
Abstract
Fillers are frequently used in aesthetic medicine and, although usually safe, complications can occur. Vascular occlusion leading to tissue necrosis is a rare but severe complication. Alopecia after hyaluronic acid injection has been recently reported, being a vascular compromise the most probable physiopathological mechanism. The trichoscopic findings in this entity have not been described yet. A case report of a 30-year-old female who developed this complication following a hyaluronic acid injection as well as the description of the trichoscopic findings are presented in this report.
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Affiliation(s)
- Daniel Asz-Sigall
- Oncodermatology and Trichology Clinic, National University of Mexico, Mexico City, Mexico
| | - Karla Iñigo-Gomez
- Dermatology Department, “Dr. Manuel Gea Gonzalez” General Hospital, Mexico City, Mexico
| | | | | | - Roberto Arenas
- Micology Section, “Dr. Manuel Gea Gonzalez” General Hospital, Mexico City, Mexico
| | - Antonella Tosti
- Dermatology Department, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
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