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Tejera-Vaquerizo A, Boada A, Puig S, Nagore E, Fernández-de-Misa R, Ferrándiz L, Conde-Taboada A, Castro E, Richarz NA, Paradela S, Llambrich Á, Salgüero I, Diago A, Samaniego E, Flórez Á, Segura S, Maldonado-Seral C, Coronel-Pérez IM, Tomás-Velázquez A, Rodríguez P, Mayor A, García-Doval I, Grau-Pérez M. Melanoma Registry of the Spanish Academy of Dermatology and Venereology (REGESMEL): Description and Data in its First Year of Operation. Actas Dermosifiliogr 2024:S0001-7310(24)00184-4. [PMID: 38452890 DOI: 10.1016/j.ad.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/24/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The incidence of melanoma is rising in Spain. The prognostic stages of patients with melanoma are determined by various biological factors, such as tumor thickness, ulceration, or the presence of regional or distant metastases. The Spanish Academy of Dermatology and Venereology (AEDV) has encouraged the creation of a Spanish Melanoma Registry (REGESMEL) to evaluate other individual and health system-related factors that may impact the prognosis of patients with melanoma. The aim of this article is to introduce REGESMEL and provide basic descriptive data for its first year of operation. METHODS REGESMEL is a prospective, multicentre cohort of consecutive patients with invasive cutaneous melanoma that collects demographic and staging data as well as individual and healthcare-related baseline data. It also records the medical and surgical treatment received by patients. RESULTS A total of 450 cases of invasive cutaneous melanoma from 19 participant centres were included, with a predominance of thin melanomas≤1mm thick (54.7%), mainly located on the posterior trunk (35.2%). Selective sentinel lymph node biopsy was performed in 40.7% of cases. Most cases of melanoma were suspected by the patient (30.4%), or his/her dermatologist (29.6%). Patients received care mainly in public health centers (85.2%), with tele-dermatology resources being used in 21.6% of the cases. CONCLUSIONS The distribution of the pathological and demographic variables of melanoma cases is consistent with data from former studies. REGESMEL has already recruited patients from 15 Spanish provinces and given its potential representativeness, it renders the Registry as an important tool to address a wide range of research questions.
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Affiliation(s)
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Puig
- Servicio de Dermatología, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de investigación biomédica en red de enfermedades raras, CIBERER, Barcelona, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - R Fernández-de-Misa
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - L Ferrándiz
- Unidad de Melanoma, Servicio de Dermatología médico-quirúrgico, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Conde-Taboada
- Servicio de Dermatología, Hospital Clínico San Carlos, Madrid, España
| | - E Castro
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - N A Richarz
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
| | - S Paradela
- Servicio de Dermatología, Complexo Hospitalario A Coruña, A Coruña, España
| | - Á Llambrich
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - I Salgüero
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Samaniego
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur, SERGAS-UVIGO, Pontevedra, España
| | - S Segura
- Servicio de Dermatología, Hospital del Mar de Barcelona, Barcelona, España
| | - C Maldonado-Seral
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - I M Coronel-Pérez
- Servicio de Dermatología, Hospital Universitario Virgen de Valme de Sevilla, Sevilla, España
| | - A Tomás-Velázquez
- Servicio de Dermatología, Clínica Universidad de Navarra, Madrid, España
| | - P Rodríguez
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España; Servicio de Dermatología, Hospital Ruber Internacional, Madrid, España
| | - A Mayor
- Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - M Grau-Pérez
- Unidad de Investigación, Academia Española de Dermatología y Venereología, Madrid, España; Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
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Ríos-Viñuela E, García-Vázquez M, Juan MJ, Nagore E, Requena C, Sanmartín O, Llombart B. Avelumab to treat Merkel cell carcinoma: real-life experience in a dedicated oncology center. Actas Dermosifiliogr 2024:S0001-7310(24)00059-0. [PMID: 38423921 DOI: 10.1016/j.ad.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
The arrival of immunotherapy has revolutioned the management of patients with metastatic Merkel cell carcinoma (MCC). We conducted an observational, retrospective study of 14 cases treated with avelumab. The response rate was 57%: complete response was reached in 29% of patients, and partial responses in 29%. The drug proved effective in 83% (5/6) of the patients with a single metastatic site. However, the disease progressed in 75% (3/4) of the patients with bone metastases. PD1-L expression, MCC polyomavirus (MCPyV) positivity, and an impaired neutrophil-to-lypmhocyte ratio (NLR) could not be associated with responses to the therapy. Avelumab is an effective and safe drug for the management of advanced MCC, and its effectiveness appears to be impacted by the number and location of metastases.
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Affiliation(s)
- E Ríos-Viñuela
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - M García-Vázquez
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - M J Juan
- Servicio de Oncología Médica, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - B Llombart
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
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Massa A, Isasi-Fuster A, Requena C, Manrique-Silva E, Kumar R, Nagore E. Nodular type but not vitamin D levels increases the risk of second primary cancers in melanoma patients: An observational study of 663 patients. Actas Dermosifiliogr 2024; 115:143-149. [PMID: 37832865 DOI: 10.1016/j.ad.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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Affiliation(s)
- A Massa
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Isasi-Fuster
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - C Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany; Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain; Department of Dermatology, Fundación Instituto Valenciano de Oncología, València, Spain.
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Massa A, Isasi-Fuster A, Requena C, Manrique-Silva E, Kumar R, Nagore E. Nodular Type but Not Vitamin D Levels Increases the Risk of Second Primary Cancers in Melanoma Patients: An Observational Study of 663 Patients. Actas Dermosifiliogr 2024; 115:T143-T149. [PMID: 38048949 DOI: 10.1016/j.ad.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/08/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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Affiliation(s)
- A Massa
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Isasi-Fuster
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany; Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - E Nagore
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, Spain; Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, València, Spain.
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Garcia-Casado Z, Millán-Esteban D, Manrique-Silva E, Requena C, Traves V, Nagore E. Germline cancer-related mutations detected by routine targeted NGS for tumour analysis: A series of 357 melanoma patients. J Eur Acad Dermatol Venereol 2023; 37:e1384-e1387. [PMID: 37422710 DOI: 10.1111/jdv.19323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Z Garcia-Casado
- Laboratory of Molecular Biology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - D Millán-Esteban
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - E Manrique-Silva
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - V Traves
- Department of Pathological Anatomy, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
- Department of Dermatology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Pellegrini C, Cardelli L, Ghiorzo P, Pastorino L, Potrony M, García-Casado Z, Elefanti L, Stefanaki I, Mastrangelo M, Necozione S, Aguilera P, Rodríguez-Hernández A, Di Nardo L, Rocco T, Del Regno L, Badenas C, Carrera C, Malvehy J, Requena C, Bañuls J, Stratigos AJ, Peris K, Menin C, Calista D, Nagore E, Puig S, Landi MT, Fargnoli MC. High- and intermediate-risk susceptibility variants in melanoma families from the Mediterranean area: A multicentre cohort from the MelaNostrum Consortium. J Eur Acad Dermatol Venereol 2023; 37:2498-2508. [PMID: 37611275 PMCID: PMC10842987 DOI: 10.1111/jdv.19461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Most of large epidemiological studies on melanoma susceptibility have been conducted on fair skinned individuals (US, Australia and Northern Europe), while Southern European populations, characterized by high UV exposure and dark-skinned individuals, are underrepresented. OBJECTIVES We report a comprehensive pooled analysis of established high- and intermediate-penetrance genetic variants and clinical characteristics of Mediterranean melanoma families from the MelaNostrum Consortium. METHODS Pooled epidemiological, clinical and genetic (CDKN2A, CDK4, ACD, BAP1, POT1, TERT, and TERF2IP and MC1R genes) retrospective data of melanoma families, collected within the MelaNostrum Consortium in Greece, Italy and Spain, were analysed. Univariate methods and multivariate logistic regression models were used to evaluate the association of variants with characteristics of families and of affected and unaffected family members. Subgroup analysis was performed for each country. RESULTS We included 839 families (1365 affected members and 2123 unaffected individuals). Pathogenic/likely pathogenic CDKN2A variants were identified in 13.8% of families. The strongest predictors of melanoma were ≥2 multiple primary melanoma cases (OR 8.1; 95% CI 3.3-19.7), >3 affected members (OR 2.6; 95% CI 1.3-5.2) and occurrence of pancreatic cancer (OR 4.8; 95% CI 2.4-9.4) in the family (AUC 0.76, 95% CI 0.71-0.82). We observed low frequency variants in POT1 (3.8%), TERF2IP (2.5%), ACD (0.8%) and BAP1 (0.3%). MC1R common variants (≥2 variants and ≥2 RHC variants) were associated with melanoma risk (OR 1.4; 95% CI 1.0-2.0 and OR 4.3; 95% CI 1.2-14.6, respectively). CONCLUSIONS Variants in known high-penetrance genes explain nearly 20% of melanoma familial aggregation in Mediterranean areas. CDKN2A melanoma predictors were identified with potential clinical relevance for cancer risk assessment.
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Affiliation(s)
- C Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - L Cardelli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Ghiorzo
- IRCCS Ospedale Policlinico San Martino, Genetica dei Tumori rari, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - L Pastorino
- IRCCS Ospedale Policlinico San Martino, Genetica dei Tumori rari, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - M Potrony
- Department of Biochemistry and Molecular Genetics, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Z García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, València, Spain
| | - L Elefanti
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - I Stefanaki
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Mastrangelo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Necozione
- Epidemiology Unit, Department of Life, Health and Environmental Science, University of L'Aquila, L'Aquila, Italy
| | - P Aguilera
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | - L Di Nardo
- UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - T Rocco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Dermatology Unit, Ospedale San Salvatore, L'Aquila, Italy
| | - L Del Regno
- UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Badenas
- Department of Biochemistry and Molecular Genetics, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
| | - C Carrera
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J Malvehy
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - J Bañuls
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - A J Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - K Peris
- UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - D Calista
- Department of Dermatology, Maurizio Bufalini Hospital, Cesena, Italy
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - S Puig
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - M T Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - M C Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Dermatology Unit, Ospedale San Salvatore, L'Aquila, Italy
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Benavent MP, Viñuela ER, Nagore E, Monteagudo C, Aguerralde M, Cano DM, Llombart B, Guillén CS, Canales IP, Requena C, Sanmartín O. [[Translated article]]Lymphovascular Invasion and High Mitotic Count Are Associated With Increased Risk of Recurrence in Pleomorphic Dermal Sarcoma. Actas Dermosifiliogr 2023:S0001-7310(23)00479-9. [PMID: 37302481 DOI: 10.1016/j.ad.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/02/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Atypical fibroxanthoma and pleomorphic dermal sarcoma (PDS) are rare mesenchymal tumors. Due to the low incidence of PDS and a historically confusing nomenclature, little is known about the true aggressiveness of this tumor. The aim of this study was to investigate clinical and histologic risk factors for recurrence in PDS. MATERIAL AND METHODS Retrospective, observational, bicentric study of 31 PDSs diagnosed and treated at Hospital Clínico Universitario de Valencia and Instituto Valenciano de Oncología in Valencia, Spain, between 2005 and 2020. We described the clinical and histologic features of these tumors and performed univariate analysis and multivariate Cox regression analysis. RESULTS In the univariate analysis, tumor recurrence (P < .001), necrosis (P = .020), lymphovascular invasion (P = .037), perineural invasion (P = .041), and mitotic count (< 18 vs ≥ 18 mitoses per 10 high-power fields) (P = .093) were associated with worse disease-free survival. In the multivariate Cox regression analysis, mitotic count and lymphovascular invasion retained their significance as predictors of worse disease-free survival (P < .05). CONCLUSIONS PDS is an aggressive tumor in which a high mitotic count (≥ 18) and lymphovascular invasion are associated with a higher risk of recurrence and worse disease-free survival. Necrosis and perineural invasion are also probably linked to increased tumor aggressiveness.
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Affiliation(s)
- M Pons Benavent
- Servicio de Dermatología, Hospital Virgen de Los Lírios, Alcoy (Alicante), España
| | - E Ríos Viñuela
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario, Valencia, España
| | - M Aguerralde
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - D Mata Cano
- Servicio de Anatomía Patológica, Hospital de Tortosa Verge de la Cinta, Tortosa (Tarragona), España
| | - B Llombart
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Serra Guillén
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - I Pinazo Canales
- Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
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Requena C, Traves V, Ferrandis E, Almero MA, Casado ZG, Silva EM, Briz ÁS, Escalonilla P, Nagore E. [[Translated article]]Melanoma arising in plaque-type blue nevus and dermal melanocytosis: Diagnostic and prognostic value of BAP1. Actas Dermosifiliogr 2023:S0001-7310(23)00477-5. [PMID: 37302484 DOI: 10.1016/j.ad.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/02/2023] [Indexed: 06/13/2023] Open
Abstract
Melanoma arising in blue nevus, also known as melanoma ex blue nevus, is a specific form of melanoma whose genetic profile is different to that of other cutaneous melanomas and surprisingly similar to that of uveal melanoma. Although melanoma ex blue nevus can appear de novo, it usually arises in a preexisting blue nevus or dermal melanocytosis. Not all nodular lesions arising in association with blue nevus or dermal melanocytosis are melanomas, however, and because clinical and histologic findings may be insufficient for a definitive diagnosis, additional studies such as comparative genomic hybridization are important. Detection of chromosomal aberrations supports a diagnosis of malignancy. Studies of the BAP1 gene are particularly useful in this setting because loss of expression is indicative of melanoma. We present 3 cases on the spectrum of blue nevus to melanoma ex blue nevus that were studied using molecular biology techniques.
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Affiliation(s)
- C Requena
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain.
| | - Víctor Traves
- Servicios de Dermatología, Anatomía Patológica, Spain
| | - E Ferrandis
- Otorrinolaringología y Biología molecular, Spain
| | | | - Z García Casado
- del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain
| | - E Manrique Silva
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - Á Santos Briz
- del Hospital Universitario Salamanca y Dermatología, Spain
| | - P Escalonilla
- del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - E Nagore
- Servicios de Dermatología, Anatomía Patológica, Spain; Otorrinolaringología y Biología molecular, Spain; del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain; del Hospital Universitario Salamanca y Dermatología, Spain; del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
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Requena C, Traves V, Ferrandis E, Antón Almero M, García-Casado Z, Manrique-Silva E, Santos Briz Á, Escalonilla P, Nagore E. Melanoma Arising in Plaque-Type Blue Nevus and Dermal Melanocytosis: Diagnostic and Prognostic Value of BAP1. Actas Dermosifiliogr 2023:S0001-7310(23)00299-5. [PMID: 37088284 DOI: 10.1016/j.ad.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
Melanoma arising in blue nevus, also known as melanoma ex blue nevus, is a specific form of melanoma whose genetic profile is different to that of other cutaneous melanomas and surprisingly similar to that of uveal melanoma. Although melanoma ex blue nevus can appear de novo, it usually arises in a preexisting blue nevus or dermal melanocytosis. Not all nodular lesions arising in association with blue nevus or dermal melanocytosis are melanomas, however, and because clinical and histologic findings may be insufficient for a definitive diagnosis, additional studies such as comparative genomic hybridization are important. Detection of chromosomal aberrations supports a diagnosis of malignancy. Studies of the BAP1 gene are particularly useful in this setting because loss of expression is indicative of melanoma. We present 3 cases on the spectrum of blue nevus to melanoma ex blue nevus that were studied using molecular biology techniques.
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Affiliation(s)
| | | | | | | | | | | | - Á Santos Briz
- del Instituto Valenciano de Oncología. Servicios de Anatomía Patológica, Spain
| | - P Escalonilla
- del Hospital Universitario Salamanca y Dermatología del Hospital Nuestra Señora de Sonsoles de Ávila, Spain
| | - E Nagore
- Servicios de Dermatología, Spain
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10
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Pons Benavent M, Ríos-Viñuela E, Nagore E, Monteagudo C, Aguerralde M, Mata Cano D, Llombart B, Serra-Guillén C, Pinazo Canales I, Requena C, Sanmartín O. Lymphovascular Invasion and High Mitotic Count Are Associated With Increased Risk of Recurrence in Pleomorphic Dermal Sarcoma. Actas Dermosifiliogr 2023:S0001-7310(23)00301-0. [PMID: 37088288 DOI: 10.1016/j.ad.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/22/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Atypical fibroxanthoma and pleomorphic dermal sarcoma (PDS) are rare mesenchymal tumors. Due to the low incidence of PDS and a historically confusing nomenclature, little is known about the true aggressiveness of this tumor. The aim of this study was to investigate clinical and histologic risk factors for recurrence in PDS. MATERIAL AND METHODS Retrospective, observational, bicentric study of 31 PDSs diagnosed and treated at Hospital Clínico Universitario de Valencia and Instituto Valenciano de Oncología in Valencia, Spain, between 2005 and 2020. We described the clinical and histologic features of these tumors and performed univariate analysis and multivariate Cox regression analysis. RESULTS In the univariate analysis, tumor recurrence (P < .001), necrosis (P = .020), lymphovascular invasion (P = .037), perineural invasion (P = .041), and mitotic count (< 18 vs ≥ 18 mitoses per 10 high-power fields) (P = .093) were associated with worse disease-free survival. In the multivariate Cox regression analysis, mitotic count and lymphovascular invasion retained their significance as predictors of worse disease-free survival (P < .05). CONCLUSIONS PDS is an aggressive tumor in which a high mitotic count (≥ 18) and lymphovascular invasion are associated with a higher risk of recurrence and worse disease-free survival. Necrosis and perineural invasion are also probably linked to increased tumor aggressiveness.
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Affiliation(s)
- M Pons Benavent
- Servicio de Dermatología, Hospital Virgen de Los Lírios, Alcoy (Alicante), España
| | - E Ríos-Viñuela
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario, Valencia, España
| | - M Aguerralde
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - D Mata Cano
- Servicio de Anatomía Patológica, Hospital de Tortosa Verge de la Cinta, Tortosa (Tarragona), España
| | - B Llombart
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Serra-Guillén
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - I Pinazo Canales
- Servicio de Dermatología, Hospital Clínico Universitario, Valencia, España
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - O Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
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11
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Requena C, Manrique E, Nagore E. [[Translated article]]Update on Lentigo Maligna: Diagnostic Signs and Treatment. Actas Dermosifiliogr 2023; 114:T413-T424. [PMID: 37086944 DOI: 10.1016/j.ad.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/28/2023] [Indexed: 04/24/2023] Open
Abstract
Lentigo maligna (LM) is an in situ cutaneous melanoma that arises in sun-damaged skin. Its most common presentation is a progressive, slow-growing, irregularly pigmented spot on the face of older patients. Although the exact percentage of LMs that progress to invasive tumors is unknown, it is thought to lie between 2% and 5%. Both the clinical and histologic diagnosis of LM can be challenging, especially in patients with early-stage or atypical disease. Treatment also holds challenges, because lesions are located in highly visible areas and are often large. Surgery can thus compromise cosmetic and sometimes functional outcomes. We review clinical and histopathological findings that can facilitate the diagnosis of LM. We also examine treatment options, with a focus on surgery.
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Affiliation(s)
- C Requena
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain.
| | - E Manrique
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain.
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12
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Requena C, Manrique E, Nagore E. Update on Lentigo Maligna: Diagnostic Signs and Treatment. Actas Dermosifiliogr 2023; 114:413-424. [PMID: 36925098 DOI: 10.1016/j.ad.2023.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/15/2023] Open
Abstract
Lentigo maligna (LM) is an in situ cutaneous melanoma that arises in sun-damaged skin. Its most common presentation is a progressive, slow-growing, irregularly pigmented spot on the face of older patients. Although the exact percentage of LMs that progress to invasive tumors is unknown, it is thought to lie between 2% and 5%. Both the clinical and histologic diagnosis of LM can be challenging, especially in patients with early-stage or atypical disease. Treatment also holds challenges, because lesions are located in highly visible areas and are often large. Surgery can thus compromise cosmetic and sometimes functional outcomes. We review clinical and histopathological findings that can facilitate the diagnosis of LM. We also examine treatment options, with a focus on surgery.
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Affiliation(s)
- C Requena
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain.
| | - E Manrique
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Servicio de Dermatología. Instituto Valenciano de Oncología, Valencia, Spain.
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13
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Martin-Gorgojo A, García-Doval I, Buendía-Eisman A, Nagore E. [Translated article] Analysis of Undergraduate Dermatology Syllabi at Spanish Universities: Does the Weight of Theoretical Content Match the Skin Conditions Seen in Primary Care and General Dermatology Practices? Actas Dermosifiliogr 2023; 114:T194-T212. [PMID: 36690144 DOI: 10.1016/j.ad.2022.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/24/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Undergraduate dermatology courses vary in the nearly 50 Spanish medical faculties that teach the subject. This study aimed to describe the characteristics of these courses and to analyze whether the weight assigned to dermatology topics reflects the caseloads of primary care physicians and general dermatologists in the Spanish national health system. MATERIAL AND METHODS Cross-sectional study of syllabi used in Spanish medical faculties during the 2021-2022 academic year. We determined the number of teaching hours in public and private university curricula and compared the weight of dermatology topics covered to the dermatology caseloads of primary care physicians and general dermatologists as reported in published studies. RESULTS Most medical faculties taught dermatology for one semester. The median number of credits offered was 4.5. On average, lectures covered 24 theoretical topics, and seminars and workshops covered 9 topics. We identified a clear disparity between the percentage of time devoted to dermatology topics in course lectures and the skin conditions usually managed in primary care and general dermatology practices. DISCUSSION The skin diseases most commonly treated by primary care physicians and general dermatologists are underrepresented in the curricula of Spanish medical faculties. The topics that should be given more weight in syllabi, or recovered for inclusion in dermatology courses, should be re-examined. Our findings show that the topics that ideally should be emphasized more are types of dermatitis, infectious skin diseases, acne, psoriasis, rashes, and the differential diagnosis of benign and malignant neoplasms. There should be additional support for the theoretical teaching of these topics.
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Affiliation(s)
- A Martin-Gorgojo
- Sección Especialidades Médicas, Servicio ITS/Dermatología, Organismo Autónomo Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain.
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, Spain; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | - E Nagore
- Departamento de Dermatología, Universidad Católica de Valencia San Vicente Mártir. Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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14
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Tejera-Vaquerizo A, Cañueto J, Nagore E. [Translated article] Tumor Doubling Time in Skin Cancer: Can It Be Estimated and Is It Useful? Actas Dermosifiliogr 2023; 114:T247-T252. [PMID: 36717070 DOI: 10.1016/j.ad.2022.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/09/2022] [Indexed: 01/30/2023] Open
Abstract
Skin cancer, like other cancers, is characterized by the uncontrolled growth of transformed cells. Tumor growth has been studied for decades. We review different methods for measuring skin tumor growth and propose a new system for estimating tumor doubling time that could be useful in the management of skin cancer.
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Affiliation(s)
- A Tejera-Vaquerizo
- Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, Spain; Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain.
| | - J Cañueto
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain; Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - E Nagore
- Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, Spain; Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain; Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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15
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Martin-Gorgojo A, García-Doval I, Buendía-Eisman A, Nagore E. Analysis of Undergraduate Dermatology Syllabi at Spanish Universities: Does the Weight of Theoretical Content Match the Skin Conditions Seen in Primary Care and General Dermatology Practices? Actas Dermosifiliogr 2023; 114:194-212. [PMID: 36370834 DOI: 10.1016/j.ad.2022.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Undergraduate dermatology courses vary in the nearly 50 Spanish medical faculties that teach the subject. This study aimed to describe the characteristics of these courses and to analyze whether the weight assigned to dermatology topics reflect the caseloads of primary care physicians and general dermatologists in the Spanish national health system. MATERIAL AND METHODS Cross-sectional study of syllabi used in Spanish medical faculties during the 2021-2022 academic year. We determined the number of teaching hours in public and private university curricula and compared the weight of dermatology topics covered to the dermatology caseloads of primary care physicians and general dermatologists as reported in published studies. RESULTS Most medical faculties taught dermatology for one semester. The median number of credits offered was 4.5. On average, lectures covered 24 theoretical topics, and seminars and workshops covered 9 topics. We identified a clear disparity between the percentage of time devoted to dermatology topics in course lectures and the skin conditions usually managed in primary care and general dermatology practices. DISCUSSION The skin diseases most commonly treated by primary care physicians and general dermatologists are underrepresented in the curricula of Spanish medical faculties. The topics that should be given more weight in syllabi, or recovered for inclusion in dermatology courses, should be re-examined. Our findings show that the topics that ideally should be emphasized more are types of dermatitis, infectious skin diseases, acne, psoriasis, rashes, and the differential diagnosis of benign and malignant neoplasms. There should be additional support for the theoretical teaching of these topics.
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Affiliation(s)
- A Martin-Gorgojo
- Sección Especialidades Médicas, Servicio ITS/Dermatología, Organismo Autónomo Madrid Salud, Ayuntamiento de Madrid, Madrid, España.
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Madrid, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | | | - E Nagore
- Departamento de Dermatología, Universidad Católica de Valencia San Vicente Mártir. Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
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16
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Tejera-Vaquerizo A, Cañueto J, Nagore E. Tumor Doubling Time in Skin Cancer: Can It Be Estimated and Is it Useful? Actas Dermosifiliogr 2023; 114:247-252. [PMID: 36273551 DOI: 10.1016/j.ad.2022.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 12/15/2022] Open
Abstract
Skin cancer, like other cancers, is characterized by the uncontrolled growth of transformed cells. Tumor growth has been studied for decades. We review different methods for measuring skin tumor growth and propose a new system for estimating tumor doubling time that could be useful in the management of skin cancer.
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Affiliation(s)
- A Tejera-Vaquerizo
- Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, España; Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - J Cañueto
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Unidad de Oncología Cutánea, Hospital San Juan de Dios, Córdoba, España; Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), España; Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
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17
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Pastor-Tomás N, Bañuls J, Nagore E. Clinical Relevance of Cherry Angiomas. Actas Dermosifiliogr 2023; 114:240-246. [PMID: 36370831 DOI: 10.1016/j.ad.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
Cherry angiomas are the most common vascular tumors of the skin. They are particularly prevalent in the general population and become more common with age. Although an association with cancer was suggested at the end of the 19th century, when these tumors were first described, it could not be demonstrated. For many decades, therefore, cherry angiomas were considered to have no clinical relevance other than their association with age. A number of studies in recent years, however, have shown a link between cherry angiomas and exposure to various toxic substances and medications, benign and malignant diseases, and immunosuppression, rekindling interest in these lesions and providing clues for a better understanding of their etiology, pathophysiology, and clinical relevance.
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Affiliation(s)
- N Pastor-Tomás
- Servicio de Dermatología, Hospital General Universitario de Elda, Elda, Alicante,Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, España.
| | - J Bañuls
- Servicio de Dermatología, Hospital General Universitario de Alicante-ISABIAL, Alicante, Departamento de Medicina Clínica, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, València, Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, València, España
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Nagore E. Editor's note. Actas Dermosifiliogr 2022; 113 Suppl 1:S1. [PMID: 36543460 DOI: 10.1016/j.ad.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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19
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Gómez-Ferrer A, Collado A, Ramírez M, Domínguez J, Casanova J, Mir C, Wong A, Marenco JL, Nagore E, Soriano V, Rubio-Briones J. A single-center comparison of our initial experiences in treating penile and urethral cancer with video-endoscopic inguinal lymphadenectomy (VEIL) and later experiences in melanoma cases. Front Surg 2022; 9:870857. [PMID: 36225221 PMCID: PMC9548630 DOI: 10.3389/fsurg.2022.870857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/08/2022] [Indexed: 12/01/2022] Open
Abstract
Background Video-endoscopic inguinal lymphadenectomy (VEIL) is a minimally invasive approach that is increasingly indicated in oncological settings, with mounting evidence for its long-term oncological safety. Objectives To present our single-center experience of treating penile and urethral cancer with VEIL, as well as its more recent application in melanoma patients. Methods We prospectively recorded our experiences with VEIL from September 2010 to July 2018, registering the patient primary indication, surgical details, complications, and follow-up. Results Twenty-nine patients were operated in one (24) or both (5) groins; 18 had penile cancer, 1 had urethral cancer, and 10 had melanoma. A mean 8.62 ± 4.45 lymph nodes were removed using VEIL and of these, an average of 1.00 ± 2.87 were metastatic; 16 patients developed lymphocele and 10 presented some degree of lymphedema; there were no skin or other major complications. The median follow-up was 19.35 months; there were 3 penile cancer patient recurrences in the VEIL-operated side. None of the melanoma patients presented a lymphatic inguinal recurrence. Conclusions VEIL is a minimally invasive technique which appears to be oncologically safe showing fewer complications than open surgery. However, complications such as lymphorrhea, lymphocele, or lymphedema were not diminished by using VEIL.
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Affiliation(s)
- A. Gómez-Ferrer
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
- Correspondence: Álvaro Gómez-Ferrer
| | - A. Collado
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - M. Ramírez
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Domínguez
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Casanova
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - C. Mir
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - A. Wong
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. L. Marenco
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - E. Nagore
- Dermatology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - V. Soriano
- Medical Oncology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
| | - J. Rubio-Briones
- Urology Department, Valencian Institute of Oncology Foundation, Valencia, Spain
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Moro R, Nagore E. Practical Considerations About Optimal Skin Incisions/Excisions in Dermatologic Surgery with Emphasis on Incisions Orientation and Primary Cutaneous Melanoma Surgery. Actas Dermosifiliogr 2022; 113:491-497. [PMID: 35697408 DOI: 10.1016/j.ad.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 10/09/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022] Open
Abstract
Dermatologic surgery has 2main objectives: 1) to guarantee surgical radicality; and 2) to achieve optimal aesthetic and functional results. These 2paradigms and their hierarchy must be considered when performing surgical procedures on the skin. Even the easiest intervention, the elliptical excision, presents some features that should be known to achieve such goals. One of these features is the incision orientation. The optimal incisions orientation is still matter of debate, especially because studies that compare the outcomes of performing incisions in different directions are lacking. However, some anatomical, clinical, and histological observations may point out why incising the skin in one orientation is better than another. Knowing the theory behind skin incisions/excisions become of outmost importance when dealing with primary cutaneous melanoma surgery. Especially if the melanocytic lesion is suspected to be an invasive melanoma and a sentinel lymph node biopsy will be required.
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Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Instituto Dermatológico Dr. Alonso, Hospital Vithas Valencia 9 de Octubre, Valencia, España.
| | - E Nagore
- Departamento de Dermatología, Instituto Valenciano de Oncología, Valencia, España
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Moro R, Nagore E. [Translated article] Practical Considerations About Optimal Skin Incisions/Excisions in Dermatologic Surgery with Emphasis on Incisions Orientation and Primary Cutaneous Melanoma Surgery. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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22
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. [Translated article] Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ríos-Viñuela E, Manrique-Silva E, Nagore E, Nájera-Botello L, Requena L, Requena C. [Translated article] Subungual Melanocytic Lesions in Pediatric Patients. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nagore E, Moreno-Ramírez D, Ortiz-Romero P, Martín-Sánchez E, Martínez-Fernández A, Puig S. [Translated article] Epidemiology of Melanoma in Spain: Estimation of Number of Patients With Stage III Disease Eligible for Adjuvant Therapies. Actas Dermo-Sifiliográficas 2022. [DOI: 10.1016/j.ad.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Moro R, Sánchez-Silva A, Aguerralde-Martin M, González-Cuevas R, Peruilh-Bagolini L, Traves V, Manrique-Silva E, Requena C, Nagore E. Prognostic Value of Vitamin D Serum Levels in Cutaneous Melanoma. Actas Dermosifiliogr 2022; 113:347-353. [PMID: 35623724 DOI: 10.1016/j.ad.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/28/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Vitamin D plays a fundamental role in many metabolic pathways, including those involved in cell proliferation and the immune response. Serum levels of this vitamin have been linked to melanoma risk and prognosis. This study aimed to assess the prognostic value of vitamin D serum level in melanoma. MATERIAL AND METHODS Retrospective, observational, longitudinal, and analytical study of 286 patients with a histologic diagnosis of melanoma in whom serum levels of vitamin D were measured at the time of diagnosis. We analyzed associations between serum level and epidemiologic and clinical variables and pathology findings; we also analyzed the influence of vitamin D on overall survival. An iterative loop was used to identify a vitamin D serum level to test for its an association with survival. RESULTS A vitamin D level less than 9.25ng/mL was associated with a histologic finding of ulceration. After a median follow-up period of 39.4 months, 24 patients (8.4%) had died. The cutoff of 9.25ng/mL was associated with lower overall survival according to both the Kaplan-Meier curves and multivariate Cox regression analysis. CONCLUSION Vitamin D levels less than 9.25ng/mL are associated with ulceration in melanoma and serve as an independent prognostic factor for overall survival in this disease.
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Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Clinica San Carlo, Paderno Dugnano, Italia
| | - A Sánchez-Silva
- Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España
| | - M Aguerralde-Martin
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España
| | - R González-Cuevas
- Servicio de Dermatología, Hospital del Salvador, Santiago, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Peruilh-Bagolini
- Facultad de Medicina, Universidad de Chile, Santiago, Chile; Fundación Arturo López Pérez (FALP), Oncologic Institute, Santiago, Chile
| | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, España
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Máster de Ingeniería de Análisis de Datos, Toma de Decisiones y Mejora de Procesos, Universidad Politécnica de Valencia, Valencia, España; Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
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Nagore E, Moreno-Ramírez D, Ortiz-Romero P, Martín-Sánchez E, Martínez-Fernández A, Puig S. Epidemiology of Melanoma in Spain: Estimation of Number of Patients With Stage III Disease Eligible for Adjuvant Therapies. Actas Dermosifiliogr 2022; 113:354-362. [PMID: 35623725 DOI: 10.1016/j.ad.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/27/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Accurate information on the incidence of melanoma by stage and a better understanding of transition between stages are important for determining the burden of disease and assessing the impact of new adjuvant therapies on recurrence and survival. The aim of this study was to estimate the incidence rates of the various stages of melanoma in Spain and to estimate the number of patients with stage III disease who are eligible for adjuvant systemic therapies. MATERIALS AND METHOD We built an epidemiological model using prospectively collected data from patients diagnosed with de novo or recurrent melanoma between 2012 and 2016 in the melanoma units of 4 public hospitals. RESULTS The estimated crude incidence rates for stage I and II melanoma were 7 and 2.9 cases per 100,000 person-years, respectively. The corresponding rates for stage III and IV melanoma were 1.9 and 1.3 cases per 100,000 person-years; 25.8% of patients with stage III melanoma were stage IIIA, 47% were stage IIIB, and 27.3% were stage IIIC. The respective estimated incidence rates for recurrent stage III and IV melanoma were 1.1 and 0.9 cases per 100,000 person-years. Overall, 54% of patients with recurrent stage III melanoma had progressed from stage I or II; the other cases corresponded to changes in substage. Of the patients with stage III melanoma, 85% of those with a de novo diagnosis and 80% of those who had relapsed had resectable disease, meaning they were eligible for adjuvant therapy; 47% of these patients had a BRAF mutation. CONCLUSIONS The above estimates could have a major impact on health care resource planning. Assessing the number of patients with melanoma who are eligible for adjuvant therapies in melanoma could help decision-makers and clinicians anticipate future needs for the management of this disease.
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Affiliation(s)
- E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - D Moreno-Ramírez
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - P Ortiz-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Martín-Sánchez
- Departamento de Acceso al Mercado, Novartis Farmacéutica S.A., Barcelona, España
| | | | - S Puig
- Servicio de Dermatología, Hospital Universitari Clínic, Barcelona, España
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Ríos-Viñuela E, Manrique-Silva E, Nagore E, Nájera-Botello L, Requena L, Requena C. Subungual Melanocytic Lesions in Pediatric Patients. Actas Dermosifiliogr 2022; 113:388-400. [PMID: 35623729 DOI: 10.1016/j.ad.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 01/07/2023] Open
Abstract
The study of subungual melanocytic lesions can present challenges because of the clinical and histologic characteristics of the nail unit and the difficulty of performing nail biopsies and processing specimens. These lesions can be even more challenging in children due to differences in clinical and epidemiological profiles between the adult and pediatric populations. Many of the clinical features of subungual melanocytic lesions that would raise alarm in an adult do not have the same implications in children. Consensus is also lacking on when a nail biopsy is needed to rule out malignancy in the pediatric setting. In view of these considerations and the rarity of subungual melanoma in childhood, the recommended approach in most cases is a watch-and-wait strategy. Subungual melanocytic lesions in children may also show atypical histopathologic features that are not necessarily associated with aggressive behavior. Subungual melanoma is very rare in childhood, with just 21 cases described to date. None of the patients developed visceral metastasis or died as a result and the diagnosis was controversial in many of the cases. Considering the above and the significantly higher frequency and particular characteristics of longitudinal melanonychia with a benign etiology in children, subungual melanocytic lesions should be managed differently in this setting than in adults. In most cases, a watch-and-wait approach is the most appropriate strategy.
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Affiliation(s)
- E Ríos-Viñuela
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - E Manrique-Silva
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - L Nájera-Botello
- Servicio de Anatomía Patológica, Hospital Universitario Puerta del Hierro, Madrid, España
| | - L Requena
- Servicio de Dermatología, Fundación Jiménez Díaz, Madrid, España
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
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Flórez Menéndez A, Nagore E, Buendía Eisman A. Cuentos Lunares: Poems and Flash Fiction That Save Lives — A Euromelanoma Project During the COVID-19 Pandemic. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dalmasso B, Pastorino L, Nathan V, Shah NN, Palmer JM, Howlie M, Johansson PA, Freedman ND, Carter BD, Beane-Freeman L, Hicks B, Molven A, Helgadottir H, Sankar A, Tsao H, Stratigos AJ, Helsing P, Van Doorn R, Gruis NA, Visser M, Wadt KAW, Mann G, Holland EA, Nagore E, Potrony M, Puig S, Menin C, Peris K, Fargnoli MC, Calista D, Soufir N, Harland M, Bishop T, Kanetsky PA, Elder DE, Andreotti V, Vanni I, Bruno W, Höiom V, Tucker MA, Yang XR, Andresen PA, Adams DJ, Landi MT, Hayward NK, Goldstein AM, Ghiorzo P. Germline ATM variants predispose to melanoma: a joint analysis across the GenoMEL and MelaNostrum consortia. Genet Med 2021; 23:2087-2095. [PMID: 34262154 PMCID: PMC8553617 DOI: 10.1038/s41436-021-01240-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Ataxia-Telangiectasia Mutated (ATM) has been implicated in the risk of several cancers, but establishing a causal relationship is often challenging. Although ATM single-nucleotide polymorphisms have been linked to melanoma, few functional alleles have been identified. Therefore, ATM impact on melanoma predisposition is unclear. METHODS From 22 American, Australian, and European sites, we collected 2,104 familial, multiple primary (MPM), and sporadic melanoma cases who underwent ATM genotyping via panel, exome, or genome sequencing, and compared the allele frequency (AF) of selected ATM variants classified as loss-of-function (LOF) and variants of uncertain significance (VUS) between this cohort and the gnomAD non-Finnish European (NFE) data set. RESULTS LOF variants were more represented in our study cohort than in gnomAD NFE, both in all (AF = 0.005 and 0.002, OR = 2.6, 95% CI = 1.56-4.11, p < 0.01), and familial + MPM cases (AF = 0.0054 and 0.002, OR = 2.97, p < 0.01). Similarly, VUS were enriched in all (AF = 0.046 and 0.033, OR = 1.41, 95% CI = 1.6-5.09, p < 0.01) and familial + MPM cases (AF = 0.053 and 0.033, OR = 1.63, p < 0.01). In a case-control comparison of two centers that provided 1,446 controls, LOF and VUS were enriched in familial + MPM cases (p = 0.027, p = 0.018). CONCLUSION This study, describing the largest multicenter melanoma cohort investigated for ATM germline variants, supports the role of ATM as a melanoma predisposition gene, with LOF variants suggesting a moderate-risk.
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Affiliation(s)
- B Dalmasso
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy.
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy.
| | - L Pastorino
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - V Nathan
- Oncogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - N N Shah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - J M Palmer
- Oncogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - M Howlie
- Oncogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - P A Johansson
- Oncogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - N D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - B D Carter
- American Cancer Society, Atlanta, GA, USA
| | - L Beane-Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - B Hicks
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - A Molven
- Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - H Helgadottir
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - A Sankar
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - H Tsao
- Wellman Center for Photomedicine, Department of Dermatology, MGH Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - A J Stratigos
- First Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - P Helsing
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - R Van Doorn
- Department Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - N A Gruis
- Department Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Visser
- Department Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - K A W Wadt
- Department of Clinical Genetics, University Hospital of Copenhagen, Copenhagen, Denmark
| | - G Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - E A Holland
- Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - M Potrony
- Biochemistry and Molecular Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - S Puig
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
- Dermatology Department, Melanoma Unit, HospitalClínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - C Menin
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - D Calista
- Dermatology Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - N Soufir
- Dépatement de Génétique Moléculaire, Hôpital Bichat-Claude Bernard, Paris, France
| | - M Harland
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - T Bishop
- Section of Epidemiology and Biostatistics, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - P A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - D E Elder
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - V Andreotti
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - I Vanni
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - W Bruno
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - V Höiom
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - M A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - X R Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - P A Andresen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - D J Adams
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - M T Landi
- Divison of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - N K Hayward
- Oncogenomics Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - A M Goldstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - P Ghiorzo
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
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Flórez Menéndez A, Nagore E, Buendía Eisman A. Cuentos Lunares: Poems and Flash Fiction That Save Lives - A Euromelanoma Project During the COVID-19 Pandemic. Actas Dermosifiliogr (Engl Ed) 2021; 113:1-3. [PMID: 34052203 PMCID: PMC8197447 DOI: 10.1016/j.ad.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/16/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- A Flórez Menéndez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España.
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - A Buendía Eisman
- Área de Dermatología, Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
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Ríos-Viñuela E, Nájera-Botello L, Requena L, Nagore E, Requena C. Subungual Melanocytic Lesions: Key Clinical and Pathologic Concepts and Biopsy Techniques. Actas Dermosifiliogr (Engl Ed) 2021; 112:S1578-2190(21)00166-9. [PMID: 34053897 DOI: 10.1016/j.adengl.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/26/2020] [Indexed: 11/15/2022] Open
Abstract
Both dermatologists and pathologists sometimes find daunting the evaluation of melanonychia (especially subungual melanocytic lesions) because of the fear of performing nail surgery due to the risk of dystrophy, difficulties processing and interpreting nail biopsy specimens, and a general lack of experience in the field. Nevertheless, mastery of nail biopsy techniques, correct processing and orientation of specimens, and familiarity with the histologic particularities of the nail apparatus can attenuate the undoubted complexity and facilitate the tasks involved. Longitudinal excision is the biopsy technique that ensures the simplest histologic interpretation, and it is associated with a low risk of nail dystrophy when performed correctly. Clinical and epidemiological data are crucial. Subungual melanoma in childhood, for instance, is very rare and even lesions with atypical clinical and/or histologic features are probably benign. The presence of suprabasal melanocytes and other findings that would suggest malignancy at other sites are considered normal in the nail apparatus. Subungual melanoma shows a lentiginous pattern in the early stages of disease, and detection of an inflammatory infiltrate accompanying atypical lentiginous subungual lesions would appear to be one of the first diagnostic findings.
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Affiliation(s)
- E Ríos-Viñuela
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
| | - L Nájera-Botello
- Servicio de Anatomía Patológica, Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - L Requena
- Servicio de Dermatología, Fundación Jiménez Díaz, Madrid, Spain
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Arenbergerova M, Lallas A, Nagore E, Rudnicka L, Forsea AM, Pasek M, Meier F, Peris K, Olah J, Posch C. Position statement of the EADV Melanoma Task Force on recommendations for the management of cutaneous melanoma patients during COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e427-e428. [PMID: 33780557 PMCID: PMC8251426 DOI: 10.1111/jdv.17252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - A Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - A M Forsea
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.,Oncologic Dermatology Department, Elias University Hospital Bucharest, Bucharest, Romania
| | - M Pasek
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - F Meier
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany.,Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - K Peris
- UOC di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - J Olah
- Department of Oncotherapy, Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - C Posch
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria
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Moro R, Requena C, Ríos-Viñuela E, Manrique-Silva E, Traves V, Calzavara-Pinton PG, Gualdi G, Nagore E. May melanophages hinder the subclinical spread of lentigo maligna and lentigo maligna melanoma? Results from a pilot study. J Eur Acad Dermatol Venereol 2021; 35:e365-e367. [PMID: 33462879 DOI: 10.1111/jdv.17127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/10/2020] [Accepted: 01/14/2021] [Indexed: 12/31/2022]
Affiliation(s)
- R Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Dermatologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - E Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - V Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - P G Calzavara-Pinton
- Department of Dermatology, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - G Gualdi
- Dermatologic Clinic, Department of Medicine and Aging Science, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
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Botella-Estrada R, Boada-García A, Carrera-Álvarez C, Fernández-Figueras M, González-Cao M, Moreno-Ramírez D, Nagore E, Ríos-Buceta L, Rodríguez-Peralto JL, Samaniego-González E, Tejera-Vaquerizo A, Vílchez-Márquez F, Descalzo-Gallego MA, García-Doval I. Clinical Practice Guideline on Melanoma From the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermosifiliogr (Engl Ed) 2021; 112:142-152. [PMID: 32721390 DOI: 10.1016/j.ad.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022] Open
Abstract
Specialist approaches to the diagnosis and treatment of melanoma have undergone many changes. This guideline aims to provide Spanish dermatologists with evidence-based information for resolving the most common doubts that arise in clinical practice. Members of the Spanish Oncologic Dermatology and Surgery Group (GEDOC) with experience treating melanoma were invited to participate in drafting the guideline. The group developed a new guideline on the basis of existing ones, using the ADAPTE collaboration process, first summarizing the care process and posing relevant clinical questions, then selecting guidelines with the best scores according to the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. Finally, the group searched the selected guidelines for answers to the clinical questions, drafted recommendations, and sent them for external review. The guideline is structured around 21 clinical questions chosen for their relevance to issues that make clinical decisions about the management of melanoma difficult. Evidence from existing guidelines was used to answer the questions. A limitation of this guide derives from the scarce evidence available for answering some questions. Moreover, some areas are changing rapidly, so recommendations must be updated often. The present guideline offers answers to clinical questions about the routine management of melanoma in clinical practice and provides dermatologists with a reference to guide decisions, taking into consideration the resources available and patient preferences.
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Affiliation(s)
- R Botella-Estrada
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España; Departamento de Medicina, Universitat de València, Valencia, España.
| | - A Boada-García
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | | | - M Fernández-Figueras
- Área de Anatomía Patológica, Hospital Universitario General de Cataluña-Quirón Salud, Barcelona, España
| | - M González-Cao
- Translational Cancer Research Unit, Instituto Oncológico Dr. Rosell, Hospital Universitario Dexeus, Barcelona, España
| | - D Moreno-Ramírez
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - L Ríos-Buceta
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - J L Rodríguez-Peralto
- Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Samaniego-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | | | - F Vílchez-Márquez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - M A Descalzo-Gallego
- Unidad de Investigación, Fundación Piel Sana, Academia Española de Dermatología y Venereología, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana, Academia Española de Dermatología y Venereología, Madrid, España
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Botella-Estrada R, Boada-García A, Carrera-Álvarez C, Fernández-Figueras M, González-Cao M, Moreno-Ramírez D, Nagore E, Ríos-Buceta L, Rodríguez-Peralto J, Samaniego-González E, Tejera-Vaquerizo A, Vílchez-Márquez F, Descalzo-Gallego M, García-Doval I. Clinical Practice Guideline on Melanoma From the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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36
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Nagore E, Martinez-Garcia MA, Gomez-Olivas JD, Manrique-Silva E, Martorell A, Bañuls J, Carrera C, Ortiz P, Gardeazabal J, Boada A, de Eusebio E, Chiner E, Gonzalez C, Pérez-Gil A, Cullen D, Formigón M, de Unamuno B, Navarro-Soriano C, Muriel A, Gozal D. Relationship between type 2 diabetes mellitus and markers of cutaneous melanoma aggressiveness: an observational multicentric study in 443 patients with melanoma. Br J Dermatol 2021; 185:756-763. [PMID: 33453061 DOI: 10.1111/bjd.19813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/01/2020] [Accepted: 01/11/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Some studies have suggested a relationship between type 2 diabetes mellitus (T2DM) and increased incidence of melanoma. Efforts are under way to identify preventable and treatable factors associated with greater melanoma aggressiveness, but no studies to date have examined the relationship between T2DM and the aggressiveness of cutaneous melanoma at diagnosis. OBJECTIVES To explore potential associations between T2DM, glycaemic control and metformin treatment and the aggressiveness of cutaneous melanoma. METHODS We conducted a cross-sectional multicentric study in 443 patients diagnosed with cutaneous melanoma. At diagnosis, all patients completed a standardized protocol, and a fasting blood sample was extracted to analyse their glucose levels, glycated haemoglobin concentration and markers of systemic inflammation. Melanoma characteristics and aggressiveness factors [Breslow thickness, ulceration, tumour mitotic rate (TMR), sentinel lymph node (SLN) involvement and tumour stage] were also recorded. RESULTS The mean (SD) age of the patients was 55·98 (15·3) years and 50·6% were male. The median Breslow thickness was 0·85 mm. In total, 48 (10·8%) patients were diagnosed with T2DM and this finding was associated with a Breslow thickness > 2 mm [odds ratio (OR) 2·6, 95% confidence interval (CI) 1·4-4·9; P = 0·004)] and > 4 mm (OR 3·6, 95% CI 1·7-7·9; P = 0·001), TMR > 5 per mm2 (OR 4·5, 95% CI 1·4-13·7; P = 0·009), SLN involvement (OR 2·3, 95% CI 1-5·7; P = 0·038) and tumour stages III-IV (vs. I-II) (OR 3·4, 95% CI 1·6-7·4; P = 0·002), after adjusting for age, sex, obesity, alcohol intake and smoking habits. No significant associations emerged between glycated haemoglobin levels, metformin treatment and melanoma aggressiveness. CONCLUSIONS T2DM, rather than glycaemic control and metformin treatment, is associated with increased cutaneous melanoma aggressiveness at diagnosis.
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Affiliation(s)
- E Nagore
- Dermatology Department, Instituto Valenciano de Oncologia, Valencia, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - M A Martinez-Garcia
- Pneumology Department, Hospital Universitario i Politécnico la Fe, Valencia, Spain.,CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
| | - J D Gomez-Olivas
- Pneumology Department, Hospital Universitario i Politécnico la Fe, Valencia, Spain
| | - E Manrique-Silva
- Dermatology Department, Instituto Valenciano de Oncologia, Valencia, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - A Martorell
- Dermatology Department, Hospital de Manises, Valencia, Spain
| | - J Bañuls
- Dermatology Department, Hospital General de Alicante, Alicante, Spain
| | - C Carrera
- Dermatology Department, Hospital Clinic, Barcelona, Spain
| | - P Ortiz
- Dermatology Department, Hospital 12 de Octubre, Madrid, Spain
| | - J Gardeazabal
- Dermatology Department, Hospital de Cruces, Bilbao, Spain
| | - A Boada
- Dermatology Department, Hospital Germans Trials i Pujol, Barcelona, Spain
| | - E de Eusebio
- Dermatology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - E Chiner
- Pneumology Department, Hospital San Juan de Alicante, Spain
| | - C Gonzalez
- Dermatology Department, Hospital d Getafe, Madrid, Spain
| | - A Pérez-Gil
- Dermatology Department, Hospital de Valme, Seville, Spain
| | - D Cullen
- Dermatology Department, Fundación Jiménez Diaz, Madrid, Spain
| | - M Formigón
- Dermatology Department, Consorcio Sanitario Terrassa, Barcelona, Spain
| | - B de Unamuno
- Dermatology Department, Hospital Universitario i Politécnico la Fe, Valencia, Spain
| | - C Navarro-Soriano
- Pneumology Department, Hospital Universitario i Politécnico la Fe, Valencia, Spain
| | - A Muriel
- Biostatistic Unit, Hospital Ramón y Cajal. IRYCIS, CIBERESP, Nursery Department and Physiotherapy, Alcalá University, Madrid, Spain
| | - D Gozal
- Department of Child Health, University of Missouri, Columbia, MO, USA
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Ríos-Viñuela E, Nájera-Botello L, Requena L, Nagore E, Requena C. Subungual Melanocytic Lesions: Key Clinical and Pathologic Concepts and Biopsy Techniques. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00003-X. [PMID: 33465340 DOI: 10.1016/j.ad.2020.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/11/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022] Open
Abstract
Both dermatologists and pathologists sometimes find daunting the evaluation of melanonychia (especially subungual melanocytic lesions) because of the fear of performing nail surgery due to the risk of dystrophy, difficulties processing and interpreting nail biopsy specimens, and a general lack of experience in the field. Nevertheless, mastery of nail biopsy techniques, correct processing and orientation of specimens, and familiarity with the histologic particularities of the nail apparatus can attenuate the undoubted complexity and facilitate the tasks involved. Longitudinal excision is the biopsy technique that ensures the simplest histologic interpretation, and it is associated with a low risk of nail dystrophy when performed correctly. Clinical and epidemiological data are crucial. Subungual melanoma in childhood, for instance, is very rare and even lesions with atypical clinical and/or histologic features are probably benign. The presence of suprabasal melanocytes and other findings that would suggest malignancy at other sites are considered normal in the nail apparatus. Subungual melanoma shows a lentiginous pattern in the early stages of disease, and detection of an inflammatory infiltrate accompanying atypical lentiginous subungual lesions would appear to be one of the first diagnostic findings.
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Affiliation(s)
- E Ríos-Viñuela
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | - L Nájera-Botello
- Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro, Madrid, España
| | - L Requena
- Servicio de Dermatología, Fundación Jiménez Díaz, Madrid, España
| | - E Nagore
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
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Soufir N, Benfodda M, Descamps V, Gazal S, Madjlessi-Ezra N, Colomb M, Baccard M, Archimbaud A, Renard F, Fite C, Grange A, Levy-Sitbon C, Vuong V, Jehou J, Arnoult-Coudoux E, Bachoud A, Massart-Manil S, Nicaise-Bergere C, Machuel B, Schernberg C, Lami MC, Basset-Seguin N, Lebbe C, Dupin N, Wolkenstein P, Bagot M, Saiag P, Fraitag S, Bensussan A, Marinho E, Nagore E, Kumar R, Grange F. L’algorithme MELAPRED apparaît comme un outil clef du dépistage ciblé du mélanome. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tejera-Vaquerizo A, Cañueto J, Toll A, Santos-Juanes J, Jaka A, Ferrandiz C, Sanmartín O, Ribero S, Moreno-Ramírez D, Almazán F, Fuente MJ, Podlipnik S, Nagore E. Estimated Effect of COVID-19 Lockdown on Skin Tumor Size and Survival: An Exponential Growth Model. Actas Dermosifiliogr 2020. [PMID: 34012154 PMCID: PMC7502279 DOI: 10.1016/j.adengl.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background and objectives Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. Material and methods Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. Results Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five- and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. Conclusions In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect to see to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays.
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Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río Córdoba, Spain
| | - J Cañueto
- Servicio de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - A Toll
- Servicio de Dermatología, Hospital Clìnic de Barcelona, Barcelona, Spain
| | - J Santos-Juanes
- Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - A Jaka
- Servicio de Dermatología, Hospital Germans Trial i Pujol, Badalona, Barcelona, Spain
| | - C Ferrandiz
- Servicio de Dermatología, Hospital de la Vall d'Hebron, Barcelona, Spain
| | - O Sanmartín
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| | - S Ribero
- Departamento de Dermatología, Hospital Universitario de Turín, Turín, Italy
| | - D Moreno-Ramírez
- Unidad de Melanoma, Servicio de Dermatología Médico-Quirúrgica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - F Almazán
- Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - M J Fuente
- Servicio de Dermatología, Hospital Germans Trial i Pujol, Badalona, Barcelona, Spain
| | - S Podlipnik
- Servicio de Dermatología, Hospital Clìnic de Barcelona, Barcelona, Spain
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Manrique-Silva E, Rachakonda S, Millán-Esteban D, García-Casado Z, Requena C, Través V, Kumar R, Nagore E. Clinical, environmental and histological distribution of BRAF, NRAS and TERT promoter mutations among patients with cutaneous melanoma: a retrospective study of 563 patients. Br J Dermatol 2020; 184:504-513. [PMID: 32506424 DOI: 10.1111/bjd.19297] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The distinct somatic mutations that define clinical and histopathological heterogeneity in cutaneous melanoma could be dependent on host susceptibility to exogenous factors like ultraviolet radiation. OBJECTIVES Firstly, to characterize patients with cutaneous melanoma clinically and pathologically based on the mutational status of BRAF, NRAS and TERT promoter. Secondly, to elucidate the modified features due to the presence of TERT promoter mutations over the background of either BRAF or NRAS mutations. METHODS We performed a retrospective study on 563 patients with melanoma by investigating somatic mutations in BRAF, NRAS and TERT promoter. RESULTS We observed co-occurrence of TERT promoter mutations with BRAF and NRAS mutations in 26.3% and 6.9% of melanomas, respectively. Multivariate analysis showed an independent association between BRAF mutations and a decreased presence of cutaneous lentigines at the melanoma site, and an increased association with the presence of any MC1R polymorphism. We also observed an independent association between TERT promoter mutations and increased tumour mitotic rate. Co-occurrence of BRAF and TERT promoter mutations was independently associated with occurrence of primary tumours at usually sun-exposed sites, lack of histological chronic sun damage in surrounding unaffected skin at the melanoma site, and increased tumour mitotic rate. Co-occurrence of NRAS and TERT promoter mutations was independently associated with increased tumour mitotic rate. The presence of TERT promoter together with BRAF or NRAS mutations was associated with statistically significantly worse survival. CONCLUSIONS The presence of TERT promoter mutations discriminates BRAF- and NRAS-mutated tumours and indicates a higher involvement of ultraviolet-induced damage and tumours with worse melanoma-specific survival than those without any mutation. These observations refine classification of patients with melanoma based on mutational status.
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Affiliation(s)
- E Manrique-Silva
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.,Department of Dermatology, Instituto Valenci, Valencia, Spain
| | - S Rachakonda
- Division of Molecular Genetic Epidemiology, Division of Functional Genome Analysis, German Cancer Research Center, Heidelberg, Germany
| | - D Millán-Esteban
- Department of Molecular Biology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - Z García-Casado
- Department of Molecular Biology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - C Requena
- Department of Dermatology, Instituto Valenci, Valencia, Spain
| | - V Través
- Department of Pathology, Instituto Valenciano de Oncologia (IVO), Valencia, Spain
| | - R Kumar
- Division of Molecular Genetic Epidemiology, Division of Functional Genome Analysis, German Cancer Research Center, Heidelberg, Germany
| | - E Nagore
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Moro R, Traves V, Requena C, Nagore E. Staged Excision With Micrographic Monitoring of Margins in Lentigo Maligna. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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42
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Tejera-Vaquerizo A, Boada A, Nagore E. Why is the Cutaneous Melanoma Mortality Rate not Falling? Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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43
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Moro R, Traves V, Requena C, Nagore E. Cirugía por etapas con control micrográfico de los márgenes del lentigo maligno. Actas Dermo-Sifiliográficas 2020; 111:522-523. [DOI: 10.1016/j.ad.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/06/2019] [Accepted: 09/29/2019] [Indexed: 10/24/2022] Open
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Tejera-Vaquerizo A, Nagore E. Estimated effect of COVID-19 lockdown on melanoma thickness and prognosis: a rate of growth model. J Eur Acad Dermatol Venereol 2020; 34:e351-e353. [PMID: 32362041 PMCID: PMC7267312 DOI: 10.1111/jdv.16555] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Boada A, Tejera-Vaquerizo A, Ribero S, Puig S, Moreno-Ramírez D, Osella-Abate S, Cassoni P, Malvehy J, Podlipnik S, Requena C, Manrique-Silva E, Rios-Martin JJ, Ferrándiz C, Nagore E. Age as a prognostic factor in thick and ultrathick melanomas without lymph node metastasis. J Eur Acad Dermatol Venereol 2020; 34:e513-e517. [PMID: 32259328 DOI: 10.1111/jdv.16423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/05/2020] [Accepted: 03/24/2020] [Indexed: 02/06/2023]
Affiliation(s)
- A Boada
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Spain
| | - A Tejera-Vaquerizo
- Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain
| | - S Ribero
- Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain
| | - D Moreno-Ramírez
- Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - S Osella-Abate
- Section of Surgical Pathology, Medical Science Department, University of Turin, Turin, Italy
| | - P Cassoni
- Section of Surgical Pathology, Medical Science Department, University of Turin, Turin, Italy
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain
| | - S Podlipnik
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain
| | - C Requena
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - E Manrique-Silva
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
| | - J J Rios-Martin
- Pathology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - C Ferrándiz
- Dermatology Department, Hospital Universitari Germans Trial i Pujol, Fundació Institut d'Investigació Germans Trias i Pujol, Badalona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Spain
| | - E Nagore
- Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain
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Pastor-Tomás N, Martínez-Franco A, Bañuls J, Peñalver JC, Traves V, García-Casado Z, Requena C, Kumar R, Nagore E. Risk factors for the development of a second melanoma in patients with cutaneous melanoma. J Eur Acad Dermatol Venereol 2020; 34:2295-2302. [PMID: 32163215 DOI: 10.1111/jdv.16341] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/25/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cutaneous melanoma patients have an increased risk of developing other neoplasms, especially cutaneous neoplasms and other melanomas. Identifying factors associated with an increased risk might be useful in the development of melanoma guidelines. OBJECTIVES To identify risk factors related to the development of a second primary melanoma in a series of patients diagnosed with sporadic melanoma and to establish the estimated incidence rate. METHODS A longitudinal study based on prospective follow-up information of patients diagnosed with sporadic cutaneous melanoma at our centre from 2000 to 2015 was performed. Cumulative incidence was estimated based on competing risk models, and the association of characteristics with the risk of a second melanoma was performed by Cox proportional hazard models. RESULTS Out of 1447 patients included in the study, after a median follow-up of 61 months, 55 patients (3.8%) developed a second melanoma. Fair hair colour, more than 100 common melanocytic nevi and the presence of more than 50 cherry angiomas were independently associated with the development of a second melanoma. The site and the histological subtype of the first and second melanomas were not consistent. The second melanomas were thinner than the first ones. CONCLUSIONS Fair-haired and multiple-nevi patients might benefit from more intensive prevention measures. The finding of cherry angiomas as a risk factor suggests that these lesions could be markers of skin sun damage in the setting of certain degree of genetic susceptibility.
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Affiliation(s)
- N Pastor-Tomás
- Department of Dermatology, Hospital General Universitario de Elda, Alicante, Spain.,Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - A Martínez-Franco
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - J Bañuls
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain.,Departament of Medicina Clínica, Universidad Miguel Hernández. Sant Joan D'Alacant, Alicante, Spain
| | - J C Peñalver
- Department of Thoracic Surgery, Instituto Valenciano de Oncología, València, Spain
| | - V Traves
- Department of Pathology, Instituto Valenciano de Oncología, València, Spain
| | - Z García-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncología, València, Spain
| | - C Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - R Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - E Nagore
- School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
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Earnshaw C, Nagore E, Roeck K, Schneider S, Budden T, Craig S, Griffiths C, Furney S, Krutmann J, Viros A. 554 Skin ageing continues long after ultraviolet radiation damage. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tejera-Vaquerizo A, Descalzo-Gallego MA, Traves V, Requena C, Bolumar I, Pla A, Nagore E. No association between smoking and sentinel lymph node metastasis and survival in cutaneous melanoma. J Eur Acad Dermatol Venereol 2019; 33:2283-2290. [PMID: 31283036 DOI: 10.1111/jdv.15789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/21/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is little evidence that smoking is associated with metastasis in patients with cutaneous melanoma. OBJECTIVE Using a propensity score matching analysis, we assessed whether smoking was associated with a higher rate of sentinel lymph node (SLN) metastasis and worse survival in these patients. METHODS Retrospective cohort study at a referral hospital for melanoma. We studied 762 patients with known smoking status from the melanoma database of the Instituto Valenciano de Oncología who underwent SLN biopsy between 1 January 2000 and 31 December 2016. The patients were matched by smoking status. The matching procedure was implemented using three logistic regression models featuring never vs. former smokers, never vs. current smokers and former vs. current smokers. The study outcomes were disease-free survival (DFS), melanoma-specific survival (MSS), overall survival (OS) and SLN status. RESULTS The following groups were formed based on the propensity matching scores: 114 pairs of smokers vs. never smokers, 113 pairs of smokers vs. former smokers and 174 pairs of never smokers vs. former smokers. Smoking status was not associated with SLN metastasis or with DFS, MSS or OS in any of the three groups. CONCLUSION Smoking does not influence SLN metastasis or survival in patients with cutaneous melanoma.
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Affiliation(s)
- A Tejera-Vaquerizo
- Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río (Córdoba), Spain
| | | | - V Traves
- Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
| | - I Bolumar
- Servicio de Cirugía, Instituto Valencia de Oncología, Valencia, Spain
| | - A Pla
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valencia, Spain
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain
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Suppa M, Gandini S, Njimi H, Bulliard JL, Correia O, Duarte AF, Peris K, Stratigos AJ, Nagore E, Longo MI, Bylaite-Bucinskiene M, Karls R, Helppikangas H, Del Marmol V. Prevalence and determinants of sunbed use in thirty European countries: data from the Euromelanoma skin cancer prevention campaign. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:13-27. [PMID: 30811698 DOI: 10.1111/jdv.15311] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although considered as a first-group carcinogen, indoor tanning is a common practice in Europe. Euromelanoma is a pan-European skin cancer prevention campaign. OBJECTIVES To compare several European countries in terms of the prevalence and determinants of sunbed use. METHODS Participants in the Euromelanoma campaigns filled in questionnaires containing demographics and risk factors, including type/duration of sunbed use. Multivariate analyses adjusted for age, gender, education, skin type and year of survey were employed to assess factors independently associated with sunbed use in each country. RESULTS In total, 227 888 individuals (67.4% females, median age 44, 63.4% highly educated, 71.9% skin types III-VI) from 30 countries participated. Overall, the prevalence of sunbed ever use was 10.6% (≤19-year-olds: 5.9%; 20 to 35-year-olds: 17.0%; >35-year-olds: 8.3%). Females displayed a higher prevalence than males in all countries. Balkan countries displayed the highest female/male ratios (≥4). Sunbed use was significantly more prevalent among skin type III-VI (14/30 countries) and highly educated participants (11/30 countries). Significant correlations were found between sunbed use prevalence and countries' latitude (P < 0.001) and sunshine (P = 0.002); Italy and Spain represented exceptions towards excessive exposure. Very different prevalence rates were found for Spain (19.3%) and Portugal (2.0%). Scandinavian countries ranked highest in sunbed use among ≤19-year-olds, Baltic countries among 20 to 35-year-olds. CONCLUSIONS Sunbed use prevalence was higher in northern, sun-deprived countries, with the exception of Italy and Spain. The main determinants of sunbed use were age (young adults) and gender (females), whereas education and skin type had a less relevant effect. Geographic particularities were found in four regions: Iberian (prevalence ten times higher in Spain than Portugal), Balkan (prevalence disproportionately higher among women), Baltic (highest prevalence among young adults) and Scandinavian (highest prevalence among adolescents). These data have public health relevance for future interventions aimed at reducing sunbed use in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Njimi
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J L Bulliard
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - O Correia
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Center for Health Technology and Services Research (CINTESIS), Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A F Duarte
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - A J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Universidad Católica de València San Vicente Ferrer, Valencia, Spain
| | - M I Longo
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - M Bylaite-Bucinskiene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Karls
- Department of Infectiology and Dermatology, Riga Stradins University, Riga, Latvia
| | - H Helppikangas
- Dermatology Department, Clinical Center, University of Sarajevo, Sarajevo, Bosnia & Herzegovina
| | | | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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50
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Suppa M, Gandini S, Njimi H, Bulliard JL, Correia O, Duarte AF, Peris K, Stratigos AJ, Nagore E, Longo MI, Bylaite-Bucinskiene M, Karls R, Helppikangas H, Del Marmol V. Association of sunbed use with skin cancer risk factors in Europe: an investigation within the Euromelanoma skin cancer prevention campaign. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:76-88. [PMID: 30811689 DOI: 10.1111/jdv.15307] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/20/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sunbed use has been significantly associated with increased risk of melanoma and non-melanoma skin cancer (NMSC), but its relationship with melanoma's risk factors such as high nevus count, atypical nevi and lentigines is poorly studied. Euromelanoma is a skin cancer prevention campaign conducted all over Europe. It offers a once-a-year screening during which participants' data, including sunbed use and phenotype, are collected via questionnaires. OBJECTIVES To investigate the association of sunbed use with nevus count, atypical nevi, lentigines and suspicion of skin cancer. METHODS To ensure reliability of the data, we defined inclusion and exclusion criteria for countries' eligibility for the risk analysis. Multivariate logistic regression models (including age, gender, education, skin type, family history of melanoma, personal history of skin cancer, any sun exposure and any sunscreen use) were used to calculate summary odds ratios (SORs) of each clinical endpoint for ever sunbed use. RESULTS Overall, 227 888 individuals from 30 countries completed the Euromelanoma questionnaire. After the data quality check, 16 countries were eligible for the multivariate analysis, for a total of 145 980 participants (64.8% females; median age 43 years; 62.3% highly educated; 28.5% skin type I-II; 11.0% ever sunbed use). Ever sunbed use was independently associated with nevus count >50 [SOR = 1.05 (1.01-1.10)], atypical nevi [SOR = 1.04 (1.00-1.09)], lentigines [SOR = 1.16 (1.04-1.29)] and suspicion of melanoma [SOR = 1.13 (1.00-1.27)]. Conversely, no significant association was found between ever sunbed use and suspicion of NMSC [SOR = 1.00 (0.91-1.10)]. CONCLUSIONS Indoor tanning is significantly associated with well-recognized risk factors for melanoma (including high nevus count, presence of atypical nevi and lentigines) as well as suspicion of melanoma within the Euromelanoma screenees. In order to reduce the prevalence of melanoma risk factors, avoidance/discontinuation of sunbed use should always be encouraged, especially but not exclusively for individuals with high-risk phenotypes.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Njimi
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J L Bulliard
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - O Correia
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.,Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A F Duarte
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - A J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.,Universidad Católica de València San Vicente Ferrer, Valencia, Spain
| | - M I Longo
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - M Bylaite-Bucinskiene
- Clinic of Infectious, Chest diseases, Dermatovenereology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Karls
- Department of Infectiology and Dermatology, Riga Stradins University, Riga, Latvia
| | - H Helppikangas
- Dermatology Department, Clinical Center, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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