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Hennemann A, Puzenat E, Decreuse M, Vuillier F, Nardin C, Aubin F. Intracranial hemorrhage caused by dabrafenib and trametinib therapy for metastatic melanoma. Melanoma Res 2024; 34:280-282. [PMID: 38602773 DOI: 10.1097/cmr.0000000000000820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Although generally well tolerated compared with chemotherapy, molecular targeted therapy used in metastatic melanoma may be associated with life-threatening toxicity. We report the case of a patient with metastatic melanoma treated by dabrafenib plus trametinib who developed intracranial hemorrhage. Physicians should be aware of this rare but life-threatening adverse event of B-rapidly accelerated fibrosarcoma (BRAF) and mitogen-activated protein kinase kinase (MEK) inhibitors. However, they should be also careful about the bleeding origin, which can prove to be a new onset of melanoma metastasis or anticoagulation overdose, or even an uncontrolled arterial hypertension.
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Affiliation(s)
| | - Eve Puzenat
- Department of Dermatology, University Hospital, Inserm 1098
| | - Marion Decreuse
- Department of Neurology, University Hospital, Besançon, France
| | | | - Charlée Nardin
- Department of Dermatology, University Hospital, Inserm 1098
| | - François Aubin
- Department of Dermatology, University Hospital, Inserm 1098
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2
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Kennedy OJ, Ali N, Lee R, Monaghan P, Adam S, Cooksley T, Lorigan P. Thyroid dysfunction after immune checkpoint inhibitors in a single-centre UK pan-cancer cohort: A retrospective study. Eur J Cancer 2024; 202:113949. [PMID: 38432099 DOI: 10.1016/j.ejca.2024.113949] [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: 11/08/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE This study investigated thyroid dysfunction with immune checkpoint inhibitors (ICIs) in terms of proportions affected, risk factors, thyroid sequelae, and overall survival (OS). METHODS Among patients with normal baseline free T4 (fT4) and thyroid stimulating hormone (TSH) receiving ICIs at a large cancer centre, proportions of hyperthyroidism/hypothyroidism were determined (any, subclinical [normal fT4, abnormal TSH], overt [abnormal fT4, abnormal TSH], isolated hyperthyroxinaemia/hypothyroxinaemia and secondary) with onset times and subsequent thyroid statuses. Associations of overt dysfunction with OS were estimated using Cox regression and methods robust to immortal time bias (time-dependent Cox regression and 3- and 6-month landmark analyses). Associations of baseline variables with overt hyperthyroidism and hypothyroidism were estimated using Fine and Gray regression. RESULTS Of 1349 patients, 34.2% developed hyperthyroidism (10.3% overt), including 54.9% receiving combination ICIs, while 28.2% developed hypothyroidism (overt 9.3%, secondary 0.5%). A third of overt hypothyroidism cases occurred without preceding hyperthyroidism. Subclinical thyroid dysfunction returned directly to normal in up to half. Overt hyperthyroidism progressed to overt hypothyroidism in 55.4% (median 1.6 months). Melanoma treatment in the adjuvant vs. advanced setting caused more overt hyperthyroidism (12.1% vs. 7.5%) and overt hypothyroidism (14.5% vs. 9.7%). Baseline eGFR < 60 mL/min/1.73 m2 (HR=1.68, 1.07-2.63) was associated with overt hyperthyroidism and sex (HR=0.60, 0.42-0.87) and TSH (4th vs. 1st quartile HR=1.87, 1.10-3.19) with overt hypothyroidism. Overt dysfunction was associated with OS in the Cox analysis (HR=0.65, 0.50-0.85, median follow-up 22.2 months) but not in the time-dependent Cox (HR=0.79, 0.60-1.03) or landmark analyses (3-month HR=0.74, 0.51-1.07; 6-month HR=0.91, 0.66-1.24). CONCLUSION Thyroid dysfunction affects up to half of patients receiving ICIs. The association with OS is unclear after considering immortal time bias. The clinical courses include recovery, thyrotoxicosis and de novo overt hypothyroidism. Adjuvant treatment for melanoma, where longer-term harms are of concern, causes more frequent/aggressive dysfunction.
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Affiliation(s)
- Oliver John Kennedy
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK; Division of Cancer Sciences, The University of Manchester, Manchester, M13 9PL, UK.
| | - Nadia Ali
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Rebecca Lee
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK; Division of Cancer Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - Phillip Monaghan
- Division of Cancer Sciences, The University of Manchester, Manchester, M13 9PL, UK; The Christie Pathology Partnership, Manchester, M20 4BX, UK
| | - Safwaan Adam
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK; Division of Cancer Sciences, The University of Manchester, Manchester, M13 9PL, UK
| | - Tim Cooksley
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Paul Lorigan
- The Christie NHS Foundation Trust, Manchester, M20 4BX, UK; Division of Cancer Sciences, The University of Manchester, Manchester, M13 9PL, UK
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Cetiner OF, Dundar HE, Kantarcioglu-Coskun S, Torun S, Tokmak S. Metastatic Melanoma of the Common Bile Duct Presented with Dyspepsia. Korean J Gastroenterol 2024; 83:163-166. [PMID: 38659253 DOI: 10.4166/kjg.2024.011] [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] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/21/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
Malignant melanoma (MM) is an aggressive tumor that can metastasize to any organ, but biliary tract metastasis is scarce. We describe a very rare case of MM metastasis to the common bile duct (CBD), presented with only dyspeptic symptoms. The patient had mildly elevated alkaline phosphatase and gamma-glutamyl transferase levels. Magnetic resonance cholangiopancreatography demonstrated a dilated common bile duct with a distal stricture. The MM diagnosis was established with the ampulla of Vater biopsy specimens obtained by endoscopic retrograde cholangiopancreatography (ERCP), and the patient's symptoms were resolved after biliary stenting. Both primary CBD cancer and other cancer types like MM that metastasize to CBD can cause obstruction and can be manifested only by dyspeptic symptoms. MM metastasis to CBD can cause obstruction manifested only by dyspeptic symptoms without obstructive jaundice. ERCP can be employed as a promising option for treatment and diagnosis. New-onset dyspeptic symptoms in patients with a history of MM should be investigated thoroughly, especially in the context of biliary metastasis.
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Affiliation(s)
| | | | | | - Serkan Torun
- Department of Gastroenterology, Internal Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Salih Tokmak
- Department of Gastroenterology, Internal Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey
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Åkerla P, Pukkala E, Helminen M, Korhonen N, Karppinen T. Skin Cancer Risk of Narrow-Band UV-B (TL-01) Phototherapy: A Multi-Center Registry Study with 4,815 Patients. Acta Derm Venereol 2024; 104:adv39927. [PMID: 38629891 DOI: 10.2340/actadv.v104.39927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
Narrow-band TL-01 ultraviolet B phototherapy (TL-01) is an effective and widely used treatment for many skin diseases. The purpose of the investigation was to assess the risk of skin cancers in patients treated with TL-01 phototherapy who have not received any other phototherapy modalities. This cohort study included 4,815 TL-01 treated patients in Finland with psoriasis or atopic dermatitis. Clinical information was collected from the hospital records and linked with Finnish Cancer Registry data. The follow-up started from the first TL-01 treatment and the mean follow-up time was 8.4 years. Standardized incidence ratios were calculated for basal cell carcinoma, cutaneous melanoma, and squamous cell carcinoma. The standardized incidence ratio for basal cell carcinoma was 2.5 (95% confidence interval 1.8-3.5), for cutaneous melanoma 4.0 (95% confidence interval 2.1-6.8) and for squamous cell carcinoma 3.7 (95% confidence interval 1.7-7.0). For basal cell carcinoma and squamous cell carcinoma, the standardized incidence ratios remained similar during the whole follow-up time while the standardized incidence ratio for cutaneous melanoma was markedly higher during the first 5 years of follow-up. In conclusion, an increased incidence of skin cancers was observed among TL-01 treated patients. It should be confirmed in the future whether the skin cancer risk of TL-01 phototherapy will remain high in a longer follow-up.
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Affiliation(s)
- Petra Åkerla
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Eero Pukkala
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Mika Helminen
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland; Tays Research Services, Tampere University Hospital, Tampere, Finland
| | - Niina Korhonen
- Department of Dermatology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Toni Karppinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. Environ Res 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [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] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Doan L, Yoo KY, Hale C, Rodriguez P. Follicular involvement by malignant melanocytes: A rare cause of hair repigmentation associated with underlying melanoma. J Cutan Pathol 2024; 51:259-261. [PMID: 38126238 DOI: 10.1111/cup.14583] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/02/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Leandra Doan
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Ki-Young Yoo
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
- Department of Dermatology, Kaiser Permanente, Carson, California, USA
| | - Christopher Hale
- Department of Dermatology, Kaiser Permanente, Carson, California, USA
| | - Paola Rodriguez
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
- Department of Dermatology, Kaiser Permanente, Carson, California, USA
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Wang E, Ahad T, Liu YA, Lee TK, Lui H, Crawford RI, Kalia S. Incidence and profile of skin cancers in patients following ultraviolet phototherapy without psoralens: A retrospective cohort study. J Am Acad Dermatol 2024; 90:759-766. [PMID: 38070541 DOI: 10.1016/j.jaad.2023.11.053] [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: 11/11/2022] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Psoralen + ultraviolet-A (PUVA) is associated with photocarcinogenesis. However, carcinogenic risk with other ultraviolet phototherapies remains unclear. OBJECTIVE Evaluate whether phototherapy without psoralens increases skin cancer risk. METHODS Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003). RESULTS In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI: 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen. LIMITATIONS Treatment and follow-up duration. CONCLUSION No increased risk of melanoma and keratinocyte cancer was found with phototherapy.
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Affiliation(s)
- Elle Wang
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Tashmeeta Ahad
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Yi A Liu
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim K Lee
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Department of Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
| | - Harvey Lui
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Richard I Crawford
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Photomedicine Institute, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Department of Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
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8
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Pradhan R, Yu OHY, Platt RW, Azoulay L. Glucagon like peptide-1 receptor agonists and the risk of skin cancer among patients with type 2 diabetes: Population-based cohort study. Diabet Med 2024; 41:e15248. [PMID: 37876318 DOI: 10.1111/dme.15248] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
AIMS The objective of this study was to determine whether the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with an increased risk of melanoma and nonmelanoma skin cancer, separately, compared with the use of sulfonylureas among patients with type 2 diabetes. METHODS Using the United Kingdom Clinical Practice Research Datalink (2007-2019), we assembled two new-user active comparator cohorts. In the first cohort assessing melanoma as the outcome, 11,786 new users of GLP-1 RAs were compared with 208,519 new users of sulfonylureas. In the second cohort assessing nonmelanoma skin cancer as the outcome, 11,774 new users of GLP-1 RAs were compared with 207,788 new users of sulfonylureas. Cox proportional hazards models weighted using propensity score fine stratification were fit to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of melanoma and nonmelanoma skin cancer, respectively. RESULTS Compared with sulfonylureas, GLP-1 RAs were not associated with an increased risk of either melanoma (42.6 vs. 43.9 per 100,000 person-years, respectively; HR 0.96, 95% CI 0.53-1.75) or nonmelanoma skin cancer (243.9 vs. 229.9 per 100,000 person-years, respectively; HR 1.03, 95% CI 0.80-1.33). There was no evidence of an association between cumulative duration of use with either melanoma or nonmelanoma skin cancer. Consistent results were observed in secondary and sensitivity analyses. CONCLUSIONS In this population-based cohort study, GLP-1 RAs were not associated with an increased risk of melanoma or nonmelanoma skin cancer, compared with sulfonylureas.
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Affiliation(s)
- Richeek Pradhan
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Quebec, Canada
| | - Oriana H Y Yu
- Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Quebec, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Robert W Platt
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Quebec, Canada
| | - Laurent Azoulay
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
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Grant-Kels JM. JAAD Game Changer: Poor prognosis for thin ulcerated melanomas and implications for a more aggressive approach to treatment. J Am Acad Dermatol 2024; 90:726. [PMID: 37689161 DOI: 10.1016/j.jaad.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
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Schreiber M, Macháček T, Vajs V, Šmídová B, Majer M, Hrdý J, Tolde O, Brábek J, Rösel D, Horák P. Suppression of the growth and metastasis of mouse melanoma by Taenia crassiceps and Mesocestoides corti tapeworms. Front Immunol 2024; 15:1376907. [PMID: 38571957 PMCID: PMC10987685 DOI: 10.3389/fimmu.2024.1376907] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 04/05/2024] Open
Abstract
Cancer is still one of the leading causes of death, with an estimated 19.3 million new cases every year. Our paper presents the tumor-suppressing effect of Taenia crassiceps and Mesocestoides corti on B16F10 melanoma, the intraperitoneal application of which followed the experimental infection with these tapeworms, resulting in varying degrees of effectiveness in two strains of mice. In the case of M. corti-infected ICR mice, a strong tumor growth suppression occurred, which was accompanied by a significant reduction in the formation of distant metastases in the liver and lung. Tapeworm-infected C57BL/6J mice also showed a suppression of tumor growth and, in addition, the overall survival of infected C57BL/6J mice was significantly improved. Experiments with potential cross-reaction of melanoma and tapeworm antigens with respective specific antibodies, restimulation of spleen T cells, or the direct effect of tapeworm excretory-secretory products on melanoma cells in vitro could not explain the phenomenon. However, infections with T. crassiceps and M. corti increased the number of leukocytes possibly involved in anti-tumor immunity in the peritoneal cavity of both ICR and C57BL/6J mice. This study unveils the complex interplay between tapeworm infections, immune responses, and melanoma progression, emphasizing the need for further exploration of the mechanisms driving observed tumor-suppressive effects.
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Affiliation(s)
- Manfred Schreiber
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Tomáš Macháček
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Vojtěch Vajs
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Barbora Šmídová
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Martin Majer
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
| | - Jiří Hrdý
- Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Ondřej Tolde
- Department of Cell Biology, and Biotechnology and Biomedicine Center of the Academy of Sciences and Charles University in Vestec (BIOCEV), Charles University, Prague, Czechia
| | - Jan Brábek
- Department of Cell Biology, and Biotechnology and Biomedicine Center of the Academy of Sciences and Charles University in Vestec (BIOCEV), Charles University, Prague, Czechia
| | - Daniel Rösel
- Department of Cell Biology, and Biotechnology and Biomedicine Center of the Academy of Sciences and Charles University in Vestec (BIOCEV), Charles University, Prague, Czechia
| | - Petr Horák
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czechia
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Olsen CM, Pandeya N, Ragaini BS, Neale RE, Whiteman DC. International patterns and trends in the incidence of melanoma and cutaneous squamous cell carcinoma, 1989-2020. Br J Dermatol 2024; 190:492-500. [PMID: 37890023 DOI: 10.1093/bjd/ljad425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) and melanoma have different associations with sun exposure. OBJECTIVES To compare trends in the incidence rates of cSCC and melanoma, to provide insight into changing patterns of exposure to ultraviolet radiation (UVR). METHODS We compared trends in the incidence of cSCC and melanoma in seven susceptible populations residing at mid-to-high latitudes: Finland, Norway, Sweden, Denmark, Scotland, the Netherlands and Tasmania (Australia). We fitted Joinpoint models to describe trends in age-standardized incidence rates for melanoma and cSCC and calculated the average annual percentage rate of change for the period 1989-2020 (1989-2018 for Tasmania). We calculated the incident rate ratio (IRR) as the ratio of the age-standardized rates (European Standard Population) for cSCC to melanoma and conducted age-period-cohort modelling to compare age, period and cohort effects. RESULTS The ratio of cSCC-to-melanoma incidence increased with proximity to the equator and over time. In the most recent time period, the incidence of cSCC was higher than the incidence of melanoma for men and women in all seven populations. While the ratio of cSCC-to-melanoma incidence was higher for men vs. women, in most countries the cSCC-to-melanoma IRR increased over time to a greater extent in women than in men. Melanoma incidence was higher among younger people and cSCC incidence was higher among older people; the age at which the incidence of cSCC overtook the incidence of melanoma was progressively younger with proximity to the equator. CONCLUSIONS Despite concerted international efforts to preserve the ozone layer over the past four decades resulting in significant reductions in surface ultraviolet B at mid-latitudes, the incidence of skin cancer, particularly cSCC, continues to rise in those regions. Our findings are consistent with a stronger association with age-associated cumulative sun exposure for cSCC vs. melanoma and suggest that women are currently receiving greater UV radiation exposure than in the past.
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Affiliation(s)
- Catherine M Olsen
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Nirmala Pandeya
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Bruna S Ragaini
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Rachel E Neale
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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12
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Nevakivi R, Siiskonen H, Haimakainen S, Harvima IT. Spectrum of malignant and premalignant skin lesions in 505 adult subjects at risk of skin cancers. BMC Cancer 2024; 24:338. [PMID: 38486210 PMCID: PMC10938716 DOI: 10.1186/s12885-024-12035-w] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/21/2024] [Indexed: 03/18/2024] Open
Abstract
Patients at risk of skin cancers can develop varying types of cutaneous malignancies. However, some subjects may develop only one type of lesion. In this cross-sectional study, the spectrum of premalignant (PM) and malignant skin lesions and their risk factors were studied. Therefore, 505 adult subjects (aged 21-79 years, 256 males and 249 females, 96 with immunosuppression) at risk of any type of skin cancer were examined for cutaneous malignancies, nevi, actinic keratoses, photodamage, and possible risk factors. First, 12 different groups were identified with a varying set of PM and/or malignant skin lesions. Next, 5 larger groups were formed from them: basal cell carcinoma (BCC) only, malignant melanoma (MM) only, squamous cell carcinoma (SCC) and/or PM, BCC + SCC and/or PM, and MM + keratinocyte carcinoma (KC) and/or PM. The groups with BCC or MM only were younger and showed less photodamage than the mixed groups, while SCC/PM showed similarity with them. In logistic regression analyses, the platelet-to-lymphocyte ratio was associated with an increased risk of concomitant KC (OR 1.028, p = 0.023) or SCC/PM (OR 1.009, p = 0.047) in subjects with MM or BCC, respectively. Actinic keratoses produced ORs 0.246-0.252 (p = 0.008-0.020) for BCC in subjects with SCC/PM. Interestingly, atypical mole syndrome decreased the risk of SCC/PM in subjects with BCC (OR 0.092, p = 0.001). Advanced age was a significant risk factor for an additional type of lesion in all 3 comparisons (ORs 1.088-1.388, p = 0.001). In conclusion, even though there are numerous patients with only one lesion type, advancing age may determine the final lesion multiplicity.
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Affiliation(s)
- Reetta Nevakivi
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland, POB 100, 70029.
| | - Hanna Siiskonen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland, POB 100, 70029
| | - Salla Haimakainen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland, POB 100, 70029
| | - Ilkka T Harvima
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland, POB 100, 70029
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13
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McTighe SP, Taylor EA, Allbritton J, Lewin-Smith MR. Localized Cutaneous Argyria at the Site of a Prior Melanoma Excision Confirmed by Scanning Electron Microscopy With Energy Dispersive X-ray Analysis. Am J Dermatopathol 2024; 46:155-158. [PMID: 38153266 DOI: 10.1097/dad.0000000000002610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
ABSTRACT Localized cutaneous argyria is a rare condition caused by the accumulation of silver particles in the skin, leading to blue-gray discoloration. Argyria may mimic melanoma and lead to misdiagnosis. We present a patient with a history of melanoma that developed a blue-gray nodule at a prior melanoma graft. The diagnosis was confirmed using scanning electron microscopy and energy dispersive x-ray analysis. These techniques differentiate argyria from melanoma and can be performed on formalin-fixed, paraffin-embedded, tissue sections. Health care providers should be alert that argyria may mimic recurrent melanoma in patients unaware of silver exposure.
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Affiliation(s)
- Shane P McTighe
- Dermatologist, Martin Army Community Hospital, Fort Moore, GA
| | | | - Jill Allbritton
- Dermatopathologist/Dermatologist, The Joint Pathology Center, Silver Spring, MD; and
| | - Michael R Lewin-Smith
- Dermatopathologist/Dermatologist, The Joint Pathology Center, Silver Spring, MD; and
- Senior Environmental Pathologist, The Joint Pathology Center, Silver Spring, MD
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14
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Brunet-Possenti F, Birzu C, Deschamps L, Hacein-Bey-Abina S, Psimaras D, Chrétien P. Impact of anti-PD-1 therapy in a melanoma patient with paraneoplastic anti-ITPR1 encephalitis. Rev Neurol (Paris) 2024; 180:216-217. [PMID: 38061970 DOI: 10.1016/j.neurol.2023.10.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 03/17/2024]
Affiliation(s)
- F Brunet-Possenti
- Department of Oncodermatology, Université Paris Cité, Hôpital Bichat Claude-Bernard, Paris, France.
| | - C Birzu
- Inserm, CNRS, UMR S 1127, Institut du cerveau, Sorbonne Université, Paris, France; Department of Neurology Mazarin, Center for Patients with Neurological Complications of Oncologic Treatments, Sorbonne Université, Hôpital La Pitié Salpêtrière, Paris, France
| | - L Deschamps
- Department of Pathology, Hôpital Bichat Claude-Bernard, Paris, France
| | - S Hacein-Bey-Abina
- Department of Immunology, Université Paris Cité, Hôpital Bicêtre, Paris, France
| | - D Psimaras
- Department of Neurology Mazarin, Center for Patients with Neurological Complications of Oncologic Treatments, Sorbonne Université, Hôpital La Pitié Salpêtrière, Paris, France
| | - P Chrétien
- Department of Immunology, Université Paris Cité, Hôpital Bicêtre, Paris, France
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15
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Boz S, Kwiatkowski M, Zwahlen M, Bochud M, Bulliard JL, Konzelmann I, Bergeron Y, Rapiti E, Maspoli Conconi M, Bordoni A, Röösli M, Vienneau D. A cohort analysis of residential radon exposure and melanoma incidence in Switzerland. Environ Res 2024; 243:117822. [PMID: 38048864 DOI: 10.1016/j.envres.2023.117822] [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] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/18/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
Radon is a radioactive noble gas found in Earth's crust. It accumulates in buildings, and accounts for approximately half the ionizing radiation dose received by humans. The skin is considerably exposed to ionizing radiation from radon. We aimed to evaluate the association between residential radon exposure and melanoma and squamous cell carcinoma incidence. The study included 1.3 million adults (20 years and older) from the Swiss National Cohort who were residents of the cantons of Vaud, Neuchâtel, Valais, Geneva, Fribourg, and Ticino at the study baseline (December 04, 2000). Cases of primary tumours of skin (melanoma and squamous cell carcinoma) were identified using data from cantonal cancer registries. Long-term residential radon and ambient solar ultraviolet radiation exposures were assigned to each individual's address at baseline. Cox proportional hazard models with age as time scale, adjusted for canton, socioeconomic position, demographic data available in the census, and outdoor occupation were applied. Total and age specific effects were calculated, in the full population and in non-movers, and potential effect modifiers were tested. In total 4937 incident cases of melanoma occurred during an average 8.9 years of follow-up. Across all ages, no increased risk of malignant melanoma or squamous cell carcinoma incidence in relation to residential radon was found. An association was only observed for melanoma incidence in the youngest age group of 20-29 year olds (1.68 [95% CI: 1.29, 2.19] 100 Bq/m3 radon). This association was mainly in women, and in those with low socio-economic position. Residential radon exposure might be a relevant risk factor for melanoma, especially for young adults. However, the results must be interpreted with caution as this finding is based on a relatively small number of melanoma cases. Accumulation of radon is preventable, and measures to reduce exposure and communicate the risks remain important to convey to the public.
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Affiliation(s)
- Seçkin Boz
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; Neuchâtel Cancer Registry, Neuchâtel, Switzerland
| | | | | | | | | | - Andrea Bordoni
- Ticino Cancer Registry, Institute of Pathology South of Switzerland, Locarno, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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Paolino G, Carugno A, Rongioletti F, Ponzoni M, Russo V, Sena P, Ardigò M, Costanzo A, Mercuri SR, Valenti M. Bone marrow metastases: a systematic review of a neglected involvement in malignant melanoma. Melanoma Res 2024; 34:31-37. [PMID: 37939076 DOI: 10.1097/cmr.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The occurrence of bone marrow metastases (BMM) in melanoma patients is often underestimated, with only 7% detected during in-vivo staging procedures but rising to 45% in autopsy cases. This systematic review aims to shed light on the clinical and laboratory features of BMM in melanoma by analyzing 73 studies selected from 2 482 initially retrieved from PubMed, Embase , and Cochrane CENTRAL databases. Our findings reveal a slight male predominance, with a median age at BMM diagnosis of 56 years. Primary melanoma sites included the skin (52%), mucosa (8.8%), uvea (20.5%) and unidentified (19%). BMM was preceded by lymph node involvement in 36.5% of cases, whereas 63% showed no nodal metastases, with direct BMM occurring in 22.5% and metastases to other sites in 41%. Common BMM symptoms included pain (60.7%), anemia (80%), thrombocytopenia, leukoerythroblastosis, pancytopenia and leukopenia, while disseminated intravascular coagulation was detected in 11% of cases. In 23.6% of cases, BMM was amelanotic. The prognosis for BMM is grim, with a median survival of only 2 months. Conventional therapies for BMM remain largely ineffective, emphasizing the importance of considering bone marrow as a potential metastatic site in melanoma patients.
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Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo
- Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca
| | - Franco Rongioletti
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Maurilio Ponzoni
- Vita-Salute San Raffaele University
- Pathology Unit, IRCCS Ospedale San Raffaele
| | - Vincenzo Russo
- Unit of Immuno-Biotherapy of Melanoma and Solid Tumors, IRCCS Ospedale San Raffaele
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo
| | - Marco Ardigò
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Santo Raffaele Mercuri
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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17
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Anguita R, Makuloluwa A, Bhalla M, Katta M, Sagoo MS, Charteris DG. Rhegmatogenous retinal detachment in choroidal melanoma: clinical features and surgical outcomes. Eye (Lond) 2024; 38:494-498. [PMID: 37596400 PMCID: PMC10858248 DOI: 10.1038/s41433-023-02709-3] [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: 04/04/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE To describe the clinical features, prognostic factors, safety and rate of success of surgery and visual outcomes in patients with rhegmatogenous retinal detachment (RRD) and choroidal melanoma (CM). METHODS A retrospective, observational case-series of 21 patients with rhegmatogenous retinal detachment or combined tractional-rhegmatogenous retinal detachment in patients with choroidal melanoma over a period of 20 years. RESULTS Nineteen patients were included in the final analysis. The mean elevation of CM was 4.0 mm and the mean largest diameter was 11.0 mm. RRD occurred after the CM treatment in 14 eyes at a mean interval of 44.2 months. The RRD was macula-on RRD in 6 eyes, there was posterior vitreous detachment (PVD) in 15 and PVR in 7 eyes. BCVA at presentation was 0.71 logMAR and final was 1.5 logMAR (p = 0.01). The primary surgical success rate was 59%. No intraocular or extraocular tumour dissemination occurred. Mean follow-up was 66 months. CONCLUSION RRD in patients with CM is uncommon but requires multidisciplinary management. Anatomical results are favourable but visual outcomes are poor due to a combination of factors related to melanoma treatment, macular retinal detachment and PVR. Vitrectomy as a surgical intervention for RRD in treated CM appears to be safe in terms tumour dissemination.
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Affiliation(s)
- Rodrigo Anguita
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK.
- Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK.
- Department of Ophthalmology, Inselspital, University Hospital of Bern, Bern, Switzerland.
| | - Achini Makuloluwa
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Minak Bhalla
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Mohamed Katta
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
| | - Mandeep S Sagoo
- Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - David G Charteris
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at UCL Institute of Ophthalmology and Moorfields Eye Hospital, London, EC1V 2PD, UK
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18
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Mejía Posada MI, Gutiérrez Gómez M, María Vásquez-Trespalacios E, Garces Abad MA, Londoño García AM, González Álvarez T. Dermoscopic Changes in Melanocytic Lesions in 368 Patients With Atypical Nevus Syndrome and Their Association With Melanoma Incidence: A Cohort Study. Actas Dermosifiliogr 2024; 115:130-136. [PMID: 37689350 DOI: 10.1016/j.ad.2023.08.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Atypical nevus syndrome has been described as one of the main risk factors for melanoma. The aim of this study was to analyze dermoscopic changes observed in melanocytic lesions over a follow-up period of 5 years in patients with atypical nevus syndrome. MATERIAL AND METHODS We conducted a retrospective follow-up study of a cohort of patients seen at a specialized skin cancer and digital body mapping clinic in Medellin, Colombia, between January 2017 and December 2022. We analyzed the dermoscopic changes observed during this period and explored their association with newly diagnosed melanoma. RESULTS A total of 368 patients (187 women) with a median (interquartile range) age of 43 (37-51) years were included. The dermoscopic features observed at 5 years were an atypical network (222 patients, 60.3%), asymmetric globules (163, 44.2%), white-gray regression areas (105, 28.5%), lesion regression (72, 19.5%), a negative pigment network (59, 16%), asymmetric eccentric pigmentation (28, 7.6%), asymmetric projections (21, 5.7%), and asymmetric vascular patterns (8, 2.1%). Melanoma was diagnosed in 12.2% of patients during follow-up. Features significantly associated with a shorter time to melanoma onset were grayish-white areas (P <.001), asymmetric globules (P=.011), asymmetric eccentric pigmentation (P=.047), and a negative pigment network (P=.001). CONCLUSIONS The main dermoscopic features of melanocytic lesions in patients with atypical nevus syndrome associated with progression to melanoma were grayish-white areas, asymmetric globules, asymmetric spots, and a negative pigment network.
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Affiliation(s)
- M I Mejía Posada
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia.
| | | | | | - M A Garces Abad
- Servicio de Dermatología, Universidad CES, Medellín, Colombia
| | - A M Londoño García
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia
| | - T González Álvarez
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia
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19
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Mejía Posada MI, Gutiérrez Gómez M, Vásquez-Trespalacios EM, Garces Abad MA, Londoño García AM, González Álvarez T. [Translated article] Dermoscopic Changes in Melanocytic Lesions in 368 Patients With Atypical Nevus Syndrome and Their Association With Melanoma Incidence: A Cohort Study. Actas Dermo-Sifiliográficas 2024; 115:T130-T136. [PMID: 38048957 DOI: 10.1016/j.ad.2023.11.018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/08/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Atypical nevus syndrome has been described as one of the main risk factors for melanoma. The aim of this study was to analyze dermoscopic changes observed in melanocytic lesions over a follow-up period of 5 years in patients with atypical nevus syndrome. MATERIAL AND METHODS We conducted a retrospective follow-up study of a cohort of patients seen at a specialized skin cancer and digital body mapping clinic in Medellin, Colombia, between January 2017 and December 2022. We analyzed the dermoscopic changes observed during this period and explored their association with newly diagnosed melanoma. RESULTS A total of 368 patients (187 women) with a median (interquartile range) age of 43 (37-51) years were included. The dermoscopic features observed at 5 years were an atypical network (222 patients, 60.3%), asymmetric globules (163, 44.2%), white-gray regression areas (105, 28.5%), lesion regression (72, 19.5%), a negative pigment network (59, 16%), asymmetric eccentric pigmentation (28, 7.6%), asymmetric projections (21, 5.7%), and asymmetric vascular patterns (8, 2.1%). Melanoma was diagnosed in 12.2% of patients during follow-up. Features significantly associated with a shorter time to melanoma onset were grayish-white areas (P<.001), asymmetric globules (P=.011), asymmetric eccentric pigmentation (P=.047), and a negative pigment network (P=.001). CONCLUSIONS The main dermoscopic features of melanocytic lesions in patients with atypical nevus syndrome associated with progression to melanoma were grayish-white areas, asymmetric globules, asymmetric spots, and a negative pigment network.
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Affiliation(s)
- M I Mejía Posada
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia.
| | | | | | - M A Garces Abad
- Servicio de Dermatología, Universidad CES, Medellín, Colombia
| | - A M Londoño García
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia
| | - T González Álvarez
- Servicio de Dermatología, Universidad CES, Medellín, Colombia; Facultad de Medicina, Universidad CES, Medellín, Colombia
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20
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Joshi TP, Dodoo GN, Jain S, Sampige R, Thapar R, Wu AX, Zhang S, Dokic Y, Shimizu I. Association of autoimmune hepatitis with melanoma and nonmelanoma skin cancer: a case-control study using the All of Us Research Program. Clin Exp Dermatol 2024; 49:180-181. [PMID: 37847601 DOI: 10.1093/ced/llad353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023]
Abstract
The risk of developing melanoma and nonmelanoma skin cancer (NMSC) in patients with autoimmune hepatitis (AIH) has been poorly studied. Here, we use the National Institutes of Health's All of Us Research Program to show that AIH is associated with melanoma and NMSC, an association that persists in multivariate analysis accounting for potential confounders.
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Affiliation(s)
| | | | | | | | | | | | | | - Yelena Dokic
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA
| | - Ikue Shimizu
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA
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21
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Mohareb AM, Kang J, Montazeri K, Shroff SG. Case 2-2024: A 57-Year-Old Woman with Melanoma and Fever. N Engl J Med 2024; 390:255-265. [PMID: 38231627 DOI: 10.1056/nejmcpc2300974] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Affiliation(s)
- Amir M Mohareb
- From the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Massachusetts General Hospital, and the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Harvard Medical School - both in Boston
| | - Jiyoon Kang
- From the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Massachusetts General Hospital, and the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Harvard Medical School - both in Boston
| | - Kamaneh Montazeri
- From the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Massachusetts General Hospital, and the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Harvard Medical School - both in Boston
| | - Stuti G Shroff
- From the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Massachusetts General Hospital, and the Departments of Medicine (A.M.M., K.M.), Radiology (J.K.), and Pathology (S.G.S.), Harvard Medical School - both in Boston
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Baskurt D, Vural S, Ertekin SS, Baykal C. Oral mucosa involvement in pediatric patients with xeroderma pigmentosum: a comprehensive review. Int J Dermatol 2024; 63:59-72. [PMID: 37964400 DOI: 10.1111/ijd.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder presenting with an inability to repair UV-induced DNA damage. This can lead to the development of neoplasms affecting multiple organ systems, with onset often in childhood. Unfortunately, no cure currently exists for XP, and management strategies focus on sun protection and early intervention for malignancies. Although most skin problems in XP patients are UV induced, various oral lesions are also described. However, the literature has not extensively characterized the oral manifestations and their prognostic significance. METHODS We conducted a comprehensive review to evaluate the prevalence and nature of oral mucosal lesions in pediatric XP patients. RESULTS Our literature search yielded 130 pediatric XP patients with oral involvement and 210 associated tumoral or non-tumoral lesions. Squamous cell carcinoma was the most common type of oral mucosal tumor reported, with other malignancies including basal cell carcinoma, melanoma, angiosarcoma, fibrosarcoma, and trichilemmal carcinoma. CONCLUSION Given the potential morbidity and mortality associated with oral mucosal tumors in XP patients, our study aims to raise awareness of these manifestations. Early diagnosis and treatment are crucial for managing these lesions effectively, and routine oral exams should be considered a critical component of dermatological evaluations for XP patients, especially in the pediatric age group.
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Affiliation(s)
- Defne Baskurt
- School of Medicine, Koç University, Istanbul, Turkey
| | - Secil Vural
- School of Medicine, Koç University, Istanbul, Turkey
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Sümeyre S Ertekin
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Algamdi SS, Alhamad DM. Unusual Presentation of Unilateral Choroidal Melanoma with Bilateral Vasculitis in Young Individual: A Case Report and Review of Literature. Acta Med Indones 2024; 56:102-106. [PMID: 38561890] [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] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Ocular melanoma stands as the predominant primary intraocular malignancy, albeit infrequently exhibiting ipsilateral inflammatory manifestations. In this article, we present an exceptional case involving a middle-aged male who presented with unilateral ocular choroidal melanoma alongside bilateral retinal vasculitis. The patient initially received temporary steroid treatment, followed by brachytherapy, which contributed to the resolution of vasculitis symptoms. The study aims to document the atypical occurrence of bilateral retinal vasculitis, which could potentially masquerade as melanoma, emphasizing the need for heightened vigilance and further investigations when encountering choroidal masses in its presence. Future research endeavors are warranted to better understand the incidence of such occurrences in this context.
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Affiliation(s)
- Saleh S Algamdi
- Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
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Dehner CA, Johnson EF, Peters MS, Guo RR. Primary melanoma of the nipple: Report of 10 cases including coexistence with Paget's disease. Pathol Res Pract 2024; 253:155058. [PMID: 38181578 DOI: 10.1016/j.prp.2023.155058] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
Primary melanoma of the nipple (PMN) is exceedingly rare, with only single cases reported to date. We identified 10 patients with PMN: 5 females, 5 males, median age 55.5 years (range 29-66) at diagnosis of melanoma in situ (4 cases) or invasive melanoma (6 cases, Breslow depth 0.2 mm to 3.5 mm). Follow-up was available for all 10 patients (median 19 months, range 1-183). Nine patients had no evidence of disease; one patient died of disease (13.5 months) after presenting with a nodal metastasis. One case was exceptional, because the patient presented with a pigmented lesion that histopathologically exhibited co-existence of melanoma in situ and Paget disease, a challenging differential diagnosis due to immunohistochemical pitfalls in distinction between melanoma in situ and the pigmented variant of mammary Paget disease. Here we report the second largest series of PMN including a case of PMN colliding with mammary Paget disease, to raise awareness of these rare malignancies.
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Affiliation(s)
- Carina A Dehner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Emma F Johnson
- Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Margot S Peters
- Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ruifeng Ray Guo
- Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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25
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Gómez-Olivas JD, Campos-Rodriguez F, Nagore E, Martorell A, García-Rio F, Cubillos C, Hernandez L, Bañuls J, Arias E, Ortiz P, Cabriada V, Gardeazabal J, Montserrat JM, Carrera C, Masa JF, Gomez de Terreros J, Abad J, Boada A, Mediano O, Castillo-Garcia M, Chiner E, Landete P, Mayos M, Fortuna A, Barbé F, Sanchez-de-la-Torre M, Cano-Pumarega I, Perez-Gil A, Gomez-Garcia T, Cullen D, Somoza M, Formigon M, Aizpuru F, Oscullo G, Garcia-Ortega A, Almendros I, Farré R, Gozal D, Martinez-Garcia MA. Role of Sleep Apnea and Long-Term CPAP Treatment in the Prognosis of Patients With Melanoma: A Prospective Multicenter Study of 443 Patients. Chest 2023; 164:1551-1559. [PMID: 37348828 DOI: 10.1016/j.chest.2023.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/03/2022] [Revised: 05/20/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND OSA has been associated with increased incidence and aggressiveness of melanoma. However, the long-term impact of OSA and CPAP treatment on the prognosis of melanoma remains unexplored. RESEARCH QUESTION Are OSA and CPAP treatment associated independently with a poor prognosis for cutaneous melanoma? STUDY DESIGN AND METHODS Four hundred forty-three patients with a diagnosis of cutaneous melanoma (2012-2015) underwent a sleep study within 6 months of diagnosis. The main 5-year outcome of the study was a composite of melanoma recurrence, metastasis, or mortality. Patients were divided into four groups: baseline apnea-hypopnea index (AHI) of fewer than 10 events/h (no OSA; control group), OSA treated with CPAP and good adherence, untreated or poor CPAP adherence in moderate (AHI, 10-29 events/h), and severe OSA (AHI, ≥ 30 events/h). Survival analysis was used to determine the independent role of OSA and CPAP treatment on melanoma composite outcome. RESULTS Three hundred ninety-one patients (88.2%) were available for analysis at 5-year follow-up (mean age, 65.1 ± 15.2 years; 49% male; Breslow index, 1.7 ± 2.5 mm). One hundred thirty-nine patients had AHI of fewer than 10 events/h (control group); 78 patients with OSA were adherent to CPAP; and 124 and 50 patients had moderate and severe OSA, respectively, without CPAP treatment. Median follow-up was 60 months (interquartile range, 51-74 months). During follow-up, 32 relapses, 53 metastases, and 52 deaths occurred (116 patients showed at least one of the main composite outcomes). After adjusting for age, sex, sentinel lymph nodes affected at diagnosis, BMI, diabetes, nighttime with an oxygen saturation below 90%, Breslow index, Epworth sleepiness scale scores, and melanoma treatment, moderate (hazard ratio [HR], 2.45; 95% CI, 1.09-5.49) and severe OSA (HR, 2.96; 95% CI, 1.36-6.42) were associated with poorer prognosis of melanoma compared with the control group. However, good adherence to CPAP avoided this excess risk (HR, 1.66; 95% CI, 0.71-3.90). INTERPRETATION Moderate to severe untreated OSA is an independent risk factor for poor prognosis of melanoma. Treatment with CPAP is associated with improved melanoma outcomes compared with untreated moderate to severe OSA.
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Affiliation(s)
- Jose Daniel Gómez-Olivas
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Francisco Campos-Rodriguez
- Respiratory Department, Instituto Andaluz de Investigación, Seville, Spain; Hospital Valme, IBIS, Instituto Andaluz de Investigación, Seville, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncologia, Hospital de Manises, Valencia, Spain
| | | | - Francisco García-Rio
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Carolina Cubillos
- Respiratory Department, Hospital Universitario La Paz, IdiPaz, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Luis Hernandez
- Respiratory Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Jose Bañuls
- Dermatology Department, Hospital General Universitario Balmis de Alicante, UMH, Spain; Clinical Medicine Department, UMH, Spain
| | - Eva Arias
- Respiratory Department, Hospital Universitario 12 de Octubre, Spain
| | - Pablo Ortiz
- Dermatology Department, Hospital Universitario 12 de Octubre, Spain
| | - Valentin Cabriada
- Respiratory Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Juan Gardeazabal
- Dermatology Department, Hospital Universitario Cruces, Barakaldo, Spain
| | - Josep Maria Montserrat
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Clinic-IDIBAPS, Spain
| | | | - Juan Fernando Masa
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Javier Gomez de Terreros
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario San Pedro de Alcantara, Caceres, Spain
| | - Jorge Abad
- Respiratory Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Adam Boada
- Dermatology Department, Hospital Universitario Germans Trials I Pujol, Spain
| | - Olga Mediano
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Marta Castillo-Garcia
- Respiratory Department, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | - Eusebi Chiner
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Pedro Landete
- Respiratory Department, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Mercedes Mayos
- Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ana Fortuna
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Respiratory Department, Hospital Universitario Santa Creu i Sant Pau, Spain
| | - Ferrán Barbé
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | - Manuel Sanchez-de-la-Torre
- CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Group of Precision Medicine in Chronic Diseases, Respiratory Department, University Hospital Arnau de Vilanova and Santa María, Spain; Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida. IRBLleida, Lleida, Spain
| | | | - Amalia Perez-Gil
- Dermatology Department, Instituto Andaluz de Investigación, Seville, Spain
| | - Teresa Gomez-Garcia
- Respiratory Department, Fundacion Jimenez Diaz, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Daniela Cullen
- Dermatology Department, Fundacion Jimenez Diaz, Madrid, Spain
| | - Maria Somoza
- Respiratory Department, Consorcio Sanitario Terrassa, Spain
| | | | - Felipe Aizpuru
- Biostatistical Service, BioAraba, Health Research Institute, OSI Araba University Hospital, Basque Health Service, University of the Basque Country, Leioa, Spain
| | - Grace Oscullo
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Alberto Garcia-Ortega
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain
| | - Isaac Almendros
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - Ramón Farré
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Madrid, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain; Unitat de Biofisica i Bioenginyeria, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, The University of Missouri, Columbia, MO
| | - Miguel Angel Martinez-Garcia
- Respiratory Department, Hospital Universitario y Politecnico la Fe, Hospital de Manises, Valencia, Spain; CIBERes, VCIBER de Enfermedades Respiratorias, Madrid, Spain.
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Li Y, Wu J, Cao Z. Childhood sunburn and risk of melanoma and non-melanoma skin cancer: a Mendelian randomization study. Environ Sci Pollut Res Int 2023; 30:122011-122023. [PMID: 37962759 PMCID: PMC10724097 DOI: 10.1007/s11356-023-30535-3] [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] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
Previous evidence has suggested that childhood sunburn could be a risk factor for cutaneous malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, existing observational studies could not reveal the causal associations genetically. This study aimed to investigate whether there was a genetic causal relationship between childhood sunburn and skin cancers. Univariable Mendelian randomization (MR) and Causal Analysis Using Summary Effect analysis was carried out for causal estimates and evaluation for the horizontal pleiotropy. Multivariable MR and the mediation effects analysis were used to test whether the causal associations were mediated by potential confounders. A suggestively significant causal association between childhood sunburn and MM was indicated (OR = 4.74; 95% CI: 1.31-17.19; p = 1.79E-02). Genetically predicted childhood sunburn was significantly associated with increased risk of overall melanoma in situ (MIS) (OR = 4.02; 95% CI: 2.00-8.08; p = 9.40E-05), MIS of face (OR = 18.28; 95% CI: 5.28-63.35; p = 4.59E-06), and MIS of trunk (OR = 7.05; 95% CI: 2.06-24.13; p = 1.88E-03). Similar trends were found for childhood sunburn and NMSC (OR = 8.16; 95% CI: 6.07-10.99; p = 1.53E-20), including both basal cell carcinoma (BCC) (OR = 3.76; 95% CI:2.96-4.77; p = 2.19E-08) and squamous cell carcinoma (SCC) (OR = 7.44; 95% CI: 5.09-10.87; p = 2.19E-08). After adjustment for hair and skin color, facial ageing, vitamin D levels, body mass index, alcohol consumption, and smoking status, childhood sunburn showed an independent association with MIS, MIS of face, MIS of trunk, as well as NMSC, including both BCC and SCC. Mediation analysis showed no significant mediation effect. This study demonstrated a causal relationship between childhood sunburn and the risk of both MM and NMSC, which suggested that enhanced screening and prevention for childhood sunburn could contribute to the early detection and decreased risk of MM and NMSC.
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Affiliation(s)
- Yajia Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jianhuang Wu
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Ziqin Cao
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
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Langbour C, Law-Wan J, Ben-Saad R, Zaragoza J, Gunness VRN, Mouzoune S, Ibrahim N, Salliot C. Intramedullary spinal cord metastasis: a rare complication of malignant melanoma. Eur J Dermatol 2023; 33:694-696. [PMID: 38465556 DOI: 10.1684/ejd.2023.4575] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Camille Langbour
- Rheumatology unit, Centre Hospitalier Régional d'Orléans, France
| | - Johan Law-Wan
- Rheumatology unit, Centre Hospitalier Régional d'Orléans, France
| | - Rim Ben-Saad
- Rheumatology unit, Centre Hospitalier Régional d'Orléans, France
| | - Julia Zaragoza
- Dermatology unit, Centre Hospitalier Régional d'Orléans, France
| | | | - Sofiane Mouzoune
- Nuclear medicine unit, Centre Hospitalier Régional d'Orléans, France
| | - Nada Ibrahim
- Rheumatology unit, Centre Hospitalier Régional d'Orléans, France
| | - Carine Salliot
- Rheumatology unit, Centre Hospitalier Régional d'Orléans, France
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Zhao Y, Amorrortu RP, Stewart SC, Ghia KM, Williams VL, Sondak VK, Tsai KY, Pinilla-Ibarz J, Chavez JC, Rollison DE. Melanoma and CLL co-occurrence and survival: role of KC history. BMC Cancer 2023; 23:1084. [PMID: 37946198 PMCID: PMC10636833 DOI: 10.1186/s12885-023-11573-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Survival following melanoma and chronic lymphocytic leukemia (CLL) have both been individually associated with previous history of non-melanoma skin cancers (specifically keratinocyte carcinomas [KC]). Furthermore, melanoma and CLL have been reported to occur within the same patients. The survival experience of patients with both cancers is understudied, and the role of history of KC is unknown. Additional research is needed to tease apart the independent associations between KC and CLL survival, KC and melanoma survival, and the co-occurrence of all three cancers. METHODS A retrospective cohort study was conducted among patients who were diagnosed with melanoma and/or CLL at a comprehensive cancer center between 2008 and 2020. Multivariable Cox regression models were used to examine the association between history of KC and survival following melanoma and/or CLL with careful consideration of calendar year of diagnosis, treatment regimens and other risk factors. A nested case-control study comparing patients with both CLL and melanoma to those with only CLL or only melanoma was conducted to compare blood parameters across the three groups. RESULTS A time-dependent association was observed between history of KC and favorable melanoma survival within 4 years following diagnosis and poorer survival post 7 years after melanoma diagnosis. History of KC was not significantly associated with survival following the diagnosis of CLL, after adjustment for clinical factors including historical/concurrent melanoma. Patients with co-occurring melanoma and CLL tended to be diagnosed with melanoma first and had elevated blood parameters including white blood cell and lymphocyte counts as compared with patients who were diagnosed with only melanoma. CONCLUSIONS History of KC was an independent predictor of survival following melanoma but not of CLL. Additional studies are needed to determine if blood parameters obtained at the time of melanoma diagnosis could be used as a cost-effective way to identify those at high risk of asymptomatic CLL for the promotion of earlier CLL diagnosis.
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Affiliation(s)
- Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Sandra C Stewart
- Department of Cancer Registry, Moffitt Cancer Center, Tampa, FL, USA
| | - Kavita M Ghia
- Collaborative Data Services Core, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth Y Tsai
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Julio C Chavez
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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Eid E, Maloney NJ, Cai ZR, Zaba LC, Kibbi N, John EM, Linos E. Risk of Multiple Primary Cancers in Patients With Merkel Cell Carcinoma: A SEER-Based Analysis. JAMA Dermatol 2023; 159:1248-1252. [PMID: 37703005 PMCID: PMC10500424 DOI: 10.1001/jamadermatol.2023.2849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/21/2023] [Indexed: 09/14/2023]
Abstract
Importance The risk of subsequent primary cancers after a diagnosis of cutaneous Merkel cell carcinoma (MCC) is not well established. Objective To evaluate the risk of subsequent primary cancers after the diagnosis of a first primary cutaneous MCC. Design, Setting, and Participants This cohort study analyzed data from 17 registries of the Surveillance, Epidemiology, and End Results (SEER) Program from January 1, 2000, to December 31, 2019. In all, 6146 patients diagnosed with a first primary cutaneous MCC were identified. Main Outcomes and Measures The primary outcome was the relative and absolute risks of subsequent primary cancers after the diagnosis of a first primary MCC, which were calculated using the standardized incidence ratio (SIR; ratio of observed to expected cases of subsequent cancer) and the excess risk (difference between observed and expected cases of subsequent cancer divided by the person-years at risk), respectively. Data were analyzed between January 1, 2000, and December 31, 2019. Results Of 6146 patients with a first primary MCC diagnosed at a median (IQR) age of 76 (66-83) years, 3713 (60.4%) were men, and the predominant race and ethnicity was non-Hispanic White (5491 individuals [89.3%]). Of these patients, 725 (11.8%) developed subsequent primary cancers, with an SIR of 1.28 (95% CI, 1.19-1.38) and excess risk of 57.25 per 10 000 person-years. For solid tumors after MCC, risk was elevated for cutaneous melanoma (SIR, 2.36 [95% CI, 1.85-2.97]; excess risk, 15.27 per 10 000 person-years) and papillary thyroid carcinoma (SIR, 5.26 [95% CI, 3.25-8.04]; excess risk, 6.16 per 10 000 person-years). For hematologic cancers after MCC, risk was increased for non-Hodgkin lymphoma (SIR, 2.62 [95% CI, 2.04-3.32]; excess risk, 15.48 per 10 000 person-years). Conclusions and Relevance This cohort study found that patients with MCC had an increased risk of subsequently developing solid and hematologic cancers. This increased risk may be associated with increased surveillance, treatment-related factors, or shared etiologies of the other cancers with MCC. Further studies exploring possible common etiological factors shared between MCC and other primary cancers are warranted.
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Affiliation(s)
- Edward Eid
- Program for Clinical Research and Technology, Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Nolan J. Maloney
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Zhuo Ran Cai
- Program for Clinical Research and Technology, Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Lisa C. Zaba
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Esther M. John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Eleni Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
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Pradhan R, Yu OHY, Platt RW, Azoulay L. Dipeptidyl peptidase-4 inhibitors and the risk of skin cancer among patients with type 2 diabetes: a UK population-based cohort study. BMJ Open Diabetes Res Care 2023; 11:e003550. [PMID: 37949470 PMCID: PMC10649616 DOI: 10.1136/bmjdrc-2023-003550] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/16/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION The dipeptidyl peptidase-4 (DPP-4) enzyme significantly influences carcinogenic pathways in the skin. The objective of this study was to determine whether DPP-4 inhibitors are associated with the incidence of melanoma and nonmelanoma skin cancer, compared with sulfonylureas. RESEARCH DESIGN AND METHODS Using the United Kingdom Clinical Practice Research Datalink, we assembled two new-user active comparator cohorts for each skin cancer outcome from 2007 to 2019. For melanoma, the cohort included 96 739 DPP-4 inhibitor users and 209 341 sulfonylurea users, and 96 411 DPP-4 inhibitor users and 208 626 sulfonylurea users for non-melanoma skin cancer. Propensity score fine stratification weighted Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs of melanoma and non-melanoma skin cancer, separately. RESULTS Overall, DPP-4 inhibitors were associated with a 23% decreased risk of melanoma compared with sulfonylureas (49.7 vs 65.3 per 100 000 person-years, respectively; HR 0.77, 95% CI 0.61 to 0.96). The HR progressively reduced with increasing cumulative duration of use (0-2 years HR 1.14, 95% CI 0.84 to 1.54; 2.1-5 years HR 0.44, 95% CI 0.29 to 0.66; >5 years HR 0.33, 95% CI 0.14 to 0.74). In contrast, these drugs were not associated with the incidence of non-melanoma skin cancer, compared with sulfonylureas (448.1 vs 426.1 per 100 000 person-years, respectively; HR 1.06, 95% CI 0.98 to 1.15). CONCLUSIONS In this large, population-based cohort study, DPP-4 inhibitors were associated with a reduced risk of melanoma but not non-melanoma skin cancer, compared with sulfonylureas.
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Affiliation(s)
- Richeek Pradhan
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, Québec, Canada
| | - Oriana H Y Yu
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, Québec, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, Québec, Canada
| | - Robert W Platt
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, Québec, Canada
| | - Laurent Azoulay
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, Québec, Canada
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Schön V, Stocker D, Jüngst C, Dummer R, Ramelyte E. Immune-Related Sclerosing Cholangitis and Subsequent Pyogenic Liver Abscesses in Two Patients With Melanoma Treated by Triplet Therapy: A Case Report. J Immunother 2023; 46:346-350. [PMID: 37728439 PMCID: PMC10540752 DOI: 10.1097/cji.0000000000000486] [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: 05/18/2023] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
Immune checkpoint inhibitors have improved the treatment of many cancers. However, immune-related (IR) adverse events can limit their use. A rare but potentially severe IR adverse event is IR-cholangitis, which is mostly induced by anti-programmed cell death 1 (PD1) antibodies and is often corticosteroid-resistant. Consequently, immunosuppressive therapy is increased, which interferes with the antitumor response and bears the risk of infection. We report on 2 patients with BRAF V600E mutant melanoma, who presented with IR-sclerosing cholangitis under triplet therapy with atezolizumab [anti-programmed cell death ligand 1 (PD-L1) antibody], vemurafenib (BRAF inhibitor), and cobimetinib (MEK inhibitor). In both cases, the administration of corticosteroids initially resulted in a marginal improvement but was followed by a rebound of biliary enzymes and the subsequent emergence of pyogenic liver abscesses with bacteremia. Liver abscesses developed without preceding invasive procedures, which implies that a more restrictive approach to immunosuppressive therapy for IR-cholangitis should be considered. To our knowledge, we report the first 2 cases of IR-cholangitis and subsequent liver abscesses without prior invasive intervention, the first cases of IR-cholangitis induced by triplet therapy, and 2 of the few anti-PD-L1 induced cases contributing to the evidence that both anti-PD1 and anti-PD-L1 antibodies induce IR-cholangitis. Treatment strategies for IR-cholangitis need to be improved to prevent life-threatening infectious complications.
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Affiliation(s)
- Viola Schön
- University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Stocker
- University of Zurich, Zurich, Switzerland
- Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Jüngst
- University of Zurich, Zurich, Switzerland
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Egle Ramelyte
- University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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32
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Arvia R, Tanturli M, Ugolini F, Vannucchi M, Massi D, Zakrzewska K. Molecular investigation of some DNA viruses in mucosal melanoma: Case-control study. J Med Virol 2023; 95:e29269. [PMID: 38009623 DOI: 10.1002/jmv.29269] [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: 06/23/2023] [Revised: 10/12/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
The association between viral infections and both cutaneous and mucosal melanoma (MM) has not been fully investigated. Here, we assessed the prevalence of the DNA of a broad range of viruses in 31 MMs and 15 biopsies of healthy mucosa (HM) using molecular methods. The parvoviruses CuV and B19V, herpesviruses HSV1, HSV2, EBV, HHV6, and HHV8, polyomavirus MCPyV, and α-HPVs were not detected, or rarely found, in MMs, and in HM, of the digestive, respiratory, and female genital tract. The overall prevalence of β-HPV in MMs was not significantly higher compared to that in HM (70.9% and 53.3% respectively; p = 0.514). However, the number of MMs positive for β-HPV types belonging to Species 3 and 5 and for some viral types belonging to Species 1, 2, 3, and 5 were significantly higher compared with HM (p < 0.05). Moreover, compared to HM, the MM samples contained a significantly higher number of β-HPV types, mainly belonging to Species 1, 3, and 5 (p < 0.05). Our data, although suggesting a role for certain β-HPV types in MM oncogenesis, require additional investigation in larger populations to support this hypothesis.
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Affiliation(s)
- Rosaria Arvia
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michele Tanturli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Filippo Ugolini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Margherita Vannucchi
- Department of Medical Biotechnology, Section of Pathology, University of Siena, Siena, Italy
| | - Daniela Massi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Krystyna Zakrzewska
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Mallardo D, Woodford R, Menzies AM, Zimmer L, Williamson A, Ramelyte E, Dimitriou F, Wicky A, Wallace R, Mallardo M, Cortellini A, Budillon A, Atkinson V, Sandhu S, Olivier M, Dummer R, Lorigan P, Schadendorf D, Long GV, Simeone E, Ascierto PA. The role of diabetes in metastatic melanoma patients treated with nivolumab plus relatlimab. J Transl Med 2023; 21:753. [PMID: 37880788 PMCID: PMC10601323 DOI: 10.1186/s12967-023-04607-4] [Citation(s) in RCA: 1] [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: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The combination of nivolumab + relatlimab is superior to nivolumab alone in the treatment of naive patients and has activity in PD-1 refractory melanoma. We had previously observed a reduced expression of LAG3 in melanoma tissue from patients with type 2 diabetes. METHOD To evaluate the impact of diabetes on oncological outcomes of patients with advanced melanoma treated with nivolumab plus the LAG3 inhibitor relatlimab we performed a retrospective multicenter study. RESULTS Overall, 129 patients were included: 88 without diabetes before the treatment, 37 who were diagnosed with type 2 diabetes before the start of treatment, and 4 without diabetes before treatment who developed immune checkpoint inhibitor-induced diabetes (ICI-DM). PFS was 21.71 months (95% CI: 15.61-27.81) in patients without diabetes, 10.23 months (95% CI: 5.81-14.66) in patients with type 2 diabetes, and 50.85 months (95% CI: 23.04-78.65) in patients who developed ICI-DM. OS was 37.94 months (95% CI: 31.02-44.85) in patients without diabetes, 22.12 months (95% CI: 14.41-29.85) in those with type 2 diabetes and 57.64 months (95% CI: 42.29-72.99) in those who developed ICI-DM. Multivariate analysis showed that the presence of diabetes and LDH was correlated with OS and PFS. The mean OS was 64.63 months in subjects with low levels of glucose (< 137 mg/dl) and 36.27 months in those with high levels (hazard ratio 0.16, 95% CI: 0.04-0.58; p = 0.005). The patients whose glucose blood level increased after 3 months of treatment with nivolumab + relatinib compared to baseline (ratio of blood level at baseline/after 3 months > 1.5) had a worse prognosis than those whose glucose level had not increased. This result was observed also in subgroups treated either in first line or further lines. Patients who developed ICI-DM during the study period had better outcomes than the overall population and patients without diabetes. CONCLUSIONS LAG3 inhibition for treating metastatic or unresectable melanoma has a reduced efficacy in patients with type 2 diabetes, possibly due to a low expression of LAG3 in tumor tissue. Higher level evidence should be obtained.
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Affiliation(s)
- Domenico Mallardo
- Melanoma, Cancer Immunotherapy, and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Via Mariano Semmola, 53, 80131, Naples, Italy
| | - Rachel Woodford
- Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Alexander M Menzies
- Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Lisa Zimmer
- Department of Dermatology, University Hospital Essen, NCT-West, German Cancer Consortium, Partner Site Essen and University Alliance Ruhr, Research Center One Health, Essen, Germany
| | - Andrew Williamson
- Christie NHS Foundation Trust and Division of Cancer Services, University of Manchester, Manchester, UK
| | - Egle Ramelyte
- Department of Dermatology, University of Zurich, Zurich, Switzerland
| | | | - Alexandre Wicky
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | | | - Mario Mallardo
- Melanoma, Cancer Immunotherapy, and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Via Mariano Semmola, 53, 80131, Naples, Italy
| | - Alessio Cortellini
- Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W120HS, UK
- Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Biomedico, Rome, Italy
| | - Alfredo Budillon
- Scientific Director, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Victoria Atkinson
- Greenslopes Private Hospital, University of Queensland QLD, Greenslopes, Australia
| | | | - Michielin Olivier
- Department of Oncology, Precision Oncology Center, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University of Zurich, Zurich, Switzerland
| | - Paul Lorigan
- Christie NHS Foundation Trust and Division of Cancer Services, University of Manchester, Manchester, UK
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen, NCT-West, German Cancer Consortium, Partner Site Essen and University Alliance Ruhr, Research Center One Health, Essen, Germany
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Ester Simeone
- Melanoma, Cancer Immunotherapy, and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Via Mariano Semmola, 53, 80131, Naples, Italy
| | - Paolo A Ascierto
- Melanoma, Cancer Immunotherapy, and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Via Mariano Semmola, 53, 80131, Naples, Italy.
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Vilaseca A, Martínez-Sáez E, González V, Auger C, Naranjo L, Ruiz-García R. Teaching NeuroImage: Paraneoplastic Cerebellar Degeneration and Antibodies to TRIM 9 and 67 Secondary to Melanoma. Neurology 2023; 101:e1652-e1653. [PMID: 37580164 PMCID: PMC10585673 DOI: 10.1212/wnl.0000000000207702] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/09/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
- Andreu Vilaseca
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Martínez-Sáez
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Victoria González
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina Auger
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Naranjo
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Raquel Ruiz-García
- From the Department of Neurology (A.V., V.G.), Department of Pathology (E.M.-S.), and MRI Unit (C.A.), Vall d'Hebron University Hospital; Department of Immunology (L.N., R.R.-G.), Centre Diagnòstic Biomèdic, Hospital Clínic; and Neuroimmunology Program (R.R.-G.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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35
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Axiaris G, Ioannou A, Papoutsaki M, Marinos L, Liontos M, Michopoulos S, Zampeli E. Case Report: Malignant melanoma in a patient with Crohn's disease treated with ustekinumab. F1000Res 2023; 11:424. [PMID: 37867623 PMCID: PMC10589619 DOI: 10.12688/f1000research.110356.2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/24/2023] Open
Abstract
The cornerstone of inflammatory bowel disease (IBD) treatment is immunomodulators. IBD patients are at increased risk of intestinal and extraintestinal malignancy. Ustekinumab is a fully humanized monoclonal anti-IL12/23 antibody with a good safety profile. Malignancies of breast, colon, head and neck, kidney, prostate, thyroid, and non-melanoma skin cancer have been reported among patients who received ustekinumab. We report the case of a 42-year-old Crohn's patient on long-term treatment with ustekinumab, who developed achromatic malignant melanoma. Crohn's was diagnosed at the age of 15, with upper and lower gastrointestinal involvement and was initially treated with azathioprine (2mg/kg for 4 years) and infliximab (5mg/kg for 6 weeks). Due to ileal obstruction, the patient underwent stricturoplasty and received adalimumab (40mg every other week) for two years. He then discontinued therapy and a year later underwent right hemicolectomy. Adalimumab was reinstituted (40mg every other week) and the patient remained in clinical remission for two years. His overall exposure to adalimumab was four years. Ustekinumab was initiated due to a relapse and after 3 years, an incident of scalp itching led to the diagnosis metastatic achromatic malignant melanoma bearing BRAF V600E mutation. He received targeted therapy with an initial good response. We aim to point out the risk of dermatologic malignancy in IBD patients on long-term immunosuppression and the lifelong and meticulous evaluation that is required.
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Affiliation(s)
- Georgios Axiaris
- Gastroenterology Department, Alexandra General Hospital, Athens, Greece, 11528, Greece
| | - Alexandros Ioannou
- Gastroenterology Department, Alexandra General Hospital, Athens, Greece, 11528, Greece
| | - Marina Papoutsaki
- Dermatology Department, Syggros Hospital, Athens, Greece, 11528, Greece
| | - Leonidas Marinos
- Pathology Department, Evangelismos Hospital, Atherns, Greece, 11528, Greece
| | - Michael Liontos
- Oncology Department, Alexandra General Hospital, Athens, Greece, 11528, Greece
| | - Spyridon Michopoulos
- Gastroenterology Department, Alexandra General Hospital, Athens, Greece, 11528, Greece
| | - Evanthia Zampeli
- Gastroenterology Department, Alexandra General Hospital, Athens, Greece, 11528, Greece
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36
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Zhang X, Lee WD, Leitner BP, Zhu W, Fosam A, Li Z, Gaspar RC, Halberstam AA, Robles B, Rabinowitz JD, Perry RJ. Dichloroacetate as a novel pharmaceutical treatment for cancer-related fatigue in melanoma. Am J Physiol Endocrinol Metab 2023; 325:E363-E375. [PMID: 37646579 PMCID: PMC10642987 DOI: 10.1152/ajpendo.00105.2023] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
Cancer-related fatigue (CRF) is one of the most common complications in patients with multiple cancer types and severely affects patients' quality of life. However, there have only been single symptom-relieving adjuvant therapies but no effective pharmaceutical treatment for the CRF syndrome. Dichloroacetate (DCA), a small molecule inhibitor of pyruvate dehydrogenase kinase, has been tested as a potential therapy to slow tumor growth, based largely on its effects in vitro to halt cell division. We found that although DCA did not affect rates of tumor growth or the efficacy of standard cancer treatment (immunotherapy and chemotherapy) in two murine cancer models, DCA preserved physical function in mice with late-stage tumors by reducing circulating lactate concentrations. In vivo liquid chromatography-mass spectrometry/mass spectrometry studies suggest that DCA treatment may preserve membrane potential, postpone proteolysis, and relieve oxidative stress in muscles of tumor-bearing mice. In all, this study provides evidence for DCA as a novel pharmaceutical treatment to maintain physical function and motivation in murine models of CRF.NEW & NOTEWORTHY We identify a new metabolic target for cancer-related fatigue, dichloroacetate (DCA). They demonstrate that in mice, DCA preserves physical function and protects against the detrimental effects of cancer treatment by reducing cancer-induced increases in circulating lactate. As DCA is already FDA approved for another indication, these results could be rapidly translated to clinical trials for this condition for which no pharmaceutical therapies exist beyond symptom management.
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Affiliation(s)
- Xinyi Zhang
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Won D Lee
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, United States
- Lewis Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, United States
| | - Brooks P Leitner
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Wanling Zhu
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Andin Fosam
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Zongyu Li
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Rafael C Gaspar
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Alexandra A Halberstam
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Briana Robles
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
- University of Florida, Gainesville, Florida, United States
| | - Joshua D Rabinowitz
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, United States
- Lewis Sigler Institute for Integrative Genomics, Princeton University, Princeton, New Jersey, United States
- Department of Chemistry, Princeton University, Princeton, New Jersey, United States
- Ludwig Institute for Cancer Research, Princeton, New Jersey, United States
| | - Rachel J Perry
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
- Department of Cellular & Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, United States
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37
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Nukata R, Ikeda H, Akaike N, Fujiwara T, Yamashita H, Uezato M, Kinosada M, Kurosaki Y, Shindo K, Chin M. White Embolus-induced Basilar Artery Occlusion Due to Pulmonary Vein Invasion of a Metastasis of a Malignant Melanoma. Intern Med 2023; 62:2889-2893. [PMID: 36823083 PMCID: PMC10602821 DOI: 10.2169/internalmedicine.1269-22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/16/2023] [Indexed: 02/23/2023] Open
Abstract
An 80-year-old woman presented with impaired consciousness after malignant melanoma resection. Magnetic resonance angiography showed basilar artery occlusion, which was subjected to mechanical thrombectomy for recanalization. A pathological analysis of the retrieved embolus revealed that it was derived from a metastasis of malignant melanoma. Contrast-enhanced chest computed tomography showed multiple pulmonary metastases, one of which was in the right upper lobe and invaded the pulmonary vein. To our knowledge, this is the first case of white embolus-induced cerebral embolism due to pulmonary vein invasion of a metastasis of a pathologically diagnosed malignant melanoma.
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Affiliation(s)
- Ryotaro Nukata
- Department of Neurology, Kurashiki Central Hospital, Japan
| | - Hiroyuki Ikeda
- Department of Neurosurgery, Kurashiki Central Hospital, Japan
| | - Natsuki Akaike
- Department of Neurosurgery, Kurashiki Central Hospital, Japan
| | - Toshio Fujiwara
- Department of Neurosurgery, Kurashiki Central Hospital, Japan
| | | | - Minami Uezato
- Department of Neurosurgery, Kurashiki Central Hospital, Japan
| | | | | | - Katsuro Shindo
- Department of Neurology, Kurashiki Central Hospital, Japan
| | - Masaki Chin
- Department of Neurosurgery, Kurashiki Central Hospital, Japan
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38
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Kim PJ, Lansang RP, Ko E, Abu-Hilal M. Incidence of melanoma and non-melanoma skin cancer in patients with celiac disease: a systematic review and meta-analysis. Eur J Dermatol 2023; 33:506-513. [PMID: 38297926 DOI: 10.1684/ejd.2023.4565] [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] [Indexed: 02/02/2024]
Abstract
There is conflicting observational evidence regarding the association between skin cancer and celiac disease (CD). The purpose of this review was to investigate the incidence rate ratio (IRR) of skin cancer incidence between patients with and without CD. MEDLINE and EMBASE databases were searched on October 27th, 2021 and eight articles were identified for review. Quality assessment was conducted using the Newcastle Ottawa Scale. Seven articles were included in meta-analysis for a pooled estimate of IRR across all skin cancers, malignant melanoma (MM), and non-melanoma skin cancers (NMSC). In total, 74,860 CD patients were followed for 710,214 person-years in the meta-analysis. Overall combined incidence was 99.8 cases per 100,000 person-years. Meta-analysis of all skin cancer incidence showed no significant difference in CD patients compared to controls (IRR: 1.06; 95% CI: 0.95, 1.17; p=0.29; I2: 0%). Five studies reported on MM incidence; there was no significant difference in incidence compared to controls (IRR: 0.87, 95% CI: 0.72, 1.06; p=0.22; I2: 9%). Five studies reported on NMSC incidence, revealing a significantly increased risk of NMSC in CD patients (IRR: 1.14; 95% CI: 1.01, 1.28; p=0.04; I2: 0%). Our findings suggest a significantly increased incidence of NMSC in CD patients compared to control data and no significant association between CD and MM incidence. The findings are limited by the quantity and quality of the evidence. Nonetheless, clinicians should emphasize the importance of sun protection, such as sunscreen usage and self-examination for patients with CD.
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Affiliation(s)
- Patrick J Kim
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rafael Paolo Lansang
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emma Ko
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mohannad Abu-Hilal
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, Faculty of Health Sciences, Division of Dermatology, McMaster University, Hamilton, Ontario, Canada
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39
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Petronzio A, Smith M, Drake M, Cowardbéy K. When a heel wound is not just a wound: an unusual presentation of malignant melanoma. Int J Dermatol 2023; 62:e566-e567. [PMID: 37264695 DOI: 10.1111/ijd.16666] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/26/2023] [Accepted: 03/14/2023] [Indexed: 06/03/2023]
Affiliation(s)
| | - Mahalia Smith
- Department of Internal Medicine, McGovern Medical School at UTHealth Houston, Houston, TX, USA
- Memorial Hermann Health System, Houston, TX, USA
| | - Madeline Drake
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA
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40
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Laillet J, Monnet P, Goldfarb L, Belkhir R, Robert C. Secondary hypertrophic osteoarthropathy revealing a metastatic melanoma. Eur J Cancer 2023; 192:113247. [PMID: 37625239 DOI: 10.1016/j.ejca.2023.113247] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 08/27/2023]
Affiliation(s)
- J Laillet
- Dermatology Department, Gustave Roussy Institute, Villejuif, France
| | - P Monnet
- Dermatology Department, Gustave Roussy Institute, Villejuif, France
| | - L Goldfarb
- Nuclear Medicine Department, Centre Hospitalier Fréderic Joliot, CEA, Orsay, France
| | - R Belkhir
- Rheumatology Department, FHU CARE, AP-HP-Hôpital Bicêtre, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - C Robert
- Dermatology Department, Gustave Roussy Institute, Villejuif, France; Gustave Roussy and Paris Saclay University, Villejuif, France.
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Gironi LC, Esposto E, Zottarelli F, Giorgione R, Farinelli P, Zavattaro E, Cammarata E, Di Cristo N, Ogliara P, Camillo L, Giordano M, Mellone S, Pasini B, Ambrosi A, Savoia P. Temporal correlation between the first melanoma and the first noncutaneous tumor in CKDN2A genotyped patients. Melanoma Res 2023; 33:425-430. [PMID: 37352544 DOI: 10.1097/cmr.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
CDKN2A pathogenic variants are well known to be associated with cutaneous melanoma and noncutaneous tumors (NCTs). Herein, we investigated the temporal correlation between the first cutaneous melanoma and NCT both in CDKN2A mutation carriers (MUT) and in wild-type melanoma patients, a poorly explored issue to date. Two hundred forty-five cutaneous melanoma patients were genotyped for the CDKN2A gene and divided into 51 MUT and 189 wild-type; the remaining five variant carriers were excluded from the analyses. MUT developed a significantly higher number of cutaneous melanoma than wild-type, while 13.7% in both genotyped groups received a diagnosis of at least one malignant NCT, without statistically significant differences. The onset of the first cutaneous melanoma preceded that of the first malignant or benign NCT in both MUT and wild-type patients by an average of 4.5 and 3.02 years, respectively. Considering only malignant tumors, the diagnosis of melanoma preceded that of the first NCT on an average of 8 and 4.34 years, in MUT and wild-type patients respectively. We emphasize the relevance to adopt a global vision for the primary and secondary surveillance of patients affected by cutaneous melanoma, not only limited to high-risk for multiple primary skin cancers but also to NCT that may develop several years after the diagnosis of the first cutaneous melanoma.
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Affiliation(s)
| | | | | | | | | | - Elisa Zavattaro
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | | | - Nunzia Di Cristo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin
| | - Lara Camillo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Mara Giordano
- Department of Health Sciences, University of Eastern Piedmont, Novara
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Simona Mellone
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara
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Yu N, Wang J, Liu Y, Guo Y. Multivariate Mendelian randomization provides no evidence for causal associations among both psoriasis and psoriatic arthritis, and skin cancer. Front Immunol 2023; 14:1252720. [PMID: 37795084 PMCID: PMC10546308 DOI: 10.3389/fimmu.2023.1252720] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
Background Some retrospective studies reported that psoriasis (PsO) and psoriatic arthritis (PsA) may have been associated with an elevated risk of skin cancer. The causal associations among them remain unclear. Objectives To evaluate the causal association of among both PsO and PsA, and skin cancer. Methods We performed large-scale two-sample and Multivariate Mendelian randomization analyses to examine whether there is a causal relationship between PsO and PsA, and skin cancer, encompassing basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and cutaneous melanoma (CM). Results Genetically predicted PsO, per log-odds ratio increase, showed no significant association with the risk of BCC, cSCC, and CM. The odds ratios (with corresponding 95% confidence intervals) for BCC, cSCC, and CM were 1.00 (0.99,1.01) (PIvw = 0.990), 0.94(0.89, 1.00) (PIvw = 0.065), and 0.99 (0.98, 1.01) (PIvw = 0.239), respectively. PsA showed a significant association with a decreased risk of BCC, with odds ratios (with corresponding 95% confidence intervals) of 1.00 (1.00, 1.00) (PIvw = 0.214) and 1.00 (1.00, 1.00) (PIvw = 0.477), respectively. Univariate analysis of the FinnGen database demonstrated PsA did exhibit a significant association with the decrease risk of BCC, with an odds ratio of 0.94(0.90,0.99) (PIvw = 0.016). However, this association disappeared after other risk factors were adjusted. Conclusions Our findings suggest no causal association between PsO and PsA and the genetic risk of skin cancer. Further observational studies are required to elucidate the relationship among PsO, PsA, and skin cancer.
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Affiliation(s)
- Nianzhou Yu
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiayi Wang
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yuancheng Liu
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yeye Guo
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Aviv-Shimoni S, Uri I, Milloh-Raz H, Percik R. Isolated autoimmune adrenocorticotropic hormone deficiency: A positive predictor of survival among cancer patients treated with checkpoint inhibitors. Autoimmun Rev 2023; 22:103387. [PMID: 37352903 DOI: 10.1016/j.autrev.2023.103387] [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: 05/31/2023] [Accepted: 06/18/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE We aimed to characterize cancer patients who developed isolated adrenocorticotrophic hormone (ACTH) deficiency (IAD) after treatment with checkpoint-inhibitors (CPIs), including clinical manifestations, laboratory findings and risk factors, and to evaluate the prognostic significance of this complication. DESIGN A retrospective case-control study. METHODS We conducted a retrospective analysis of 2225 cancer patients treated with CPIs between 2015 and 2021 in our institute. We identified a subgroup of patients with sub-normal cortisol levels due to ACTH deficiency, and comprehensively extracted all relevant data. We compared the patients survival rates using a log-rank test and a multi-variable Cox regression. RESULTS Among 2225 patients, hypocortisolemia was documented in 99 (4.45%) patients, and 19 of them were diagnosed with IAD (0.85%). Asthenia and diarrhea were the most reported complaints (36.8%), and melanoma was the most common malignancy (68.42%) within the IAD group. In multivariable analysis, IAD was associated with better survival rates (p = .018), female gender (63.2% vs 40%, p = .041), treatment with Ipilimumab (57.9% vs. 19.4%, p < .001), and younger age (median 56 IQR 51-69, vs. median 69 IQR 60-76, p = .004). CONCLUSIONS IAD is the dominant autoimmune etiology for cortisol deficiency among patients receiving immunotherapy and is reported for the first time as a positive predictor of survival among cancer patients treated with CPIs. In our patients, IAD development was associated with female gender, treatment with ipilimumab, and younger age.
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Affiliation(s)
- Shir Aviv-Shimoni
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; School of Public Health, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Uri
- Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
| | - Hadar Milloh-Raz
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ruth Percik
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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44
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Martinez DDAES, Lupi O, D'Ácri AM. The association between skin cancer and HIV infection. Indian J Dermatol Venereol Leprol 2023; 89:725-728. [PMID: 37067140 DOI: 10.25259/ijdvl_902_2021] [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: 09/01/2021] [Accepted: 09/01/2022] [Indexed: 02/05/2023]
Abstract
Background People affected by Human Immunodeficiency Virus (HIV), are burdened by a higher risk of developing malignancies including non-melanoma skin cancer (NMSC) and melanoma skin cancer. Objective To evaluate the association of HIV with melanoma and NMSC at a University Hospital. Methods This is a cross-sectional retrospective study of HIV-infected and a matched comparison group, analyzing the associations between skin cancer and HIV infection. Results Compared to the HIV-uninfected, HIV-infected had 80% association with skin cancer (CI 95%: 1.3-2.4, P = 0.001) The risk was 45-fold higher by patients" age (CI 95%: 3.3-15.9: P = 0.001). When adjusted for patient age, sex and race, the risk was 6.4 fold ligher of having cancer if compared to the others (CI 95%: 49-84, P = 0.001). Melanoma was not found in HIV-infected. Conclusion With this study, we have demonstrated that HIV-infected patients have an increased risk of BCC and SCC. Preventive dermatologic management is pivotal in the care of immunosuppressed patients. These patients must undergo the dermatological examination annually and should receive extensive counseling regarding sun avoidance, use of sunscreens,and sun-protective clothing.
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Affiliation(s)
- Daniela de Abreu E Silva Martinez
- Department of Dermatology, Gaffree & Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Omar Lupi
- Department of Dermatology, Gaffree & Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Antônio Macedo D'Ácri
- Department of Dermatology, Gaffree & Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
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45
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Usui-Taniguchi M, Kaji T, Taniguchi K, Kawakami Y, Morizane S, Toi Y. A pediatric case of gradually spreading longitudinal melanonychia initially accompanied by Hutchinson's sign. J Dermatol 2023; 50:e297-e298. [PMID: 37122178 DOI: 10.1111/1346-8138.16805] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Mana Usui-Taniguchi
- Department of Dermatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Tatsuya Kaji
- Department of Dermatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kohei Taniguchi
- Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yoshio Kawakami
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Shin Morizane
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yoichiro Toi
- Department of Dermatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
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46
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Brunsgaard EK, Jensen J, Grossman D. Melanoma in skin of color: Part II. Racial disparities, role of UV, and interventions for earlier detection. J Am Acad Dermatol 2023; 89:459-468. [PMID: 35533770 DOI: 10.1016/j.jaad.2022.04.057] [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: 03/06/2022] [Revised: 04/08/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
Despite a higher incidence of melanoma among White individuals, melanoma-specific survival is worse among individuals with skin of color. Racial disparities in survival are multifactorial. Decreased skin cancer education focused on people with skin of color, lower rates of screening, increased socioeconomic barriers, higher proportions of more aggressive subtypes, and underrepresentation in research and professional education contribute to delays in diagnosis and treatment. Although high, intermittent UV exposure during childhood has been established as a significant modifiable risk factor for melanoma in individuals with lighter skin phototypes, there are limited data on UV exposure and melanoma risk in people with darker skin phototypes. The second article of this continuing medical education series will examine factors contributing to racial disparities in melanoma-specific survival, discuss the role of UV radiation, and address the need for further research and targeted educational interventions for melanoma in individuals with skin of color.
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Affiliation(s)
- Elise K Brunsgaard
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Jakob Jensen
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Communication, University of Utah, Salt Lake City, Utah
| | - Douglas Grossman
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah.
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47
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Dirven I, Vander Mijnsbrugge AS, Mignon S, Tijtgat J, Kint N, Neyns B. Auto-immune hemolytic anemia and hemophagocytic lymphohistiocytosis as immune-related adverse event in patients with metastatic melanoma and concurrent chronic lymphocytic leukemia: a case series and literature review. Melanoma Res 2023; 33:338-344. [PMID: 37114670 DOI: 10.1097/cmr.0000000000000895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Auto-immune hemolytic anemia (AIHA) and hemophagocytic lymphohistiocytosis (HLH) are both rare immune-related adverse events (irAEs) following treatment with immune checkpoint inhibitors. Consensus treatment guidelines are currently lacking. Patients with a solid malignancy and a concurrent lymphoproliferative disorder, such as chronic lymphocytic leukemia (CLL), might be more prone to develop hematological irAEs. We report the case history of two patients, diagnosed with CLL, who during treatment for metastatic melanoma with nivolumab, a PD-1 immune checkpoint blocking mAb, developed AIHA and HLH in combination with AIHA. Furthermore, we provide a review of the literature on published cases of immune-related AIHA and HLH and their correlation with CLL.
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MESH Headings
- Humans
- Melanoma/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Lymphohistiocytosis, Hemophagocytic/chemically induced
- Lymphohistiocytosis, Hemophagocytic/complications
- Skin Neoplasms
- Anemia, Hemolytic
- Neoplasms, Second Primary
- Anemia, Hemolytic, Autoimmune/chemically induced
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Affiliation(s)
- Iris Dirven
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel)
| | - An-Sofie Vander Mijnsbrugge
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel)
| | - Sacha Mignon
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel)
| | - Jens Tijtgat
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel)
| | - Nicolas Kint
- Department of Hematology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Bart Neyns
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB)/Universitair Ziekenhuis Brussel (UZ Brussel)
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Chae Woon P, Kim I, Kim JH, Hwang JH. Association of clinical manifestations of secondary lymphedema and lymph node dissection sites in the lower extremities of patients with melanoma. Acta Oncol 2023; 62:880-888. [PMID: 37656769 DOI: 10.1080/0284186x.2023.2238547] [Citation(s) in RCA: 1] [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: 04/10/2023] [Accepted: 06/29/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Lymphedema is a chronic, debilitating disease that often requires life-long management. Predicting clinical manifestations and prognosis is crucial in clinical practice because the treatment of lymphedema should be individualized for best clinical outcome. The aim of this study is to explore the location and severity of lymphedema secondary to inguinal and/or iliac lymph node dissection (LND) in patients with melanoma. METHODS Patients with melanoma who received LND at a single tertiary medical center between 1 January 2010 and 31 September 2022 were retrospectively reviewed. Patient who received inguinal LND only were designate as the inguinal group while those who received both ilioinguinal LND were included in the ilioinguinal group. Volumetric measurement was used to objectify the severity and location of lymphedema. Clinical data was acquired for 12-15 months of follow-up. RESULTS Among 81 patients, 43 (53%) had developed lymphedema in the lower extremities at an average of 33 days after the surgery. Initially, patients manifested with medial thigh lymphedema in the inguinal group while patients were presented with whole leg lymphedema in the ilioinguinal group. Lower leg volume of the ilioinguinal group was significantly higher than the inguinal group. After more than 12 months of lymphedema treatment, upper leg volume was higher in the ilioinguinal group than the inguinal group (12.7% vs 5.4%, p < 0.05). CONCLUSION Lymphedema developed in early post-op period. The ilioinguinal group presented with a larger volume of lymphedema in the distal area of the legs. Even after sufficient treatment, predominant lymphedema remained in the proximal leg for the ilioinguinal group. Patients with both inguinal and iliac LND were associated with more severe lymphedema. Based on the dissection sites, the clinical manifestations and prognosis of leg lymphedema can vary widely. Thus, clinicians should consider the dissection site when approaching melanoma patients with lymphedema.
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Affiliation(s)
- Paek Chae Woon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Inah Kim
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Han Kim
- Division of Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Koros C, Simitsi AM, Bougea A, Papagiannakis N, Antonelou R, Pachi I, Angelopoulou E, Prentakis A, Zachou A, Chrysovitsanou C, Beratis I, Fragkiadaki S, Kontaxopoulou D, Eftymiopoulou E, Stanitsa E, Potagas C, Papageorgiou SG, Karavasilis E, Velonakis G, Prassopoulos V, Geronicola-Trapali X, Stefanis L. Double Trouble: Association of Malignant Melanoma with Sporadic and Genetic Forms of Parkinson's Disease and Asymptomatic Carriers of Related Genes: A Brief Report. Medicina (Kaunas) 2023; 59:1360. [PMID: 37629650 PMCID: PMC10456316 DOI: 10.3390/medicina59081360] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
Introduction: Previous epidemiological evidence has established the co-occurrence of malignant melanoma (MM) and Parkinson's disease (PD). Shared molecular mechanisms have been proposed to be implicated in this relationship. The aim of the present study was to assess the prevalence of MM in patients with sporadic and genetic types of PD, as well as in asymptomatic carriers of PD-related genes. Methods: Data regarding past medical history and concomitant disease of 1416 patients with PD (including 20 participants with prodromal disease who phenoconverted to PD), 275 healthy controls (HCs) and 670 asymptomatic carriers of PD-related genes were obtained from the database of the Parkinson's Progression Markers Initiative (PPMI). Focus was placed on information about a medical record of MM. We also retrieved data regarding the genetic status of selected PPMI participants with a positive MM history. Results: In total, 46 patients with PD reported a positive MM history. Concerning the genetic forms of PD, nine of these PD patients (2.47%) carried a Leucine Rich Repeat Kinase 2 (LRRK2) gene mutation (mainly the G2019S), while eight (4.49%) harbored a Glucocerebrosidase (GBA) gene mutation (mainly the N370S). No alpha-synuclein (SNCA) gene mutation was identified in patients with an MM history. The remaining 29 PD patients (3.5%) were genetically undetermined. In total, 18 asymptomatic carriers of PD-related genes had a positive medical history for MM: among them, 10 carried an LRRK2 gene mutation (2.69%) and 10 a GBA gene mutation (3.51%) (2 were dual carriers). MM history was identified for seven HCs (2.5%). Conclusions: We replicated the previously reported association between genetically undetermined PD (GU-PD) and MM. A correlation of LRRK2 mutations with the development of MM could not be verified in either symptomatic PD patients or asymptomatic carriers, implicating distinct pathogenetic mechanisms as compared to GU-PD. Importantly, despite the limited literature evidence on Gaucher disease, this study highlights for the first time the relatively high prevalence of MM among asymptomatic and symptomatic PD GBA mutation carriers, with potential clinical implications.
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Affiliation(s)
- Christos Koros
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Athina-Maria Simitsi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Nikolaos Papagiannakis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Roubina Antonelou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Ioanna Pachi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Andreas Prentakis
- Nuclear Medicine Unit, Attikon Hospital, 12462 Athens, Greece; (A.P.); (X.G.-T.)
| | - Athena Zachou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Chrysa Chrysovitsanou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Ion Beratis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Efthymia Eftymiopoulou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Evangelia Stanitsa
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Constantin Potagas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
| | - Efstratios Karavasilis
- Research Unit of Radiology, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, 11528 Athens, Greece; (E.K.); (G.V.)
| | - Georgios Velonakis
- Research Unit of Radiology, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, “Attikon” University General Hospital, 11528 Athens, Greece; (E.K.); (G.V.)
| | | | | | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.S.); (A.B.); (N.P.); (R.A.); (I.P.); (E.A.); (A.Z.); (C.C.); (I.B.); (S.F.); (D.K.); (E.E.); (E.S.); (C.P.); (S.G.P.); (L.S.)
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Morgan FC, Yehia L, McDonald C, Martinez-Agosto JA, Hardan AY, Tamburro J, Sahin M, Bayart C, Eng C. Characterizing dermatologic findings among patients with PTEN hamartoma tumor syndrome: Results of a multicenter cohort study. J Am Acad Dermatol 2023; 89:90-98. [PMID: 35143913 PMCID: PMC9357227 DOI: 10.1016/j.jaad.2022.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/21/2021] [Revised: 11/15/2021] [Accepted: 01/02/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dermatologic phenotypes in PTEN hamartoma tumor syndrome (PHTS) are heterogeneous and poorly documented. OBJECTIVE To characterize dermatologic findings among PHTS and conduct an analysis of genotype-dermatologic phenotype associations. METHODS Mucocutaneous findings were reviewed in a multicenter cohort study of PHTS. Genotype-dermatologic phenotype associations were tested using multivariable regression. RESULTS A total of 201 patients were included. Children were significantly less likely than adults to have oral papillomas, vascular malformations, benign follicular neoplasms, and acral keratoses. There were no cases of skin cancer among children. Basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma developed in 5%, 2%, and 1% of White adults, respectively. After adjusting for age, missense mutations were associated with 60% lower odds of developing cutaneous papillomatous papules (odds ratio: 0.4; 95% confidence interval [0.2, 0.7]), oral papillomas (0.4; 95% confidence interval [0.2, 0.9]), and vascular malformations (0.4; 95% confidence interval [0.2, 0.8]). LIMITATIONS Partly retrospective data. CONCLUSION Children are less likely than adults to have certain dermatologic findings, likely due to age-related penetrance. The risk of pediatric melanoma and the lifetime risk of nonmelanoma skin cancer in PHTS may not be elevated. Missense variants may be associated with the development of fewer dermatologic findings but future validation is required.
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Affiliation(s)
| | - Lamis Yehia
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Christine McDonald
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Antonio Y Hardan
- Department of Child Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Joan Tamburro
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Mustafa Sahin
- Translational Neurosciences Center, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Cheryl Bayart
- Department of Dermatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Charis Eng
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio; Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Center for Personalized Genetic Healthcare, Community Care and Population Health, Cleveland Clinic, Cleveland, Ohio; Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio; Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio; Germline High Risk Cancer Focus Group, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.
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