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Abu Rached N, Gambichler T, Ocker L, Skrygan M, Seifert C, Scheel CH, Stockfleth E, Bechara FG. Haptoglobin is an independent marker for disease severity and risk for metabolic complications in hidradenitis suppurativa: A prospective study. J Eur Acad Dermatol Venereol 2024; 38:205-213. [PMID: 37669834 DOI: 10.1111/jdv.19495] [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: 06/26/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease that is highly correlated with obesity. Haptoglobin serum levels have recently been recognized as an important biomarker linking obesity with chronic inflammation. OBJECTIVE To compare haptoglobin with previously proposed serum biomarkers for the determination of disease severity in HS patients. For this purpose, disease severity of HS patients was determined by a panel of clinical scores as well as several risk factors, such as weight and smoking habits. METHODS A prospective, diagnostic accuracy study was performed at the International Centre for Hidradenitis suppurativa/Acne inversa Bochum (ICH). The study included a total of 263 patients, including 131 who had a confirmed diagnosis of HS in Hurley I (n = 16), II (n = 56) and III (n = 59) HS, and 132 healthy controls. The main outcome was to identify serological inflammatory markers for HS disease severity [severe (III) vs. moderate/mild (II/I)] as assessed by Hurley classification. RESULTS The serum levels of acute phase proteins haptoglobin and CRP, as well as the number of neutrophils in peripheral blood, number of monocytes, the systemic immune-inflammation index and the pan-immune-inflammatory value correlated with disease severity according to established clinical scores (mHSS, SAHS, Hurley, DLQI). HS patients had significantly higher haptologlobin levels compared to healthy controls. Logistic regression analysis revealed haptoglobin as the only independent marker predicting severe HS. CONCLUSION In this prospective study, we discovered that the serum levels of the acute phase protein haptoglobin levels serve as an independent marker of disease severity in HS. While this presents the first study in the context of HS. Thus, the present data not only yield a highly promising serum marker to be further validated.
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Affiliation(s)
- N Abu Rached
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - T Gambichler
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology and Phlebology, Christian Hospital Unna, Unna, Germany
| | - L Ocker
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - M Skrygan
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - C Seifert
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - F G Bechara
- Department of Dermatology, Venereology and Allergology, International Centre for Hidradenitis Suppurativa/Acne Inversa (ICH), Ruhr-University Bochum, Bochum, Germany
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
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Krasowska D, Gambichler T, Cortés C, Horev A, Compagno N, Dahale SS, Papanastasiou P, Keefe D. Long‐term efficacy, safety, and tolerability of secukinumab in children and adolescents with severe chronic plaque psoriasis: Two‐year results from a Phase
III
double‐blind, randomised controlled trial. J Eur Acad Dermatol Venereol 2023. [PMID: 36971771 DOI: 10.1111/jdv.19063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Secukinumab has previously demonstrated sustained efficacy and favourable safety for up to 52 weeks in paediatric patients (children and adolescents aged 6 to <18 years) with severe chronic plaque psoriasis (NCT02471144). OBJECTIVE To investigate the long-term (104 weeks) efficacy and safety of secukinumab. METHODS After 52 weeks, patients continued to receive secukinumab low dose (LD [75/150 mg]) or high dose (HD [75/150/300 mg]). Patients on etanercept (0.8 mg/kg) until Week 52 entered follow-up. Data for patients receiving secukinumab LD from the beginning and those switching to secukinumab LD from placebo ('Any secukinumab' LD) and patients receiving secukinumab HD from the beginning and those switching to secukinumab HD from placebo ('Any secukinumab' HD) are presented. ASSESSMENTS Psoriasis Area and Severity Index (PASI) score, PASI (75/90/100) responses, Investigator's Global Assessment modified 2011 (IGA mod 2011) 0/1 response, Children's Dermatology Life Quality Index (CDLQI) score and CDLQI 0/1 response up to Week 104, and, safety up to Week 104 for all patients and up to 4 years for some patients (~320 patient-years [PY] of treatment). RESULTS Secukinumab-treated patients showed sustained PASI 75/90/100 and IGA mod 2011 0/1 responses up to Week 104. Throughout the second year of treatment, efficacy was similar for the 'Any secukinumab' LD and HD groups for PASI 75 and IGA mod 2011 0/1 responses. PASI 90/100 responses were mostly comparable between the dose groups up to Week 88, but higher in the 'Any secukinumab' HD than the 'Any secukinumab' LD group at Week 104. Patients achieved a sustained CDLQI 0/1 response that was similar between the 'Any secukinumab' LD (61.1%) and HD (65.0%) groups. Safety data were consistent with the established safety profile of secukinumab. CONCLUSION Secukinumab demonstrated sustained long-term efficacy (up to 2 years) and a favourable safety profile (~320 PY of treatment) in paediatric patients with severe chronic plaque psoriasis.
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Affiliation(s)
- D Krasowska
- Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Cortés
- Department of Dermatology, La Samaritana University Hospital, Dermatology Program National University of Colombia, Pontificia Universidad Javeriana and Los Andes University, Bogotá, Colombia
| | - A Horev
- Pediatric Dermatology Service, Soroka University Medical Centre, Beer Sheva, Israel
| | | | | | | | - D Keefe
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
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Gambichler T, Finis C, Abu Rached N, Scheel CH, Becker JC, Lang K, Käfferlein HU, Brüning T, Abolmaali N, Susok L. Expression of DNA mismatch repair proteins in melanoma patients treated with immune checkpoint inhibitors. J Cancer Res Clin Oncol 2023; 149:1241-1247. [PMID: 35419731 PMCID: PMC9984342 DOI: 10.1007/s00432-022-04002-4] [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: 03/11/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the protein expression of DNA mismatch repair (MMR) proteins in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy. METHODS Immunohistochemistry was performed on tumor tissue for MMR proteins MLH1, MSH2, MSH6, and PMS2 in 50 metastatic CM patients treated with ICI (ipilimumab, nivolumab, pembrolizumab). RESULTS Best overall response (BOR) rate was 48% (24/50). Reduced MMR protein expression (nuclear expression in < 80% of tumor cells) was observed in 8 patients (16%). Compared to other clinical parameters, baseline neutrophil/lymphocyte ratio and reduced intratumoral MMR protein expression (P = 0.0033) were determined as the only parameters significantly associated with favorable BOR. However, in this small study population, reduced MMR protein expression did not reach statistical significance in multivariate analysis. CONCLUSION Reduced MMR protein expression is observed in CM and might predict favorable BOR in patients treated with ICI, as was observed for other entities. However, these findings need to be substantiated in larger patient cohorts.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße, 5644791, Bochum, Germany.
| | - C Finis
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße, 5644791, Bochum, Germany
| | - N Abu Rached
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße, 5644791, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße, 5644791, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - H U Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - N Abolmaali
- Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße, 5644791, Bochum, Germany
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Gambichler T, Würfel L, Abu Rached N, Mansour R, Bechara FG, Scheel CH. Systemic immune-inflammation biomarkers in psoriasis patients under interleukin 17A-inhibitor treatment. J Eur Acad Dermatol Venereol 2023. [PMID: 36682043 DOI: 10.1111/jdv.18895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - L Würfel
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - F G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
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Gambichler T, Kautz O, Schacht R, Boms S. Unilateral Blaschkoid‐linear verrucous lichen planus under immunotherapy with pembrolizumab. J Eur Acad Dermatol Venereol 2022; 37:e624-e625. [PMID: 36394377 DOI: 10.1111/jdv.18759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Affiliation(s)
- T. Gambichler
- Department of Dermatology, Christian Hospital Unna Unna Germany
- Skin Cancer Center, Department of Dermatology, Ruhr‐University Bochum Bochum Germany
| | - O. Kautz
- NordWestHisto Westerstede Germany
| | - R. Schacht
- Department of Dermatology, Christian Hospital Unna Unna Germany
| | - S. Boms
- Department of Dermatology, Christian Hospital Unna Unna Germany
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Susok L, Said S, Reinert D, Mansour R, Scheel CH, Becker JC, Gambichler T. The pan-immune-inflammation value and systemic immune-inflammation index in advanced melanoma patients under immunotherapy. J Cancer Res Clin Oncol 2022; 148:3103-3108. [PMID: 35006344 PMCID: PMC9508007 DOI: 10.1007/s00432-021-03878-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy. METHODS PIV and SII were calculated before the start of ICI therapy and at time of progression/death in patients with metastatic CM (stage III/IV). Sex-age-matched CM patients in stage I/II and healthy subjects (HC) served as controls. RESULTS The median PIV of stage III/IV patients was significantly (P = 0.0011) higher than in stage I/II patients and HC. SII was significantly (P = 0.00044) lower in HC than in CM patients. At baseline, PIV and SII did significantly correlate with lactate dehydrogenase (P = 0.045/0.017). However, ROC curve statistics revealed that SII and PIV were not significantly associated with clinical parameters, including best response to ICI treatment (P = 0.87/0.64), progression-free survival (P = 0.73/0.91), and melanoma-specific survival (P = 0.13/0.17). Moreover, there were no significant changes of PIV and SII from baseline to progression/death (P = 0.38/0.52). CONCLUSIONS Even though both immune-inflammation biomarkers showed some power to differentiate between CM stages and HC, respectively, PIV and SII seem not to be significant predictors for clinical outcome measures of CM patients under ICI therapy.
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Affiliation(s)
- L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Said
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - D Reinert
- Department of Radiology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | | | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
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Gambichler T, Elfering J, Meyer T, Bruckmüller S, Stockfleth E, Skrygan M, Käfferlein HU, Brüning T, Lang K, Wagener D, Schröder S, Nick M, Susok L. Protein expression of prognostic genes in primary melanoma and benign nevi. J Cancer Res Clin Oncol 2022; 148:2673-2680. [PMID: 34757537 PMCID: PMC9470607 DOI: 10.1007/s00432-021-03779-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the protein expression characteristics of genes employed in a recently introduced prognostic gene expression assay for patients with cutaneous melanoma (CM). METHODS We studied 37 patients with CM and 10 with benign (melanocytic) nevi (BN). Immunohistochemistry of primary tumor tissue was performed for eight proteins: COL6A6, DCD, GBP4, KLHL41, KRT9, PIP, SCGB1D2, SCGB2A2. RESULTS The protein expression of most markers investigated was relatively low (e.g., DCD, KRT9, SCGB1D2) and predominantly cytoplasmatic in melanocytes and keratinocytes. COL6A6, GBP4, and KLHL41 expression was significantly enhanced in CM when compared to BN. DCD protein expression was significantly correlated with COL6A6, GBP4, and KLHL41. GBP4 was positively correlated with KLHL41 and inversely correlated with SCGB2B2. The latter was also inversely correlated with serum S100B levels at time of initial diagnosis. The presence of SCGB1D2 expression was significantly associated with ulceration of the primary tumor. KRT9 protein expression was significantly more likely found in acral lentiginous melanoma. The presence of DCD expression was less likely associated with superficial spreading melanoma subtype but significantly associated with non-progressive disease. The absence of SCGB2A2 expression was significantly more often observed in patients who did not progress to stage III or IV. CONCLUSIONS The expression levels observed were relatively low but differed in part with those found in BN. Even though we detected some significant correlations between the protein expression levels and clinical parameters (e.g., CM subtype, course of disease), there was no major concordance with the protective or risk-associated functions of the corresponding genes included in a recently introduced prognostic gene expression assay.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
| | - J Elfering
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - T Meyer
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Bruckmüller
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Skrygan
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - H U Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - K Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - D Wagener
- Pathology/Labor Lademannbogen MVZ GmbH, Hamburg, Germany
| | - S Schröder
- Pathology/Labor Lademannbogen MVZ GmbH, Hamburg, Germany
| | - M Nick
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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Gambichler T, Scheel CH, Arafat Y, Kautz O, Boms S. Erythrodermic pityriasis rubra pilaris after SASRS-CoV-2 vaccination with concomitant COVID-19 infection. J Eur Acad Dermatol Venereol 2022; 36:e675-e676. [PMID: 35536694 PMCID: PMC9347623 DOI: 10.1111/jdv.18214] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Y Arafat
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - O Kautz
- NordWestHisto, Westerstede, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
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Gambichler T, Espey B, Doerler M, Stranzenbach R. Dipeptidyl Peptidase-4 Inhibitor Induced Bullous Pemphigoid Complicated by Acquired Reactive Perforating Dermatosis. Actas Dermo-Sifiliográficas 2022; 113:914-915. [DOI: 10.1016/j.ad.2021.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/13/2021] [Accepted: 01/31/2021] [Indexed: 12/20/2022] Open
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Gambichler T, Hessam S, Cramer P, Abu Rached N, Bechara G. Complete blood collection‐based systemic inflammation biomarkers for patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2022; 36:1593-1596. [DOI: 10.1111/jdv.18175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
- T. Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr‐University Bochum Bochum Germany
| | - S. Hessam
- Department of Dermatology, Venereology and Allergology, Ruhr‐University Bochum Bochum Germany
| | - P. Cramer
- Department of Dermatology, Venereology and Allergology, Ruhr‐University Bochum Bochum Germany
| | - N. Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr‐University Bochum Bochum Germany
| | - G. Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr‐University Bochum Bochum Germany
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Gambichler T, Stricker I, Neid M, Tannapfel A, Susok L. Impressive response to four cycles cemiplimab of a sonidegib-resistant giant basosquamous carcinoma of the midface. J Eur Acad Dermatol Venereol 2022; 36:e490-e492. [PMID: 35143084 DOI: 10.1111/jdv.17993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/15/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - I Stricker
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - M Neid
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - A Tannapfel
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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Gambichler T, Said S, Abu Rached N, Scheel CH, Susok L, Stranzenbach R, Becker JC. Pan-immune-inflammation value independently predicts disease recurrence in patients with Merkel cell carcinoma. J Cancer Res Clin Oncol 2022; 148:3183-3189. [PMID: 35098389 PMCID: PMC9508022 DOI: 10.1007/s00432-022-03929-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/17/2022] [Indexed: 12/25/2022]
Abstract
Purpose We aimed to determine whether the pan-immune-inflammation value (PIV) of patients with Merkel cell carcinoma (MCC) at primary diagnosis differs from controls and whether it is associated with disease stage and outcome. Methods In this retrospective study, we recruited MCC patients with stage I–III. PIV was calculated from absolute complete blood cell counts obtained within one week at MCC diagnosis as follows: [neutrophils (103/mm3) × platelets (103/mm3) × monocytes (103/mm3)]/lymphocytes (103/mm3). As controls, we studied age–gender-matched cutaneous melanoma (CM, stage I–III) patients and healthy controls (HC). Univariate and multivariate statistics were used. Results The median PIV in MCC patients was significantly increased compared to both CM patients as well as healthy controls. PIV of MCC patients in stage II and III was significantly higher compared to stage I patients. ROC analysis revealed that MCC recurrence was significantly associated with a PIV greater than 372 [p < 0.0001, Youden index 0.58; hazard ratio: 4 (95% confidence interval: 1.7 to 9.2)]. In multivariate analysis, only a PIV greater than 372 and higher MCC stage were determined as independent predictors for disease recurrence. Conclusion We determined, for the first time, the prognostic ability of the promising blood-based biomarker PIV in MCC patients and observed that PIV is increased in MCC patients in dependence on disease stage and independently predicts MCC recurrence.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
| | - S Said
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - N Abu Rached
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
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13
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Gambichler T, Stockfleth E, Susok L. Aggressive cutaneous squamous cell carcinoma in a hydroxyurea- and ruxolitinib-pretreated patient with polycythaemia vera. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:63-65. [PMID: 34855240 DOI: 10.1111/jdv.17406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/02/2021] [Indexed: 12/26/2022]
Abstract
Hydroxyurea and ruxolitinib are frequently used to treat myeloproliferative disorders, including polycythaemia vera, and chronic treatment is associated with many cutaneous adverse effects such as the development of aggressive non-melanoma skin cancer (NMSC). We report an 85-year-old man with a history of hydroxyurea- and ruxolitinib-treated polycythaemia vera who was referred for the management of progressively growing tumours on his scalp. Histopathology of the largest scalp lesion revealed a partly desmoplastic cutaneous squamous carcinoma with perineural invasion. Initial imaging revealed metastatic disease in cervical lymph nodes, bones and lungs. The scalp lesions were successfully treated with bleomycin-based electrochemotherapy. Under initial systemic therapy using four cycles of cetuximab, metastatic disease progressed. Following the approval by the health insurance, compassionate use of pembrolizumab monotherapy was initiated. After three cycles of pembrolizumab, however, metastatic disease further progressed and the patient finally died from global respiratory insufficiency. The present case exemplifies the cutaneous adverse effects of long-term hydroxyurea and ruxolitinib therapy, frequently resulting in highly aggressive NMSCs that are usually not responsive to systemic treatments even such as immune checkpoint inhibitors.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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14
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Gambichler T, Scheel CH, Reuther J, Susok L. Management of immune-related adverse events in anti-PD-1-treated patients with advanced cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:23-28. [PMID: 34855251 DOI: 10.1111/jdv.17402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022]
Abstract
Immune checkpoint inhibitors (ICI) have shown very promising results in the management of patients with inoperable or metastatic cutaneous squamous cell carcinoma (cSCC). However, ICI can cause a range of immune-related adverse events (irAEs) affecting a multitude of organs including skin, gastrointestinal tract, endocrine system, heart, lung, kidneys and the nervous system. In principle, clinical management irAEs does not change significantly with respect to the kind of cancer treated with ICI. However, advanced cSCC typically occurs in a clinically challenging patient population typically presenting with advanced age and/or significant comorbidities such as immunosuppression due to haematological malignancies and their respective treatment. Moreover, many patients with advanced cSCC are organ transplant patients taking immunosuppressants. As a consequence use of ICI per se and management of ICI-induced irAEs generates more complexity and difficulties in patients with cSCC compared to other entities. Here, we provide a brief review on the management of anti-programmed cell death protein 1-induced irAEs in patients with cSCC focusing on the characteristic clinical challenges present in this population.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J Reuther
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.,Department of Dermatology, Dermatological Radiotherapy and Dermatohistopathology, Special Clinics Hornheide, Münster, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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15
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Gambichler T, Philippou S, Scheel CH, Susok L. Development of thoracic sarcoid reactions associated with complete response to anti-PD-1 therapy in a patient with advanced cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:35-40. [PMID: 34855255 DOI: 10.1111/jdv.17401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/23/2021] [Indexed: 01/13/2023]
Abstract
In patients with advanced cutaneous squamous cell carcinoma (cSCC), positive efficacy data were reported for anti-PD-1 antibodies. However, anti-PD-1 treatment is associated with a wide range of immune-related adverse events (irAEs). Here, we report on a 78-year-old woman with a huge cSCC on the right cheek spanning from the temporal to the cervical region with evidence for infiltration of the parotid gland, right masseter muscle and right auditory canal. Ultrasound revealed cervical, submandibular and supraclavicular lymph node metastases on patient's right side. On the basis of a medical hardship application, treatment with pembrolizumab was initiated. After two applications, a dramatic regression of the tumour was observed. At this point, the patient was switched to cemiplimab, which, in the meantime, had become available in Germany. After 3 months on cemiplimab, the tumour-related ulcer on the right cheek showed almost complete regression and all previously affected lymph nodes displayed no evidence for malignancy. Thoracic computed tomography (CT) scans revealed enlarged mediastinal and bilateral hilar lymph nodes assessed as primarily reactive. Three months later, however, mediastinal and bilateral hilar lymph nodes further increased in size, accompanied by radiological alterations of the lung parenchyma. Lymph node biopsies revealed sarcoid reactions (SRs) including fibrotic non-caseating epitheloid cell granulomas surrounded by lymphocytes. Since the patient did not display any clinical symptoms, cemiplimab treatment was continued following a 4-week break. Three months later, CT showed significant regression of the described enlarged lymph nodes and parenchymal lung changes. Twenty months after anti-PD-1 treatment, the patient was still in complete remission. In conclusion, we describe, for the first time, the case of a patient with advanced cSCC who developed disseminated thoracic SRs which were associated with dramatic regression of tumour masses. Thus, as with other irAEs, development of SRs might be indicative of an anti-tumour response to anti-PD-1 therapy.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Philippou
- Department of Pathology and Cytology, Augusta Kliniken Bochum Hattingen, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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16
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Gambichler T, Hamdani N, Budde H, Sieme M, Skrygan M, Scholl L, Dickel H, Behle B, Ganjuur N, Scheel C, Abu Rached N, Ocker L, Stranzenbach R, Doerler M, Pfeiffer L, Becker JC. Bullous pemphigoid after SARS-CoV-2 vaccination: Spike protein-directed immunofluorescence confocal microscopy and T cell receptor studies. Br J Dermatol 2021; 186:728-731. [PMID: 34773638 PMCID: PMC8653321 DOI: 10.1111/bjd.20890] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - N Hamdani
- Institut für Forschung und Lehre (IFL), Department of Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany.,Department of Cardiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.,Institute of Physiology, Ruhr-University, Bochum, Germany
| | - H Budde
- Institut für Forschung und Lehre (IFL), Department of Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany.,Department of Cardiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.,Institute of Physiology, Ruhr-University, Bochum, Germany
| | - M Sieme
- Institut für Forschung und Lehre (IFL), Department of Molecular and Experimental Cardiology, Ruhr-University Bochum, Bochum, Germany.,Department of Cardiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.,Institute of Physiology, Ruhr-University, Bochum, Germany
| | - M Skrygan
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - L Scholl
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - H Dickel
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - B Behle
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - N Ganjuur
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - C Scheel
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - L Ocker
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - R Stranzenbach
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - M Doerler
- Department of Dermatology, Ruhr-University, Bochum, Bochum, Germany
| | - L Pfeiffer
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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17
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Gambichler T, Hessam S, Lüttringhaus T, Boms S. Prompt response of advanced cutaneous squamous cell carcinoma to cemiplimab in a kidney transplant patient under everolimus treatment. Clin Exp Dermatol 2021; 47:608-609. [PMID: 34767651 DOI: 10.1111/ced.15018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 12/22/2022]
Abstract
Immune checkpoint inhibitors (ICI) are increasingly used in numerous advanced solid cancers. Nevertheless, the safety and efficacy of ICI in solid organ transplant recipients (SOTR) are unclear, since SOTR are usually excluded from clinical investigations due to their high risk for irreversible allograft rejection.1-4.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Christian Hospital Unna, Unna, Germany.,Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Hessam
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - T Lüttringhaus
- Haemato-Oncological Outpatient Clinic, Christian Hospital Unna, Unna, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
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18
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Gambichler T, Krogias C, Tischoff I, Tannapfel A, Gold R, Susok L. Bilateral giant cell arteritis with skin necrosis following SARS-CoV-2 vaccination. Br J Dermatol 2021; 186:e83. [PMID: 34726769 PMCID: PMC8652593 DOI: 10.1111/bjd.20824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/31/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Krogias
- Department of Neurology, Ruhr-University Bochum, Bochum, Germany
| | - I Tischoff
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - A Tannapfel
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - R Gold
- Department of Neurology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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19
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Gambichler T, Boms S, Susok L, Dickel H, Finis C, Abu Rached N, Barras M, Stücker M, Kasakovski D. Cutaneous findings following COVID-19 vaccination: review of world literature and own experience. J Eur Acad Dermatol Venereol 2021; 36:172-180. [PMID: 34661927 PMCID: PMC8656409 DOI: 10.1111/jdv.17744] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/29/2021] [Indexed: 12/11/2022]
Abstract
There is growing evidence that not only the novel coronavirus disease (COVID‐19) but also the COVID‐19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID‐19 vaccination campaigns all over the world. Unspecific injection‐site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g. urticaria, angio‐oedema and anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions (“COVID arm”), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme‐like rashes. Autoimmune‐mediated skin findings after COVID‐19 vaccination include leucocytoclastic vasculitis, lupus erythematosus and immune thrombocytopenia. Functional angiopathies (chilblain‐like lesions, erythromelalgia) may also be observed. Pityriasis rosea‐like rashes and reactivation of herpes zoster have also been reported after COVID‐19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID‐19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS‐CoV‐2 (e.g. the spike‐protein sequences used to design the vaccines) and human components and may thus explain some COVID‐19 pathologies as well as adverse skin reactions to COVID‐19 vaccinations. Linked Commentary: P. Gisondi et al. J Eur Acad Dermatol Venereol 2022; 36: 165–166. https://doi.org/10.1111/jdv.17854.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.,Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - L Susok
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - H Dickel
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Finis
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Barras
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - D Kasakovski
- European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Division of Vascular Oncology and Metastasis, German Cancer Research Center Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany
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20
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Gambichler T, Rohrmoser EM, Horny K, Sucker A, Schadendorf D, Skrygan M, Susok L, Stücker M, Becker JC. Comparison of mutation profiles in primary melanomas and corresponding nodal naevi using next-generation sequencing. Clin Exp Dermatol 2021; 47:373-380. [PMID: 34591998 DOI: 10.1111/ced.14951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Nodal naevi (NN) represent aggregates of melanocytes within peripheral lymph nodes. NN are relatively often found in patients with malignant melanoma (MM), and may mimic metastatic disease. AIM To study mutation profiles in MM and NN to find out whether NN descend from a primary MM. METHODS Next-generation sequencing was performed on formalin-fixed paraffin-embedded tissue of 26 pairs of primary MM and corresponding NN detected by sentinel lymph node biopsy, and 29 MM-characteristic genes were investigated. RESULTS In this study, 90% of mutations were detected exclusively in either MM or NN, but not both, in the same patient; the percentage of identical NN and MM mutations in the same individual was only 10%. The most frequently discovered shared mutations were a C>G substitution in the CDKN2A gene and in-frame deletion in ARID1A. Oncogenic driver mutations were frequently observed in MM but only rarely in NN. About three-quarters of mutations in both MM and NN were characterized by C>T or G>A substitutions. The detected rate of ultraviolet (UV)-related C>T base changes was comparably high in both primary MM (35%) and NN (32%). CONCLUSIONS Based on our data, it seems that NN descend from previously UV-exposed BRAF wildtype cutaneous melanocytes, rather than from primary MM or arrested progenitor cells.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - E-M Rohrmoser
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - K Horny
- Department of Dermatology, Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, University Duisburg-Essen, Essen, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - A Sucker
- Department of Dermatology, Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, University Duisburg-Essen, Essen, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - D Schadendorf
- Department of Dermatology, Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, University Duisburg-Essen, Essen, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany.,Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - M Skrygan
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Department of Dermatology, Venereology and Allergology, Skin Cancer Center Ruhr-University, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - J C Becker
- Department of Dermatology, Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, University Duisburg-Essen, Essen, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany.,Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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21
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Gambichler T, Stranzenbach R, Mansour R, Lee YP, Doerler M, Stücker M. Diffuse dermal angiomatosis of the breast in a young woman. Clin Exp Dermatol 2021; 47:415-416. [PMID: 34431548 DOI: 10.1111/ced.14904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Y-P Lee
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Doerler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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22
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Gambichler T, Boms S, Hessam S, Tischoff I, Tannapfel A, Lüttringhaus T, Beckman J, Stranzenbach R. Primary cutaneous anaplastic large cell lymphoma with marked spontaneous regression of organ manifestation after SARS-CoV-2 vaccination. Br J Dermatol 2021; 185:1259-1262. [PMID: 34228815 PMCID: PMC8444914 DOI: 10.1111/bjd.20630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/03/2021] [Accepted: 07/04/2021] [Indexed: 12/01/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - S Hessam
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - I Tischoff
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - A Tannapfel
- Institute of Pathology, Ruhr-University Bochum, Bochum, Germany
| | - T Lüttringhaus
- Haemato-Oncological Outpatient Clinic, Christian Hospital Unna, Unna, Germany
| | - J Beckman
- Department of Radiology, Christian Hospital Unna, Unna, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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23
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Gambichler T, Hessam S, Skrygan M, Bakirtzi M, Kasakovski D, Bechara FG. NOD2 signalling in hidradenitis suppurativa. Clin Exp Dermatol 2021; 46:1488-1494. [PMID: 34056759 DOI: 10.1111/ced.14773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/29/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is associated with dysregulated immune responses including altered expression of cytokines, chemokines, and antimicrobial peptides and proteins (AMPs). AIMS To evaluate the expression of nucleotide-binding oligomerization domain-containing (NOD)2 and related factors in HS skin samples and keratinocyte cultures. METHODS We performed real-time PCR for NOD2, receptor-interacting serine/threonine-protein kinase (RIP)2, cyclic amine resistance locus (CARL), skin-derived antileukoproteinase (SKALP)/elafin, human β-defensin (hBD)2, LL37, psoriasin and RNAse7 in lesional and nonlesional skin of 19 patients with HS and in keratinocyte cultures [unstimulated, muramyl dipeptide (MDP)-stimulated or Pam2CSK4 (Pam2)-stimulated] from and nonlesional skin. RESULTS We observed significantly elevated mRNA expression for NOD2 (P < 0.01), hBD2 (P = 0.02), RNase7 (P < 0.001), psoriasin (P < 0.01) and SKALP/elafin (P = 0.02) in lesional compared with nonlesional skin. We found a significant correlation between NOD2 mRNA and hBD2 (r = 46; P = 0.04), psoriasin (r = 0.67; P < 0.01) and SKALP/elafin (r = 0.65; P < 0.01). In unstimulated, Pam2-stimulated and MDP-stimulated normal keratinocytes, NOD2, RIP2, CARL and SKALP/elafin expression significantly (P < 0.05) increased from 6 to 48 h, whereas in unstimulated, Pam2-stimulated and MDP-stimulated HS keratinocytes, RIP2, CARL and SKALP/elafin expression significantly (P < 0.05) declined from 6 to 48 h. mRNA expression of NOD2 (unstimulated, Pam2-stimulated, MDP-stimulated), CARL (unstimulated, Pam2-stimulated, MDP-stimulated) and SKALP/elafin (unstimulated, Pam2-stimulated) at 6 h was significantly increased in HS compared with normal keratinocytes. CONCLUSION We have shown for the first time that NOD2 signalling is activated in HS and might contribute to the pathogenesis via induction of AMPs and activation of other pathways such as nuclear factor κB signalling.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - S Hessam
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - M Skrygan
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - M Bakirtzi
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - D Kasakovski
- European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Division of Vascular Oncology and Metastasis, German Cancer Research Center Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - F G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
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24
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Gambichler T, Hartenstein I, Dreißigacker M, Stockfleth E, Stücker M, Schaller J, Schulze HJ, Becker JC, Käfferlein HU, Brüning T, Lang K. Expression of Hedgehog signalling molecules in microcystic adnexal carcinoma. Clin Exp Dermatol 2021; 46:1052-1057. [PMID: 33714217 DOI: 10.1111/ced.14634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/05/2021] [Accepted: 03/11/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Microcystic adnexal carcinoma (MAC) is a rare skin neoplasm that has not been characterized on a molecular basis. AIM To assess expression profiles of Hedgehog (HH) signalling molecules in MAC and control tumours. METHODS Immunohistochemistry was performed for Sonic Hedgehog (SHH), Indian Hedgehog (IHH), Patched 1 (PTCH1) and Smoothened (SMO) on patient MAC tissue (n = 26) and control tumour tissue, including syringoma (SyG; n = 11), trichoepithelioma (TE; n = 11) and basal cell carcinoma (BCC; n = 12) tissues. RESULTS Patched 1 and SMO immunoreactivity was significantly higher in BCC than in SyG, TE or MAC (P < 0.001 and P < 0.03, respectively). The highest IHH expression was observed in BCC and TE compared with SyG and MAC (P < 0.04). Notably, the highest SHH protein expression was observed in SyG compared with MAC, TE and even BCC (P < 0.001). In patients with MAC, SMO immunoreactivity significantly (r = 0.51; P < 0.01) correlated with PTCH1 expression. Further correlation studies did not show significant associations between the HH expression markers assessed (P > 0.05). CONCLUSION Our results indicate that alterations of the HH signalling are unlikely to play a major role in the pathogenesis of MAC, which is in contrast to the morphologically similar BCC and TE. Our observation provides additional information to the limited molecular pathology knowledge on this rare tumour.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - I Hartenstein
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Dreißigacker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J Schaller
- Dermatopathology Duisburg, Duisburg, Germany
| | - H-J Schulze
- Fachklinik Hornheide, Skin Cancer Center, Department of Dermatology and Dermato-Histo-Pathology, Münster, Germany
| | - J C Becker
- Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Department of Dermatology, University Duisburg-Essen, Essen, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - H U Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - K Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
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25
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Gambichler T, Lukas C. A rare cause of chronic wounds: trigeminal trophic syndrome due to Wallenberg syndrome. Clin Exp Dermatol 2021; 46:1324-1325. [PMID: 33914933 DOI: 10.1111/ced.14718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Lukas
- Department of Radiology, Ruhr-University Bochum, Bochum, Germany
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26
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Gambichler T, Scholl L, Dickel H, Ocker L, Stranzenbach R. Prompt onset of Rowell's syndrome following the first BNT162b2 SARS-CoV-2 vaccination. J Eur Acad Dermatol Venereol 2021; 35:e415-e416. [PMID: 33725406 PMCID: PMC8251447 DOI: 10.1111/jdv.17225] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/09/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Scholl
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - H Dickel
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Ocker
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Stranzenbach
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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27
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Susok L, Stücker M, Bechara FG, Stockfleth E, Gambichler T. Multivariate analysis of prognostic factors in patients with nodular melanoma. J Cancer Res Clin Oncol 2021; 147:2759-2764. [PMID: 33630139 PMCID: PMC8310843 DOI: 10.1007/s00432-021-03562-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/08/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Nodular melanoma (NM) is associated with worse disease outcome when compared to superficial spreading melanoma (SSM). We aimed to perform a single-center analysis of prognostic factors in patients with NM and compare the data with SSM patients. METHODS We studied 228 patients with NN and 396 patients with SSM. Patients with in situ melanomas or stage IV at diagnosis were not included in the study. Data were analyzed using the Mann-Whitney test, Chi-square test, Kaplan-Meier curves including the log-rank test, and logistic regression model. RESULTS When compared to patients with SSM, patients with NM had less likely lower Clark level, higher tumor thickness, less likely tumor regression, more often ulcerated tumors, and less likely a history of precursor lesions such as a nevus. Within a 5-year follow-up we observed significantly more disease relapses and deaths in NM patients than in SSM patients. On multivariate analysis, disease relapse in NM patients was independently predicted by tumor thickness and positive SLNB, whereas melanoma-specific death of NM patients was independently predicted by male sex and tumor thickness. Histologic regression also remained in the logistic regression model as a significant independent negative predictor of NM death. CONCLUSIONS We did not observe that NM subtype was per se a significant independent predictor for disease relapse or melanoma-specific death. Among the well-known prognostic factors such as tumor thickness and male sex, NM is also associated with other unfavorable factors such as absence of regression.
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Affiliation(s)
- L Susok
- Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - M Stücker
- Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - F G Bechara
- Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - E Stockfleth
- Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
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28
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Gambichler T, Reuther J, Stücker M, Stranzenbach R, Torres-Reyes C, Schlottmann R, Schmidt WE, Hayajneh R, Sriram A, Becker JC. SARS-CoV-2 spike protein is present in both endothelial and eccrine cells of a chilblain-like skin lesion. J Eur Acad Dermatol Venereol 2020; 35:e187-e189. [PMID: 33002210 PMCID: PMC7537109 DOI: 10.1111/jdv.16970] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Data on SARS‐CoV‐2 detection in lesional skin is controversial.1‐8 We report a PCR‐proven COVID‐19 patient with a chilblain‐like SARS‐CoV‐2 positive skin lesion. An 80‐year‐old woman presented to the emergency department at the End of March 2020. She reported an onset of fever (38.4 C°) several days before admission, along with cough and shortness of breath. RT‐PCR from a nasopharyngeal swab was positive for SARS‐CoV‐2. An X‐ray showed evidence for right‐sided pneumonic infiltrates.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J Reuther
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Torres-Reyes
- Department of Internal Medicine, Ruhr-University Bochum, Bochum, Germany
| | - R Schlottmann
- Department of Internal Medicine, Ruhr-University Bochum, Bochum, Germany
| | - W E Schmidt
- Department of Internal Medicine, Ruhr-University Bochum, Bochum, Germany
| | - R Hayajneh
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Sriram
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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29
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Hamm H, Wilsmann-Theis D, Tsianakas A, Gambichler T, Taipale K, Lauterbach J, Freudensprung U, Makepeace C. Efficacy and safety of fumaric acid esters in young patients aged 10-17 years with moderate-to-severe plaque psoriasis: a randomized, double-blinded, placebo-controlled trial. Br J Dermatol 2020; 185:62-73. [PMID: 33332574 DOI: 10.1111/bjd.19747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Apart from biologics, no systemic drugs are approved in Europe for children with moderate-to-severe psoriasis. Retrospective observational studies have shown promising results for fumaric acid esters (FAE) in this setting. OBJECTIVES To show superiority of FAE over placebo in terms of treatment response after 20 weeks in children and adolescents aged 10-17 years. METHODS In a multicentre, randomized, double-blind, placebo-controlled phase IIIb study, patients aged 10-17 years with moderate-to-severe plaque psoriasis requiring systemic therapy were randomized 2 : 1 to receive FAE (n = 91) or placebo (n = 43) over 20 weeks, followed by an open-label FAE treatment phase. The coprimary endpoints were ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and Physician's Global Assessment (PGA) score of 0 or 1 (clear or almost clear) at week 20. The study was registered with EudraCT number 2012-000035-82. RESULTS At week 20, 55% [95% confidence interval (CI) 0·44-0·65] of FAE-treated patients achieved a PASI 75 response vs. 19% (95% CI 0·08-0·33) in the placebo group (absolute difference 36%, 95% CI 0·20-0·53; P < 0·001). In total, 42% (95% CI 0·32-0·53) in the FAE group vs. 7% (95% CI 0·01-0·19) in the placebo group achieved a PGA score of 0 or 1 at week 20 (absolute difference 35%, 95% CI 0·21-0·49; P < 0·001). During the double-blind period, drug-related adverse events occurred more frequently in patients receiving FAE compared with placebo (76% vs. 47%). Gastrointestinal disorders were the most common adverse events. CONCLUSIONS FAE administered over a period of 20 weeks demonstrated a better response than placebo; the difference was statistically significant and clinically meaningful. Application up to 40 weeks was generally well tolerated. However, further studies are required.
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Affiliation(s)
- H Hamm
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - D Wilsmann-Theis
- Department for Dermatology and Allergy, University Bonn, Bonn, Germany
| | - A Tsianakas
- Central Study Coordination for Innovative Dermatology (ZID), University Dermatology Clinic Münster, Münster, Germany
| | - T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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30
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Gambichler T, Bünnemann H, Scheel CH, Bechara FG, Stücker M, Stockfleth E, Becker JC. Does very early timing of lymph node surgery after resection of the primary tumour improve the clinical outcome of patients with melanoma? Clin Exp Dermatol 2020; 45:1011-1018. [PMID: 32422686 DOI: 10.1111/ced.14291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/22/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND In patients with cutaneous melanoma (CM), the time span between resection of the primary tumour and sentinel lymph node biopsy (SLNB) as well as the subsequent interval between SLNB and complete lymph node dissection (CLND) varies greatly. AIM To determine whether very early timing of SLNB after resection of the primary tumour, or timing of CLND after SLNB affect the clinical outcome of patients with CM, compared with longer time intervals. METHODS We compared the time spans between complete resection of the primary tumour and SLNB, and the interval between SLNB and CLND in a cohort of 896 patients with melanoma who had undergone SLNB. An interval between primary resection and SLNB or between SLNB and CLND of up to 7 days was classified as very early (VE-SLNB and VE-CLND, respectively). This time span was compared with intervals of > 7 days. Univariate and multivariate statistics were performed. RESULTS VE-SLNB was significantly associated with the presence of micrometastases. However, this was probably due to tumour thickness being significantly higher in patients with VE-SLNB compared with patients with later SLNB. Importantly, VE-SLNB was not significantly associated with disease relapse and VE-CLND was not associated with melanoma-specific death. CONCLUSIONS VE-SLNB and VE-CLND neither improved nor worsened the clinical outcome of patients. Thus, timing of SLNB and CLND has no influence on the overall clinical outcome of patients with melanoma. Our findings support the rational planning of lymph node surgery after resection of the primary tumour and provide help for effective patient counselling.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center Ruhr-University, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, St Josef Hospital, Bochum, Germany
| | - H Bünnemann
- Skin Cancer Center Ruhr-University, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, St Josef Hospital, Bochum, Germany
| | - C H Scheel
- Skin Cancer Center Ruhr-University, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, St Josef Hospital, Bochum, Germany
- Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Department of Dermatology, University Duisburg-Essen, Essen, Germany
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - F G Bechara
- Skin Cancer Center Ruhr-University, Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, St Josef Hospital, Bochum, Germany
| | - M Stücker
- Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Department of Dermatology, University Duisburg-Essen, Essen, Germany
| | - E Stockfleth
- Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Department of Dermatology, University Duisburg-Essen, Essen, Germany
| | - J C Becker
- Translational Skin Cancer Research, German Cancer Consortium (DKTK) Partner Site Essen/Düsseldorf, Department of Dermatology, University Duisburg-Essen, Essen, Germany
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
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31
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Hessam S, Gambichler T, Skrygan M, Scholl L, Sand M, Meyer T, Stockfleth E, Bechara F. Increased expression profile of NCSTN, Notch and PI3K/AKT3 in hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 35:203-210. [DOI: 10.1111/jdv.16962] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Affiliation(s)
- S. Hessam
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
- Department of Dermatology and Phlebology Katharinen‐Hospital Unna Unna Germany
| | - T. Gambichler
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - M. Skrygan
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - L. Scholl
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - M. Sand
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
- Department of Plastic and Reconstructive Surgery St. Josef‐Hospital Essen‐Kupferdreh Germany
| | - T. Meyer
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - E. Stockfleth
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - F.G. Bechara
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
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32
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Gambichler T. On phototherapy‐induced alterations of serum folate levels. J Eur Acad Dermatol Venereol 2020; 34:e504-e505. [DOI: 10.1111/jdv.16419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T. Gambichler
- Department of Dermatology Skin Cancer Center Ruhr‐University Bochum Bochum Germany
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33
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Peinemann F, Harari M, Peternel S, Chan T, Chan D, Labeit AM, Gambichler T. Indoor salt water baths followed by artificial ultraviolet B light for chronic plaque psoriasis: abridged Cochrane review. Br J Dermatol 2020; 183:1123-1124. [PMID: 32628281 DOI: 10.1111/bjd.19385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- F Peinemann
- Pediatric Oncology and Hematology, Children's Hospital, University of Cologne, Cologne, Germany
| | - M Harari
- Dead Sea and Arava Science Center, Dead Sea Branch, Ein Bokek, Israel
| | - S Peternel
- Department of Dermatovenereology, Clinical Hospital Center Rijeka, Rijeka, Croatia.,University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - T Chan
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - D Chan
- Cochrane Skin Group, The University of Nottingham, Nottingham, UK
| | - A M Labeit
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - T Gambichler
- Department of Dermatology, Ruhr-Universität Bochum, Bochum, Germany
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34
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Gambichler T, Steuke AK, Schmitz L, Stockfleth E, Becker JC. Altered hydroxymethylation in cutaneous squamous cell carcinoma and keratoacanthoma. Br J Dermatol 2020; 183:955-957. [PMID: 32407588 DOI: 10.1111/bjd.19219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - A-K Steuke
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Schmitz
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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35
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Gambichler T, Seifert C, Lehmann M, Lukas C, Scheel C, Susok L. Concurrent Vogt-Koyanagi-Harada disease and impressive response to immune checkpoint blockade in metastatic melanoma. Immunotherapy 2020; 12:439-444. [PMID: 32308086 DOI: 10.2217/imt-2019-0206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Vogt-Koyanagi-Harada disease (VKHD)-like symptoms have previously been reported in 11 melanoma patients treated with immune checkpoint inhibitors. Materials & methods: We report a female patient with multilocular metastatic melanoma who was treated with nivolumab. Results: Following the first nivolumab dose, she experienced bilateral blurry vision, hearing loss, vertigo and ataxia. Ocular ultrasound was consistent with the diagnosis of uveitis. Audiography revealed severe bilateral sensorineural hearing loss. A high-dose corticosteroid regimen was initiated under which the patient developed generalized vitiligo. Abdominal and thoracic CT scans showed an almost complete response to nivolumab therapy. This patient fulfilled all criteria of VKHD which is characterized pathogenetically by an antimelanocytic autoimmune process. Conclusion: The present case showed an impressive response to antimelanoma immunotherapy. Based on these data, the occurrence of VKHD in melanoma patients appears to be a strong indicator for immune checkpoint inhibitor efficacy.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - C Seifert
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - M Lehmann
- Department of Throat, Nose & Ear, Ruhr-University Bochum, Bochum, Germany
| | - C Lukas
- Department of Radiology, Ruhr-University Bochum, Bochum, Germany
| | - C Scheel
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
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36
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Gambichler T, Wrobel M, Koim S, Becker JC, Käfferlein HU, Brüning T, Lang K. A study on DNA hydroxymethylation in Kaposi sarcoma and cutaneous angiosarcoma. J Eur Acad Dermatol Venereol 2020; 34:e785-e787. [PMID: 32279358 DOI: 10.1111/jdv.16444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Wrobel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Koim
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - H U Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | - K Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
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37
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Hessam S, Gambichler T, Höxtermann S, Skrygan M, Sand M, Garcovich S, Meyer T, Stockfleth E, Bechara F. Frequency of circulating subpopulations of T‐regulatory cells in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:834-838. [DOI: 10.1111/jdv.16071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022]
Affiliation(s)
- S. Hessam
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - T. Gambichler
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - S. Höxtermann
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - M. Skrygan
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - M. Sand
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
- Department of Plastic and Reconstructive Surgery St. Josef‐Hospital Essen‐Kupferdreh Germany
| | - S. Garcovich
- Institute of Dermatology F. Policlinico Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - T. Meyer
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - E. Stockfleth
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
| | - F.G. Bechara
- Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum Bochum Germany
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Ganjuur N, Abu Rached N, Doerler M, Gambichler T. Rickettsialpox caused by Rickettsia africae in an elderly woman. Clin Exp Dermatol 2020; 45:905-907. [PMID: 32180236 DOI: 10.1111/ced.14221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- N Ganjuur
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Doerler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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Gambichler T, Ardabili S, Lang K, Dreißigacker M, Scheel C, Brand-Saberi B, Skrygan M, Stockfleth E, Käfferlein HU, Brüning T, Becker JC. Expression of Lefty predicts Merkel cell carcinoma-specific death. J Eur Acad Dermatol Venereol 2020; 34:2016-2020. [PMID: 32022949 DOI: 10.1111/jdv.16271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/27/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Lefty and Nodal are transforming growth factor β-related proteins, which, beside their role in determination of laterality during embryogenesis, have also been linked with cancer progression. OBJECTIVES Prompted by the observed significant left-sided laterality of Merkel cell carcinoma (MCC), we addressed whether Lefty and Nodal are expressed in MCC and correlated expression patterns with clinical parameters such as MCC laterality and patient outcome. METHODS Expression of Lefty and Nodal in primary MCC was assessed in 29 patients by immunohistochemistry. The histology (H-)score was calculated and correlated with clinical parameters. RESULTS The median (range) H-score of Lefty and Nodal was 17.6 (0-291) and 74.9 (0.7-272), respectively. There was a significant correlation between Lefty expression and Nodal expression (correlation coefficient of 0.60, P = 0.0006). There was no significant correlation between Lefty expression and Nodal expression with either tumour laterality, gender, age, Merkel cell polyomavirus status, disease stage, anatomical localization of primary tumours or disease relapse. On univariate analysis, low Lefty expression and Nodal expression were significantly associated with MCC-specific death (P = 0.010 and P = 0.019, respectively). On univariate analysis, low Lefty expression was the only significant independent predictor for MCC-specific death (P = 0.025) as indicated by an odds ratio of 14 (95% CI: 1.43-137.33). CONCLUSIONS Lefty and Nodal are frequently expressed in MCC, but not correlated with tumour laterality. Importantly, our data suggest that a low level of Lefty expression in primary MCC is a strong predictor of MCC-specific death.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Ardabili
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - K Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - M Dreißigacker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Scheel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - B Brand-Saberi
- Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - M Skrygan
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - H U Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances, Ruhr-University Bochum (IPA), Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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40
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Gambichler T, Kronenberg C, Segert MH, Susok L. Childhood subacute cutaneous lupus erythematosus associated with transaminitis. Clin Exp Dermatol 2020; 45:593-595. [PMID: 31850540 DOI: 10.1111/ced.14160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Kronenberg
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M H Segert
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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41
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Gambichler T, Susok L, Fels M, Schneider‐Gold C, Hof zum Berge F, Stockfleth E, Ayzenberg I. Autoimmune radiculoplexus neuropathy under adjuvant nivolumab treatment of a female patient with melanoma. Br J Dermatol 2020; 182:246-247. [DOI: 10.1111/bjd.18358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T. Gambichler
- Skin Cancer Center Ruhr‐University Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - L. Susok
- Skin Cancer Center Ruhr‐University Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - M. Fels
- Department of Neurology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - C. Schneider‐Gold
- Department of Neurology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - F. Hof zum Berge
- Department of Neurology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - E. Stockfleth
- Skin Cancer Center Ruhr‐University Department of Dermatology, Venereology and Allergology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
| | - I. Ayzenberg
- Department of Neurology Ruhr‐University Bochum St Josef Hospital Gudrunstraße 56 44791 Bochum Germany
- Department of Neurology Sechenov First Moscow State Medical University Moscow Russia
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42
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Gambichler T, Schröter U, Höxtermann S, Susok L, Stockfleth E, Becker JC. Decline of programmed death-1-positive circulating T regulatory cells predicts more favourable clinical outcome of patients with melanoma under immune checkpoint blockade. Br J Dermatol 2019; 182:1214-1220. [PMID: 31361026 DOI: 10.1111/bjd.18379] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of T regulatory lymphocytes (Tregs) and their immunosuppressive mechanisms in the context of programmed death (PD)-1 blockade is not completely understood. OBJECTIVES To assess the impact of PD-1-blocking antibody treatment on Treg subpopulations in the blood. METHODS We studied circulating Treg subpopulations in patients with melanoma under nivolumab or pembrolizumab treatment using flow cytometry and correlated these findings with clinical outcomes. RESULTS These analyses revealed that the frequency of CD4+ CD25++ CD127- PD-1+ lymphocytes (PD-1+ Tregs) significantly decreased after the first cycle of immunotherapy (23% vs. 8·6%, P = 0·043). Compared with patients who did not show a significant decline of PD-1+ Tregs after the first treatment, those who did had better clinical outcomes with respect to progression-free survival (PFS, P = 0·022) and melanoma-specific death (MSD, P = 0·0038). Multivariate analysis confirmed that a significant decline of PD-1+ Tregs in peripheral blood after the first treatment cycle is a significant predictor of more favourable PFS and MSD (P = 0·04 and 0·017, respectively). Interestingly, the occurrence of immune-related adverse events was also an independent predictor for decreased risk of MSD (P = 0·047; odds ratio 0·064, 95% confidence interval 0·0042-0·97). CONCLUSIONS We provide preliminary evidence that circulating PD-1+ Tregs rapidly decline after the initiation of treatment with PD-1-blocking antibodies, which is associated with reduced risk of melanoma progression and MSD. Patients showing no decrease of these PD-1+ Tregs in peripheral blood are characterized by an impaired response to immune checkpoint blockade and worse outcome. What's already known about this topic? Programmed death (PD)-1-blocking antibodies are highly effective in melanoma treatment. However, more than half of patients do not benefit from this therapy and to date it is difficult to predict which patients will respond to it. What does this study add? PD-1-blocking antibody therapy rapidly results in a decline of circulating PD-1+ T regulatory cells (Tregs). What is the translational message? Patients showing a decrease of PD-1+ Tregs appear to have better clinical outcome under PD-1 treatment.
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Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - U Schröter
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Höxtermann
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
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43
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Gambichler T, Doerler M, Nöpel-Dünnebacke S, Matschke J, Bräsen JH, Linke RP, Susok L. Haemorrhagic bullous lesions in cutaneous light-chain amyloidosis with smouldering myeloma. J Eur Acad Dermatol Venereol 2019; 34:e13-e15. [PMID: 31390676 DOI: 10.1111/jdv.15844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Doerler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Nöpel-Dünnebacke
- Department of Hematology, Oncology and Palliative Care, Ruhr-University Bochum, Bochum, Germany
| | - J Matschke
- Department of Hematology, Oncology and Palliative Care, Ruhr-University Bochum, Bochum, Germany
| | - J H Bräsen
- Institute of Pathology, Nephropathology Unit, Hannover Medical School, Hannover, Germany
| | - R P Linke
- Reference Center of Amyloid Diseases, Munich, Germany
| | - L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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44
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Gambichler T, Selke L, Rüddel I, Dreißigacker M, Stockfleth E, Schmitz L. Expression of indolamine-2,3-dioxygenase and cyclooxygenase-2 in different disease stages of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33:e446-e447. [PMID: 31251418 DOI: 10.1111/jdv.15763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - L Selke
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - I Rüddel
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - M Dreißigacker
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - L Schmitz
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
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45
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Gambichler T, Salveridou K, Schmitz L, Käfferlein H, Brüning T, Stockfleth E, Sand M, Lang K. Low Drosha protein expression in cutaneous T‐cell lymphoma is associated with worse disease outcome. J Eur Acad Dermatol Venereol 2019; 33:1695-1699. [DOI: 10.1111/jdv.15652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/12/2019] [Indexed: 12/17/2022]
Affiliation(s)
- T. Gambichler
- Department of Dermatology Ruhr‐University Bochum Bochum Germany
| | - K. Salveridou
- Department of Dermatology Ruhr‐University Bochum Bochum Germany
| | - L. Schmitz
- Department of Dermatology Ruhr‐University Bochum Bochum Germany
| | - H.U. Käfferlein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances Ruhr‐University Bochum (IPA) Bochum Germany
| | - T. Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances Ruhr‐University Bochum (IPA) Bochum Germany
| | - E. Stockfleth
- Department of Dermatology Ruhr‐University Bochum Bochum Germany
| | - M. Sand
- Department of Dermatology Ruhr‐University Bochum Bochum Germany
| | - K. Lang
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurances Ruhr‐University Bochum (IPA) Bochum Germany
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46
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Schmitz L, Grinblat B, Novak B, Hoeh AK, Händschke K, von Dobbeler C, Bierhoff E, Szeimies RM, Gambichler T, Torezan L, Festa-Neto C, Stockfleth E, Dirschka T. Somatic mutations in kinetochore gene KNSTRN are associated with basal proliferating actinic keratoses and cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2019; 33:1535-1540. [PMID: 30972880 DOI: 10.1111/jdv.15615] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Mutations in kinetochore gene KNSTRN accelerate the development of cutaneous squamous cell carcinoma (SCC) and may correlate with different histological classifications of actinic keratosis (AKs). OBJECTIVE To determine KNSTRN gene mutation frequency in healthy skin (HS), actinically damaged skin (ADS), in AKs with different histomorphological gradings and invasive SCCs. METHODS All samples were histologically evaluated. AK lesions were additionally classified according to their upwards (AK I-III) and downwards (PRO I-III) directed growth pattern. Mutation analyses of all samples were performed using the Sanger method. RESULTS With one exception, all detected mutations in KNSTRN gene showed an alanine-to-glutamate substitution at codon 40 (p.Ala40Glu). p.Ala40Glu mutation was found in 6.9% (2/29) of HS, in 16.1% (5/31) of ADS, in 18.3% (20/109) of AKs and in 30.0% (9/30) of invasive SCCs. Further stratification of AKs using the common AK classification of Röwert-Huber revealed the p.Ala40Glu mutation in 14.7% (5/43), 13.3% (4/30) and 24.4% (11/45) (AK I, II and III). In contrast, the new PRO classification showed a distribution of 3.6% (1/28) in PRO I, 21.7% (13/60) in PRO II and 28.6% (6/21) in PRO III. Mutation frequency in HS showed significant differences compared to AKs classified as PRO III and invasive SCCs (P < 0.05). In contrast, there were no statistically significant differences between HS and AKs when classified according to Röwert-Huber. CONCLUSIONS Recurrent somatic mutation p.Ala40Glu in KNSTRN gene is associated with basal proliferating AKs in accordance with invasive SCCs. This supports the impact of basal proliferative pattern in terms of progression.
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Affiliation(s)
- L Schmitz
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - B Grinblat
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - B Novak
- Department of Animal Physiology, Ruhr-University, Bochum, Germany
| | - A-K Hoeh
- CentroDerm GmbH, Wuppertal, Germany
| | | | | | - E Bierhoff
- Heinz-Werner-Seifert-Institute of Dermatopathology, Bonn, Germany
| | - R-M Szeimies
- Department of Dermatology and Allergology, Vest Hospital, Academic Teaching Hospital University of Bochum, Recklinghausen, Germany
| | - T Gambichler
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - L Torezan
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - C Festa-Neto
- Department of Dermatology, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - E Stockfleth
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - T Dirschka
- CentroDerm GmbH, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
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Schmitz L, Gupta G, Stücker M, Doerler M, Gambichler T, Welzel J, Szeimies RM, Bierhoff E, Stockfleth E, Dirschka T. Evaluation of two histological classifications for actinic keratoses - PRO classification scored highest inter-rater reliability. J Eur Acad Dermatol Venereol 2019; 33:1092-1097. [PMID: 30887613 DOI: 10.1111/jdv.15580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/26/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Actinic keratoses (AKs) can histologically be classified by the extent of atypical keratinocytes throughout the epidermis or their pattern of basal proliferation. Currently, no data on the inter-rater reliability of both scores is available. OBJECTIVE To evaluate the inter-rater reliability of the two classification schemes; histological grade (AK I-III) and basal proliferation (PRO I-III). METHODS Histological images of 54 AKs were classified by 21 independent dermatopathologists with regard to basal proliferation (PRO I-III), histological grade (AK I-III) and assumed risk of progression into invasive carcinoma. RESULTS Overall, of the 54 AKs 16.7% (9/54) were classified as AK I, 66.7% (36/54) as AK II, and 16.7% (9/54) as AK III. With regards to basal growth pattern, 25.9% (14/54) were classified as PRO I, 42.6% (23/54) as PRO II, and 31.5% (17/54) as PRO III. We observed a highly significant inter-rater reliability for PRO-grading (P < 0.001) which was higher than for AK-grading (Kendall's W coefficient: AK = 0.488 vs. PRO = 0.793). We found substantial agreement for assumed progression risk for AKs with worsening basal proliferation (k = 0.759) compared to moderate agreement (k = 0.563) for different AK-gradings. CONCLUSIONS Histological classification of basal growth pattern (PRO) showed higher inter-rater reliability compared to the established classification of atypical keratinocytes throughout epidermal layers. Moreover, experienced dermatopathologists considered basal proliferation to be more important in terms of progression risk than upwards directed growth patterns. It should be considered to classify AKs according to their basal proliferation pattern (PRO I-III).
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Affiliation(s)
- L Schmitz
- Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - G Gupta
- Department of Dermatology, University Hospital Monklands, Lanarkshire, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - M Stücker
- Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - M Doerler
- Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - T Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - J Welzel
- Department of Dermatology and Allergology, General Hospital Augsburg, Augsburg, Germany
| | - R M Szeimies
- Department of Dermatology and Allergology, Vest Hospital, Academic Teaching Hospital University of Bochum, Recklinghausen, Germany
| | - E Bierhoff
- Heinz-Werner-Seifert-Institute of Dermatopathology, Bonn, Germany
| | - E Stockfleth
- Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - T Dirschka
- CentroDerm Clinic, Wuppertal, Germany.,Faculty of Health, University Witten-Herdecke, Witten, Germany
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Gambichler T, Schug T, Doerler M. Disseminated skin necroses in a patient with multiple myeloma and monoclonal cryoglobulinaemia. J Eur Acad Dermatol Venereol 2019; 33:e166-e167. [PMID: 30811662 DOI: 10.1111/jdv.15403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791, Bochum, Germany
| | - T Schug
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791, Bochum, Germany
| | - M Doerler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, 44791, Bochum, Germany
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49
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Gambichler T, Schmitt K, Rüddel I, Dreibigacker M, Stockfleth E, Becker JC. Decreased 5-hydroxymethylcytosine immunoreactivity in primary Merkel cell carcinoma is a strong predictor for disease-specific death. Br J Dermatol 2019; 181:389-390. [PMID: 30703276 DOI: 10.1111/bjd.17705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - K Schmitt
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - I Rüddel
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Dreibigacker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - E Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, German Cancer Consortium, Dermatology, University Duisburg-Essen, Essen, Germany
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50
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Blazejak C, Stranzenbach R, Gambichler T, Stendel S, Wehkamp U, Klemke CD, Wobser M, Olk J, Nicolay J, Stadler R, Assaf C. Low-dose gemcitabine therapy in CTCL: ‘real-life” data of the German Cutaneous Lymphoma Network. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30594-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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