Familial skin cancer syndromes Ransohoff, Katherine J., BA; Jaju, Prajaka D., BA; Tang, Jean Y., MD, PhD ...
Journal of the American Academy of Dermatology,
March 2016, Letnik:
74, Številka:
3
Journal Article
Recenzirano
Phenotypic traits, such as red hair and freckling, increase melanoma risk by 2- to 3-fold. In addition, approximately 10% of melanomas are caused by inherited germline mutations that increase ...melanoma risk from 4- to >1000-fold. This review highlights the key genes responsible for inherited melanoma, with an emphasis on when a patient should undergo genetic testing. Many genetic syndromes associated with increased melanoma risk are also associated with an increased risk of other cancers. Identification of these high-risk patients is essential for preventive behavior reinforcement, genetic counseling, and ensuring other required cancer screenings.
Direct-to-consumer teledermatology is radically changing the way some patients obtain dermatologic care. Many direct-to-consumer teledermatology services offer care to patients younger than 18 years, ...but policies and standards are nonuniform. For pediatric patients, direct-to-consumer teledermatology is a substantial departure from in-person care. More consensus, standards, and guidelines are necessary.
Background Across cancers, the decision to pursue genetic testing is influenced more by subjective than objective factors. However, skin cancer, which is more prevalent, visual, and multifactorial ...than many other malignancies, may offer different motivations for pursuing such testing. Objectives The primary objective was to determine factors influencing the decision to receive genetic testing for skin cancer risk. A secondary objective was to assess the impact of priming with health questions on the decision to receive testing. Methods We distributed anonymous online surveys through ResearchMatch.org to assess participant health, demographics, motivations, and interest in pursuing genetic testing for skin cancer risk. Two surveys with identical questions but different question ordering were used to assess the secondary objective. Results We received 3783 responses (64% response rate), and 85.8% desired testing. Subjective factors, including curiosity, perceptions of skin cancer, and anxiety, were the most statistically significant determinants of the decision to pursue testing ( P < .001), followed by history of sun exposure (odds ratio 1.85, P < .01) and history of skin cancer (odds ratio 0.5, P = .01). Age and family history of skin cancer did not influence this decision. Participants increasingly chose testing if first queried about health behaviors ( P < .0001). Limitations The decision to pursue hypothetical testing may differ from in-clinic decision-making. Self-selected, online participants may differ from the general population. Surveys may be subject to response bias. Conclusion The decision to pursue genetic testing for skin cancer is primarily determined by subjective factors, such as anxiety and curiosity. Health factors, including skin cancer history, also influenced decision-making. Priming with consideration of objective health factors can increase the desire to pursue testing.
A Subdermal Source: Contact Dermatitis Fogel, Alexander L., BS; Longmire, Michelle, MD; Rieger, Kerri E., MD, PhD ...
The American journal of medicine,
06/2015, Letnik:
128, Številka:
6
Journal Article
Recenzirano
Odprti dostop
A patient can be allergic to a new knee and such allergy is an often-overlooked complication of prosthetic implant surgery. Here, Fogel et al present their assessment, diagnosis and management of a ...60-year-old woman who presented to their dermatology clinic with a pruritic, crusted rash on her right knee. Eighteen months earlier, she had undergone a right knee replacement with an Evolution Medial-Pivot knee system. No complications occurred, and the patient had normal healing at the surgical site. Her past medical history was notable for conditions within the atopic diathesis, including severe asthma, sinusitis, postnasal drip, and a childhood history of eczema. In addition, she reported allergies to medications, including lisinopril and epineph rine. A review of systems was otherwise unrevealing.
Familial skin cancer syndromes Jaju, Prajakta D., BA; Ransohoff, Katherine J., BA; Tang, Jean Y., MD, PhD ...
Journal of the American Academy of Dermatology,
March 2016, Letnik:
74, Številka:
3
Journal Article
Recenzirano
Nonmelanoma skin cancers (NMSCs) represent the most common malignancies worldwide, with reported incidence rising each year. Both cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma ...(BCC), as well as other NMSCs, represent complex diseases with a combination of environmental and genetic risk factors. In general, hereditary cancer syndromes that increase the risk of NMSC fall under several broad categories: those associated with immunodeficiencies, those that affect skin pigmentation, and those that perturb key molecular pathways involved in the pathogenesis of NMSCs. Many of the syndromes are also associated with extracutaneous manifestations, including internal malignancies; therefore, most require a multidisciplinary management approach with a medical geneticist. Finally, dermatologists play a critical role in the diagnosis and management of these conditions, because cutaneous findings are often the presenting manifestations of disease.
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