BACKGROUNDMelanoma can early metastasize to regional lymph nodes. The sentinel lymph node (SLN) is the first lymph node draining directly from the site of primary melanoma, and the pathohistological ...status of the SLN is the most significant prognostic factor for overall survival prevalence and prognosis in patients with melanoma. Ultrasound is a very useful for the imaging of regional lymph node metastases, combined with Doppler and cytopuncture. OBJECTIVEThe aim of this study was to investigate the role of ultrasound assessment of regional lymph nodes in melanoma staging. PATIENTS AND METHODSThe study included all patients with primary melanoma detected in the period between 2003 and 2012, in whom diagnostic processing has not proven distant metastases or physical examination did not find enlarged lymph nodes. In total, 202 surgically treated patients were included in the study, of which 101 patients underwent ultrasound examination of regional lymph nodes using a linear probe of at least 12 MHz, while ultrasound of regional lymph nodes was not performed for 101 patients. RESULTSThe results of this study emphasize the importance of ultrasound in the diagnostics and treatment of patients with melanoma. Based on the observation of the occasional positive ultrasound and fine needle aspiration cytology (FNAC) in regional lymph nodes, our results indicate that a proportion of patients can avoid sentinel lymph node biopsy (SLNB). In case of a positive ultrasound findings (complemented with FNAC of suspicious nodes), direct dissection of regional lymph nodes is recommended. However, negative ultrasound findings do not exclude the presence of micrometastases due to poor sensitivity of this method and is not a contraindication for SLNB. CONCLUSIONTherefore, there is a need for further studies on metastatic melanoma, especially those in the sentinel lymph nodes and in its early stage.
Nonmelanoma skin cancers (NMSC), basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC) are the most common neoplasms worldwide. Their incidence has been continually rising. This is ...due to several risk factors such as chronic sun exposure, longer life expectancy, sun-damaged skin, genetic predisposition, and immunosuppression. NMSCs are curable cancers if detected early and treated appropriately. Clinical examination is the first step towards their diagnosis, with accuracy depending on clinician expertise. Dermoscopy has become an irreplaceable diagnostic procedure for clinical examination and improving diagnostic accuracy of skin cancers. However, skin biopsy with histopathological analysis remains the gold standard in establishing a definite diagnosis. Repeated biopsies, however, are not acceptable in patients with multiple suspicious lesions and are often redundant in cases of lesions that are challenging to identify, as they are often benign. Several medical imaging technologies are available as additional tools for noninvasive examination of NMSCs and include reflectance confocal microscopy (RCM), high-frequency ultrasound (HFUS), optical coherence tomography (OCT), Raman spectroscopy, fluorescence polarization, and others. These methods enable clinicians to establish more rapid and accurate diagnoses without the need for invasive biopsies and to achieve optimal treatment for NMSC. RCM an HFUS are discussed along with their clinical applications.
Alopecia areata (AA) je česta dermatološka bolest, imunološki posredovana te obilježena gubitkom kose. Točna patologija bolesti još uvijek nije u potpunosti razjašnjena, ali prihvaćena je teorija po ...kojoj vlastiti imunološki sustav napada folikule dlaka. Tijek bolesti može biti relapsirajući, remitirajući ili perzistentan. Bolest se najčešće manifestira oštro ograničenim okruglim područjima s gubitkom dlaka bez drugih fizičkih simptoma. Najčešće je zahvaćeno vlasište, no može doći do potpunog gubitka dlaka u vlasištu, što se naziva alopecia totalis, ili gubitka dlaka na tijelu – alopecia universalis. Dječak u dobi od nepunih dvanaest godina s dugogodišnjom anamnezom alopecije universalis i atopijskim dermatitisom uspješno je liječen upadacitinibom, JAK 1 inhibitorom, uz potpuni porast kose i poboljšanje kliničke slike atopijskog dermatitisa. Najveći učinak liječenja ostvaren je na psihološki status bolesnika i njegove obitelji. Liječenje bolesnika s alopecijom areatom jest izazovno, kao i
liječenje svih imunološki posredovanih bolesti, no moderna terapija u dermatologiji donosi nove terapijske mogućnosti uz poboljšanje kvalitete života bolesnika.
Nonmelanoma skin cancers (NMSC), basal cell carcinoma
(BCC), and cutaneous squamous cell carcinoma (cSCC) are the most
common malignancies worldwide with a prevalence of epidemic proportions
and ...continually rising global incidence rates, associated with
increased morbidity rates and significant economic burden of their
management. Although treatable cancers with low rates of metastasis
and mortality, NMSCs reach an incurable state in small proportion of
patients, becoming advanced, unresectable, or metastatic. Until recent
years, patients with these conditions were considered for palliative radiotherapy
and/or classical chemotherapies, which offer modest clinical
benefit. Based on better understanding of the pathogenesis of these
cancers, novel targeted therapies have been developed. We review novel
systemic approaches for the treatment of aggressive forms of BCCs and
cSCCs, with special emphasis on approved targeted molecular therapies
and immunotherapies.
The aim of this study was to analyze microphthalmia-associated transcription factor (MITF) as a marker for the detection of circulating melanoma cells, determine its prognostic value in melanoma ...patients, and compare it with tyrosinase. Blood samples from 201 melanoma patients in all stages of the disease and 40 healthy volunteers were analyzed. RNA was isolated from mononuclear cell fraction of the blood and assayed by reverse transcription-PCR for the expression of MITF and tyrosinase. All samples from healthy volunteers were negative for both MITF and tyrosinase. Out of 201 blood samples from melanoma patients 32 were positive for MITF, 20 for tyrosinase, and four for both MITF and tyrosinase. Analysis of MITF as an additional marker to tyrosinase allowed for detection of circulating melanoma cells in a larger number of melanoma patients in comparison to tyrosinase analysis alone (48 vs. 20 positive). A positive value of MITF was associated with shorter progression-free (P=0.005) and overall survival (P=0.042). A positive value of tyrosinase was associated with shorter overall survival (P=0.012), whereas there was no significant association between the value of tyrosinase and progression-free survival. The value of MITF was selected with multivariate analysis as the independent prognostic factor for progression-free survival, whereas the only independent prognostic factor for overall survival was the stage of disease. This study has shown that MITF is a specific marker for detection of circulating melanoma cells that has a prognostic value in melanoma patients. Determination of MITF in addition to tyrosinase improved the detection of circulating melanoma cells in melanoma patients.
Melanoma is one of the most malignant skin tumors with constantly rising incidence worldwide, especially in fair-skinned populations. Melanoma is usually diagnosed at the average age 50, but, ...nowadays is also diagnosed more frequently in younger adults, and very rarely in childhood. There is no unique or specific clinical presentation of a melanoma. The clinical presentation of melanomas varies depending on the anatomic localization and the type of growth, i.e., the histopathological type of the cancer. There are four major histopathological types of melanoma--superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Although dermatoscopy is a very useful tool in early melanoma detection, dermatoscopical features of melanomas are also variable. Therefore, experience and education in dermatoscopy is crucial in the evaluation of skin tumors. Differential diagnosis of melanomas includes a wide range of benign and malignant skin lesions, due to their clinical presentation and resemblance to various dermatological entities. In this review we present the most important aspects of clinical, dermatoscopical, and histopathological features of melanomas.
ABSTRACT
Treatment of lichen planopillaris (LPP) remains a significant challenge due to the irreversible damage inflicted on hair follicles combined with the low efficacy of existing treatments. We ...hypothesized that growth factors released by the use of platelet‐rich plasma (PRP) may arrest the development of LPP. To test our hypothesis, we treated an LPP patient that has failed previous treatments with a new PRP regimen. Following PRP treatment and six months follow‐up, the patient experienced complete regression of itching and hair shedding. To the best of our knowledge, this is the first report of successful treatment of LPP with a PRP regimen.
Nonmelanoma skin cancers (NMSC), basal cell carcinoma
(BCC), and cutaneous squamous cell carcinoma (cSCC) are the most
common malignancies worldwide with a prevalence of epidemic proportions and ...continually rising global incidence rates, associated with
increased morbidity rates and significant economic burden of their
management. Although treatable cancers with low rates of metastasis
and mortality, NMSCs reach an incurable state in small proportion of
patients, becoming advanced, unresectable, or metastatic. Until recent
years, patients with these conditions were considered for palliative radiotherapy and/or classical chemotherapies, which offer modest clinical benefit. Based on better understanding of the pathogenesis of these
cancers, novel targeted therapies have been developed. We review novel
systemic approaches for the treatment of aggressive forms of BCCs and
cSCCs, with special emphasis on approved targeted molecular therapies
and immunotherapies
