Pediatric Cutaneous Oncology
Skin cancers represent the most common malignancy worldwide. In children, the diagnosis of skin cancer is rare and raises the possibility of an underlying genetic predisposition. Recent molecular advances have increased understanding of certain genetically determined regulatory pathways that constantly protect the skin from atypical cell growth and cancer. Knowledge about these underlying gene defects aids a dermatologist ’s ability to recommend confirmatory genetic testing and provides potential targets for future therapies. In this review, we outline genetic conditions important to dermatologists that are associated wi...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Jackson G. Turbeville, Jennifer L. Hand Source Type: research
A Practical Review of the Presentation, Diagnosis, and Management of Cutaneous B-Cell Lymphomas
This review of cutaneous B-cell lymphoma (CBCL) is focused on the clinical presentation, treatment, and workup of each type of lymphoma. Part 1 is an overview of each of the CBCLs, including clinical presentation, recent advances in the pathobiology, and evidence regarding treatment strategies. Part 2 is a detailed guide to the steps in diagnosis and workup of a newly diagnosed CBCL according to the International Society for Cutaneous Lymphoma/European Organization for Research and Treatment of Cancer and NCCN guidelines. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Nikhil Goyal, Daniel O ’Leary, Joi B. Carter, Nneka Comfere, Olayemi Sokumbi, Amrita Goyal Source Type: research
Merkel Cell Carcinoma
Merkel cell carcinoma (MCC) is a neuroendocrine carcinoma that typically presents as a rapidly enlarging violaceous papulonodule on sun-damaged skin in elderly patients. MCC has high rates of local recurrence, metastasis, and poor survival. Treatment of the primary tumor involves surgical excision with possible adjuvant radiation therapy, whereas regional nodal disease is treated with some combination of lymph node dissection and radiation therapy. Immune checkpoint inhibitors, such as avelumab and pembrolizumab, are first-line agents for metastatic MCC. Monitoring for recurrence can be aided by Merkel cell polyomavirus on...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Daniel J. Lewis, Joseph F. Sobanko, Jeremy R. Etzkorn, Thuzar M. Shin, Cerrene N. Giordano, Stacy L. McMurray, Joanna L. Walker, Junqian Zhang, Christopher J. Miller, H. William Higgins Source Type: research
Approaches to Tumors of the Nail Unit and Genitalia
The nail unit and genitalia represent rare locations where malignant tumors may arise. Human papillomavirus has emerged as a causative agent of the development of the most common malignancies in these sites. Tissue preservation with surgery is of utmost importance, and tissue-sparing approaches are increasingly emphasized in the dermatology, urology, and gynecology literature. In addition to its tissue-sparing nature, Mohs micrographic surgery allows the complete evaluation of histologic margins to ensure tumor extirpation and may be the ideal treatment modality. The authors herein present approaches for the evaluation and...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Kishan M. Shah, Kevin Y. Shi, Rajiv I. Nijhawan, Divya Srivastava Source Type: research
Melanoma classification and management in the era of molecular medicine
Melanoma is the most lethal form of skin cancer although surgery is often curative when combined with early screening and prevention. In recurrent or advanced cancer, the emergence of chemotherapy, targeted therapy, and immune checkpoint inhibitors has demonstrated promising clinical outcomes. Such approaches can remarkably halt the progression of disease for many years, although are limited by the acquisition of resistance. The development and approval of combination therapies has further changed the treatment paradigm for certain melanomas. This review focuses on the current state of melanoma epidemiology and recent adva...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Sarem Rashid, Michael Shaughnessy, Hensin Tsao Source Type: research
Gene Expression Profiles in Cutaneous Oncology
This article provides a high-level review of diagnostic and prognostic GEPs that have been developed specifically for squamous cell carcinoma and melanoma. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Bo M. Kitrell, Elliot D. Blue, Alfredo Siller, Marissa B. Lobl, Tyler D. Evans, Melodi Javid Whitley, Ashley Wysong Source Type: research
Preventative Options and the Future of Chemoprevention for Cutaneous Tumors
Chemoprophylaxis against nonmelanoma skin cancer (NMSC) should be considered in high-risk populations such as those with certain genetic disorders, immunosuppressive states, chronic radiation, excessive UV exposure, or extensive personal or family history of NMSC. The methods for chemoprevention have progressed beyond traditional sunscreen into more effective strategies including DNA repair enzymes, nicotinamide, systemic retinoids, and nonsteroidal anti-inflammatory drugs. Other therapies are still being investigated and include treatments that target premalignant lesions, capecitabine, hedgehog inhibitors, difluoromethyl...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Jane Margaret Anderson, Lauren Moy, Ronald L. Moy Source Type: research
Cutaneous Oncology
Cutaneous malignancies continue to be a cause of morbidity and mortality for patients worldwide. Diagnostic and treatment options for these malignancies have improved, yet our expectations for best patient outcomes continue to drive advancement. The current issue gives a broad overview of the common and uncommon cutaneous malignancies and cutaneous lymphomas, their clinicopathologic characteristics, approaches to diagnosis, and current and future treatment options. New diagnostic and prognostic tools, including gene expression profiling, are discussed for certain malignancies, while targeted treatments and immunotherapies ...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Stanislav N. Tolkachjov Tags: Preface Source Type: research
Unconscious Bias
Unconscious biases (also known as implicit biases) are involuntary stereotypes or attitudes held about certain groups of people that may influence our behaviors, understandings, and actions, often with unintended detrimental consequences. Implicit bias appears in multiple facets of medical education, training, and promotion with negative effects on diversity and equity efforts. Notable health disparities exist among minority groups in the United States, which may partly be attributable to unconscious biases. Although there is little evidence supporting the effectiveness of current bias/diversity training programming, stand...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Temitayo A. Ogunleye Source Type: research
Exploring Race, Racism, and Structural Racism in Medicine
Race and racism are rooted in the man-made belief that the color of a person ’s skin determines a person’s hierarchal rank in humanity. Early scientific theories of polygenics and misleading scientific studies were used to promote the concept of the inferiority of people of color and to support and maintain the institution of slavery. These discriminatory practices have filtered into society as structural racism, including the field of medicine. Structural racism has led to health disparities in black and brown communities. Dismantling structural racism requires us all to become change agents at societal and institutio...
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Pamela S. Allen, Natasha M. Mickel Source Type: research
Gender Equity in Medicine and Dermatology in the United States
Over the past 50 years there has been an increase in the representation of women in medicine with similar rates of men and women graduating from medical training today. Nevertheless, gender gaps in leadership, research publications, and compensation persist. Herein, we review trends in gender differences among leadership positions in academic medicine with a particular focus on dermatology, evaluate the roles of mentorship, motherhood, and gender bias on gender equity, and discuss constructive solutions for addressing gender inequities that persist in academic medicine today. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - October 27, 2022 Category: Dermatology Authors: Janell M. Tully, Jenny E. Murase, Jane M. Grant-Kels, Dedee F. Murrell Source Type: research
Vascular Anomalies
Before the development of the International Society for the Study of Vascular Anomalies (ISSVA) classification system in 1996, nomenclature used to describe vascular lesions was inconsistent and imprecise. This since widely adopted system stratifies vascular anomalies into vascular malformations and tumors. Vascular tumors involve abnormal proliferation of vascular cells and are further classified as benign, locally aggressive/borderline, or malignant. Vascular malformations are lesions of defective vascular morphogenesis with quiescent endothelium and are named according to their vessel composition, and subdivided into si...
Source: Dermatologic Clinics - October 1, 2022 Category: Dermatology Authors: Laura Andrews, Chelsea Shope, Lara Wine Lee, Marcelo Hochman Source Type: research
Diagnostic Imaging
Vascular tumors and malformations encompass a spectrum of pathology that varies widely in presentation, severity, and treatments. Although typically a clinical diagnosis, accurate classification of lesions is often challenging. Imaging plays an integral role in confirming the clinical diagnosis, determining the extent of disease and planning treatment strategies. Ultrasound and MRI constitute the backbone of diagnostic imaging in vascular anomalies; however, other modalities such as radiography, computed tomography, and conventional angiography can play a role in certain situations. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - October 1, 2022 Category: Dermatology Authors: John McAlhany, Ricardo Yamada Source Type: research
Arteriovenous Malformations
This article focuses on clinical findings and natural history of AVMs. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - October 1, 2022 Category: Dermatology Authors: Shomoukh AlShamekh Source Type: research
Medical Treatment of Vascular Anomalies
The treatment of vascular malformations and vascular anomalies is often complex, combining various approaches in the art of medicine to provide best outcomes and quality of life for these patients. Treatment may include but is not limited to the following: local control with compression garments and attire, pain control, surgical procedures and debulking, laser therapy, sclerotherapy, and medical management. In this article, the authors discuss the aspects of medical management, visiting the history of medical treatment, and the recent utilization and success of enzymatic pathway inhibitors, specifically sirolimus and new ...
Source: Dermatologic Clinics - October 1, 2022 Category: Dermatology Authors: Alexa DeMaio, Christina New, Shayla Bergmann Source Type: research
