Background:Postoperative management of close or positive margins after conventional excision of facial nonmelanoma skin cancer is challenging, especially in elderly patients and anatomically constrained sites where re-excision may impose functional or aesthetic morbidity. Methods:We retrospectively analysed 238 facial carcinoma cases treated by conventional excision at a peripheral ENT unit, including 172 basal cell carcinomas (BCC) and 66 squamous cell carcinomas (SCC). Margins were classified as clear, close or positive. Outcomes were analysed descriptively; two-sided Fisher exact tests were used as exploratory descriptors of distributional imbalance under sparse-event conditions, not as tests of treatment superiority or equivalence. Results:In BCC, no recurrence occurred after clear margins (0/90). Among non-clear-margin BCCs, recurrence remained uncommon after structured surveillance (5/65) and early re-excision (1/17). In SCC, recurrence occurred only after positive margins (3/15), with none after clear or close margins. Conclusion:The findings support histotype-specific postoperative interpretation of margin status after conventional facial skin cancer excision. In this cohort, selected lower-risk BCC cases were managed through structured surveillance, whereas SCC recurrence was confined to positive-margin cases, supporting a lower threshold for timely re-excision or equivalent oncologic management when clinically feasible.
Introduction:Cemiplimab has been licensed for use in the United Kingdom as the sole immunotherapy agent for first-line use in advanced cutaneous squamous cell carcinoma (a-cSCC). Given that previous clinical trials leading to the approval of cemiplimab had relatively small patient cohorts with relatively short follow-up periods, with a large proportion of patients who had received prior systemic treatment, this retrospective real-world study sought to add further insight into survival and toxicity in patients who exclusively had received first-line use of cemiplimab, as well as comparing response rates (RRs) based on primary site location. Methods:This retrospective study identified patients diagnosed with a-cSCC between 01/08/2019 and 31/03/2024 who received cemiplimab as first-line treatment at our institution. Data to enable response assessment and toxicity were collected and analyzed. Results:50 patients were identified with a mean age of 75 years (range: 44-94). 78% (n = 39) of the patients' primary lesion originated from the head and neck (H&N) region, whilst the remaining 22% (n = 11) had a primary lesion from other areas. No patients had received prior systemic treatment for a-cSCC. Overall, the disease control rate (DCR) was 74%, and the RR was 55.8% with complete response in 35% (n = 15), partial response in 21% (n = 9), and stable disease in 19% (n = 8). In patients with H&N primary site of disease, RR was 58.9% versus 27.2% in patients with non-H&N primary site of disease, with a p value of 0.027. The overall mean PFS for the study population was 27.3 months (95% CI: 21.2-33.5 months), with the median PFS not reached for the study duration. The median PFS for patients with H&N primary site of disease was not reached as compared to the median PFS of 4 months (95% CI: 2.2-5.7 months) for patients with non-H&N primary site of disease, with a p value of 0.049. The median OS for the study population was 34 months (95% CI: 15.4-52.5 months). Grade 3 toxicities were reported in 22% (n = 11) with no Grade 4 toxicites. Discussion:The use of cemiplimab as first-line treatment in a-cSCC demonstrates high efficacy and low rates of serious toxicity, which is especially reassuring in a patient cohort comprising of more elderly patients. The high complete RR seen in our patient cohort may reflect the exclusive first-line use of cemiplimab in our study, as per now established real-world practice in a-cSCC. Higher RRs and PFS are seen in patients with head/neck primary site of disease vs. non head/neck primary site, which should be evaluated further in future clinical trials.
Background:Basal cell carcinomas (BCCs) with aggressive histology are infiltrative, destructive, aggressive, and metastatic tumors. Aggressive variants include morpheaform, infiltrative, metatypical or basosquamous, micronodular, and mixed subtypes. Selecting the appropriate treatment is crucial to eliminate this type of tumor and avoid complications such as mutilation and deformities when located in the facial region, as well as tumor recurrence. Interferons may represent a therapeutic option because of their curative potential and long-term cosmetic effects. Material and Methods:A descriptive, longitudinal, observational case-series study was conducted, including patients with a histopathological diagnosis of aggressive BCC. Perilesional HeberFERON was administered for three weeks, and patients were then followed for 5 years. The main outcome variables were cure at 16 weeks and recurrence at 5 years. Results:Twenty-three patients were included, and one discontinued treatment. After therapy, 14 (63.6%) patients achieved cure (complete response [CR]). Those who did not achieve a CR underwent surgery and were declared cured. All 22 patients were followed for five years; two (9.0%) were lost to follow-up. Survival analysis showed that 86.4% (95% CI, 74%-99%) had the probability of remaining recurrence-free at five years. Conclusions:HeberFERON can be considered a first-line treatment for BCC with aggressive histology and as a therapy prior to subsequent surgery.
Background:Cutaneous lymphomas (CLs) are rare neoplastic skin disorders, primarily of T-cell origin. Since the widespread rollout of SARS-CoV-2 vaccines, several cases of CLs and non-neoplastic lymphoproliferative disorders (nn-LPDs) temporally associated with vaccination have been reported, raising concerns about a potential immunologic link. Objective:To systematically review the literature on cases of CLs and related nn-LPDs occurring after COVID-19 vaccination, focusing on clinical features, subtype distribution, latency to onset, and proposed pathophysiological mechanisms. Methods:A systematic review was conducted according to PRISMA guidelines. Case reports and series describing new-onset or relapsed CLs or nn-LPDs temporally following SARS-CoV-2 vaccination were included. Demographic, clinical, histological, therapeutic and temporal data were extracted and analysed. Results:Fifteen manuscripts encompassing 35 cases met the inclusion criteria. Eighteen (51.4%) were histologically confirmed CLs, most commonly lymphomatoid papulosis (n = 9), followed by Sézary syndrome (n = 3) and mycosis fungoides (n = 2). The remaining 17 cases (48.6%) were classified as nn-LPDs, including cutaneous lymphoid hyperplasia, lymphomatoid reactions and CD4+ small/medium T-cell lymphoproliferative disorders. CD30 positivity was noted in 76.2% of the cases with available immunophenotyping. Most patients (80%) received the BNT162b2 (Pfizer-BioNTech) vaccine. In the 17 new-onset CLs, time to onset ranged from 3 to 42 days, with most cases clustering within 14 days. Conclusions:Most of the cases were low-grade T-cell CLs and nn-LPDs. Although a causal relationship cannot be established, the short latency observed in many new-onset cases raises the possibility that some patients may have harboured an undiagnosed disease, with vaccination acting as a trigger for clinical manifestation or for raised awareness. These findings support indeed the need for continued pharmacovigilance among clinicians, especially in patients with prior or latent lymphoproliferative conditions. Nevertheless, these extremely rare and indolent events should not alter the overall favourable risk-benefit profile of COVID-19 vaccination.
BackgroundBasal cell carcinoma (BCC) is the most common skin cancer worldwide. However, it is relatively uncommon in noncraniofacial areas.ObjectiveTo analyse the clinical and pathological features of Chinese patients with noncraniofacial BCC.MethodsWe retrospectively analysed the clinical data of 305 patients with BCC admitted to the Department of Dermatology of Beijing Chao-Yang Hospital, Capital Medical University, from January 2020 to December 2024. Following strict selection criteria, 73 patients were included in this study. We statistically analysed patient demographics, disease duration, lesion characteristics, treatment modalities and pathological subtypes.ResultsSeventy-three cases of noncraniofacial BCC were identified, accounting for 23.93% of all cases. The average patient age was 64.29 years, with a peak incidence in the 70-79 age group (24, 32.88%) and a male-to-female ratio of 0.74:1. The most commonly affected site was the trunk (27, 37.0%), followed by the perineal area (15, 20.5%). The limbs and axillae were also affected. Histopathologically, the nodular (38, 52.1%) and superficial (29, 39.7%) subtypes predominated.ConclusionsNoncraniofacial BCC accounts for 23.93% of all BCC cases in our Chinese cohort and predominantly affects elderly female patients (peak age: 70-79 years; M:F = 0.74:1). The trunk (37.0%) and perineal area (20.5%) were the most common sites, with the nodular (52.1%) and superficial subtypes (39.7%) predominating histopathologically. These findings emphasize the importance of comprehensive screening for noncraniofacial lesions and timely skin biopsy to prevent misdiagnosis. They also provide valuable clinical references for the management of this specific subgroup of BCC in Chinese patients.
Background:Locally advanced basal cell carcinoma represents a therapeutic challenge, especially if already exposed to hedgehog (Hh) pathway inhibitor (HPI) therapy. Effectiveness after switching to another HPI still requires exploration. Methods:This observational, descriptive study retrospectively evaluates the clinical outcomes of sonidegib in patients with vismodegib-treated locally advanced basal cell carcinoma in a real-world, multicenter cohort across nine centers. Twelve patients with histologically aggressive locally advanced basal cell carcinoma previously exposed to vismodegib for at least 3 months were analyzed. Each received sonidegib at a standard dosage. Treatment response was assessed clinically according to tumor size changes and classified as complete response (100% decrease), partial response (at least 50% decrease), stable disease (up to 20% increase or less than 50% decrease), or disease progression (at least 20% increase). Adverse events (AEs) were documented. Results:Two patients achieved complete clinical response, nine demonstrated partial response, and one exhibited disease progression. Disease control was achieved in 11 of the 12 patients (91.7%). No novel AEs have been documented, and they were managed through dose adjustments or temporary interruptions. Conclusion:These findings suggest that sonidegib could still show efficacy and may still serve as a viable second-line option after prior Hh pathway suspension.
Aim/Objectives: Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a poorly understood etiology and lacking high-level evidence to guide its management. This study examined the presentation and outcome related to MCC treatment at a Canadian center. Materials and Methods: The electronic and paper records of a population-based cohort of 74 cases of MCC identified by the Manitoba Cancer Registry between 2000 and 2019 to be treated with potential curability intent were retrospectively reviewed. Age, gender, stage of disease at initial presentation, treatment intent and modalities used, and their oncological outcome were recorded and analyzed using SPSS 27 & centerdot;0. A two-sided Pearson test was used for intergroup comparisons. Disease-specific survival (DSS) was estimated by the Kaplan-Meier product limit method, and the effect of individual prognostic factors on survival was assessed using the log-rank test. The Cox-proportional hazard model was used to determine the independent influence of prognostic factors on DFS and DSS. Results: The mean age at diagnosis was 75.9 years; 51% were female, 35% had a history of nonmelanoma skin cancer, 4% had a history of melanoma, and 12% had a history of immunosuppression. Eighty-three percent of patients were treated with curative intent. Five-year DSS and DFS were 57.2% and 45.7%, respectively. The head and neck were the most common sites involved (59%); however, the location of MCC did not influence DSS. Forty percent of patients had pathologic Stage III/IV disease. For the patients treated with curative intent, the patient's gender or treatment modality did not impact the DSS. The stage of disease (HR = 1.04; 95% CI = 1.00-1.08; p < 0.001) and the age of disease (HR = 1.04; 95% CI = 1.00-1.08; p = 0.046) independently influenced DSS at presentation. Conclusion: The stage at presentation and age at diagnosis but not the site of MCC or radical treatment modality were identified as independent predictors of DSS.
Introduction:Mycosis fungoides (MF) is the most common form of cutaneous T cell lymphoma. Given that MF is a rare disease, evidence regarding its impact on sleep and quality of life is limited; however, our study aims to evaluate this aspect. Patients and Methods:In this case-control study, 72 patients with MF were enrolled in the case group, and 72 matched healthy individuals were enrolled in the control group. Data regarding sleep disturbances were collected and analyzed using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires. Poor sleep quality was defined as a score > 5. Results:The control and case groups had median scores of 5.12 ± 2.57 and 10.22 ± 3.75 by PSQI and 6.39 ± 4.86 and 16.28 ± 6.99 by ISI, respectively. Multiple logistic regression revealed a significant association between the study group and the prevalence of poor sleep quality, as measured by both the PSQI (p < 0.0001) and the ISI (p < 0.0001). However, age, sex, marital status, pruritus, disease stage and onset, and lesion locations were not found to be associated with poor sleep quality. Discussions:Both the severity and prevalence of sleep disorders were significantly higher in the patients compared to a matched healthy population. Due to the profound impact of sleep on quality of life and considering the high prevalence of sleep disorders in patients with MF, evaluating a patient's sleep quality could improve their quality of life. Therefore, professional treatment can be administered if sleep disorders are observed or suspected.
Cutaneous melanoma (CM) remains a rapidly rising malignancy, with metastatic disease still carrying a limited 5-year survival. Immune checkpoint inhibitors (ICIs) have changed the treatment landscape, yet only a fraction of patients achieves durable benefit. Easily obtainable blood-based biomarkers are, therefore, needed to guide patient selection and prognostication. Eosinophilic granulocytes have emerged as potential modulators of antitumor immunity. In this systematic review and meta-analysis, we adhered to PRISMA guidelines and searched PubMed, Cochrane Library, and Scopus for studies published from 2011 onward that evaluated baseline peripheral eosinophil counts (absolute or percentage) as predictors of overall survival (OS) in advanced (stage III/IV) melanoma patients treated with ICI. Six cohort studies totaling 4.243 patients met inclusion criteria, each reporting hazard ratios (HRs) and 95% confidence intervals (CIs) in multivariable analyses for high versus low baseline eosinophil groups. Study quality was high (Newcastle-Ottawa Scale ≥ 7 stars), though selection biases were noted across all cohorts. A random-effects meta-analysis (DerSimonian-Laird method) initially yielded a pooled HR of 0.69 (95% CI: 0.36-1.30) for high versus low eosinophil counts, but heterogeneity was substantial (I 2 = 77.8%, p < 0.001). Through Baujat and leave-one-out diagnostics, one study was identified as an influential outlier; its exclusion reduced heterogeneity down to 33.3% (p=0.20). Reanalysis of the remaining five studies (n = 4.158) demonstrated a significant survival advantage for patients with elevated baseline eosinophils (HR: 0.51 and 95% CI: 0.39-0.66; p < 0.001). Funnel plot symmetry and a nonsignificant Egger's test (p=0.27) indicated no evidence of publication bias. These findings support baseline peripheral eosinophil count as a cost-effective, readily available biomarker associated with improved OS under ICI therapy in advanced melanoma. However, prospective studies with standardized eosinophil thresholds, comprehensive covariate adjustment, and integrated mechanistic analyses are warranted to validate and operationalize this marker for patient stratification in clinical practice.
This study utilized molecular docking techniques to investigate the potential of phytochemical compounds in Houttuynia cordata Thunb. extract as inhibitors of the oncogenic MAPK signaling pathway in melanoma. The docking results revealed that several phytochemical compounds exhibited favorable binding interactions with the BRAFV600E, MEK, and ERK ATP-binding site. A total of 16 compounds have high affinity (binding energies < -9 kcal/mol) for BRAFV600E, 13 compounds for MEK-1, 6 compounds for MEK-2, 18 compounds for ERK-1, and 10 compounds for ERK-2. Hesperidin exhibited the lowest binding energy to BRAFV600E (-10.216 kcal/mol) and ERK-2 (-10.336 kcal/mol). Quercitrin has the lowest binding energy against MEK-1 (-9.963 kcal/mol), 3-hydroxy-β-sitost-5-en-7-one demonstrated the lowest binding energy to ERK-1 (-10.495 kcal/mol), and rutin was best against MEK-2 with a calculated binding energy value of -9.963 kcal/mol. The binding modes of these compounds are compared with the known inhibitors of the oncoprotein targets that showed similar interactions to key amino acid residues indicating their inhibitory potential and are suggested as promising candidates for melanoma treatment.
Objective:This study aims to evaluate the diagnostic efficacy of dermoscopy for cutaneous squamous cell carcinoma (cSCC). Methods:A retrospective analysis was conducted on skin lesions diagnosed as cSCC via histopathology at the Department of Dermatology, Pingdu District, The Affiliated Hospital of Qingdao University, between January 2021 and August 2024 (case group). Lesions suspected of cSCC but ultimately diagnosed as other conditions served as the control group. The study compared disease progression and dermoscopic features between the two groups through chi-square test and logistic regression analysis, using histopathological results as the diagnostic reference standard. Results:The case group consisted of 41 lesions, while the control group comprised 18 lesions diagnosed with conditions including actinic keratosis, basal cell carcinoma, and keratoacanthoma. The clinical misdiagnosis rate was approximately 30.5%. Notably, a disease duration of less than 2 years (28/41, 68.29%), the presence of white circles (21/41, 51.22%) and blood spots (35/41, 85.37%), and a total of ≥ 5 dermoscopic features (19/41, 46.34%) were significantly more prevalent in the case group compared to the control group (both p < 0.05). Among these, a disease duration of less than 2 years, along with the presence of white circles and blood spots, demonstrated statistical significance in differentiating cSCC from other conditions (both p < 0.05). Conclusions:For patients with clinically suspected cSCC, a disease duration of less than 2 years and dermoscopic observation of white circles and blood spots provide substantial diagnostic value.
Introduction:Mycosis fungoides (MF) represents the most prevalent form of cutaneous lymphoma, characterized by diverse histopathological patterns. However, recent comprehensive studies systematically evaluating the spectrum of histopathological patterns and changes associated with MF in patients within Iran are notably lacking. Method:This cross-sectional descriptive study analyzed 64 skin biopsy slides diagnosed with MF, archived from 2013 to 2023 at Al-Zahra Hospital and a private dermatopathology laboratory in Isfahan, Iran. Inclusion criteria included all slides with complete demographic data and a confirmed MF diagnosis. Patterns and finding of these slides were analyzed according to age, gender, and biopsy site. Data analysis was performed using SPSS Version 26.0, with significance set at p < 0.05. Results:The study included 31 females and 33 males, with a mean age of 44.64 ± 14.91 years. The most common biopsy site was the trunk (45.31%). The predominant histopathologic patterns observed were psoriasiform (33 cases), lichenoid (14 cases), and spongiotic (10 cases), with universal epidermotropism across all slides. Parakeratosis and cytological atypia were found in 37 and 31 cases, respectively. Notably, eosinophils were more frequent in males (p=0.016), and cytological atypia were significantly more common in males than females (p=0.044). Mild dermal infiltrate was the most prevalent, particularly in the 35-42 and 43-56 age groups, with a significant age-related variation (p=0.041). Conclusion:This study reveals that psoriasiform, lichenoid, and spongiotic patterns are the most common in MF, with epidermotropism present in all cases. Age and gender significantly influence certain features, but overall, histopathological patterns showed no significant variation by biopsy location or age group.
Hispanic and Latino melanoma patients face significant disparities in patient outcomes and survival rates due to challenges in melanoma care, including later-stage diagnoses, disproportionate financial burdens, and cultural differences. Healthcare insurance status is an important contributing factor to these disparities, with uninsured Hispanic patients being more likely to delay seeking medical attention and face higher out-of-pocket costs. Socioeconomic factors, including lower income levels, limited education, and occupations that may increase UV exposure exacerbate these disparities. Additional factors such as inadequate patient education, language barriers, and inadequate health education campaigns also limit melanoma awareness, prevention, and healthcare access in Hispanic populations. Consequently, there is an urgent need for culturally tailored interventions, such as community-based, targeted health campaigns and enhanced, culturally sensitive provider training to better address these disparities and improve melanoma outcomes in Hispanic and Latino populations.
The incidence of nonmelanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), is increasing globally, driven by factors such as chronic UV exposure, climate change, and aging populations. This comprehensive retrospective cohort study examined 1252 patients treated for NMSCs at the Plastic Surgery Unit of the University of Messina, Italy, from 2012 to 2023. The study aimed to assess demographic characteristics, histological types, lesion attributes, recurrence rates, and geographical variations in NMSC incidence. Beyond confirming global epidemiological trends, this study highlights clinically relevant factors influencing tumor presentation, including environmental risk exposure, lesion recurrence, and histological aggressiveness. Data were collected on patient demographics, tumor location, histological subtype, lesion diameter, presence of ulceration, recurrence, and differentiation grade. Statistical analysis was conducted using R software (Version 4.2.0). Findings demonstrated that patients residing in coastal areas had a significantly higher incidence of NMSCs, reinforcing the role of exposure and environmental pollutants in carcinogenesis. These findings align with global trends and highlight the urgent need for early diagnosis, targeted dermatological surveillance, and public health interventions to mitigate the rising burden of NMSCs. The study underscores the necessity of enhanced sun protection awareness, integration of dermatological screenings in primary care settings, and improved treatment protocols to reduce recurrence and morbidity.
Background: Cutaneous squamous cell carcinoma (CSCC) is the second most prevalent form of skin cancer globally. However, its incidence is rising relative to basal cell carcinoma (BCC) in countries such as Australia and the United States. In South Africa, where the population is exposed to numerous CSCC risk factors, including high ultraviolet radiation levels and a high burden of immunosuppression, there remains a notable paucity of scientific literature characterising the disease within this context. Aims: To describe the clinical, histopathological and risk profile characteristics of CSCC in a South African cohort to identify patterns that can inform local clinical practice and guide future research priorities. Methods: A retrospective data analysis of patients seen at Tygerberg Academic Hospital between 1 September 2019 and 31 August 2020 was conducted. Demographic and clinical data were extracted from medical records. Two study evaluators used predetermined criteria to review the histopathological features in skin biopsies. Risk stratification of lesions followed the guidelines of the National Comprehensive Cancer Network. Results: Over one year, 113 CSCCs were diagnosed in 83 patients. Participants were primarily Fitzpatrick skin phototype I (65.1%) and male (60.2%), with a median age of 73 years and a male-to-female ratio of 1.51:1. The BCC-to-CSCC incidence ratio was 1.71:1. Most lesions had been present for over 6 months (87.6%) and were located on the head and neck (59.3%). Punch biopsies diagnosed 62.8% of lesions. Histologically, 63.7% were well differentiated, and 40.7% were invasive. Conventional CSCCs comprised 75.2% of lesions; 5.3% were the high-risk acantholytic subtype. A high recurrence risk was found in 77.0% of lesions. Conclusion: This study highlights the heterogeneous nature of CSCC in South Africa and underscores the need for prospective, context-specific research to enhance prevention, early detection and management efforts nationwide.
Introduction: Nevus sebaceous (NS) is a rare congenital hamartoma that may cause some concerns for parents. Benign skin tumors can develop in NS, although malignant transformations have occasionally been documented. This study aimed to investigate the histopathological characteristics of NS lesions in relation to sex, age, location, type, and any associated superimposed tumors. Methods: This retrospective cross-sectional study was conducted on the histopathologic reports of 60 patients with NS who were referred to our center between 2010 and 2022. Information, including sex, age, location of the lesion, and histopathological features of the NS lesion, was recorded. Results: The mean age of the patients was 24.52 ± 12.19 years, and 65.0% of the patients (39 cases) were men. Most of the lesions were observed on the scalp and face. Benign and malignant neoplasms were observed in 5% and 10% of patients, respectively. All the cases of malignant tumors (six cases) were identified as basal cell carcinoma, and three cases were benign tumors of syringocystadenoma papilliferum. Demodex infestation and apocrine gland dilatation were observed in 56.7% and 23.3% of patients, respectively. Benign neoplasms were significantly more frequent in women (p=0.039). In addition, malignant neoplasms were significantly more prevalent among patients aged ≥ 25 years (p=0.001). The frequencies of acanthosis and focal parakeratosis were higher in the scalp, and sebaceous hyperplasia was more common in the face (p < 0.05). Conclusion: Our study revealed that malignant tumors were more common than benign lesions in patients with NS. Benign neoplasms were more frequent in women. Malignant neoplasms were detected in patients aged more than 25 years.
Background: Ultraviolet (UV) radiation from the sun is a major risk factor for skin cancers. Nonetheless, many individuals in western countries tan outdoors. This study aimed to identify types of tanners and their reasons for outdoor tanning based on a Q methodology study. Methods: A heterogeneous sample of 25 participants aged 19–61 years was recruited and interviewed using the Q sort method. The participants ranked 37 reasons for outdoor tanning according to their subjectively perceived importance in a predetermined grid. Data were analyzed using an inverted factor analysis technique developed specifically for Q methodology. The transcripts of the postsort interviews were used to better understand the quantitative findings. Results: Three groups (factors) of tanners were identified based on 22 of the 25 participants. While enhancement of attractiveness was a major reason for outdoor tanning in the middle‐aged group, the youngest and the oldest groups had a stronger focus on relaxation, well‐being, and mental health. All three groups stated that vitamin D production was an important factor for tanning outdoors. Discussion: These findings suggest that people may have different reasons for exposing themselves to harmful UV radiation, but that there is a pattern most participants in our study could be assigned to. Especially the finding that all groups tanned outdoors to meet their vitamin D needs seems to be a starting point for future research and skin cancer prevention.
Cutaneous T-cell lymphomas (CTCLs) are a type of non-Hodgkin lymphoma that usually involves the skin. It has different subtypes including mycosis fungoides (MFs), Sézary syndrome (SS), primary cutaneous anaplastic large lymphoma (PC-ALCL), lymphomatoid papulosis (LyP), and subcutaneous panniculitis-like T-cell lymphoma (SPTCL). There are several reports of incidence, relapse, or progression of CTCLs by using specific drugs. We aim to identify drug- and vaccine-induced CTCL characteristics. A systematic search was conducted using MeSH terms/keywords: CTCL and drug-induced or drug-associated or vaccine-associated or vaccine induced through PubMed/Medline, Scopus, Web of Science, and Embase until May 10, 2024. Out of 14,031 papers, 60 articles were included, involving 71 patients with a mean age of 53.5 ± 17 years. Among them, 52.1% were male. Medications were categorized into four groups: conventional, biologics, small molecules, and vaccines. The most frequently reported medications in the first group were fingolimod (n = 8) and methotrexate (n = 7). Infliximab (n = 6) and etanercept (n = 5) were the most commonly reported biologics. Pfizer-BioNTech (n = 11) vaccine and JAK inhibitors (n = 3) were the most reported vaccine and small molecules. LyP (n = 17) was the most frequently reported type of CTCL, followed by PC-ALCL (n = 13), MF (n = 11), SS (n = 8), and SPTCL (n = 8). The most common underlying conditions were rheumatoid arthritis (n = 15) and multiple sclerosis (n = 10). Twenty patients (28%) experienced disease regression after discontinuing the drug, with a mean ± SD of 8.6 ± 8.8 weeks. In 14 patients (20%), chemotherapy and/or radiotherapy were initiated. Six patients passed away after being diagnosed with CTCL: two because of CTCL recurrence and four because of other complications. It is important recognizing CTCL as a possible, although rare, adverse effect of certain drugs and vaccines, and taking a history of vaccinations, especially COVID-19 vaccines, and immunosuppressive drugs such as fingolimod, TNF-a inhibitors, and methotrexate.
Background: Skin cancer is a major global health issue that can be life‐threatening. The current study explores the knowledge, attitudes, and practices of healthcare professionals and the general population regarding skin cancer. Method: A cross‐sectional study was conducted between January and June 2023 in Lahore, the second‐largest city in Pakistan. A total of 407 respondents from the general population and 230 healthcare professionals were recruited using a convenient and snowball sampling technique, respectively. Data were collected using questionnaires and statistical analysis, including chi‐square tests, and bivariate logistic regression was performed using SPSS Version 20. Result: In the overall population, 46.4% identified as male, 45.0% as female, and 8.6% chose not to disclose their gender. Significantly differing levels of skin cancer knowledge were observed between genders, with males reporting a higher knowledge (36.4%, crude odds ratio = 1.413, p < 0.001) compared to females (32.9%). In addition, females displayed a more positive attitude (crude odds ratio = 1.874, p < 0.001) and practice (crude odds ratio = 1.401, p < 0.05) toward skin cancer prevention. Furthermore, younger age groups exhibited greater knowledge, attitudes, and practices regarding skin cancer. Education and employment status also have a direct influence on skin cancer knowledge and practices. Moreover, in the current study, healthcare professionals comprised 61.3% physicians, 16.5% nurses, and 22.2% pharmacists. Among these, 37.3% of physicians, 11.3% of nurses, and 12.6% of pharmacists demonstrated the ability to identify common signs and symptoms of skin cancer in a patient ( p < 0.001). Furthermore, 44% of physicians regarded regular skin cancer screenings as “very important” ( p < 0.01). In addition, 27.4% of physicians and 8.7% of pharmacists exhibited a positive attitude toward regular screening of at‐risk patients ( p < 0.05). Conclusion: The current study highlights gender and age disparities in skin cancer knowledge and prevention among the general population, emphasizing the need for targeted public health interventions to enhance knowledge and proactive practices. In addition, among healthcare professionals, it reveals variations in knowledge levels, emphasizing the importance of tailored education initiatives to promote consistent skin cancer prevention and management practices within the healthcare community.
Acral melanoma (AM) is the most common type of melanoma arising in people with skin of color. AM is often diagnosed late and associated with poor outcomes. Melanoma outcomes are also impacted by socioeconomic status. Although uncommon, AM is a public health concern in South Africa because of its epidemiology and association with health access issues, which predispose to late diagnosis. South African patients are managed based on staging systems and treatment guidelines developed for other populations. This cohort study aimed to determine the survival outcomes in a cohort of South African AM patients and how these were associated with demographic, clinical, pathological, and management data. The study included patients diagnosed at a referral hospital between 1 January 2010 and 31 December 2021. Analysis occurred in 2022 and 2023. The main outcomes of interest were survival time in months (overall and progression‐free, OS and PFS). Survival outcomes were analyzed using Kaplan–Meier survival curves. Survival probabilities were compared between subgroups using log‐rank tests. Univariate and multivariable analyses were performed using the Cox proportional hazards models to assess factors associated with survival. Ninety‐one patients were included in the analysis. After a median follow‐up of 28 months (range: 0–151 months), 48 patients (52.7%) had died. The 3‐ and 5‐year survival rates for the entire cohort were 64.8% and 56.0% respectively. Notably, the OS and PFS were not affected by the population group (p value = 0.628, not significant). The examination of OS and PFS by the clinical stage group demonstrated proportional hazard. Although SLNB comprised a small group, the results appear to be prognostically valid, specifically for OS. The results indicate that the AJCC eighth edition staging is broadly applicable to AM in this population; however, a rigorous comparison was not possible. SLNB appears to be prognostically valid. No difference in survival outcomes by population group was shown.
