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The Application of Differing Machine Learning Algorithms and Their Related Performance in Detecting Skin Cancers and Melanomas 不同机器学习算法在皮肤癌和黑色素瘤检测中的应用及其相关性能
IF 1.1 Q3 DERMATOLOGY Pub Date : 2022-05-04 DOI: 10.1155/2022/2839162
Suboh Alkhushayni, Du’a Al-zaleq, Luwis Andradi, Patrick Flynn
Skin cancer, and its less common form melanoma, is a disease affecting a wide variety of people. Since it is usually detected initially by visual inspection, it makes for a good candidate for the application of machine learning. With early detection being key to good outcomes, any method that can enhance the diagnostic accuracy of dermatologists and oncologists is of significant interest. When comparing different existing implementations of machine learning against public datasets and several we seek to create, we attempted to create a more accurate model that can be readily adapted to use in clinical settings. We tested combinations of models, including convolutional neural networks (CNNs), and various layers of data manipulation, such as the application of Gaussian functions and trimming of images to improve accuracy. We also created more traditional data models, including support vector classification, K-nearest neighbor, Naïve Bayes, random forest, and gradient boosting algorithms, and compared them to the CNN-based models we had created. Results had indicated that CNN-based algorithms significantly outperformed other data models we had created. Partial results of this work were presented at the CSET Presentations for Research Month at the Minnesota State University, Mankato.
皮肤癌及其不太常见的黑色素瘤是一种影响多种人群的疾病。由于它通常是通过视觉检查来检测的,因此它是机器学习应用的一个很好的候选者。由于早期发现是取得良好结果的关键,任何能够提高皮肤科医生和肿瘤学家诊断准确性的方法都是值得关注的。在将不同的现有机器学习实现与公共数据集和我们试图创建的几个数据集进行比较时,我们试图创建一个更准确的模型,可以很容易地适应临床环境。我们测试了模型的组合,包括卷积神经网络(cnn),以及各种数据操作层,例如高斯函数的应用和图像的修剪以提高准确性。我们还创建了更传统的数据模型,包括支持向量分类、k近邻、Naïve贝叶斯、随机森林和梯度增强算法,并将它们与我们创建的基于cnn的模型进行比较。结果表明,基于cnn的算法明显优于我们创建的其他数据模型。这项工作的部分结果在曼卡托明尼苏达州立大学的CSET研究月报告中发表。
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引用次数: 3
Biomimetic Nanoscale Materials for Skin Cancer Therapy and Detection 用于皮肤癌治疗和检测的仿生纳米材料
IF 1.1 Q3 DERMATOLOGY Pub Date : 2022-04-07 DOI: 10.1155/2022/2961996
Hamza Abu Owida
Skin cancer has developed as one of the most common types of cancer in the world, with a significant impact on public health impact and the economy. Nanotechnology methods for cancer treatment are appealing since they allow for the effective transport of medicines and other biologically active substances to specific tissues while minimizing harmful consequences. It is one of the most significant fields of research for treating skin cancer. Various nanomaterials have been employed in skin cancer therapy. The current review will summarize numerous methods of treating and diagnosing skin cancer in the earliest stages. There are numerous skin cancer indicators available for the prompt diagnosis of this type of disease. Traditional approaches to skin cancer diagnosis are explored, as are their shortcomings. Electrochemical and optical biosensors for skin cancer diagnosis and management were also discussed. Finally, various difficulties concerning the cost and ease of use of innovative methods should be addressed and overcome.
皮肤癌已成为世界上最常见的癌症类型之一,对公共卫生和经济产生重大影响。纳米技术治疗癌症的方法很有吸引力,因为它们允许药物和其他生物活性物质有效地运输到特定组织,同时最大限度地减少有害后果。这是治疗皮肤癌最重要的研究领域之一。各种纳米材料已被用于皮肤癌的治疗。本综述将总结在早期阶段治疗和诊断皮肤癌的多种方法。有许多皮肤癌指标可用于迅速诊断这种类型的疾病。探讨了传统的皮肤癌诊断方法,以及它们的缺点。讨论了电化学和光学生物传感器在皮肤癌诊断和管理中的应用。最后,应解决和克服创新方法的成本和易用性方面的各种困难。
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引用次数: 4
Clinicopathological Analysis and Surgical Outcome of Eyelid Malignancies: A Study of 332 Cases 眼睑恶性肿瘤332例临床病理分析及手术疗效分析
IF 1.1 Q3 DERMATOLOGY Pub Date : 2022-02-18 DOI: 10.1155/2022/4075668
Syeed Mehbub Ul Kadir, Mukti Rani Mitra, Riffat Rashid, Murtuza Nuruddin, Md. Kamrul Hassan Khan, G. Haider, M. Nessa
Background Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Aim To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Methods This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2–3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis. Results Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection. Conclusion Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC.
背景:眼睑肿瘤在眼科手术中很常见。恶性病例仅占所有眼睑肿瘤的四分之一。最具侵略性的眼睑恶性肿瘤是皮脂腺癌,但它的发生在西方国家是罕见的。在我们的临床实践中,我们发现皮脂腺癌与基底细胞癌一样常见。因此,建立对更具侵略性的眼睑恶性肿瘤的认识以降低发病率和死亡率是至关重要的。目的评估孟加拉国人口中眼睑恶性肿瘤的相对频率,说明其临床特征和管理策略的结果,并建立对更具侵袭性的眼睑恶性肿瘤的认识,以降低发病率和死亡率。方法对孟加拉国332例患者进行回顾性病例系列研究。本研究分析了2014 - 2019年组织学证实的原发性眼睑恶性肿瘤的所有记录资料,并对其进行了至少6个月的随访(6年)。所有患者均行手术切除,组织病理学证实无肿瘤边缘,冷冻切片或切除活检,2-3 mm正常组织显微镜下观察,然后进行眼睑重建。采用计算机统计软件SPSS进行分析,采用适当的显著性检验(卡方检验)进行统计分析。结果皮脂腺癌(SGC)发生率最高,为42%,其次为基底细胞癌(BCC) 38%,鳞状细胞癌(SqCC) 18%,恶性黑色素瘤(MM) 02%。SGC、BCC、SqCC和MM的平均发病年龄分别为57.41岁、62.56岁、64.73岁和59.28岁。与其他恶性肿瘤相比,SGC的女性(59%)略高于男性(41%)。色素沉着与恶性黑色素瘤(100%)和BCC(81%)相关。统计学上,眼睑恶性肿瘤在位置、大小、色素沉着、复发和侵袭性等方面存在显著差异。复发率低,在随访期间,采用冷冻切片活检清除边缘的患者(3%)比采用切除活检的患者(21.5%)低。结膜穿刺活检(8%)作为排除SGC样面扩散的重要工具。本文对33例(11%)中度眼睑缺损局部切除后采用三角肌皮尾皮瓣重建。结论皮脂腺癌(SGC)是孟加拉国眼睑恶性肿瘤中发病率最高的一种。SGC侵袭性更强,复发率高于BCC和SqCC。
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引用次数: 4
Knowledge, Attitude, and Practice toward Skin Cancer Prevention and Detection among Jordanian Medical Students: A Cross-Sectional Study. 约旦医科学生对皮肤癌症预防和检测的知识、态度和实践:跨学科研究。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2022-02-14 eCollection Date: 2022-01-01 DOI: 10.1155/2022/6989827
Khaled Seetan, Almu'atasim Khamees, Afnan Migdadi, Mosab Abu Shqeer, Maram Jameel Hasan, Leen Ahmad Shatnawi, Tala Abu Bakr, Nada Zayed

Introduction: Skin cancer is one of the most growing types of cancer, especially in the Mediterranean, even though it is a preventable disease. The purpose of this study is to assess medical students' knowledge, attitude, and practice about skin cancer prevention and detection.

Methods: A cross-sectional study was conducted using a validated structured questionnaire covering the areas of knowledge, attitude, and practice of the study participants.

Results: The study involved 1530 students; 55.3% were females. Most of the students possessed proper knowledge about skin cancer (81%). The most prevalent skin cancer risk factors were sun exposure during the day (83.5%) and immunosuppression (71.2%). More than half of the students did not have any habits of skin examination (61.5%). 20% of the students never used sunscreen, while only 20% of them avoided sun exposure during day hours.

Conclusion: The general level of the medical students' knowledge of skin cancer and its risk factors appeared to be higher than what is found in other studies; it is reasonable as the study participants were medical students. However, the protective behavior from the sun was inadequate when compared to the level of knowledge reported. Additional education about the behavior toward sun exposure and protection against skin cancer may be needed to be implemented in the dermatology curriculum.

导读:皮肤癌是增长最快的癌症之一,尤其是在地中海地区,尽管它是一种可预防的疾病。摘要本研究旨在了解医学生对皮肤癌预防与检测的知识、态度与行为。方法:采用一份经过验证的结构化问卷进行横断面研究,涵盖研究参与者的知识、态度和实践领域。结果:研究涉及1530名学生;55.3%为女性。大多数学生对皮肤癌有适当的了解(81%)。最常见的皮肤癌危险因素是白天暴晒(83.5%)和免疫抑制(71.2%)。超过一半的学生没有任何皮肤检查的习惯(61.5%)。20%的学生从不使用防晒霜,而只有20%的学生在白天避免晒太阳。结论:医学生对皮肤癌及其危险因素的认知总体水平高于其他研究;这是合理的,因为研究参与者是医学生。然而,与报道的知识水平相比,防晒行为是不够的。在皮肤病学课程中,可能需要进行更多关于阳光照射行为和预防皮肤癌的教育。
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引用次数: 2
UV-Induced Skin Cancer Knowledge, Sun Exposure, and Tanning Behavior among University Students: Investigation of an Opportunity Sample of German University Students. 紫外线诱发皮肤癌知识、日晒和大学生晒黑行为:对德国大学生机会样本的调查。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2021-12-29 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5558694
Marc Rocholl, Julia Hannappel, Michaela Ludewig, Swen Malte John

Ultraviolet radiation (UVR) is the most important risk factor for developing skin cancer. University students can be considered as a particularly high-risk group for long- and short-term adverse effects of UVR due to intensive solar UVR exposure and high rates of sunburn. While validated questionnaires for assessing solar UVR exposure and sun protection behavior are available in German, a questionnaire for assessing the level of knowledge about this topic is still missing. We conducted a literature search for cross-sectional studies assessing skin cancer and sun protection knowledge among university students in Medline (via PubMed) and analyzed existing questionnaires and topics contained therein. We chose to translate the "Skin Cancer and Sun Knowledge Scale" referring to the TRAPD method into the German language and pilot-tested the translation with an opportunity sample of German students. The literature search revealed 36 eligible studies. Four major topics were identified within the studies: knowledge on skin cancer, risk factors, UVR, and sun protection measures. One hundred and seven German university students (86.0% female) with a mean age of 26.25 years (SD ± 4.58; range: 19-46) participated in our pilot study. The internal reliability of the scale was KR-20 = 0.624. We discovered an improvable level of knowledge in terms of skin cancer among the study population. Statistical analyses revealed no significant associations between the level of knowledge and UVR exposure or tanning behavior, respectively. The skin cancer and sun protection knowledge of German university students should be examined thoroughly. While the psychometric properties of the SCSK require further thorough investigation, first empirical experiences indicate the suitability of the tool to assess the level of knowledge regarding skin cancer and sun protection.

紫外线辐射(UVR)是癌症发生的最重要的危险因素。大学生可以被认为是紫外线长期和短期不良影响的特别高危人群,因为强烈的太阳紫外线暴露和高晒伤率。虽然德语中有用于评估太阳紫外线暴露和防晒行为的有效问卷,但用于评估该主题知识水平的问卷仍然缺失。我们通过PubMed对Medline大学生的皮肤癌症和防晒知识进行了横断面研究,并分析了现有的问卷和其中包含的主题。我们选择将参考TRAPD方法的“皮肤癌症和太阳知识量表”翻译成德语,并利用德国学生的机会样本对翻译进行了试点测试。文献检索显示36项符合条件的研究。研究中确定了四个主要主题:皮肤癌症知识、危险因素、紫外线辐射和防晒措施。107名德国大学生(86.0%为女性),平均年龄26.25岁(SD ± 4.58;范围:19-46)参与了我们的试点研究。该量表的内部可靠性为KR-20 = 0.624.我们发现研究人群在癌症方面的知识水平有所提高。统计分析显示,知识水平与紫外线暴露或晒黑行为之间分别没有显著关联。对德国大学生的皮肤癌症和防晒知识应进行全面检查。虽然SCSK的心理测量特性需要进一步彻底调查,但首次经验表明,该工具适用于评估皮肤癌症和防晒知识水平。
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引用次数: 4
Factors Associated with Skin Cancers in People with Albinism in Togo. 多哥白化病患者患皮肤癌的相关因素
IF 1.1 Q3 DERMATOLOGY Pub Date : 2021-12-23 eCollection Date: 2021-01-01 DOI: 10.1155/2021/3433493
Abas Mouhari-Toure, Sefako Abla Akakpo, Julienne Noude Teclessou, Piham Gnossike, Saliou Adam, Garba Mahamadou, Panawé Kassang, Yvette Elegbede, Tchin Darre, Koussake Kombate, Palokinam Pitché, Bayaki Saka

Objective: The aim of this study was to identify the factors associated with skin cancers in people with albinism (PWA) in Togo.

Method: This is a retrospective analytical study of the records of PWA examined during five dermatological consultation campaigns from 2019 to 2021.

Results: During the study period, 517 PWA were seen. Sixty-four (12.3%) of these PWA had presented with 137 cases of skin cancer. The sex ratio (M/F) was 0.9. The average age of PWA with skin cancer was 39.69 ± 15.61 years and that of PWA without skin cancer was 19.17 ± 15.24 years (p ≤ 0.001). The 137 cases of skin cancers were dominated by basal cell carcinomas (45.9%). These skin cancers were located preferentially in the cephalic region (77 cases; 56.2%), followed by the upper limbs (33 cases; 24.1%). In multivariate analysis, the risk factors for skin cancers in PWA were age over 39 years (p ≤ 0.001) and the presence of actinic keratoses (p ≤ 0.001). In contrast, the presence of ephelides (p=0.018) was a protective factor.

Conclusion: This study confirms that advanced age and actinic keratoses are risk factors for skin cancer in PWA, in connection with the cumulative role of solar radiation. Its originality lies in the identification of ephelides as a protective factor. The knowledge and consideration of these risk factors will make it possible to optimise strategies for the prevention of skin cancers in PWA.

目的:本研究的目的是确定与多哥白化病(PWA)患者皮肤癌相关的因素。方法:回顾性分析2019 - 2021年5次皮肤科会诊期间的PWA检查记录。结果:研究期间共观察到PWA 517例。其中64例(12.3%)出现了137例皮肤癌。性别比(M/F)为0.9。伴有皮肤癌的PWA患者的平均年龄为39.69±15.61岁,无皮肤癌的PWA患者的平均年龄为19.17±15.24岁(p≤0.001)。137例皮肤癌以基底细胞癌为主(45.9%)。这些皮肤癌主要位于头侧区域(77例;56.2%),其次是上肢33例;24.1%)。在多因素分析中,PWA皮肤癌的危险因素是年龄大于39岁(p≤0.001)和存在光化性角化病(p≤0.001)。相反,黄芪的存在(p=0.018)是一个保护因素。结论:本研究证实高龄和光化性角化病是PWA皮肤癌的危险因素,与太阳辐射的累积作用有关。它的独创之处在于,它把球孢菌确定为一种保护因子。了解和考虑这些危险因素将有可能优化预防PWA皮肤癌的策略。
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引用次数: 2
Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer. 术中冷冻切片在非黑色素瘤皮肤癌患者手术治疗中的应用。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2021-11-01 eCollection Date: 2021-01-01 DOI: 10.1155/2021/4944570
LiAnn Loh, Priya Tiwari, Jingtzer Lee, O-Wern Low, Vigneswaran Nallathamby, Hanjing Lee, Jane Lim, Thiam Chye Lim, Yan Lin Yap

Background: Intraoperative frozen section (IFS) is often utilised in the surgical treatment of nonmelanocytic skin cancer (NMSC) in sensitive facial regions when Mohs micrographic surgery (MMS) is not available.

Objective: To compare the outcome of NMSC patients with excision performed with and without IFS.

Materials and methods: A retrospective, single-centre study was performed on all patients who had undergone resection of NMSC with and without IFS control at the National University Hospital (NUH) from 2010 to 2015.

Results: 116 patients were recruited, of which 86 had IFS and 30 did not. The complete excision rate of patients with IFS was higher at 87.2% (p=0.0194), need for secondary operation was lower at 1.2% (p=0.005), and need for postsurgery radiotherapy or chemotherapy was lower at 1.2% (p=0.001). The average duration of surgery in patients who underwent IFS was 95.4 minutes compared to 70.1 minutes in cases which did not undergo IFS.

Conclusion: Our study showed an increased complete excision rate and reduced need for secondary surgeries and adjuvant therapy in patients with IFS. However, a longer operative duration was required. Use of IFS may be useful in patients with NMSC lesions in sensitive regions requiring complex reconstruction after tumour excision.

背景:术中冷冻切片(IFS)常用于敏感面部区域非黑素细胞皮肤癌(NMSC)的手术治疗,当莫氏显微摄影手术(MMS)不可用时。目的:比较有IFS和没有IFS的NMSC患者的预后。材料和方法:2010年至2015年,在国立大学医院(NUH)进行了一项回顾性、单中心研究,研究对象是所有在有和没有IFS对照的情况下接受了NMSC切除术的患者。结果:招募了116例患者,其中86例有IFS, 30例无IFS。IFS患者的完全切除率较高,为87.2% (p=0.0194),二次手术需求较低,为1.2% (p=0.005),术后放疗或化疗需求较低,为1.2% (p=0.001)。接受IFS的患者平均手术时间为95.4分钟,而未接受IFS的患者平均手术时间为70.1分钟。结论:我们的研究表明,IFS患者的完全切除率增加,二次手术和辅助治疗的需求减少。然而,需要更长的手术时间。对于肿瘤切除后需要复杂重建的敏感区域的NMSC病变患者,使用IFS可能是有用的。
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引用次数: 3
MDM4 Isoform Expression in Melanoma Supports an Oncogenic Role for MDM4-A. 黑色素瘤中的 MDM4 同工酶表达支持 MDM4-A 的致癌作用。
IF 1.2 Q3 DERMATOLOGY Pub Date : 2021-10-16 eCollection Date: 2021-01-01 DOI: 10.1155/2021/3087579
Abdullah Alatawi, SoonJye Kho, Michael P Markey

The p53 tumor suppressor integrates upstream signals such as DNA damage and active oncogenes to initiate cell cycle arrest or apoptosis. This response is critical to halting inappropriate growth signals. As such, p53 activity is lost in cancer. In melanoma, however, the p53 gene is intact in a reported 94% of human cases. Rather than direct mutation, p53 is held inactive through interaction with inhibitory proteins. Here, we examine the expression of the two primary inhibitors of p53, MDM2 and MDM4, in genomic databases and biopsy specimens. We find that MDM4 is frequently overexpressed. Moreover, changes in splicing of MDM4 occur frequently and early in melanomagenesis. These changes in splicing must be considered in the design of therapeutic inhibitors of the MDM2/4 proteins for melanoma.

p53 肿瘤抑制因子整合 DNA 损伤和活跃的癌基因等上游信号,启动细胞周期停滞或细胞凋亡。这种反应对于阻止不适当的生长信号至关重要。因此,p53 的活性在癌症中会丧失。然而,在黑色素瘤中,据报道有 94% 的人类病例中 p53 基因完好无损。p53 并非直接突变,而是通过与抑制蛋白相互作用而失去活性。在此,我们研究了基因组数据库和活检标本中 p53 的两个主要抑制因子 MDM2 和 MDM4 的表达情况。我们发现,MDM4 经常过度表达。此外,在黑色素瘤发生的早期,MDM4的剪接经常发生变化。在设计治疗黑色素瘤的MDM2/4蛋白抑制剂时,必须考虑到剪接的这些变化。
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引用次数: 0
Diagnosis and Management of Lentigo Maligna: Clinical Presentation and Comprehensive Review. 白斑病的诊断与治疗:临床表现与综合评述》(Diagnosis and Management of Lentigo Maligna: Clinical Presentation and Comprehensive Review)。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2021-07-24 eCollection Date: 2021-01-01 DOI: 10.1155/2021/7178305
Piyu Parth Naik

Lentigo maligna (LM), also known as Hutchinson's melanotic freckle, is a form of in situ melanoma characterized by the proliferation of atypical melanocytes along the basal epidermis in sun-damaged skin. If left untreated, LM will progress to lentigo maligna melanoma (LMM), a form of invasive melanoma with the same prognosis as other forms of invasive melanoma. LM is more common in the elderly, with a peak occurrence between the ages of 65 and 80 years. LM, however, is rarely present on the trunk and extremities. The diagnosis of LM, confirmed by histopathological and biopsy examination, is based on clinical and dermoscopic features. It typically begins as a tan-brown macule or patch, but it can progress to a variegated pigmentation with dark black color or even amelanotic characteristics. The risk factors involved in the LM development include a history of sunburns, lighter skin types, advanced age, history of nonmelanoma skin cancers, and tendency to form solar lentigines. This article explains the clinical presentation of LM, also reviews the available information on the diagnosis and management of LM, and discusses the potential of such information in facilitating the future prospective.

黑斑(Lentigo maligna,LM)又称哈钦森黑色素雀斑,是一种原位黑色素瘤,其特征是日晒损伤的皮肤基底表皮出现非典型黑色素细胞增生。如果不及时治疗,LM 会发展为恶性黑色素瘤(LMM),这是一种浸润性黑色素瘤,其预后与其他形式的浸润性黑色素瘤相同。LM多见于老年人,发病高峰期在65至80岁之间。然而,LM很少出现在躯干和四肢。组织病理学检查和活组织切片检查证实的 LM 诊断是基于临床和皮肤镜检查的特征。皮损开始时通常为棕褐色斑丘疹或斑块,但也可能发展为带有深黑色甚至黑色素沉着特征的斑驳色素沉着。日光性黑斑病发病的危险因素包括晒伤史、浅色肤质、高龄、非黑色素瘤皮肤癌病史以及形成日光性黑斑的倾向。本文解释了日光性黑斑病的临床表现,还回顾了有关日光性黑斑病诊断和管理的现有信息,并讨论了这些信息在促进未来展望方面的潜力。
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引用次数: 0
Association of Antibiotics and Other Drugs with Clinical Outcomes in Metastatic Melanoma Patients Treated with Immunotherapy. 抗生素和其他药物与免疫治疗转移性黑色素瘤患者临床结果的关系
IF 1.1 Q3 DERMATOLOGY Pub Date : 2021-07-23 eCollection Date: 2021-01-01 DOI: 10.1155/2021/9120162
Manish D Angrish, Arun Agha, Rossanna C Pezo

Immune checkpoint inhibitors (ICIs) targeting the programmed cell death protein-1 (PD-1) and programmed cell death ligand-1 (PD-L1) have improved survival in many advanced cancers including advanced melanoma, renal cell, urothelial, and non-small-cell lung cancers. However, not all patients respond, and immune-related adverse events (irAEs) are common. Commensal gut bacteria may serve as an immunoregulatory link-mediating ICI response and toxicity. Recent studies have shown that a lack of bacterial diversity, known as gut dysbiosis, can have an adverse impact on patients' response to ICIs and predispose to the development of irAEs. Data were collected from 167 patients with metastatic melanoma who received antibiotics within 30 days prior to and/or after initiation of ICI and patients who received NSAIDs, statins, steroids, or proton-pump inhibitors (PPI) within 30 days prior to ICI initiation. The primary outcome was time-to-discontinuation (TTD) of ICI therapy, measured from the date of ICI initiation to the last treatment date. The secondary outcome of interest was toxicity, with incidence of irAEs graded as per the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Here, we demonstrate that individuals who received antibiotics had a significantly shorter time-to-discontinuation (TTD) of the ICI therapy as opposed those who were not administered antibiotics. Consistent with results from previous research, we propose that antibiotics have a negative effect on a patient's response to ICI therapy, most likely due to the result of gut dysbiosis, and should be critically assessed in terms of their use in patients undergoing ICI treatment.

针对程序性细胞死亡蛋白-1 (PD-1)和程序性细胞死亡配体-1 (PD-L1)的免疫检查点抑制剂(ici)改善了许多晚期癌症的生存率,包括晚期黑色素瘤、肾细胞、尿路上皮和非小细胞肺癌。然而,并非所有患者都有反应,免疫相关不良事件(irAEs)很常见。共生肠道细菌可能作为免疫调节环节介导ICI反应和毒性。最近的研究表明,细菌多样性的缺乏,即肠道生态失调,可能会对患者对ICIs的反应产生不利影响,并容易导致irae的发展。数据收集自167例转移性黑色素瘤患者,这些患者在ICI开始前和/或开始后30天内接受抗生素治疗,以及在ICI开始前30天内接受非甾体抗炎药、他汀类药物、类固醇或质子泵抑制剂(PPI)治疗。主要终点是ICI治疗的停药时间(TTD),从ICI开始到最后一次治疗日期。次要终点是毒性,根据不良事件通用术语标准(CTCAE) 5.0版对irae发生率进行分级。在这里,我们证明了接受抗生素治疗的个体与未接受抗生素治疗的个体相比,ICI治疗的停药时间(TTD)明显更短。与先前的研究结果一致,我们提出抗生素对患者对ICI治疗的反应有负面影响,很可能是由于肠道生态失调的结果,应该在接受ICI治疗的患者中使用抗生素进行严格评估。
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引用次数: 5
期刊
Journal of Skin Cancer
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