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A Histopathological Study of Skin Lesions in Individuals with Oculocutaneous Albinism in Togo in 2019. 2019年多哥皮肤白化病患者皮肤病变的组织病理学研究
IF 1.1 Q3 DERMATOLOGY Pub Date : 2020-07-29 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2361957
Bayaki Saka, Julienne Noude Teclessou, Sefako Abla Akakpo, Piham Gnossike, Kwamé Doh, Saliou Adam, Abas Mouhari-Toure, Garba Mahamadou, Panawé Kassang, Yvette Elegbede Moise, Tchin Darre, Koussake Kombate, Palokinam Pitché

Objective: The aim of this study was to study the histopathological patterns of skin lesions in persons with albinism (PWA) in Togo in 2019.

Method: During two mobile skin care clinics in 2019, biopsies/excisional biopsies were performed in PWA in case of clinical doubt or in front of lesions suspected to be cancerous for histological examination. Anatomopathological reports were thus analysed.

Results: During the two mobile skin care clinics, 115 biopsies/excisional biopsies were carried out in 79 PWA, with a mean age of 24 ± 16.1 years. Histological examination led to a diagnosis in 110 cases (95.6%) and was inconclusive in 5 cases (4 cases of uncertain histological diagnosis and one case of nonspecific histological lesions). Fourteen different histological diagnoses were made, with a frequency ranging from 0.9% (one case) to 26.9% (31 cases). The four most frequent diagnoses in descending order were basal cell carcinomas (BCCs) (31 cases; 26.9%), invasive squamous cell carcinomas (SCCs) or Bowen's disease (23 cases; 20%), keratosis (20 cases; 17.3%), and cysts (seven cases; 6.1%). The 54 skin carcinomas were diagnosed in 33 (41.8%) of the 79 patients who underwent skin biopsies/excisional biopsies. The BCC/SCC ratio was 1.3. No cases of cutaneous melanoma had been diagnosed.

Conclusion: Skin cancers represent the main histological diagnosis in PWA (46.9%) in Togo in 2019. The pattern of cutaneous malignancies in PWA shows the same trend as that seen in Caucasians with a predominance of basal cell carcinomas.

目的:本研究的目的是研究2019年多哥白化病(PWA)患者皮肤病变的组织病理学模式。方法:2019年2个流动皮肤护理诊所,在临床疑点或疑似癌变病灶前行PWA活检/切除活检,进行组织学检查。解剖病理报告因此被分析。结果:在两个流动皮肤护理诊所中,79例PWA共进行活检/切除活检115例,平均年龄24±16.1岁。组织学诊断110例(95.6%),不确定5例(组织学诊断不确定4例,非特异性组织学病变1例)。14种不同的组织学诊断,频率从0.9%(1例)到26.9%(31例)不等。最常见的4种诊断依次为基底细胞癌(基底细胞癌)(31例;26.9%),浸润性鳞状细胞癌(SCCs)或Bowen病(23例;20%),角化病(20例;17.3%),囊肿(7例;6.1%)。79例接受皮肤活检/切除活检的患者中,有33例(41.8%)被诊断为54例皮肤癌。BCC/SCC比值为1.3。未发现皮肤黑色素瘤病例。结论:2019年多哥地区PWA的主要组织学诊断为皮肤癌(46.9%)。PWA皮肤恶性肿瘤的模式与高加索人的趋势相同,以基底细胞癌为主。
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引用次数: 6
SunSmart Accreditation and Use of a Professional Policy Drafting Service: Both Positively and Independently Associated with High Sun Protective Hat Scores Derived from Primary School Policies. SunSmart认证和专业政策起草服务的使用:与小学政策获得的高防晒帽分数有积极和独立的关系。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2020-06-30 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9695080
A I Reeder, E E Iosua, B McNoe, A-C L Petersen

Background: The head and neck are exposed to the highest solar ultraviolet radiation levels and experience a disproportionate skin cancer burden. Sun protective hats can provide an effective barrier. Since early life exposure contributes to skin cancer risk, the World Health Organisation recommends prevention programmes in schools. The New Zealand SunSmart Schools programme is one example. Two criteria concern wearing hat outdoors: students are required to wear a hat providing protection for the face, neck, and ears; if a suitable hat is not worn, students must play in shaded areas.

Objectives: To investigate two internationally relevant interventions as plausible statistical predictors of hat policy strength: (1) skin cancer primary prevention programme membership, (2) use of a professional policy drafting service.

Methods: Of 1,242 (62%) eligible schools participating in a 2017 national survey, 1,137 reported a sun protection policy and 842 were available for categorising and allocating protective scores (0-3).

Results: In multinomial (polytomous) logistic regression models of cross-sectional association, adjusted for school characteristics, SunSmart accredited schools and those utilising a policy drafting service were independently significantly more likely than their counterparts to obtain the most protective compared to the least protective hat score (respectively, RRR 6.48: 95% CI 3.66, 11.47; 7.47: 3.67, and 15.20). For the dichotomous shade measure, similar associations were found using adjusted logistic regression (OR 3.28: 95% CI 2.11, 5.09; 2.70: 1.54, 4.74).

Conclusions: Our findings provide support for two plausible interventions that could potentially be implemented beneficially in primary schools via established infrastructure in any jurisdiction, internationally.

背景:头部和颈部暴露于最高的太阳紫外线辐射水平,并经历不成比例的皮肤癌负担。遮阳帽可以提供有效的屏障。由于生命早期接触会增加患皮肤癌的风险,世界卫生组织建议在学校开展预防项目。新西兰SunSmart学校项目就是一个例子。在户外戴帽子有两个标准:学生必须戴上帽子,以保护面部、颈部和耳朵;如果没有戴合适的帽子,学生必须在阴凉的地方玩耍。目的:研究两种国际上相关的干预措施作为政策强度的可信统计预测因素:(1)皮肤癌初级预防计划的成员资格,(2)专业政策起草服务的使用。方法:在参与2017年全国调查的1242所(62%)符合条件的学校中,1137所报告了防晒政策,842所可用于分类和分配防晒评分(0-3)。结果:在针对学校特征进行调整的横截面关联的多项(多分式)逻辑回归模型中,SunSmart认证的学校和使用政策起草服务的学校获得最具保护性的帽子得分的可能性显著高于获得最不具保护性帽子得分的可能性(分别为RRR 6.48: 95% CI 3.66, 11.47;7.47: 3.67和15.20)。对于二分荫蔽测量,使用调整后的逻辑回归发现了类似的关联(OR 3.28: 95% CI 2.11, 5.09;2.70: 1.54, 4.74)。结论:我们的研究结果为两种可行的干预措施提供了支持,这两种干预措施可以通过国际上任何司法管辖区的既定基础设施在小学中实施。
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引用次数: 0
Skin Cancer Prevalence in Outdoor Workers of Ski Resorts. 滑雪场户外工作者的皮肤癌发病率。
IF 1.2 Q3 DERMATOLOGY Pub Date : 2020-01-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8128717
Yolanda Gilaberte, Josep Manel Casanova, Ana Julia García-Malinis, Salvador Arias-Santiago, Maria Reyes García de la Fuente, Marta Pamiés-Gracia, Javier Ramirez-Palomino, Isabel Ruiz-Campos, Tamara Gracia-Cazaña, Agustín Buendia-Eisman

Background: Snow reflectivity and altitude increase the exposure of ski resort workers to solar ultraviolet radiation. The aim was to assess the presence of skin cancer in ski resorts workers and compare it with other groups of outdoor workers reviewing published studies.

Methods: An observational cross-sectional prospective study was conducted in the three largest ski resorts in Spain: Baqueira Beret, Lleida; Formigal, Huesca and Sierra Nevada, Granada. All outdoor workers including ski instructors were invited to participate in the study. The participants completed a validated questionnaire about sun exposure and underwent a skin examination.

Results: 219 workers were included in the study (80% male; mean age 43.8 (SD 11.31) years). Actinic keratosis (AK) but no other skin cancers were detected in 32 participants (14.62%). Those with AK worked in the Southernmost ski resort, were more likely to have light colour hair, and were older and with higher photoaging grade than those without them.

Conclusion: Compared to other studies, outdoor workers on ski resorts show a higher prevalence of AK than general population but a lower prevalence than other groups of outdoor workers.

背景:雪的反射率和海拔高度增加了滑雪场工作人员暴露于太阳紫外线辐射的程度。研究的目的是评估滑雪场工作人员是否患有皮肤癌,并通过回顾已发表的研究将其与其他户外工作者群体进行比较:在西班牙最大的三个滑雪场进行了一项横断面前瞻性观察研究:方法:在西班牙三个最大的滑雪场进行了一项观察性横断面前瞻性研究,这三个滑雪场是:莱里达的巴凯拉贝雷特滑雪场、韦斯卡的福米格尔滑雪场和格拉纳达的内华达山脉滑雪场。包括滑雪教练在内的所有户外工作者都应邀参加了这项研究。结果:219 名工人(80% 为男性;平均年龄 43.8 岁(标准差 11.31 岁))参与了研究。在 32 名参与者(14.62%)中发现了光化性角化病(AK),但未发现其他皮肤癌。患有 AK 的人在最南端的滑雪胜地工作,与没有 AK 的人相比,他们更有可能拥有浅色头发,年龄更大,光老化等级更高:结论:与其他研究相比,滑雪场户外工作者的 AK 患病率高于普通人群,但低于其他户外工作者群体。
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引用次数: 0
An Analysis of Biopsies for Suspected Skin Cancer at a Tertiary Care Dermatology Clinic in the Western Cape Province of South Africa. 在南非西开普省的三级护理皮肤科诊所对疑似皮肤癌的活检分析。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2020-01-27 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9061532
Johann de Wet, Minette Steyn, Henry F Jordaan, Rhodine Smith, Saskya Claasens, Willem I Visser

Background: Skin cancer is a growing health concern worldwide. It is the most common malignancy in South Africa and places a large burden on the public healthcare sector. There is a paucity of published scientific data on skin cancer in South Africa.

Objectives: To report the findings of biopsies performed in patients with suspected skin cancer attending the Tygerberg Academic Hospital (TAH) Dermatology outpatient department (OPD) in the Western Cape Province of South Africa. Methodology: A retrospective chart review identified all patients who underwent a biopsy for a suspected skin cancer diagnosis between September 2015 and August 2016 at the TAH dermatology OPD.

Results: A total number of 696 biopsies from 390 participants were identified, of which 460 were histologically confirmed as malignant lesions. The proportion of clinically suspected skin cancers that were histologically confirmed as cancer was 68%. The most commonly occurring malignancies were basal cell carcinoma (BCC) (54.8%), squamous cell carcinoma (SCC) (18.9%), squamous cell carcinoma in-situ (SCCI) (8.0%), Kaposi's sarcoma (KS) (6.7%), malignant melanoma (MM) (6.1%), and keratoacanthoma (KA) (4.6%). The number needed to treat (NTT) for all cancers diagnosed and for MM was 1.5 and 4 respectively. BCC (89.3%) and KS (67.7%) was the most common skin cancer in the white and black population respectively. The ratio of BCC to SCC was 2.03.

Conclusion: This study provides valuable scientific data on the accuracy of skin cancer diagnosis, distribution and patient demographics in the Western Cape Province of South Africa, on which further research can be based. The study highlights the burden of skin cancer on this specific population group and calls for standardised reporting methods and increased surveillance of skin cancers.

背景:皮肤癌是全世界日益关注的健康问题。它是南非最常见的恶性肿瘤,给公共卫生部门带来了巨大的负担。关于南非皮肤癌的公开科学数据很少。目的:报告在南非西开普省Tygerberg学术医院(TAH)皮肤科门诊(OPD)就诊的疑似皮肤癌患者的活检结果。方法:回顾性图表回顾确定了2015年9月至2016年8月期间在TAH皮肤科OPD接受活检诊断为疑似皮肤癌的所有患者。结果:390名参与者共696份活检,其中460份组织学证实为恶性病变。临床疑似皮肤癌病理证实为癌症的比例为68%。最常见的恶性肿瘤是基底细胞癌(BCC)(54.8%)、鳞状细胞癌(SCC)(18.9%)、鳞状细胞原位癌(SCCI)(8.0%)、卡波西肉瘤(KS)(6.7%)、恶性黑色素瘤(MM)(6.1%)和角棘瘤(KA)(4.6%)。所有诊断出的癌症和MM需要治疗的人数分别为1.5和4。BCC(89.3%)和KS(67.7%)分别是白人和黑人中最常见的皮肤癌。BCC与SCC之比为2.03。结论:本研究为南非西开普省皮肤癌诊断、分布和患者人口统计的准确性提供了有价值的科学数据,为进一步的研究奠定了基础。该研究强调了皮肤癌对这一特定人群的负担,并呼吁采用标准化的报告方法和加强对皮肤癌的监测。
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引用次数: 6
Male Sex is an Inherent Risk Factor for Basal Cell Carcinoma 男性是基底细胞癌的内在危险因素
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-10-20 DOI: 10.1155/2019/8304271
I. Bassukas, A. Tatsioni
Basal cell carcinoma (BCC) is more frequent among females <40 years old; however, it affects preferentially older males (>60 years old). In order to contribute to the study of the still largely unknown mechanisms that underlie this peculiar sex-dependent shift, we compared the kinetics of the increase of the age-specific BCC incidence rates (R) as a function of age in males and females. Studies reporting sex-stratified R were found using a PubMed search and male to female age-specific incidence rate ratios (RR) were calculated for each age-class as reported in each study and assigned to the mean of the corresponding age periods. Trends in age were assessed with Kendall's τ test and relationships between two variables by inverse variance method-weighed Loess and linear regression analysis. Sixteen data sets were eligible and confirmed a significant shift in the male to female ratio (Kendall's τ = 0.530; P < 0.001). Moreover, the slope parameter b = 1.205 (SE = 0.014) of the best fit (r2 = 0.980) regression line resulting by plotting male vs. female age-specific incidence rates predicts a statistically significant (P = 0.001), constant, about 20% faster increase of R in males of all ages. Similar relationship are also evident for cutaneous squamous cell and Merkel cell carcinoma and, even more intriguing, for sums of all cancers (excluding BCC and SCC) in many different registries. In conclusion, females are probably born with an inherently higher risk to develop BCC; however, also with a much slower increase rate of this risk as a function of age. Notably this observation seems to be not a BCC peculiarity. Because of its high incidence coupled with moderate morbidity and extremely low mortality rates, BCC may serve as a valuable, single-tumor paradigm to reproach the complex mechanisms that underline the interaction of age and sex in the pathogenesis of human malignancies.
基底细胞癌(BCC)多见于60岁以上的女性。为了对这种特殊的性别依赖转变背后的未知机制进行研究,我们比较了男性和女性年龄特异性BCC发病率(R)随年龄增长的动力学。使用PubMed检索发现报告性别分层R的研究,并计算每个研究报告的每个年龄级别的男性与女性年龄特异性发病率比(RR),并将其分配到相应年龄段的平均值。采用肯德尔τ检验评估年龄变化趋势,并采用负方差法-加权黄土法和线性回归分析评估两变量之间的关系。16个数据集符合条件,并证实了男女比例的显著变化(Kendall’s τ = 0.530;P < 0.001)。此外,绘制男性与女性特定年龄发病率曲线得到的最佳拟合(r2 = 0.980)回归线斜率参数b = 1.205 (SE = 0.014),预测各年龄段男性的R增长速度约快20%,具有统计学意义(P = 0.001)。类似的关系在皮肤鳞状细胞癌和默克尔细胞癌中也很明显,更有趣的是,在许多不同的登记处中,所有癌症(不包括BCC和SCC)的总和也很明显。总之,女性可能天生就有更高的患基底细胞癌的风险;然而,随着年龄的增长,这种风险的增长速度也要慢得多。值得注意的是,这一观察似乎不是BCC的特点。由于其高发病率、中等发病率和极低死亡率,基底细胞癌可以作为一种有价值的单一肿瘤范式,来谴责人类恶性肿瘤发病机制中强调年龄和性别相互作用的复杂机制。
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引用次数: 10
Erratum to “Basal Cell Carcinoma Pathology Requests and Reports Are Lacking Important Information” “基底细胞癌病理要求和报告缺乏重要信息”的勘误
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-07-14 DOI: 10.1155/2019/6846428
Firas A. Al-qarqaz, K. Bodoor, A. Al-Tarawneh, H. Eloqayli, Wisam Al Gargaz, D. Alshiyab, J. Muhaidat, M. Alqudah, R. Almomani, Maha Marji
[This corrects the article DOI: 10.1155/2019/4876309.].
[这更正了文章DOI: 10.1155/2019/4876309]。
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引用次数: 0
Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients 面部关键部位非黑色素瘤皮肤癌:102例手术治疗的结果和策略
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-06-26 DOI: 10.1155/2019/4798510
Carlos Alberto Ferreira de Freitas, Andreza Negreli Santos, Guilherme Canho Bittner, Baltazar Dias Sanabria, M. M. M. D. Levenhagen, Günther Hans-Filho
Background To evaluate the surgical treatment results of a consecutive series of patients with nonmelanoma skin cancer in critical facial regions such as the nose, lip, eyelid, ear, forehead, cheek, and chin. Methods This was a prospective observational cohort study evaluating the surgical treatment results of 102 patients with nonmelanoma skin cancer who underwent surgical excision and required some type of reconstruction. The reconstruction strategy used, histological type and margins, aesthetic result, and complications were evaluated. Results The most common facial site was the nose (48.01%), followed by the eyelid, ear, cheek, forehead, and lip. The most frequently used type of reconstruction was the advancement flap (30.39%), followed by transposition flap (27,45%), rotation flap (14.70%), and grafts (10.78%). Basal cell carcinoma was the most frequent histological type, accounting for 90.19% of the sample, with 54.90% of these cases being of the nodular subtype. Disease-free margins were obtained in 94.11% of the patients, and only one patient presented compromised margins and underwent marginal extension. A good cosmetic result was found in 93.13% of the participants. Conclusion Surgical treatment can provide excellent oncological, functional, and cosmetic results in the treatment of patients with nonmelanoma skin cancer at critical facial sites.
研究背景:评价连续一系列面部关键区域(如鼻子、嘴唇、眼睑、耳朵、前额、脸颊和下巴)非黑色素瘤皮肤癌患者的手术治疗效果。方法:这是一项前瞻性观察队列研究,评估102例接受手术切除并需要某种类型重建的非黑色素瘤皮肤癌患者的手术治疗结果。评估所采用的重建策略、组织类型和边缘、美学结果和并发症。结果最常见的面部部位是鼻子(48.01%),其次是眼睑、耳朵、脸颊、前额和嘴唇。最常用的重建类型是推进瓣(30.39%),其次是转位瓣(27.45%)、旋转瓣(14.70%)和移植物(10.78%)。基底细胞癌是最常见的组织学类型,占90.19%,其中结节型占54.90%。94.11%的患者获得无病边缘,只有1例患者出现边缘受损并行边缘延伸。93.13%的参与者美容效果良好。结论手术治疗面部关键部位非黑色素瘤性皮肤癌可获得良好的肿瘤、功能和美容效果。
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引用次数: 8
Sternectomy for Treating Advanced Non-Melanoma Skin Cancer. 胸骨切除术治疗晚期非黑色素瘤皮肤癌。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-05-30 eCollection Date: 2019-01-01 DOI: 10.1155/2019/3948782
Victor Emmanuel Gadelha Pinheiro, Bianca Rohsner Bezerra, Luís Arthur Brasil Gadelha Farias, Irapuan Teles de Araujo Filho, Marcio Ribeiro Studart da Fonseca

Introduction: Skin cancer is a rare indication of sternectomy. Our goal is to report the clinical course of seven patients who underwent sternectomy for skin cancer.

Methods: The survey data were collected from medical records of patients treated between 2008 and 2018 at Ceará Cancer Institute.

Results: All patients had prolonged sunlight exposure and average disease time of two years and age of 60 years. Most patients recovered favorably after treatment with prolonged survival.

Conclusion: Sternectomy remains an option with curative purposes for locally advanced skin cancer.

简介:皮肤癌是一种罕见的胸骨切除指征。我们的目的是报告7例因皮肤癌而行胸骨切除术的患者的临床过程。方法:调查数据收集于2008年至2018年在ceearcancer Institute接受治疗的患者病历。结果:所有患者日晒时间均延长,平均发病时间2年,年龄60岁。多数患者经治疗后恢复良好,生存期延长。结论:胸切除术是局部晚期皮肤癌的一种有效治疗方法。
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引用次数: 1
Immunohistochemical Analysis of BRAF (V600E) Mutation and P16 Expression in Malignant Melanoma in Lagos, Nigeria: A 10-Year Retrospective Study. 尼日利亚拉各斯地区恶性黑色素瘤中BRAF (V600E)突变和P16表达的免疫组化分析:一项10年回顾性研究
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-04-17 eCollection Date: 2019-01-01 DOI: 10.1155/2019/1628247
O Obadofin, K Badmos, N Orsi, M Bipin, O Rotimi, A Banjo

Background: In Blacks, malignant melanoma (MM) is associated with greater morbidity and mortality compared to Caucasians. MMs with BRAF V600E mutation as well as those with loss of p16 protein expression are associated with aggressive behavior and worse prognosis.

Objectives: We determined BRAF (V600E) mutation status and loss of p16 expression in MM cases in Lagos, Nigeria, and correlated these with histopathologic parameters and patients' age.

Methods: Forty-five cases of MM received between January 2005 and December 2014 in the Anatomic and Molecular Pathology Department of Lagos University Teaching Hospital were subjected to immunohistochemical studies to determine BRAF V600E mutation and p16 protein expression. These included cutaneous (n=37), musosal (n=3), and ocular MM (n=2) as well as lymph node metastatases (n=3).

Results: BRAF (V600E) mutations were detected in 5/45 (11%) while 31/45 (69%) of the cases had loss of p16 expression. No statistically significant association was found between the BRAF (V600E) mutation, loss of p16 expression, and histologic parameters such as histologic variant, Clark level, Breslow thickness, and ulceration.

Conclusion: BRAF (V600E) mutation was detected only in a small proportion of cases while loss of p16 expression occurred in most cases which also had high Clark level, high Breslow thickness, and ulceration.

背景:与白种人相比,黑人的恶性黑色素瘤(MM)的发病率和死亡率更高。携带BRAF V600E突变的mm以及p16蛋白表达缺失的mm与攻击性行为和较差的预后相关。目的:我们确定了尼日利亚拉各斯MM病例中BRAF (V600E)突变状态和p16表达缺失,并将其与组织病理学参数和患者年龄相关联。方法:对2005年1月至2014年12月在拉各斯大学教学医院解剖与分子病理科收治的45例MM患者进行免疫组化研究,检测BRAF V600E突变和p16蛋白表达。其中包括皮肤MM (n=37)、黏膜MM (n=3)、眼部MM (n=2)以及淋巴结转移瘤(n=3)。结果:BRAF (V600E)突变发生率为5/45 (11%),p16缺失发生率为31/45(69%)。BRAF (V600E)突变、p16表达缺失与组织学参数(如组织学变异、Clark水平、Breslow厚度和溃疡)之间无统计学意义的关联。结论:BRAF (V600E)突变仅在一小部分病例中检测到,而p16表达缺失在大多数病例中发生,且存在高Clark水平、高Breslow厚度和溃疡。
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引用次数: 2
Risk Factors for Developing Nonmelanoma Skin Cancer after Lung Transplantation. 肺移植后发生非黑色素瘤皮肤癌的危险因素。
IF 1.1 Q3 DERMATOLOGY Pub Date : 2019-03-10 eCollection Date: 2019-01-01 DOI: 10.1155/2019/7089482
Nikolai Gräger, Mareike Leffler, Jens Gottlieb, Jan Fuge, Gregor Warnecke, Ralf Gutzmer, Imke Satzger

Background: Nonmelanoma skin cancer (NSMC) is the most common malignancy after organ transplantation. Lung transplant recipients (LTRs) are particularly prone to develop NMSC as compared to renal or hepatic transplant recipients due to higher dosages of immunosuppression needed. Everolimus, an immunosuppressant used in organ transplant recipients, is thought to inherit a lower risk for NMSC than calcineurin inhibitors, especially in renal transplant recipients. It is currently unknown whether this also applies to LTRs.

Objectives: To determine risk factors for NMSC and precancerous lesions after lung transplantation (LTx) and to characterize the effect of everolimus-based regimens regarding this risk.

Materials and methods: 90 LTRs and former participants of the interventional trial "Immunosuppressive Therapy with Everolimus after Lung Transplantation", who were randomized to receive either an everolimus- or mycophenolate mofetil- (MMF-) based regimen, were enrolled and screened in this retrospective, single-center cohort study.

Results: After a median follow-up of 101 months, we observed a prevalence of 38% for NMSC or precancerous lesions. 33% of the patients continuously receiving everolimus from LTx to dermatologic examination compared to 39% of all other patients, predominantly receiving an MMF-based regimen, were diagnosed with at least one NMSC or precancerous lesion (P=.66). Independent risk factors for NMSC or precancerous lesions after LTx were male sex and duration of voriconazole therapy.

Conclusion: NMSC or precancerous lesions were very common after LTx, and risk factors were similar to previous reports on LTRs. Everolimus did not decrease this risk under the given circumstances of this study. Patients should be counseled regarding their risk, perform vigorous sunscreen, and undergo regular dermatological controls, regardless of their immunosuppressive regimen.

背景:非黑色素瘤皮肤癌是器官移植后最常见的恶性肿瘤。由于需要更高剂量的免疫抑制,与肾或肝移植受体相比,肺移植受体(lts)特别容易发生NMSC。依维莫司,一种用于器官移植受者的免疫抑制剂,被认为比钙调磷酸酶抑制剂具有更低的NMSC发病风险,尤其是在肾移植受者中。目前尚不清楚这是否也适用于ltr。目的:确定肺移植(LTx)后NMSC和癌前病变的危险因素,并表征依维莫司为基础的方案对这种风险的影响。材料和方法:在这项回顾性、单中心队列研究中,入选90名长期受试者和前介入试验“肺移植后依维莫司免疫抑制治疗”的参与者,随机接受依维莫司或霉酚酸酯(MMF)为基础的方案。结果:中位随访101个月后,我们观察到NMSC或癌前病变的患病率为38%。33%的患者从LTx持续接受依维莫司到皮肤检查,而39%的其他患者(主要接受mmf方案)被诊断为至少一个NMSC或癌前病变(P= 0.66)。LTx术后NMSC或癌前病变的独立危险因素是男性和伏立康唑治疗的持续时间。结论:LTx术后NMSC或癌前病变非常常见,其危险因素与以往报道的ltr相似。依维莫司在本研究的特定情况下并没有降低这种风险。无论采用何种免疫抑制方案,都应告知患者其风险,进行强力防晒,并定期进行皮肤病学控制。
{"title":"Risk Factors for Developing Nonmelanoma Skin Cancer after Lung Transplantation.","authors":"Nikolai Gräger,&nbsp;Mareike Leffler,&nbsp;Jens Gottlieb,&nbsp;Jan Fuge,&nbsp;Gregor Warnecke,&nbsp;Ralf Gutzmer,&nbsp;Imke Satzger","doi":"10.1155/2019/7089482","DOIUrl":"https://doi.org/10.1155/2019/7089482","url":null,"abstract":"<p><strong>Background: </strong>Nonmelanoma skin cancer (NSMC) is the most common malignancy after organ transplantation. Lung transplant recipients (LTRs) are particularly prone to develop NMSC as compared to renal or hepatic transplant recipients due to higher dosages of immunosuppression needed. Everolimus, an immunosuppressant used in organ transplant recipients, is thought to inherit a lower risk for NMSC than calcineurin inhibitors, especially in renal transplant recipients. It is currently unknown whether this also applies to LTRs.</p><p><strong>Objectives: </strong>To determine risk factors for NMSC and precancerous lesions after lung transplantation (LTx) and to characterize the effect of everolimus-based regimens regarding this risk.</p><p><strong>Materials and methods: </strong>90 LTRs and former participants of the interventional trial \"Immunosuppressive Therapy with Everolimus after Lung Transplantation\", who were randomized to receive either an everolimus- or mycophenolate mofetil- (MMF-) based regimen, were enrolled and screened in this retrospective, single-center cohort study.</p><p><strong>Results: </strong>After a median follow-up of 101 months, we observed a prevalence of 38% for NMSC or precancerous lesions. 33% of the patients continuously receiving everolimus from LTx to dermatologic examination compared to 39% of all other patients, predominantly receiving an MMF-based regimen, were diagnosed with at least one NMSC or precancerous lesion (<i>P=</i>.66). Independent risk factors for NMSC or precancerous lesions after LTx were male sex and duration of voriconazole therapy.</p><p><strong>Conclusion: </strong>NMSC or precancerous lesions were very common after LTx, and risk factors were similar to previous reports on LTRs. Everolimus did not decrease this risk under the given circumstances of this study. Patients should be counseled regarding their risk, perform vigorous sunscreen, and undergo regular dermatological controls, regardless of their immunosuppressive regimen.</p>","PeriodicalId":17172,"journal":{"name":"Journal of Skin Cancer","volume":"2019 ","pages":"7089482"},"PeriodicalIF":1.1,"publicationDate":"2019-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7089482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37328347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
期刊
Journal of Skin Cancer
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