Pub Date : 2024-09-06DOI: 10.1016/j.jaad.2024.06.107
Andrew T Li, Jessie X Xu, Tyler R Blah, Serigne N Lo, Robyn Pm Saw, Alexander Hr Varey, Alexander Van Akkooi, Matteo S Carlino, Ines Pires da Silva, Alexander M Menzies, Kerwin F Shannon, Georgina V Long, Richard A Scolyer, John F Thompson, Sydney Ch'ng
Background: Melanoma is increasingly recognized as a heterogeneous disease, with conflicting evidence regarding whether cutaneous head and neck melanoma (CHNM) represents a distinct entity.
Objective: Comparison of clinicopathological features and treatment outcomes of CHNM and cutaneous melanomas of other sites (CMOS).
Methods: Patients with CHNM and CMOS diagnosed between 2000 and 2018 were included. Locoregional control, distant metastasis-free survival, melanoma-specific survival (MSS), and overall survival (OS) were described using the Kaplan-Meier method. Cox regression analyses were performed to examine associations between prognostic factors and outcomes. Additional analyses of survival from time of stage IV disease diagnosis were undertaken, stratified by receipt of BRAF-targeted therapy and immune checkpoint inhibitor immunotherapy.
Results: Of 3007 CHNM and 10,637 CMOS patients, CHNM had more adverse pathological features (median age 65.9 vs 58.5, P < .001; median Breslow thickness 1.7 mm vs 1.2 mm, P < .001; and ulceration 21.2% vs 18.2%, P < .001). CHNM had worse locoregional control (hazard ratio (HR) 1.17, P < .001) and distant metastasis-free survival (HR 1.25, P < .001) but there were no significant differences in MSS or OS. Among stage IV patients who received immune checkpoint inhibitor, CHNM had better MSS (HR 0.56, P = .001) and OS (HR 0.57, P < .001) on multivariable analyses.
Limitations: Retrospective study, offset by prospective data collection.
Conclusion: CHNM is associated with a distinct clinicopathological and prognostic profile.
背景：黑色素瘤越来越被认为是一种异质性疾病：黑色素瘤越来越被认为是一种异质性疾病，关于皮肤头颈部黑色素瘤（CHNM）是否代表一个独特的实体，存在相互矛盾的证据：比较头颈部皮肤黑色素瘤和其他部位皮肤黑色素瘤（CMOS）的临床病理特征和治疗效果：纳入2000-2018年间确诊的CHNM和CMOS患者。采用 Kaplan-Meier 法描述了局部控制率（LRC）、无远处转移生存率（DMFS）、黑色素瘤特异性生存率（MSS）和总生存率（OS）。研究人员还进行了 Cox 回归分析，以检验预后因素与结果之间的关联。此外，还根据接受 BRAF 靶向疗法和免疫检查点抑制剂（ICI）免疫疗法的情况，对 IV 期疾病诊断后的存活率进行了分析：结果：在3007名CHNM和10637名CMOS患者中，CHNM患者的不良病理特征更明显（中位年龄65.9岁对58.5岁，p局限性：局限性：回顾性研究，由前瞻性数据收集抵消：结论：CHNM 与独特的临床病理和预后特征相关。
{"title":"Comparison of clinicopathological features and treatment outcomes for cutaneous melanomas of the head and neck and melanomas arising at other sites: Implications for systemic therapy.","authors":"Andrew T Li, Jessie X Xu, Tyler R Blah, Serigne N Lo, Robyn Pm Saw, Alexander Hr Varey, Alexander Van Akkooi, Matteo S Carlino, Ines Pires da Silva, Alexander M Menzies, Kerwin F Shannon, Georgina V Long, Richard A Scolyer, John F Thompson, Sydney Ch'ng","doi":"10.1016/j.jaad.2024.06.107","DOIUrl":"10.1016/j.jaad.2024.06.107","url":null,"abstract":"<p><strong>Background: </strong>Melanoma is increasingly recognized as a heterogeneous disease, with conflicting evidence regarding whether cutaneous head and neck melanoma (CHNM) represents a distinct entity.</p><p><strong>Objective: </strong>Comparison of clinicopathological features and treatment outcomes of CHNM and cutaneous melanomas of other sites (CMOS).</p><p><strong>Methods: </strong>Patients with CHNM and CMOS diagnosed between 2000 and 2018 were included. Locoregional control, distant metastasis-free survival, melanoma-specific survival (MSS), and overall survival (OS) were described using the Kaplan-Meier method. Cox regression analyses were performed to examine associations between prognostic factors and outcomes. Additional analyses of survival from time of stage IV disease diagnosis were undertaken, stratified by receipt of BRAF-targeted therapy and immune checkpoint inhibitor immunotherapy.</p><p><strong>Results: </strong>Of 3007 CHNM and 10,637 CMOS patients, CHNM had more adverse pathological features (median age 65.9 vs 58.5, P < .001; median Breslow thickness 1.7 mm vs 1.2 mm, P < .001; and ulceration 21.2% vs 18.2%, P < .001). CHNM had worse locoregional control (hazard ratio (HR) 1.17, P < .001) and distant metastasis-free survival (HR 1.25, P < .001) but there were no significant differences in MSS or OS. Among stage IV patients who received immune checkpoint inhibitor, CHNM had better MSS (HR 0.56, P = .001) and OS (HR 0.57, P < .001) on multivariable analyses.</p><p><strong>Limitations: </strong>Retrospective study, offset by prospective data collection.</p><p><strong>Conclusion: </strong>CHNM is associated with a distinct clinicopathological and prognostic profile.</p>","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.jaad.2024.08.053
Elizabeth P Long, Brooke A Burgess, Joshua L Owen
{"title":"Technology pearl: Utilizing dermatoscope adapter to obtain high-resolution histopathologic photographs with modern multilens smartphone cameras.","authors":"Elizabeth P Long, Brooke A Burgess, Joshua L Owen","doi":"10.1016/j.jaad.2024.08.053","DOIUrl":"10.1016/j.jaad.2024.08.053","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.jaad.2024.06.108
Brett G M Hughes, Alexander Guminski, Samantha Bowyer, Michael R Migden, Chrysalyne D Schmults, Nikhil I Khushalani, Anne Lynn S Chang, Jean-Jacques Grob, Karl D Lewis, George Ansstas, Fiona Day, Rahul Ladwa, Brian N Stein, Eva Muñoz Couselo, Friedegund Meier, Axel Hauschild, Dirk Schadendorf, Nicole Basset-Seguin, Badri Modi, Sophie Dalac-Rat, Lara A Dunn, Lukas Flatz, Laurent Mortier, Sarah Guégan, Lucie M Heinzerling, Janice M Mehnert, Sabiha Trabelsi, Ainara Soria-Rivas, Alexander J Stratigos, Claas Ulrich, Deborah J Wong, Marie Beylot-Barry, Paolo Bossi, Cristina Bugés Sánchez, Sunandana Chandra, Caroline Robert, Jeffery S Russell, Ann W Silk, Jocelyn Booth, Suk-Young Yoo, Frank Seebach, Israel Lowy, Matthew G Fury, Danny Rischin
Background: In the phase 2 EMPOWER-CSCC-1 study (NCT02760498), cemiplimab demonstrated antitumor activity against metastatic (mCSCC) and locally advanced cutaneous squamous cell carcinoma (laCSCC).
Objectives: To report final analysis of weight-based cemiplimab in mCSCC and laCSCC (Groups 1 and 2), fixed-dose cemiplimab in mCSCC (Group 3), and primary analysis of fixed-dose cemiplimab in mCSCC/laCSCC (Group 6).
Methods: Patients received cemiplimab (3 mg/kg intravenously [IV] every 2 weeks [Groups 1 and 2]) or cemiplimab (350 mg IV [Groups 3 and 6]) every 3 weeks. The primary endpoint was objective response rate (ORR). Duration of response (DOR) and progression-free survival (PFS) are presented per protocol, according to post-hoc sensitivity analyses that only include the period of protocol-mandated imaging assessments.
Results: At 42.5 months, ORR for Groups 1-3 (n=193) was 47.2%, estimated 12-month DOR was 88.3%, and median PFS was 26.0 months. At 8.7 months, ORR for Group 6 (n=165 patients) was 44.8%; median DOR and median PFS were not reached. Serious treatment-emergent adverse event rates (grade ≥3) were Groups 1-3: 31.1% and Group 6: 34.5%.
Conclusion: EMPOWER-CSCC-1 provides the largest prospective data on long-term efficacy and safety for anti-programmed cell death-1 therapy in advanced CSCC.
{"title":"A phase 2 open-label study of cemiplimab in patients with advanced cutaneous squamous cell carcinoma (EMPOWER-CSCC-1): Final long-term analysis of Groups 1, 2, and 3, and primary analysis of fixed-dose treatment Group 6.","authors":"Brett G M Hughes, Alexander Guminski, Samantha Bowyer, Michael R Migden, Chrysalyne D Schmults, Nikhil I Khushalani, Anne Lynn S Chang, Jean-Jacques Grob, Karl D Lewis, George Ansstas, Fiona Day, Rahul Ladwa, Brian N Stein, Eva Muñoz Couselo, Friedegund Meier, Axel Hauschild, Dirk Schadendorf, Nicole Basset-Seguin, Badri Modi, Sophie Dalac-Rat, Lara A Dunn, Lukas Flatz, Laurent Mortier, Sarah Guégan, Lucie M Heinzerling, Janice M Mehnert, Sabiha Trabelsi, Ainara Soria-Rivas, Alexander J Stratigos, Claas Ulrich, Deborah J Wong, Marie Beylot-Barry, Paolo Bossi, Cristina Bugés Sánchez, Sunandana Chandra, Caroline Robert, Jeffery S Russell, Ann W Silk, Jocelyn Booth, Suk-Young Yoo, Frank Seebach, Israel Lowy, Matthew G Fury, Danny Rischin","doi":"10.1016/j.jaad.2024.06.108","DOIUrl":"https://doi.org/10.1016/j.jaad.2024.06.108","url":null,"abstract":"<p><strong>Background: </strong>In the phase 2 EMPOWER-CSCC-1 study (NCT02760498), cemiplimab demonstrated antitumor activity against metastatic (mCSCC) and locally advanced cutaneous squamous cell carcinoma (laCSCC).</p><p><strong>Objectives: </strong>To report final analysis of weight-based cemiplimab in mCSCC and laCSCC (Groups 1 and 2), fixed-dose cemiplimab in mCSCC (Group 3), and primary analysis of fixed-dose cemiplimab in mCSCC/laCSCC (Group 6).</p><p><strong>Methods: </strong>Patients received cemiplimab (3 mg/kg intravenously [IV] every 2 weeks [Groups 1 and 2]) or cemiplimab (350 mg IV [Groups 3 and 6]) every 3 weeks. The primary endpoint was objective response rate (ORR). Duration of response (DOR) and progression-free survival (PFS) are presented per protocol, according to post-hoc sensitivity analyses that only include the period of protocol-mandated imaging assessments.</p><p><strong>Results: </strong>At 42.5 months, ORR for Groups 1-3 (n=193) was 47.2%, estimated 12-month DOR was 88.3%, and median PFS was 26.0 months. At 8.7 months, ORR for Group 6 (n=165 patients) was 44.8%; median DOR and median PFS were not reached. Serious treatment-emergent adverse event rates (grade ≥3) were Groups 1-3: 31.1% and Group 6: 34.5%.</p><p><strong>Limitations: </strong>Non-randomized study, non-survival primary endpoint.</p><p><strong>Conclusion: </strong>EMPOWER-CSCC-1 provides the largest prospective data on long-term efficacy and safety for anti-programmed cell death-1 therapy in advanced CSCC.</p>","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to Caplan et al, \"Clinico-mycological and therapeutic updates on cutaneous dermatophytic infections in the era of Trichophyton indotineae; Focus on Griseofulvin\".","authors":"Ananta Khurana, Savitha Sharath, Kabir Sardana, Anuradha Chowdhary","doi":"10.1016/j.jaad.2024.08.054","DOIUrl":"10.1016/j.jaad.2024.08.054","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.jaad.2024.08.055
Michelle D Colbert, Giang H Nguyen, Carilyn N Wieland, Michael J Camilleri, Heather Hardway, Julia S Lehman
{"title":"Diagnostic value of direct immunofluorescence testing in the evaluation of alopecia: A single-institution retrospective cohort study of 346 studies.","authors":"Michelle D Colbert, Giang H Nguyen, Carilyn N Wieland, Michael J Camilleri, Heather Hardway, Julia S Lehman","doi":"10.1016/j.jaad.2024.08.055","DOIUrl":"https://doi.org/10.1016/j.jaad.2024.08.055","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1016/j.jaad.2024.07.1527
Elke L M Ter Haar, Juul M P A van den Reek, Mahshid Sadat Chenarani Moghadam, Yvonne Schoon, Marloes M Kleinpenning, Elke M G J de Jong, Satish F K Lubeek
{"title":"Frailty and functional dependency in a multicenter cohort of older adults with psoriasis: Prevalence and extent of and implications for psoriasis management.","authors":"Elke L M Ter Haar, Juul M P A van den Reek, Mahshid Sadat Chenarani Moghadam, Yvonne Schoon, Marloes M Kleinpenning, Elke M G J de Jong, Satish F K Lubeek","doi":"10.1016/j.jaad.2024.07.1527","DOIUrl":"10.1016/j.jaad.2024.07.1527","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1016/j.jaad.2024.09.001
Jonathan Kantor
{"title":"This Month in JAAD International: November 2024: Pressure ulcers and qualitative research.","authors":"Jonathan Kantor","doi":"10.1016/j.jaad.2024.09.001","DOIUrl":"10.1016/j.jaad.2024.09.001","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-02DOI: 10.1016/j.jaad.2024.08.049
Albert E Zhou, Christian Gronbeck, Brett Sloan, Jane M Grant-Kels
{"title":"The ethical and responsible use of sick call.","authors":"Albert E Zhou, Christian Gronbeck, Brett Sloan, Jane M Grant-Kels","doi":"10.1016/j.jaad.2024.08.049","DOIUrl":"10.1016/j.jaad.2024.08.049","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaad.2024.07.064
{"title":"54695 Access to specialist care and perceived care quality among melanoma and non-melanoma skin cancer patients: A Medical Expenditure Panel Survey Analysis","authors":"","doi":"10.1016/j.jaad.2024.07.064","DOIUrl":"10.1016/j.jaad.2024.07.064","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaad.2024.07.071
{"title":"52898 Among scalp non-responder patients with eyebrow/eyelash regrowth in the first year, continued treatment with baricitinib resulted in meaningful scalp responses for patients with severe alopecia areata","authors":"","doi":"10.1016/j.jaad.2024.07.071","DOIUrl":"10.1016/j.jaad.2024.07.071","url":null,"abstract":"","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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