Blog Article
Left Cheek Atypical Spitzoid Nevus
HISTORY 23-year-old woman presents with lifelong history of left cheek mole changing recently. Biopsy in 8/2017 showed compound nevus with severe atypia with spitzoid features. Excision was performed on 2-9-18. The patient a history of atypical mole of the left back removed in 2017. DISCUSSION Spitz nevi are are spindle /…
Read MoreMelanoma In Situ of Leg – Mapping Excision Margins
The vexing problem of positive margins after excision of melanoma in situ has many solutions. In this article, we summarize them and rank them in the order of efficacy. Melanoma in situ excision margin guidelines range from the older 5 mm margin to the aggressive 10 mm margin of resection. 7 mm seems to…
Read MoreRed Light PDT Approval Process
We at Skin Cancer and Reconstructive Surgery Center wanted to upgrade our Photodynamic Therapy (PDT) treatment of AK’s and superficial BCC by switching from the Blu-U light to a red light source. Red light spectrum has been shown to be a deeper penetrating light for photodynamic therapy and, thus, has gained greater worldwide acceptance –…
Read MoreIs there a Role for Sentinel Lymph Node Biopsy in Cutaneous Squamous Cell Carcinoma?
Sentinel lymph nodes are defined as the first lymph nodes that receive metastases from a primary tumor. The concept of a first echelon node was first described by Seaman and Powers and later given the name “sentinel node” by Gould in 1960. Cabanas established the basis of modern sentinel lymph node theory by advocating that…
Read MorePDT Across the Atlantic and Medical Economics
Does medical economics bias the community standards for treatment of skin cancers? If the answer is yes, then photodynamic therapy serves as an illustrative example of this bias. Private practice dermatology in the US and National Health Service of UK are practice settings with significantly different economics and also different treatment goals. The one’s is…
Read MoreDNA Molecular Testing and Personalized Medicine – Part 2
Another genetic molecular technology that has evolved tremendously is real time polymerase chain reaction (PCR). When accompanied by reverse transcription prior to PCR (RT-PCR), it has also allowed rapid multiple gene analysis useful for cancer staging such as OncotypeDx. This platform analyzes RNA for 21 genes with RT-PCR to stratify breast cancer patients according to…
Read MoreHistory of Radiotherapy in Dermatology
Radiotherapy was born shortly after discovery of radiation by the Marie Curie and Peter Curie in 1889. First report of radiotherapy used for malignancy was published in 1896 in Medical Record by Victor Despeignes who treated a patient with gastric cancer in France. Émil Grubbé, a medical student in Chicago at the time, would later…
Read MoreDNA Molecular Testing and Personalized Medicine – Part 1
Over the last several years technological advancements in the molecular underpinnings of cancer have led to a revolution of cancer management by DNA molecular testing. By utilizing cancer genetics to guide the specific and customized treatment for each patient, the concept of personalized medicine has emerged. Melanoma has been one of the cancers extensively studied…
Read MoreSTUMP and MelTUMP
Ambiguous melanocytic lesions – those with histopathologic findings without a diagnostic consensus – are divided into thin and thick tumors. Thin lesions appear as dysplastic nevi and have a potential of being part of melanoma in situ or superficial spreading melanoma. We have explored diagnostic and therapeutic considerations of the thin lesions in a previous…
Read MorePET Imaging – Realizing a Star Trek Tricorder
PET scanning is utilized in skin cancer staging by detecting regional lymph node metastases as well as distant organ metastases. Its specificity is superior to CT and MR for N-staging, particularly with melanoma. It can be the superior modality for primary tumor staging as well. PET scan imaging is based on the increased metabolic activity…
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