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DNA Molecular Testing and Personalized Medicine – Part 2

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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…

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History of Radiotherapy in Dermatology

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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…

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DNA Molecular Testing and Personalized Medicine – Part 1

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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…

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STUMP and MelTUMP

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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…

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PET Imaging – Realizing a Star Trek Tricorder

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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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Radiation Carcinogenesis

As acceptance of radiation therapy for skin cancer grows, questions arise as to the long-term risks therapeutic radiation poses. This is an area extensively measured and studied by radiation physicists and medical dosimetrists. However, from practical point of view, most of empirical data comes form epidemiological population studies. The most dramatic of these being atomic…

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Superficial Radiotherapy – An Alternative Treatment of Superficial Carcinomas

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First successful treatment of skin cancer with fractionated radiation therapy was reported by Steinbeck and Sjogren in Sweden in 1899. Since then, superficial radiation and low energy Grenz X-rays have been utilized in office settings by radiation oncologists and dermatologists for the same purposes. In the United States, the practice continued through the 1970’s and…

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Vismodegib – A Breakthrough in Basal Cell Carcinoma Treatment

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Vismodegib, a Hedgehog Pathway Inhibitor, has been recently shown to be highly effective for advanced basal cell carcinoma in Phase II clinical studies. Discovery of the Hedgehog Signaling Pathway is enlightening in how three unrelated basic science research paths can meet at crossroads of cancer treatment breakthrough. First, there were sheep in Idaho in 1957…

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Peri-Auricular Neoplasm – Deception in Waiting

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  Peri-auricular subcutaneous lesions can be deceptive. These neoplasms have a higher risk of being non-dermal-related tumors than neoplasms of other areas of the face. Attempts at excision without consideration of a differential diagnosis can often lead to tumor compromise. Over the last several months, SCARS Center has treated several tumors previously excised partially by…

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Smoothened and Patched and Sonic Hedgehogs – From Cyclopic Sheep to Targeted Basal Cell Carcinoma Treatment

Continuing Medical Education Conferences at Scar Center

What does Frizzled, Frazzled, Dishevelled, and Smoothened have to do with the Sonic Hedgehog? These are some of the humorously named genes in Drosophila fruit flies that also happened to be expressed in humans. Besides adding character to the genes, these names occasionally reflect the traits they describe. Hedgehog (Hh) gene is part of the…

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