How to recognize a difficult squamous cell carcinoma
Authors of a study published in Clinical and Experimental Dermatology investigated the clinical and dermatoscopic features responsible for inaccurate clinical diagnosis of invasive squamous cell carcinoma (SCC) and potential clues to aid in recognition. Ten expert dermatoscopists reviewed a series of clinical and dermatoscopic images of misdiagnosed invasive SCCs. Seventy-three SCCs from 73 patients aged 37 to 97 years old were included.
[Is there an association between metformin use and the risk of nonmelanoma skin cancer? Read more.]
Most tumors were located on the cheek (20.5%), followed by forehead (16.4%), nose (12.32%), and scalp (12.32%). Thirty-seven SCCs were misdiagnosed as BCC, 15 as actinic keratosis, 10 as irritated seborrheic keratosis, seven as Bowen disease, two as viral wart, and two as cutaneous horn. White scales and keratin were voted as the main features that might have helped in the accurate clinical diagnosis of the SCCs.
DermWorld Insights and Inquiries: Sebaceous carcinoma — Double trouble
Sebaceous carcinoma (SC, aka sebaceous gland carcinoma) is double trouble — the cancer itself and its potential association with the Muir-Torre syndrome (MTS). SC is an aggressive malignancy that develops from the sebaceous glands. SC is most common in the periocular area, head, and neck but can occur anywhere sebaceous glands are present. The question of whether the patient has MTS is raised when a diagnosis of SC is rendered. Significant false-negative results with immunohistochemistry analysis for microsatellite instability and next-generation sequencing of tumor tissue have been found. Cohen and Kurzrock propose that germline testing (on normal elements such as blood, saliva, or a normal skin biopsy) for a mismatch repair gene mutation should be the initial evaluation of a patient with even a single new Muir-Torre syndrome-associated sebaceous neoplasm. Keep reading!
Exploring novel therapies for acne scar treatment
Authors of an article published in the Journal of Cosmetic Dermatology examined recent strides in acne scar treatment, with a focus on innovative therapies. Twenty-six studies were included involving participants diagnosed with acne scars at any stage. Laser and light-based therapies, including FX CO2 laser and photodynamic therapy, have shown promising outcomes in treating both acne and acne scarring, they noted. Additionally, microneedling, chemical peels, and dermal fillers played significant roles in improving the appearance of acne scars.
[Experts discuss current approaches to scar management. Read more.]
Other viable options for acne scar reduction include PRP therapy, subcision, radio frequency microneedling, cryotherapy, and fluorouracil treatments, which have all shown positive results. Combination treatments have demonstrated improved effectiveness compared to individual approaches. Soft-tissue augmentation with fillers can provide temporary improvement for atrophic acne scarring. The authors noted that the treatment selection should be based on the type and severity of the condition as well as the general health of the patients.
Survival after cessation of immunotherapies in melanoma
Authors of systematic review published in the Journal of the European Academy of Dermatology and Venereology evaluated the durability of response in melanoma patients who discontinued immune checkpoint inhibitor therapy (ICI). Twenty studies including 1,832 patients were analyzed. The pooled one- and three-year progression-free survival (PFS) rates after stopping therapy were 86% and 71%. A significantly higher one-year PFS rate was observed in patients who chose to discontinue treatment in contrast to toxicity-related therapy cessation (91% vs. 79%).
[Read highlights of some of the common (and not-so-common) skin complications associated with ICIs as well as tips for management. Read more.]
Longer ICI treatment was associated with a higher PFS rate. One- and three-year overall survival rates post ICI treatment discontinuation were 96% and 86%. Most patients remained relapse-free after ICI treatment, the authors stated. Patients with a treatment duration of at least two years are ideal candidates for treatment cessation, while treatment discontinuation may be considered after at least one year of ICI, they concluded.
Authors of an article published in Dermatologic Surgery explored the effect of radiofrequency microneedling (RFM) on treating primary hyperhidrosis. Six publications were included in the study with the level of evidence classified as Grade B, indicating moderate quality. RFM intervention resulted in a mean Hyperhidrosis Disease Severity Score (HDSS) score decrease of 1.63 (52% reduction). The strongest predictors for HDSS score decrease were dwell time, energy, and depth. The authors concluded that RFM significantly reduced HDSS scores in patients with primary hyperhidrosis.
Voluntary recall of cefazolin for injection due to mislabeling
Sandoz, Inc. has initiated a voluntary nationwide recall expansion of one additional lot of cefazolin for injection, USP, 1 gram per vial. Cefazolin is used for the treatment of some bacterial infections, including skin and skin structure infections.
The recall is due to a customer complaint that four vials of penicillin G potassium for injection, USP, 20 million units were included in the cefazolin cartons. Sandoz confirmed that the vials were incorrectly labeled. To date, the company has not received any reports of adverse events or injuries related to the product mislabeling. Read more about lots impacted by the recall.
Advertisement
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
