In a JAADletter to the editor, researchers found that overall survival for patients with Merkel cell carcinoma (MCC) is worse in head, neck, and trunk tumors than those on the extremities. Using the National Cancer Database, 7,858 cases of MCC were classified by anatomic site with 42.3% occurring on the head and neck, 10.8% on the trunk, 29.4% on the upper extremities, and 18.4% on the lower extremities.
Compared with the head and neck, there was a significantly lower risk of three-year mortality for MCC of the upper extremities and lower extremities. The trunk did not have lower risk of mortality compared with the head and neck. The greatest three-year survival was for MCC of the upper extremity (67.6%) and lower extremity (67.8%), followed by the head/neck (60%) and trunk (58.6%).
DermWorld Insights and Inquiries: Insult to injury — COVID-19-associated mucormycosis
As America unmasked this Memorial Day, COVID-19 is ravaging India. The scenes of desperation stemming from the overwhelmed heath system, poverty, and funeral pyres are almost unfathomable. In the midst of the devastation, doctors in India have observed an increasing number of patients with COVID-19 who developed mucormycosis concurrently or post-recovery.
Mucormycosis is an emergent angio-invasive mycosis caused by opportunistic fungi classified in the phylum Mucoromycota (formerly Zygomycetes). The most frequently isolated species causing cutaneous disease is Rhizopus arrhizus (formerly R. oryzae). Mucormorales are ubiquitous saprophytes gaining entry through the nasal, respiratory, and palatal mucosa, and through skin abrasion or loss of the skin barrier. In their review of 115 cases of cutaneous mucormycosis, Bonifaz et al demonstrated that 18 cases were primary and 97 were secondary. Primary cutaneous mucormycosis was most frequently associated with adhesive bands (44.4%) and trauma from traffic accidents (33.3%), presenting as extensive and deep necrotic ulcers. Secondary cutaneous mucormycosis cases were rhino-cerebral with uncontrolled diabetes (81.4%), most frequently presenting as necrosis of the eyelid and the nose (65.9%). The most effective treatment was the combination of amphotericin B with surgical debridement. Clinical and mycological cure was achieved in 31.0% of primary cases and 44.4% of secondary cases. Keep reading!
Microneedling with topical therapies for melasma
In a study published in JAAD, researchers found that treating melasma patients with topical therapy and adjuvant microneedling resulted in substantially greater improvement in the Melasma Severity Index compared with topical therapy alone. There was a moderate effect at week eight and a large effect at 12 to 16 weeks.
The meta-analysis included 12 studies with 459 melasma patients from seven different countries. Topical therapies used included topical tranexamic acid, vitamin C, platelet-rich plasma, non-hydroquinone-based depigmentation serums, and hydroquinone-based depigmenting agents.
Dermatologists discuss new understandings of the pathogenesis of melasma and emerging treatments inDermWorld.
According to a study published in Photodermatology, Photoimmunology & Photomedicine, alprazolam, tetrazepam, clobazam, and clorazepate caused phototoxic reactions. Chlordiazepoxide caused one photoallergic reaction. Photosensitivity occurred between one and three days (37.5%), seven to 14 days (25%), and after 14 days (62.5%). Photopatch testing was negative in two patients; however, these patients had positive oral provocation testing.
Does wildfire air pollution increase atopic dermatitis, itch appointments?
In a study published in JAMA Dermatology, researchers found that short-term exposure to poor air quality from wildfire and smoke was significantly associated with increased rates of weekly appointments for pediatric and adult appointments for AD and in pediatric appointments for itch.
In a study of 8,049 dermatology clinic visits by 4,147 patients, short-term wildfire-associated air pollution was significantly associated with increased rates of weekly appointments for pediatric and adult appointments for AD and in pediatric appointments for itch. The rates of pediatric and adult patient visits for AD during the California Camp Fire were 1.49 and 1.15 times the rate for non-fire weeks, respectively. Itch clinic visits during wildfire weeks were 1.82 times the rate for non-fire weeks for pediatric patients and 1.29 for adult patients.
Last week, the American Academy of Dermatology Association (AADA) released a president’s message detailing its opposition to the decision by the American Academy of PAs to change the title of the profession to physician associates. While physician assistants (PAs) are important components of patient care, this change will further confuse patients about who is providing their treatment. The Academy continues to build its opposition to the PA title change and is working with the rest of the medical community, including state medical and specialty societies, to consider next steps.
Advertisement
The American Academy of Dermatology is a non-profit professional organization and does not endorse companies or products. Advertising helps support our mission.
