Sarcomas arising in the skin are rare but potentially fatal. These tumours originate from mesenchymal cells and can be divided between those that arise in soft tissue and those arising from bone. General guidelines exist for the management of soft tissue sarcomas however there are no specific guidelines for cutaneous sarcomas. Current literature was reviewed for management of seven cutaneous sarcomas including atypical fibroxanthoma (AFX), pleomorphic dermal sarcoma (PDS), dermal and subcutaneous leiomyosarcoma (LMS), dermatofibroma sarcoma protuberans (DFDP), Kaposi’s sarcoma (KS), cutaneous angiosarcoma (CAS) and malignant peripheral nerve sheath tumour (MPNST). All suspected sarcomas should be discussed in a sarcoma multidisciplinary team (MDT) meeting. This article is not a clinical guideline but should serve as a practical summary of how these tumours present, how they are recognised histologically, and how best to manage and follow up patients. The aim is to support clinicians and facilitate the best and most evidence-based standard of care available.
Background. The incidence of skin cancer is increasing globally, leading to a greater need for dermatologists to perform skin surgery. However, skin surgery can be a potentially stressful experience for patients due to the fear of a possible cancer diagnosis coupled with anxiety related to pain and cosmetic outcomes. Aim. To examine whether there is any evidence to support the hypothesis that listening to music during dermatological surgery under local anaesthesia can help reduce patient anxiety. Methods. This systematic review considered all original research published until May 2020. Four relevant studies were identified, comprising a total of 381 patients (three randomized control trials and one case-control trial). Results. Two of the four studies showed a significant reduction in perioperative anxiety in patients who had listened to music during surgery. Both of the other studies showed no statistically significant difference between music and no music for patients, although one of these noted reduced anxiety in surgeons. Conclusion.There is currently limited evidence to support the use of perioperative music in clinical practice to reduce anxiety in skin surgery. However, given the potential benefits and the likely limited costs of this simple intervention, we believe that further research on this topic is warranted.
A 62-year-old lady presented to clinic with a cord-like tethering to her left breast following axillary sentinel lymph node biopsy for a 1.0 mm melanoma. We explore the presentation, investigations and discuss this likely under-diagnosed condition.
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