Topical therapies for skin cancer and actinic keratosis

Haque, Tasnuva; Rahman, Khondaker Miraz; Thurston, David E.; Hadgraft, Jonathan; Lane, Majella E.

doi:10.1016/j.ejps.2015.06.013

Cited by 48 publications

(36 citation statements)

References 85 publications

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“…Conventional treatments for AK include cryotherapy, laser-therapy, surgical excision, photodynamic therapy, diclofenac 3% gel, imiquimod 5% and 5-fluorouracil creams[3,4]. …”

Section: Introductionmentioning

confidence: 99%

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Skroza

Proietti

Bernardini

et al. 2017

WJCO

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AIMTo determine factors independently influencing response to ingenol mebutate therapy and assess efficacy on clinical setting of non-hypertrophic non-hyperkeratotic actinic keratosis (AK).METHODSConsecutive patients affected by non-hypertrophic non-hyperkeratotic AKs of the face or scalp were enrolled to receive ingenol mebutate 0.015% gel on a selected skin area of 25 cm2 for 3 consecutive days. Local skin reactions were calculated at each follow up visit using a validated composite score. Efficacy was evaluated by the comparison of clinical and dermoscopic pictures before the treatment and at day 57, and classified as complete, partial and poor response.RESULTSA number of 130 patients were enrolled, of which 101 (77.7%) were treated on the face, while 29 (22.3%) on the scalp. The great majority of our study population (n = 119, 91.5%) reached at least a 75% clearance of AKs and, in particular, 58 patients (44.6%) achieved a complete response while 61 (46.9%) a partial one. Logistic backward multivariate analysis showed that facial localization, level of local skin reaction (LSR) at day 2, the highest LSR values and level of crusts at day 8 were factors independently associated with the achievement of a complete response.CONCLUSIONIngenol mebutate 0.015% gel, when properly applied, is more effective on the face than on the scalp and efficacy is directly associated to LSR score.

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“…Conventional treatments for AK include cryotherapy, laser-therapy, surgical excision, photodynamic therapy, diclofenac 3% gel, imiquimod 5% and 5-fluorouracil creams[3,4]. …”

Section: Introductionmentioning

confidence: 99%

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Skroza

Proietti

Bernardini

et al. 2017

WJCO

View full text Add to dashboard Cite

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“…Other options such as topical imiquimod or fluorouracil should be limited to patients with small tumors in low‐risk locations and who are unwilling or unable to undergo better‐established therapies . Primary malignant melanomas arising in the head and neck region are rare and reported to have a worse prognosis than those originating elsewhere …”

Section: Discussionmentioning

confidence: 99%

Scalp ulcers – differential diagnoses that should be sought!

2019

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Background Ulceration of the scalp is an uncommon clinical presentation, and it may be caused by myriads of cutaneous etiologies such as infections, inflammatory disorders, and malignancies. We sought to reveal the underlying etiology of scalp ulcers referred to our tertiary wound healing clinic; we would also like to propose a classification for scalp ulcerations.Methods A retrospective study was conducted in an academic tertiary wound healing clinic between January 2015 and June 2018. The study was approved by the Women's College Hospital Institutional Research Ethics Board. We have also conducted a review of the literature to recognize the major causes of scalp ulceration reported in the literature. ResultsWe have identified a total number of 15 patients with scalp ulceration. Twelve patients with atypical scalp ulcers underwent a skin biopsy. A malignancy rate of 73% (11/ 15) was diagnosed histologically. The review of the literature showed 237 articles. After screening the title and the abstracts, we have selected 41 case reports for the full text review.Conclusion Scalp ulcers are uncommon but important. Our sample study indicates the high frequency of malignant etiologies presenting as scalp ulcers. These results emphasize not only the need for clinicians to be on the watch for the possibility of this option but rather highlights the need for early biopsy to prevent further complications. We hope that our paper helps to shed some light on this topic and guide clinicians on how to approach scalp ulceration.

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“…Imiquimod cream may be used to stimulate the local immune response in early stage melanoma patients (Figure 1) [19,20].…”

Section: Surgery and Chemotherapymentioning

confidence: 99%

Possibilities for the Therapy of Melanoma: Current Knowledge and Future Directions

Valko-Rokytovská¹,

Simkova²,

Milkovičová³

et al. 2018

Human Skin Cancers - Pathways, Mechanisms, Targets and Treatments

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This chapter presents an overview of possibilities for the therapy of melanoma, current knowledge and future direction. Skin cancer is one of the most frequent types of cancers. Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous. Detailed knowledge of melanoma at the molecular level allows to develop new treatment alternatives and to design effective new drugs. There are two approaches in therapy of melanoma in the present based on immunotherapy and targeted therapy or their combination. Immunotherapy includes immune checkpoint blockades, whereas targeted therapy is represented by protein kinase inhibitors, such as BRAF inhibitors, MEK inhibitors, and NRAS inhibitors. Detailed knowledge of protein structure and the understanding of its role in key signaling pathways in melanoma development lead to the designation of new protein kinase inhibitors in targeted therapy.The incidence of melanoma is increasing at one of the highest rates of any form of cancer in fair-skinned populations around the world. The exposure to sunlight during the past 50 years is an important factor for the increasing incidence of melanoma. Mortality rates of melanoma show stabilization in Australia, in North America, and also in European countries. Prevention campaigns aim on reducing incidence and achieving earlier diagnosis, which resulted in an ongoing trend toward thin melanoma since the last two decades. However, the impact of primary prevention measures on incidence rates of melanoma is unlikely to be seen in the near future; rather, increasing incidence rates to 40-50/100,000 inhabitants/year should be expected in Europe in the next decades [15]. The possible signs and symptoms of melanomaThe possible signs and symptoms of melanoma are new moles or spots on the surface of skin that are changing in size, shape and color. Another important sign is a spot that looks different from all of the other spots on skin. There are the ABCDE criteria for these signs, which guide to the usual signs of melanoma:A -Asymmetry; one half of a nevi or birthmark does not match the other.B -Border; the edges are irregular, jagged, or blurred.C -Color; the color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue. D -Diameter; the spot is larger than 6 mm across, although melanomas can sometimes be smaller than this. E -Evolving; the nevi are changing in size, shape, or color. Melanoma classification and stagingThe classification schemes Breslow's thickness (depth) and Clark's level have been developed based on either the vertical thickness of the lesion in millimeters or the anatomic level of invasion of the layers of skin. Breslow's depth is considered significant factor in predicting the progression of the melanoma. Increased tumor thickness is correlated with metastasis and poorer prognosis. Tumors are classified into four categories based on the depth: thickness of 0.75 mm or less, thickness of 0.76-1.5 mm, thickness of 1.51-4 mm...

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Topical therapies for skin cancer and actinic keratosis

Cited by 48 publications

References 85 publications

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Scalp ulcers – differential diagnoses that should be sought!

Possibilities for the Therapy of Melanoma: Current Knowledge and Future Directions

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