Treatment of melanotic freckle with x-rays

Petratos, M. A.

doi:10.1001/archderm.106.2.189

Cited by 11 publications

(9 citation statements)

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“…A form of therapy other than conventional surgery was used in five patients in this category. Four had recurrences (see Cases 11,12,13,and 14) and two patients (see Cases 11 and 12) of those four also devel oped metastases. One patient had metastases without a local recurrence (see case 15).…”

Section: Casementioning

confidence: 97%

See 1 more Smart Citation

Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

Pitman¹,

Kopf²,

Bart³

et al. 1979

The Journal of Dermatologic Surgery and Oncology

155

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The results of treatment of 42 cases of lentigo maligna and 16 of lentigo maligna melanoma at the New York University Medical Center was reviewed. The recurrence rate after surgical excision of 22 lesions of lentigo maligna was 9% (2/22), but after treatment of 20 such lesions with destructive techniques (X rays, curettage-electrodesiccation, cryosurgery), it was 35% (7/20). Of 11 cases of lentigo maligna melanoma that were excised, none recurred locally, but fatal metastases ensued in one case. Five patients who were eventually classified as having lentigo maligna melanomas had been treated by destructive techniques. In four of them there were local recurrences and in two, metastases as well; the fifth patient had metastases without local recurrence. On the basis of this review of these 58 cases, we conclude that surgical excision and careful histologic study of step sections through the entire lesion insure accurate diagnosis and provide the highest cure rates for lentigo maligna and lentigo maligna melanoma.

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Section: Casementioning

confidence: 97%

“…Cases 3, 4, 5, and 7 have been reported previously by us. 13 When seen by his family physician 20 months after the patient had refused re-treatment, the lesion was re ported to be unchanged in size and character. Case 2.…”

Section: Duration In Yearsmentioning

confidence: 99%

Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

Pitman¹,

Kopf²,

Bart³

et al. 1979

The Journal of Dermatologic Surgery and Oncology

155

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“…The depart- ment's Grenz ray machine was recalibrated during the time period between the publications of their two papers. The beam penetration increased from depositing the reference dose at 0Á7 mm in their 1972 paper 33 to 1Á3 mm in their final paper published in 1976; 20 i.e. the penetration almost doubled in 4 years.…”

Section: Resultsmentioning

confidence: 99%

“…Tsang et al 23 say that their findings confirm those of Harwood, which is then cited, so we have presumed that there is no overlap between the two cohorts. The article by Petratos et al 33 was from the same institution as one by Kopf et al 20 and for similar reasons only the latter was included in this analysis. The other six articles reported the experience of six other institutions.…”

Section: Methodsmentioning

confidence: 99%

Radiotherapy for lentigo maligna: a literature review and recommendations for treatment

et al. 2014

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SummaryLentigo maligna (LM) incidence is increasing. LM frequently involves the face near critical anatomical structures and as a consequence clinical management is challenging. Nonsurgical therapies, including radiotherapy (RT), are increasingly used. Evidenced-based treatment guidelines are lacking. We conducted a review of previously published data analysing RT treatment of LM. A search of PubMed, Embase and Medline databases to June 2012 identified nine clinical studies that examined the use of RT for LM treatment in at least five patients. Nine studies described 537 patients with LM treated with definitive primary RT, between 1941 and 2009, with a median reported follow-up time of 3 years. Eight articles could be reviewed for oncological outcome data. There were 18 recurrences documented in a total of 349 assessable patients (5%). Salvage was successful in the majority of recurrent LM cases by using further RT, surgery or other therapies. Progression to LM melanoma (LMM) occurred in five patients (five out of 349, 1Á4%) who all had poor outcomes. There were five marginal recurrences documented out of 123 assessable patients (4%). There were eight in-field recurrences documented with either LM (five) or LMM (three) out of 171 assessable patients (5%). A series of recommendations were then developed for RT parameters for treatment of LM. These parameters include treatment volume, dose, dose per fraction and outcome measures. These may be of use in prospective data collection. What's already known about this topic?• Radiotherapy is increasingly used for the treatment of lentigo maligna; however, there is a lack of evidence-based radiotherapy treatment guidelines. What does this study add?• This is the first literature review of radiotherapy for lentigo maligna.• We have developed recommendations for radiotherapy of lentigo maligna based on the review and our own initial experience from a multidisciplinary lentigo maligna clinic.Lentigo maligna (LM), a form of in situ melanoma, 1-3 is characterized in its earliest stages by scattered single atypical melanocytes involving the dermoepidermal junction (Fig. 1a) and extending down skin appendageal structures. It usually occurs within severely sun-damaged skin. 4 As the tumour progresses, melanocyte density and degree of cytological atypia increase (Fig. 1b). Advanced cases of LM often show confluent growth of melanocytes along the basal epidermis, nest formation and pagetoid epidermal invasion, with florid adnexal involvement (Fig. 1c). The transition at the peripheral margin of the lesion from neoplastic to non-neoplastic melanocytes can be poorly defined.5,6

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“…Superficial radiation to radical dosage will eliminate lentigo maligna and will thereby avoid disfiguring surgery, although for many patients no treatment is required-only observation. The Miescher technique (Petratos et al, 1972) employs a filtered Grenz-ray beam with up to five fractions of 2000 rads being delivered over a period of 2 weeks. The i mm depth dose is 65^0-The pigment disappears over a period of months and the lesion eventually disappears altogether.…”

mentioning

confidence: 99%

The radiotherapy of melanoma

Harmer

1976

Clin Exp Dermatol

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Treatment of melanotic freckle with x-rays

Cited by 11 publications

References 0 publications

Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

Radiotherapy for lentigo maligna: a literature review and recommendations for treatment

The radiotherapy of melanoma

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