17 research outputs found
Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial
Patient-centered motives and expectations of the treatment of actinic keratoses (AK) have received little attention until now. Hence, we aimed to profile and cluster treatment motivations and expectations among patients with AK in a nationwide multicenter, cross-sectional study including patients from 14 German skin cancer centers. Patients were asked to complete a self-administered questionnaire. Treatment motives and expectations towards AK management were measured on a visual analogue scale from 1–10. Specific patient profiles were investigated with subgroup and correlation analysis. Overall, 403 patients were included. The highest motivation values were obtained for the items “avoid transition to invasive squamous cell carcinoma” (mean ± standard deviation; 8.98 ± 1.46), “AK are considered precancerous lesions” (8.72 ± 1.34) and “treating physician recommends treatment” (8.10 ± 2.37; p < 0.0001). The highest expectation values were observed for the items “effective lesion clearance” (8.36 ± 1.99), “safety” (8.20 ± 2.03) and “treatment-related costs are covered by health insurance” (8.00 ± 2.41; p < 0.0001). Patients aged ≥77 years and those with ≥7 lesions were identified at high risk of not undergoing any treatment due to intrinsic and extrinsic motivation deficits. Heat mapping of correlation analysis revealed four clusters with distinct motivation and expectation profiles. This study provides a patient-based heuristic tool for a personalized treatment decision in patients with AK
Correlation of indoleamine 2,3-dioxygenase expression in primary cutaneous melanoma with Breslow thickness and peritumoral inflammation.
Myeloid CD11c+ S100+ dendritic cells express indoleamine 2,3-dioxygenase at the inflammatory border to invasive lower lip squamous cell carcinoma
The prevalence of squamous cell carcinoma
of the lower lip (SCC-LL) is increasing worlwide. The
expression of the enzyme indoleamine 2,3-dioxygenase
(IDO) by antigen-presenting cells and/or tumor cells
leads to tumor escape by inhibiting T cell-mediated
rejection responses. The aim of this study was to
determine the expression of IDO in SCC-LL. IDOexpression
was analyzed in 47 SCC-LL, together with
the expression of markers of T-cells (CD3), myeloid
DCs (S100, CD11c), macrophages (CD68, CD11c),
Langerhans cells (CD1a, Langerin (CD207)),
plasmacytoid DCs (CD123), and regulatory T cells
(Foxp3) by immunohistochemistry and immunofluorescence
analysis. Twelve specimens out of 47 LLSCCs
contained cells that expressed IDO. IDO-positivity
was strongly associated with the intensity of the cancerassociated
infiltrate (P=0.0007). IDO-positive cells are
located right along the border between the developing
tumor and the inflammatory infiltrate. Immunofluorescence
stainings showed that CD11c+S100+CD68-
dendritic cells (DCs) express IDO in SCC-LL. IDO
expression in LL-SCC may aid immune escape and
chronic inflammation to promote cancer progression.
Inhibition of IDO might be a therapeutic strategy to
increase the anti-tumor immune response in SCC-LL
Identification of IDO-Positive and IDO-Negative Human Dendritic Cells after Activation by Various Proinflammatory Stimuli
Kinetics of Gene Induction After FcεRI Ligation of Atopic Monocytes Identified by Suppression Subtractive Hybridization
FcεRI Induces the Tryptophan Degradation Pathway Involved in Regulating T Cell Responses
S1-guideline atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS)
Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are rare cutaneous neoplasms representing histomorphological, genetic as well as epigenetic variants of a disease spectrum. Both tumors typically manifest as nonspecific, often ulcerated, skin- to flesh-colored nodules in chronically sun-damaged skin of elderly male patients. AFX is a rather well demarcated, often rapidly growing tumor. PDS tumors are poorly circumscribed and are characterized by aggressive infiltrative growth. Fast as well as slow growth behavior has been reported for both tumors. Histologically, both are composed of spindle-shaped and epithelioid tumor cells with pleomorphic nuclei as well as atypical multinucleated giant cells. Atypical mitoses are common. In contrast to AFX, PDS involves relevant parts of the subcutis and shows areas of tumor necrosis and/or perineural infiltration. Due to the poorly differentiated nature of AFX/ PDS (Grade 3), histopathologically similar cutaneous sarcomas, undifferentiated carcinomas, melanomas and other diseases have to be excluded by immunohistochemical analysis. The treatment of choice is micrographically controlled surgery. In cases of AFX, a cure can be assumed after complete excision. Local recurrence rates are low as long as PDS tumors are surgically removed with a safety margin of 2 cm. Metastasis is rare and mostly associated with very thick or incompletely excised tumors; it mainly affects the skin and lymph nodes. Distant metastasis is even more rare. No approved and effective systemic therapy has been established