Surveyed dermatologists are less likely to curette invasive squamous cell carcinoma in solid organ transplant recipients

Background: The risk of squamous cell carcinoma (SCC) is increased in solid organ transplant recipients (OTRs), and preferential treatment modalities vary among clinicians. Objectives: The purpose of this study was to survey dermatologists regarding practice patterns for electrodesiccation and curettage (EDC) of SCC in OTRs and nontransplant patients. Methods: An 18-question survey was sent to dermatologist members of the International Transplant Skin Cancer Collaborative, Association of Professors of Dermatology, and American College of Mohs Surgery. Differences in EDC practice patterns for treatment of SCC in OTRs and nontransplant patients were evaluated. Results: Dermatologists in this study ( Conclusions: In OTRs with SCC, 48% of clinicians would consider EDC. The main factors that affect the decision to perform EDC include tumor location and patient comorbidities

Oncogenic mutations in GNAQ occur early in uveal melanoma.

PURPOSE: Early/initiating oncogenic mutations have been identified for many cancers, but such mutations remain unidentified in uveal melanoma (UM). An extensive search for such mutations was undertaken, focusing on the RAF/MEK/ERK pathway, which is often the target of initiating mutations in other types of cancer. METHODS: DNA samples from primary UMs were analyzed for mutations in 24 potential oncogenes that affect the RAF/MEK/ERK pathway. For GNAQ, a stimulatory α(q) G-protein subunit which was recently found to be mutated in uveal melanomas, re-sequencing was expanded to include 67 primary UMs and 22 peripheral blood samples. GNAQ status was analyzed for association with clinical, pathologic, chromosomal, immunohistochemical and transcriptional features. RESULTS: Activating mutations at codon 209 were identified in GNAQ in 33/67 (49%) primary UMs, including 2/9 (22%) iris melanomas and 31/58 (54%) posterior UMs. No mutations were found in the other 23 potential oncogenes. GNAQ mutations were not found in normal blood DNA samples. Consistent with GNAQ mutation being an early or initiating event, this mutation was not associated with any clinical, pathologic or molecular features associated with late tumor progression. CONCLUSIONS: GNAQ mutations occur in about half of UMs, representing the most common known oncogenic mutation in this cancer. The presence of this mutation in tumors at all stages of malignant progression suggests that it is an early event in UM. Mutations in this G-protein provide new insights into UM pathogenesis and could lead to new therapeutic possibilities

Noninvasive Determination of Melanoma Depth using a Handheld Photoacoustic Probe

In this work, we propose applying photoacoustic tomography (PAT) to address this problem. Compared with traditional optical imaging methods, PAT uses ultrasonic waves, which give approximately 1,000 times less scattering than optical waves, breaking through the optical diffusion limit (∼1 mm in the skin) for penetration (Wang and Hu, 2012; Wang and Gao, 2014). In addition, by using optical excitation of acoustic waves due to light absorption, PAT provides improved contrast of melanin, which is deficient in ultrasonographic imaging. In previous mouse models, we measured a melanoma greater than 7 mm in depth (Zhou et al., 2015). Here we extend our work to patients with melanoma, with the aim of determining the accuracy of PAT-measured melanoma depth compared with the actual BD based on excisional biopsy results. In addition, we also compare our PAT measurement with the histologic measurement obtained from partial incisional biopsy to ultimately determine the predictability and application of PAT measurements in a clinical setting

Noninvasive Determination of Melanoma Depth using a Handheld Photoacoustic Probe

In this work, we propose applying photoacoustic tomography (PAT) to address this problem. Compared with traditional optical imaging methods, PAT uses ultrasonic waves, which give approximately 1,000 times less scattering than optical waves, breaking through the optical diffusion limit (∼1 mm in the skin) for penetration (Wang and Hu, 2012; Wang and Gao, 2014). In addition, by using optical excitation of acoustic waves due to light absorption, PAT provides improved contrast of melanin, which is deficient in ultrasonographic imaging. In previous mouse models, we measured a melanoma greater than 7 mm in depth (Zhou et al., 2015). Here we extend our work to patients with melanoma, with the aim of determining the accuracy of PAT-measured melanoma depth compared with the actual BD based on excisional biopsy results. In addition, we also compare our PAT measurement with the histologic measurement obtained from partial incisional biopsy to ultimately determine the predictability and application of PAT measurements in a clinical setting

Practice and Educational Gaps in Light, Laser, and Energy Treatments

This article discusses current practice in laser dermatology, the gaps in practice, and recommendations for improvement. As is the case with other areas of cosmetic dermatology, there is a rapid development of new laser and light devices with limited epidemiologic data available to inform best practice. The high fixed cost associated with new laser devices, limited space available in some practices, and inconsistent training may limit the adoption of needed therapies. Improving research in this area; training opportunities for physicians, residents, and staff; and cost-effective laser/light device rentals programs could improve quality of current practice