Cancer Treatment Today » Skin Cancers (not melanoma)

Capecitabine to prevent skin cancer in solid organ transplantation – pro

M Levin, MD — Wed, 06 Feb 2013 17:17:44 +0000

Skin cancers, especially squamous cell cancers, are very common after solid organ transplantation (SOTR). The incidence of skin cancer varies from country to country. Early reports were ranging from 10 to 40% at 10 and 20 years after transplantation. This incidence is higher in sunny Australia, 45 and 70% at 10 and 20 years, respectively, after the transplantation. Cutaneous premalignant and malignant epithelial lesions (carcinoma) are the most frequent skin tumours in organ transplant recipients.

A recent report by Jirakulaporn suggests that oral capecitabine can prevent at least some of these cancers. Fifteen patients (13 men and two women) with a median age of 57 yr (range 40-73) were treated. Incidence rates as measured by mean number of events per month declined by 0.33 for SCC, 0.04 for BCC, and 2.45 for AK (p < 0.05). The most common grade 3 and 4 toxicities included fatigue (40.0%), hand-foot syndrome (20.0%), and diarrhea (20.0%).

Jirakulaporn T, Endrizzi B, Lindgren B, Mathew J, Lee PK, Dudek AZ. Capecitabine for skin cancer prevention in solid organ transplant recipients. Clin Transplant. 2011 Jul-Aug;25(4):541-8.

Einollahi B, Nemati E, Lessan-Pezeshki M, Simforoosh N, Nourbala MH, Rostami Z, Nafar M, Pourfarziani V, Beiraghdar F, Mahdavi-Mazdeh M, Ahmadpour P, Makhdoomi K, Ghafari A, Ardalan MR, Taebi Khosroshahi H, Oliaei F, Shahidi S, Makhlogh A, Azmandian J, Samimagham HR, Shabazian H. Skin cancer after renal transplantation: Results of a multicenter study in Iran.Ann Transplant. 2010 Jul-Sep;15(3):44-50.

For Lay version see here

Laser for Rosacea – pro

M Levin, MD — Thu, 13 Sep 2012 18:47:07 +0000

Rosacea is a skin disorder that is characterized by persistent erythema, telangiectasias and acute episodes of edema, papules, and pustules, and easy flushing. Avoidance of excessive sunlight and extreme temperatures is typically recommended. Medical management is aimed only at the inflammatory papules and pustules and the erythema that surrounds them. Treatment is based on topical, or in severe and refractory cases, on orla antibiotics and Accutane.
Goldberg (2005) wrote that monochromatic laser)and polychromatic light-based therapies are increasingly being used for the treatment of certain signs of rosacea. He points out that few well-controlled studies have been conducted on their use for the treatment of rosacea. Furthermore, a Cochrane review on interventions for rosacea (van Zuuren, et al., 2005) concluded that the quality of studies evaluating rosacea treatments was generally poor.

Goldberg DJ. Lasers and light sources for rosacea. Cutis. 2005;75(3 Suppl):22-26; discussion 33-36.
van Zuuren EJ, Graber MA, Hollis S, Interventions for rosacea. Cochrane Database Syst Rev. 2005;(3):CD003262.
van Zuuren EJ, Gupta AK, Gover MD, et al. Systematic review of rosacea treatments. J Am Acad Dermatol. 2007;56(1):107-115.
Mostafa FF, El Harras MA, Gomaa SM, et al. Comparative study of some treatment modalities of rosacea. J Eur Acad Dermatol Venereol. 2009;23(1):22-28.
Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Surg. 2009;35(6):920-928.
Korting H, Schöllmann C. Current topical and systemic approaches to treatment of rosacea. J Eur Acad Dermatol Venereol. 2009;23(8):876-882.
Scheinfeld N, Berk T. A review of the diagnosis and treatment of rosacea. Postgrad Med. 2010;122(1):139-143.

Many insurers do not cover this treatment on the basis that it is cosmetic.

PET for eccrine carcinoma – pro

M Levin, MD — Mon, 10 Sep 2012 21:07:01 +0000

Carcinomas of the eccrine sweat gland represent a rare group of tumors with potential for local destruction and metastasis. High recurrence rates have been reported following conventional surgical excision. There are case reports of detection of this entity by PET but no larger series. Sensitivity, specificity and accuracy of PET for this cancer are not known. Because of the rarity of these tumors, specific guidelines for the investigation of possible disseminated disease have not been established.

Metastatic Basal Cell Carcinoma – pro

admin — Sun, 02 Sep 2012 15:12:49 +0000

Metastatic basal cell carcinomais very rare. THE REPORTED incidence of metastatic basal cell carcinoma (MBCC) ranges from 0.003% to 0.55%. The range is in part due to the lack of accurate data for the incidence of basal cell carcinoma (BCC), which has an estimated incidence of 900 000 to 1 200 000 in the United States, but is excluded from traditional national cancer registries, such as Surveillance, Epidemiology and End Results. While BCC is a slow-growing, usually nonmetastazing but invasive tumor, at least 230 cases fulfilling the criteria for metastatic basal cell (MBCC) were reported in the literature. Metastasis to regional nodes or lungs occurred in long-standing recurrent lesions. There is little secure experience with treatment modalilities and chemotherapy must be considered experimental.

G. R. Mikhail; L. P. Nims; A. P. Kelly, Jr; D. M. Ditmars, Jr; W. R. Eyler
Metastatic basal cell carcinoma: review, pathogenesis, and report of two cases
Arch Dermatol. 1977;113(9):1261-1269.

June K. Robinson; Madhu Dahiya
Basal Cell Carcinoma With Pulmonary and Lymph Node Metastasis Causing Death
Arch Dermatol. 2003;139(5):643-648.