Publications by authors named "Ana-Maria Forsea"

Penicillin allergy is the most commonly reported drug allergy, with prevalence rates ranging from 6% to 31% across various populations and geographic areas. The penicillin allergy label is linked to higher mortality and morbidity rates, extended hospital stays, increased readmission rates, and a greater reliance on second-line antibiotics. Research indicates that nearly 99% of those labeled as penicillin-allergic can tolerate the drug.

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A unique collaboration of multi-disciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with one to two-centimeter safety margins. For a correct stage classification and treatment decision, a sentinel lymph node biopsy shall be offered in patients with tumor thickness ≥ 1.

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This guideline was developed in close collaboration with multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF) and the European Organization for Research and Treatment of Cancer (EORTC). Recommendations for the diagnosis and treatment of melanoma were developed on the basis of systematic literature research and consensus conferences. Cutaneous melanoma (CM) is the most dangerous form of skin tumor and accounts for 90 % of skin cancer mortality.

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Article Synopsis
  • * Early detection of multiple KAs is important for diagnosing underlying causes and preventing related health issues, which can improve patient quality of life and provide family counseling.
  • * Current research is limited and often based on small studies, so this work aims to review existing knowledge on multiple KAs, especially linked to genetic syndromes, and to propose a diagnostic algorithm for better clinical guidance.
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Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine malignancy characterized by its propensity for rapid growth and early regional and distant metastasis. Given its potentially lethal nature, accurate and timely diagnosis of MCC is of utmost importance. This review aims to describe non-invasive imaging methods that can serve as additional tools in the examination of MCC.

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Background: Two-dimensional (2D) classifications of iodinated contrast media (ICM) are insufficient to explain the observed skin test (ST) reactivity patterns in patients with drug hypersensitivity reactions (DHRs) to ICM.

Objective: To refine the current view on allergic DHRs to ICM by analyzing ST reactivity patterns in patients with previous reactions to ICM.

Methods: Patients with a history of DHR to ICM and positive STs, who presented at the University Hospital of Montpellier between 2004 and 2022, were included in the study.

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Article Synopsis
  • Skin cancers are super common, especially in people with fair skin, and most of them are caused by UV rays from the sun, which means we can do things to prevent them.
  • Experts from different continents suggest that fair-skinned people, especially kids, should stay out of the sun when the UV level is 3 or higher and use protection like hats, sunglasses, clothing, and sunscreen.
  • They also believe sunbathing and using tanning beds are unhealthy, so they want to spread these ideas to help everyone stay safe from skin cancer.
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Every year in Europe over 150,000 new cases of melanoma are reported and over 25,000 lives are lost to this tumor. Incidence has been rising rapidly, faster than for any other cancer, and it is expected to continue to do so in most regions. Mortality also crept up, decades-long, with only few very recent exceptions.

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A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage.

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Article Synopsis
  • * Despite a good prognosis, cSCC leads to many deaths because of its high occurrence, highlighting the importance of ongoing research and treatment recommendations.
  • * A group of experts from various European dermatological and oncology organizations has come together to update guidelines on cSCC, focusing on various aspects such as classification, diagnosis, risk factors, and prevention for both immunocompetent and immunosuppressed individuals.
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  • A multidisciplinary panel of experts from various European medical organizations has developed updated recommendations for treating invasive cutaneous squamous cell carcinoma (cSCC) based on a thorough literature review and expert consensus.
  • Treatment guidelines cover different stages of cSCC, recommending surgery with clear margins as the primary option for low and high-risk cases, while highlighting the lack of benefit from radiation for high-risk patients with clear margins.
  • For advanced cSCC that cannot be surgically treated, anti-PD-1 agents like cemiplimab are recommended as first-line therapy, with second-line options including cetuximab combined with chemotherapy or radiation.
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Introduction: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up.

Objectives: To obtain general consensus on the diagnosis, treatment, and follow-up for LM.

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Background: Dermoscopy is a well-established tool for the diagnosis of skin diseases and skin cancer. Data on the use of dermoscopy by Dutch dermatologists is lacking.

Objectives: To identify factors influencing the use of dermoscopy in daily dermatology practice and compare the results with those from other European countries.

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Article Synopsis
  • A collaboration of experts from the EDF, EADO, and EORTC has developed guidelines for diagnosing and treating cutaneous melanoma based on extensive literature reviews and clinical experience.
  • Melanomas are typically excised with safety margins of 1 to 2 cm, and sentinel lymph node dissection is recommended for certain patients, although its survival benefit is still uncertain.
  • Treatment for advanced stage III/IV melanoma involves a multidisciplinary approach, with immunotherapy or targeted therapies based on specific genetic mutations being the primary options, reflecting the rapidly evolving nature of melanoma treatment.
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  • Cutaneous melanoma (CM) is one of the most serious skin cancers, responsible for 90% of skin cancer deaths, prompting collaboration among leading European dermatology organizations to create diagnostic and treatment guidelines.
  • Melanoma diagnosis should be confirmed clinically with dermatoscopy, and histopathological examination is essential if melanoma is suspected; advanced imaging is only recommended for later-stage melanomas.
  • A proposed structured follow-up scheme is designed to monitor for relapses, though more research is needed to determine the ideal frequency of examinations; these guidelines are effective until the end of 2024.
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Background: Dermoscopy is a widely used technique, recommended in clinical practice guidelines worldwide for the early diagnosis of skin cancers. Intra-European disparities are reported for early detection and prognosis of skin cancers, however, no information exists about regional variation in patterns of dermoscopy use across Europe.

Objective: To evaluate the regional differences in patterns of dermoscopy use and training among European dermatologists.

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Melanoma claims annually more than 20,000 lives in Europe and is an important public health burden through its continuously increasing incidence and with its high mortality, costs, and complexity of care in advanced stages. Epidemiological surveillance is indispensable for the research into its causes, new prognostic markers, and innovative therapies, as well as for the building of efficient cancer control plans. However, important differences in the sources and availability of accurate epidemiological data exist among European countries and regions, contributing to a heterogeneous picture with 20-fold differences in the reported national melanoma incidence rates, divergent mortality trends, and solid disparities in survival across the Continent.

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Invasive cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in the white populations, accounting for 20% of all cutaneous malignancies. Factors implicated in cSCC etiopathogenesis include ultraviolet radiation exposure and chronic photoaging, age, male sex, immunosuppression, smoking and genetic factors. A collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation of Research and Treatment of Cancer (EORTC) was formed to update recommendations on cSCC classification, diagnosis, risk stratification, staging and prevention, based on current literature, staging systems and expert consensus.

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Article Synopsis
  • Diagnosis involves recognizing clinical symptoms and confirming them through lab tests, with disease severity varying by subtype.
  • Treatment focuses on controlling the disease, including local therapies for localized cases and systemic treatments like pegylated liposomal doxorubicin for more aggressive forms.
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Background: Nodular melanoma (NM) is more likely to be fatal compared with other melanoma subtypes, an effect attributed to its greater Breslow thickness.

Methods: Clinicopathological features of NM and superficial spreading melanoma (SSM) diagnosed in 17 centers in Europe (n = 15), the United States, and Australia between 2006 and 2015, were analyzed by multivariable logistic regression analysis, with emphasis on thin (T1 ≤ 1.0 mm) melanomas.

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Lichen planus (LP) is a chronic inflammatory skin disease that can sometimes affect mucosal surfaces, with unknown pathogenesis, even though it appears to be an autoimmune disease. The diagnosis of lichen planus is usually based on histopathological examination of the lesions. Nowadays, the classical invasive diagnostic methods are replaced by modern non-invasive techniques.

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Article Synopsis
  • There is a recognized survival disparity for melanoma patients across Europe, highlighting the need for improved access to quality care and standardized clinical pathways.* -
  • The EU-MELACARE study investigates melanoma cases in Europe by collecting data from melanoma registries in 34 countries through expert surveys.* -
  • Findings showed 13 registries from 11 countries with a majority being population-based, identifying 24 key variables that can be used to establish standardized quality assurance indicators for melanoma care across Europe.*
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Background: ECCO essential requirements for quality cancer care (ERQCC) are explanations and descriptions of challenges, organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey.

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