Publications by authors named "Elshot Y"
Article Synopsis
- Reflectance confocal microscopy (RCM) shows potential in improving surgical outcomes by detecting subclinical melanoma (LM/LMM) before surgery.
- A study involving 117 cases demonstrated that handheld RCM (HH-RCM) identified subclinical LM in 60% of instances, and 27% of cases had changed management plans, often resulting in less extensive surgeries.
- The use of HH-RCM significantly improved histological margin status to 96.5% compared to 81% in historical cases, and it contributed to a much lower local recurrence rate of 1.6%, suggesting its value in tailoring treatment for patients.
Background: Lentigo maligna melanoma (LMM) predominantly presents in the head and neck of the elderly. The value of sentinel lymph node biopsy (SLNB) for LMM patients remains to be determined, as the reported average yield of positive lymph nodes is less than 10%. In this nationwide cohort study, we wanted to identify LMM patients with an increased risk of SLNB-positivity.
View Article and Find Full Text PDFNeoadjuvant ipilimumab + nivolumab has demonstrated high pathologic response rates in stage III melanoma. Patients with low intra-tumoral interferon-γ (IFN-γ) signatures are less likely to benefit. We show that domatinostat (a class I histone deacetylase inhibitor) addition to anti-PD-1 + anti-CTLA-4 increased the IFN-γ response and reduced tumor growth in our murine melanoma model, rationalizing evaluation in patients.
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- Immune checkpoint inhibitors (ICIs) can rarely cause a serious skin reaction known as drug reactions with eosinophilia and systemic symptoms (DRESS), and this study aims to outline its clinical features, treatment, and prognosis.
- The study analyzed 13 patients who reported DRESS after ICI treatment, noting symptoms like fever, skin rash, and facial swelling, with a median onset of 22 days after starting the medication.
- Treatment typically involved stopping the ICI and administering systemic steroids, with most patients experiencing moderate severity and no fatalities linked to DRESS; however, a consensus on the best management practices is still needed.
Because of an increased risk of local recurrence following surgical treatment of lentigo maligna (melanoma) (LM/LMM), the optimal surgical technique is still a matter of debate. We aimed to evaluate the effect of different surgical techniques and reflectance confocal microscopy (RCM) on local recurrence and survival outcomes. We searched MEDLINE, Embase and PubMed databases through 20 May 2022.
View Article and Find Full Text PDFBackground: Knowledge about lentigo maligna (melanoma) (LM/LMM) and its associated prognostic clinicopathological characteristics are limited compared to that of non-LM/LMM subtypes. The current study aimed to determine the clinical relevance of the LM/LMM subtype and its influence on recurrence and survival outcomes.
Methods: All consecutive cases of primary cutaneous head and neck LM/LMM treated by wide local excision over a ten-year period were retrospectively reviewed and compared to non-LM/LMM.
Article Synopsis
- - This study analyzed severe blistering skin reactions caused by immune checkpoint inhibitors (ICI) in 32 patients, emphasizing that such reactions, although rare, can be life-threatening and are often misdiagnosed as epidermal necrolysis (EN).
- - The research found that symptoms like fever, ocular involvement, and extensive skin detachment were more common in patients diagnosed with EN compared to those with lichenoid dermatosis (LD) or unclassified dermatosis (UD), highlighting the need for careful diagnostic review.
- - Treatment usually involved corticosteroids, and 25% of patients died during the acute phase; however, most did not restart the ICI, suggesting a potential issue with management approaches that need further consensus and clarity
Article Synopsis
- - The study investigates the relationship between surgical methods (Mohs micrographic surgery vs. wide local excision) and outcomes (recurrence and survival) for Merkel cell carcinoma treatment.
- - A comprehensive literature search resulted in the inclusion of 19 case series and 12 cohort studies, concluding that there are no significant differences in outcomes between the two surgical options or different excision margins.
- - Ultimately, the findings suggest that both surgical approaches have similar recurrence and survival rates for Merkel cell carcinoma, indicating that the choice of method may not impact patient outcomes.
Background: The surgical treatment of lentigo maligna melanoma is associated with high rates of local recurrence. Handheld reflectance confocal microscopy (HH-RCM) allows for in vivo presurgical detection of subclinical lentigo maligna (melanoma) (LM/LMM).
Methods: A single-center retrospective study from December 2015 to July 2017.
Background: Reflectance confocal microscopy (RCM) is a noninvasive method for skin assessment, allowing entire lesion evaluation up to the papillary dermis. RCM is a potentially attractive alternative to punch biopsy (PB) in basal cell carcinoma (BCC).
Objectives: To determine the diagnostic accuracy of RCM vs.
Improvements in systemic cancer treatments have resulted in more patients surviving for prolonged periods of time on treatment. This has made treatment-related toxicity and quality of life concerns increasingly relevant. Hand-foot syndrome (HFS) is a common skin reaction to systemic therapy that should be anticipated with chemotherapeutic treatments such as pegylated liposomal doxorubicin, docetaxel, and fluoropyrimidines.
View Article and Find Full Text PDFThe European Academy of Facial Plastic Surgery celebrates its 40th anniversary. We aimed to describe innovations in the diagnostics and treatment in head and neck skin cancer over the past 40 years as well as future perspectives. Landmark events, developments, and highlights over the past decades for basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma are discussed.
View Article and Find Full Text PDFBackground: Reflectance confocal microscopy (RCM) imaging can be used to diagnose and subtype basal cell carcinoma (BCC) but relies on individual morphologic pattern recognition that might vary among users.
Objectives: We assessed the inter-rater and intrarater agreement of RCM in correctly diagnosing and subtyping BCC.
Methods: In this prospective study, we evaluated the inter-rater and intrarater agreement of RCM on BCC presence and subtype among three raters with varying experience who independently assessed static images of 48 RCM cases twice with four-week interval (T1 and T2).
Background: Routine punch biopsies are considered to be standard care for diagnosing and subtyping basal cell carcinoma (BCC) when clinically suspected.
Objectives: We assessed the efficacy of a one-stop-shop concept using in vivo reflectance confocal microscopy (RCM) imaging as a diagnostic tool vs. standard care for surgical treatment in patients with clinically suspected BCC.
Diagnostic accuracy of confocal microscopy imaging vs. punch biopsy for diagnosing and subtyping basal cell carcinoma.
J Eur Acad Dermatol Venereol
October 2017
Background: In vivo reflectance confocal microscopy (RCM) is a promising non-invasive skin imaging technique that could facilitate early diagnosis of basal cell carcinoma (BCC) instead of routine punch biopsies. However, the clinical value and utility of RCM vs. a punch biopsy in diagnosing and subtyping BCC is unknown.
View Article and Find Full Text PDFBackground: Basal cell carcinoma (BCC) is the most common cancer diagnosed in white populations worldwide. The rising incidence of BCC is becoming a major worldwide public health problem. Therefore, there is a need for more efficient management.
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