Circulating Tumor DNA as a Marker for Treatment Response in Metastatic Melanoma Patients Using Next-Generation Sequencing-A Prospective Feasibility Study.

We prospectively performed a longitudinal analysis of circulating tumor DNA (ctDNA) from 149 plasma samples and CT scans in Stage III and IV metastatic melanoma patients ( = 20) treated with targeted agents or immunotherapy using two custom next-generation sequencing (NGS) Ion AmpliSeq™ HD panels including 60 and 81 amplicons in 18 genes, respectively. Concordance of matching cancer-associated mutations in tissue and plasma was 73.3%.

Patients with BRAF-Mutant Advanced/Metastatic Melanoma: Original Research on the Treatment Reality in Germany and Austria in the Era of Choice.

Introduction: Cutaneous melanoma is one of the most aggressive forms of skin neoplasms and represents a major cause of neoplastic or cancer death in Europe. Without adequate therapy, the 5-year survival rate is 15% when the disease metastasizes to distant organs. The objective of our study was to evaluate the status quo of the current treatment standards in stage IV melanoma and rationale for therapy decisions in Germany and Austria between January 2016 and September 2018.

Intravitreal Steroid Treatment for Uveitis Associated with Dabrafenib and Trametinib for Metastatic Cutaneous Melanoma.

: To report a case of bilateral retinal inflammation under long-term therapy with dabrafenib/trametinib for metastatic cutaneous melanoma.: Retrospective chart review.: A 59-year-old patient with metastatic cutaneous melanoma diagnosed in 2004 under treatment with dabrafenib/trametinib since 2014 presented to our department with intraretinal hemorrhage and extrafoveal macula edema on the right eye and optic disc swelling on the left eye.

Treatment of Primary and Metastatic Multifocal Mucosal Melanoma of the Oral Cavity with Imatinib.

Background: Mucosal melanoma of the oral cavity is a rare entity and accounts for less than 1-3% of all melanomas. Contrary to cutaneous melanoma, primary oral melanoma more commonly harbors mutations in c-KIT.

Methods: A 64-year-old man presented with asymptomatic, multiple, brown-to-black macules in the oral cavity.

Tumor-associated B cells in cutaneous primary melanoma and improved clinical outcome.

B cells often infiltrate the microenvironment of human tumors. B cells can both positively and negatively regulate antitumor immune responses. In several human cancers, higher numbers of CD20(+) TAB are associated with a favorable prognosis, whereas in human primary melanomas, this association is contentious.

Hemophagocytosis in Cutaneous Autoimmune Disease.

Background: The significance of the histological visualization of hemophagocytosis in tissues depends on the context, varying from a nonspecific phenomenon to a characteristic or diagnostic feature for certain disease entities. Hemophagocytosis is also one of the key features of macrophage activation syndrome (MAS) (hemophagocytic syndrome) a potentially life-threatening complication of underlying conditions such as infections, malignancy, and autoimmune disorders. Clinical manifestations of MAS are high fever, pancytopenia, liver dysfunction, and coagulopathy.

Dermoscopy of pigmented lesions of the mucosa and the mucocutaneous junction: results of a multicenter study by the International Dermoscopy Society (IDS).

Objective: To better characterize the dermoscopic patterns of mucosal lesions in relation to the histopathologic characteristics.

Design: Retrospective and observational study.

Setting: Fourteen referral pigmented lesion clinics in 10 countries.

Ancient melanocytic nevus: a simulator of malignant melanoma.

Ancient melanocytic nevus (AN) is an unusual but distinctive melanocytic neoplasm within the spectrum of simulators of malignant melanoma. This report describes 13 patients with AN where a long follow-up information was available. Histopathology is characterized by 2 populations of melanocytes, namely, one with large pleomorphic cells and the other with small melanocytes.

Joy for morphology: dermatopathology and art.

This work displays the bridging of two fields - namely dermatopathology and art. What is astonishing is that structures one sees through the microscope reveal aesthetic and artistic aspects and sometimes resemble in a startling way the designs of certain artists. Specific examples are illustrated to enhance the joy and appreciation of morphologic images.

Collision tumors: CAMEL, METRO and other acronyms.

We describe two exceptional collision tumors, namely: a 63-year-old woman revealing a melanocytic tumor within a trichoblastoma and a 71-year-old woman with a squamous cell carcinoma colonized by dendritic cells of a melanoma. Both neoplasms showed two different tumor components with intimate relationship. The lesions are labeled in a "playful" way with the acronyms METRO (MElanocytic tumor +TRichOblastoma) and CAMEL (CArcinoma +MELanoma) to facilitate memorization.

Parapsoriasis lichenoides/parapsoriasis variegata--a new concept.

We present a new concept on the nosology of parapsoriasis lichenoides (= parakeratosis variegata) and show that this parapsoriasis type is not a separate entity. It represents different diseases: a large number of cases presenting as reticular parapsoriasis are mycosis fungoides, another group represents reticular variants of the parapsoriasis guttata group (pityriasis lichenoides acuta et chronica). Further, cases exist that can be classified as lichen planus reticularis or other diseases (e.

Drug reactions - new observations.

This Macro-Micro-Dermatology-contribution with the theme innovative drugs and drug reactions illustrates two new observations of practical interest: 1. Follicular eruption after Everolimus and 2. Atrophy of sebaceous glands after Sirolimus.

Dermoscopy patterns of halo nevi.

Background: Halo nevi (HN) are benign melanocytic nevi surrounded by a depigmented area (halo). This study aims to evaluate the dermoscopic features of HN and their changes during digital dermoscopic follow-up and to investigate the frequency of the halo phenomenon in a series of melanomas.

Observations: In a retrospective study, digital dermoscopic images of HN from patients who attended the Pigmented Skin Lesions Clinic of the Department of Dermatology, Medical University of Graz, between October 1, 1997, and March 31, 2004, were reviewed and classified by dermoscopic morphologic criteria.

Prospective, randomized, multicenter, double-blind placebo-controlled trial comparing adjuvant interferon alfa and isotretinoin with interferon alfa alone in stage IIA and IIB melanoma: European Cooperative Adjuvant Melanoma Treatment Study Group.

Purpose: The combination of interferon alfa (IFNalpha) and isotretinoin has shown a direct antiproliferative effect on human melanoma cell lines, but it remained unclear whether this combination is more effective than IFNalpha alone in patients with metastatic melanoma. We evaluated safety and efficacy of IFNalpha and isotretinoin compared with IFNalpha alone as adjuvant treatment in patients with primary malignant melanoma stage IIA and IIB.

Patients And Methods: In a prospective, randomized, double-blind, placebo-controlled trial, 407 melanoma patients in stage IIA (301 patients) and IIB (106 patients) were randomly assigned to either IFNalpha and isotretinoin (isotretinoin group; 206 patients) or IFNalpha and placebo (placebo group; 201 patients) after excision of the primary tumor.

Treatment of primary cutaneous B-cell lymphoma with rituximab.

Background: Rituximab is a genetically engineered antibody directed against the CD20 antigen. Intravenous administration of rituximab has been used for the treatment of patients with low-, intermediate-, and high-grade B-cell non-Hodgkin's lymphomas and is a registered treatment modality for this indication. Treatment of primary cutaneous B-cell lymphoma (CBCL) with intralesionally or systemically administered rituximab has been described only in a few cases.

Treatment of lentigo maligna (melanoma in situ) with the immune response modifier imiquimod.

Background: Surgical excision is the treatment of choice for lentigo maligna (LM), or melanoma in situ. Topical application of imiquimod, a local immune response modifier, is a novel therapeutic approach that leads to LM tumor clearance. This pilot, open-label, nonrandomized study evaluates the efficacy of imiquimod in patients with LM and other systemic problems that make them poor surgical risks.

Erythroderma with lichenoid granulomatous features induced by erythropoietin.

The increasing use of new drugs in cancer therapy, especially growth factors, hormones, and chemotherapies resulted in several reports of unusual skin eruptions. We studied a patient with erythroderma who had received erythropoietin because of myeloma with tumor anemia. The histological features were characterized by a lichenoid, focally granulomatous infiltrate with predominance of histiocytes.

Diagnosis and categorization of acral melanocytic lesions using teledermoscopy.

We performed a multicentre study to test the validity of teledermoscopy for diagnosing acral melanoma and to evaluate inter-observer agreement on the classification of acral melanocytic lesions. Dermoscopic images of 77 acral melanocytic lesions (71 common melanocytic naevi and 6 melanomas) were sent by email to 11 dermatologists with different degrees of experience in dermoscopy. The observers analysed the images on a computer monitor to diagnose acral melanoma or atypical lesions and to categorize all lesions.

Locoregional cutaneous metastases of malignant melanoma and their management.

The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery.

Dermoscopy of pigmented skin lesions: results of a consensus meeting via the Internet.

Background: There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions.

Objective: The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms.

Methods: Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experienced dermoscopists using a 2-step diagnostic procedure.