Actinic keratosis (AK) is a precursor to invasive squamous cell carcinoma, making early diagnosis and treatment essential to prevent progression. Among available therapeutic options, nicotinamide (NAM) has shown potential in reducing AK progression. NAM is a precursor of nicotinamide adenine dinucleotide (NAD), which activates sirtuin (SIRT)1, a protein with anti-cancer properties.
View Article and Find Full Text PDFPsoriasis is a multifactorial immune-mediated disorder linked to the interleukin (IL)-17 signalling pathway. We present an unusual case of and caused by that developed after starting the IL-17A/F inhibitor bimekizumab. Our case underlines how psoriatic patients, treated with IL-17 inhibitors, should be screened for cutaneous fungal infections before and during treatment, in order to exclude a concomitant infection or the risk of its exacerbation.
View Article and Find Full Text PDF(1) Background/Objectives: Nail psoriasis (NP) is a chronic and difficult-to-treat disease, which causes significant social stigma and impairs the patients' quality of life. Moreover, nail psoriasis is a true therapeutic challenge for clinicians. The presence of nail psoriasis can be part of a severe form of psoriasis and can have predictive value for the development of psoriatic arthritis.
View Article and Find Full Text PDFPsoriasis (PsO) is a chronic inflammatory dermatosis that often presents with erythematous, sharply demarcated lesions. Although psoriasis is primarily a dermatological disease, its immune-mediated pathogenesis produces systemic effects and is closely associated with various comorbid conditions such as cardiovascular disease (CVD), metabolic syndrome (MetS), and diabetes mellitus type II (DMII). Apremilast, an oral phosphodiesterase 4 (PDE-4) inhibitor, has shown promise in treating moderate-to-severe psoriasis and is associated with potential cardiometabolic benefits.
View Article and Find Full Text PDFBackground: The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion.
Aims: We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities.
(1) Objective: Keloid and hypertrophic scars are a challenge in clinical management, causing functional and psychological discomfort. These pathological scars are caused by a proliferation of dermal tissue following skin injury. The TGF-β/Smad signal pathway in the fibroblasts and myofibroblasts is involved in the scarring process of skin fibrosis.
View Article and Find Full Text PDFTildrakizumab, an IL-23 inhibitor, is effective and safe for the improvement of moderate-to-severe chronic plaque psoriasis. However, little evidence is available on the use of this biologic in psoriasis in difficult-to-treat locations. In this retrospective analysis, we treated patients with 100 mg tildrakizumab at Day 0, after 4 weeks and every 12 weeks thereafter.
View Article and Find Full Text PDFNew biologic agents targeting interleukin (IL)23/T-helper17 axis, such as tildrakizumab, have been developed for the treatment of plaque psoriasis. To analyze the efficacy and safety of tildrakizumab in a real life setting of patients affected by moderate-to-severe psoriasis over a 28-week treatment period. A multicentric retrospective study was conducted in patients who initiated tildrakizumab between February 2020 and March 2021.
View Article and Find Full Text PDFPurpose: The study sought to examine the association between clinical image quality of mammograms and screening sensitivity.
Methods: Four radiologists evaluated the clinical image quality of 374 invasive screen-detected cancers and 356 invasive interval breast cancers for which quality evaluation of screening mammograms could be assessed from cancers diagnosed among participants in the Quebec Breast Cancer Screening Program in 2007. Quality evaluation was based on the Canadian Association of Radiologists accreditation criteria, which are similar to those of the American College of Radiology.
Most studies that have examined the effects of mammographic density and hormone therapy use on breast cancer detection have included screen-film mammography. This study further examines this association in post-menopausal women screened by digital mammography. Approved by the University of Toronto Research Ethics Board, this study identified 688,418 women of age 50-74 years screened with digital or screen-film mammography from 2008 to 2009 within the Ontario Breast Screening Program.
View Article and Find Full Text PDFPurpose: To compare measures of diagnostic accuracy between large concurrent cohorts of women screened with digital computed radiography (CR), direct radiography (DR), and screen-film mammography (SFM).
Materials And Methods: This study was approved by the University of Toronto Research Ethics Board; informed consent was not required. Three concurrent cohorts of women aged 50-74 years who were screened from 2008-2009 in the Ontario Breast Screening Program with SFM (487,334 screening examinations, 403,688 women), DR (254,758 screening examinations, 220,520 women), or CR (74,140 screening examinations, 64,210 women) were followed for 2 years or until breast cancer diagnosis.
Our previous study found cancer detection rates were equivalent for direct radiography compared to screen-film mammography, while rates for computed radiography were significantly lower. This study compares prognostic features of invasive breast cancers by type of mammography. Approved by the University of Toronto Research Ethics Board, this study identified invasive breast cancers diagnosed among concurrent cohorts of women aged 50-74 screened by direct radiography, computed radiography, or screen-film mammography from January 1, 2008 to December 31, 2009.
View Article and Find Full Text PDFObjective: To assess the quality of screening mammograms performed in daily practice in the Quebec Breast Cancer Screening Program.
Subjects And Methods: Clinical image quality of a random subsample of 197 screening mammograms performed in 2004-2005 was independently evaluated by 2 radiologists based on the criteria by Canadian Association of Radiologists (CAR). When disagreement occurred for overall judgement or positioning score, the mammograms were reviewed by a third radiologist.
Purpose: The Ontario Breast Screening Program expanded in July 2011 to screen women age 30 to 69 years at high risk for breast cancer with annual magnetic resonance imaging (MRI) and digital mammography. To the best of our knowledge, this is the first organized screening program for women at high risk for breast cancer.
Patients And Methods: Performance measures after assessment were compared with screening results for 2,207 women with initial screening examinations.
Introduction: Although prognostic differences between screen-detected, interval and symptomatic breast cancers are known, factors associated with wait times to diagnosis among these three groups have not been studied.
Methods: Of the 16,373 invasive breast cancers diagnosed between January 1, 1995 and December 31, 2003 in a cohort of Ontario women aged 50 to 69, a random sample (N = 2,615) were selected for chart abstraction. Eligible women were classified according to detection method; screen-detected (n = 1181), interval (n = 319) or symptomatic (n = 406).
Background: Longer times from diagnosis to breast cancer treatment are associated with poorer prognosis. This study examined factors associated with wait times by phase in the breast cancer treatment pathway.
Methods: There were 1760 women eligible for the study, aged 50-69 diagnosed in Ontario with invasive breast cancer from 1995-2003.
Purpose: To evaluate the performance of digital direct radiography (DR) and computed radiography (CR) compared with that of screen-film mammography (SFM) in large concurrent cohorts.
Materials And Methods: This study was approved by the University of Toronto Research Ethics Board and did not require informed consent. Concurrent cohorts of women aged 50-74 years screened with DR (n = 220 520), CR (n = 64 210), or SFM (n = 403 688) between 2008 and 2009 were identified and followed for 12 months.
Purpose: Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs.
Methods: Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment.
Background: The addition of breast magnetic resonance imaging (MRI) to screening mammography for women with BRCA mutations significantly increases sensitivity, but there is little data on clinical outcomes. We report screening performance, cancer stage, distant recurrence rate, and breast cancer-specific mortality in our screening study.
Methods: From 1997 to 2009, 496 women aged 25 to 65 years with a known BRCA1/2 mutation, of whom 380 had no previous cancer history, were enrolled in a prospective screening trial that included annual MRI and mammography.
Most studies reporting more favourable biological features of screen-detected breast cancers compared with symptomatic or interval cancers include initial or prevalent screens and therefore may not indicate the real benefit of screening on breast cancer mortality. We conducted case-case comparisons within a cohort of eligible women (N=771 715) who were aged 50-69 between 1 January 1995 and 31 December 2003. A randomly selected sample of breast cancers (N=1848) diagnosed among these women were compared by detection method.
View Article and Find Full Text PDFBackground: Few studies have compared the prognostic value of tumor characteristics by type of breast cancer diagnosed in the interval between mammographic screenings with screen-detected breast cancers.
Methods: We conducted a case-case study within the cohort of women (n = 431 480) in the Ontario Breast Screening Program who were aged 50 years and older and were screened between January 1, 1994, and December 31, 2002. Interval cancers, defined as breast cancers diagnosed within 24 months after a negative screening mammogram, were designated as true interval cancers (n = 288) or missed interval cancers (n = 87) if they were not identified at the time of screening but were identified in retrospect.
Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast density or the use of HT among screening participants. This may affect the ability of programs to assess their effectiveness in reducing breast cancer mortality.
View Article and Find Full Text PDFCancer Epidemiol Biomarkers Prev
March 2010
Background: Evidence from breast screening trials has shown that a significant reduction in breast cancer mortality from screening can be achieved by regular attendance. Few studies have evaluated the influence of nurses on compliance with breast screening recommendations.
Methods: The cohort included 157,788 women ages 50 to 69 years who were screened at 1 of 9 regional cancer centers or 57 affiliated centers with nurses or 26 affiliated centers without nurses between January 1, 2002, and December 31, 2002, within the Ontario Breast Screening Program.