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Disparities in Skin Cancer Outcomes in the Latine/Hispanic Population.

Cutis

November 2024

Dr. Valencia is from the Department of Internal Medicine, John Hopkins Bayview Medical Center, Baltimore, Maryland. Fabiola Ramirez is from the Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso. Claudia Dubocq-Ortiz is from the University of Puerto Rico School of Medicine, Medical School Campus, San Juan. Dr. Vasquez is from the Department of Dermatology, UT Southwestern Medical Center, Dallas.

Despite having an overall lower lifetime risk for skin cancer, Latine/Hispanic individuals experience increased morbidity and mortality in skin cancer outcomes compared to non-Hispanic White individuals. The reasons for these disparate outcomes are multifactorial, but challenges in early skin cancer detection, limited awareness of risks, and inequitable access to care and/or treatment among this patient population likely are contributory. In this article, we review cutaneous malignancies in the Latine/Hispanic population and explore factors that impact overall prognosis, including unique clinical features, inadequate health coverage, medical mistrust, language barriers, differing cultural perspectives, and inadequate research.

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Conventionally, the size, shape, and biomechanics of cartilages are determined by their voluminous extracellular matrix. By contrast, we found that multiple murine cartilages consist of lipid-filled cells called lipochondrocytes. Despite resembling adipocytes, lipochondrocytes were molecularly distinct and produced lipids exclusively through de novo lipogenesis.

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Objectives: This work highlights the methods used to develop a multi-pulse 1726 nm laser system combined with bulk air-cooling for selective sebaceous gland (SG) photothermolysis using thermal imaging and software algorithms. This approach enables treating to a desired tissue temperature and depth to provide a safe, effective, reproducible, and durable treatment of acne.

Methods: We designed and built a 1726 nm laser system with a 40 W maximum power output, a highly controlled air-cooling device, and a thermal camera in the handpiece, which permits real-time temperature monitoring of the epidermis.

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The TRIPOD-LLM reporting guideline for studies using large language models.

Nat Med

January 2025

Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA.

Large language models (LLMs) are rapidly being adopted in healthcare, necessitating standardized reporting guidelines. We present transparent reporting of a multivariable model for individual prognosis or diagnosis (TRIPOD)-LLM, an extension of the TRIPOD + artificial intelligence statement, addressing the unique challenges of LLMs in biomedical applications. TRIPOD-LLM provides a comprehensive checklist of 19 main items and 50 subitems, covering key aspects from title to discussion.

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Objectives: Multiplex immunohistochemistry and immunofluorescence (mIHC/IF) are emerging technologies that can be used to help define complex immunophenotypes in tissue, quantify immune cell subsets, and assess the spatial arrangement of marker expression. mIHC/IF assays require concerted efforts to optimize and validate the multiplex staining protocols prior to their application on slides. The best practice guidelines for staining and validation of mIHC/IF assays across platforms were previously published by this task force.

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Local flap guidance for scalp reconstruction following Mohs micrographic surgery.

Arch Dermatol Res

January 2025

Department of Dermatology, University of Texas Medical Branch, 301 University Boulevard, 4.112, McCullough Building, Galveston, TX, 77555, USA.

Keratinocyte carcinomas (KCs) are commonly located on the scalp and often treated with excision with peripheral and deep en face margin assessment (PDEMA), with Mohs micrographic surgery (MMS) being the most frequently used method. Resection of these malignancies results in wounds with a wide variety of sizes, ranging from small, sub-centimeter defects, to extensive, nearly complete scalp defects. MMS is often the preferred treatment for tumor resection and margin clearance, as it allows for maximal healthy tissue preservation and has the lowest recurrence rates.

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Background: Radiofrequency microneedling (RFM) is a potential treatment for primary hyperhidrosis. However, its efficacy is unclear, and treatment parameters and outcomes vary across studies.

Objective: To understand the effect of RFM on treating primary hyperhidrosis, as measured by changes in the Hyperhidrosis Disease Severity Score (HDSS) before and after treatment, and to clearly define treatment settings most likely to optimize results.

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Google Trends and Syphilis.

J Clin Aesthet Dermatol

December 2024

Dr. Rosen and Ms. Terrell are with the Dermatology Department, School of Medicine at Baylor College of Medicine in Houston, Texas.

Article Synopsis
  • The study investigates the connection between syphilis incidence rates reported by the CDC and the public's interest in syphilis as indicated by Google search trends from 2013 to 2023.
  • There was a significant 37.65% increase in yearly searches for syphilis terms, with the most considerable spike occurring between 2021 and 2022.
  • The research highlights regional disparities in awareness and education about syphilis, with states like Mississippi and Texas showing high search interest correlating with their incidence rates, while acknowledging limitations in data collection and internet access.
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Background: Digital papillary adenocarcinoma (DPAC) is a rare but aggressive cutaneous malignant sweat gland neoplasm that occurs on acral sites. Despite its clinical significance, the cellular and genetic characteristics of DPAC remain incompletely understood.

Methods: We conducted a comprehensive genomic and transcriptomic analysis of DPAC (n = 14) using targeted next-generation DNA and RNA sequencing, along with gene expression profiling employing the Nanostring Technologies nCounter IO 360 Panel.

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Pemetrexed is a chemotherapeutic, antimetabolite agent that has been used in oncology to treat diseases such as metastatic non-small cell lung cancer and unresectable malignant pleural mesothelioma. Pemetrexed use may result in pseudocellulitis, which presents as poorly demarcated patches or plaques with erythema, edema, warmth, and tenderness. These lesions can present unilaterally or bilaterally on the lower extremities.

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Neutrophilic Panniculitis Secondary to BRAF and MEK Inhibitor Therapy to Treat Stage IIIa Cutaneous Melanoma.

J Cutan Pathol

January 2025

Department of Dermatology, San Antonio Uniformed Services Health Consortium (SAUSHEC), San Antonio, Texas, USA.

Panniculitides are a group of inflammatory disorders of the subcutaneous fat that have been reported as a rare complication of both a serine threonine kinase BRAF inhibitor monotherapy and BRAF inhibition in combination with a mitogen activated protein kinase (MEK) inhibitor combination therapy used to treat metastatic melanoma. The cutaneous manifestations of BRAF and BRAF/MEK therapies have been well documented, but neutrophilic panniculitis remains a less common complication with fewer case reports. Physician awareness of this complication when following patients on similar targeted therapies can decrease delays in appropriate management.

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Article Synopsis
  • CheckMate 204 study found that the combination of nivolumab and ipilimumab resulted in high intracranial objective response rates (icORRs) for patients with melanoma brain metastases (MBMs), prompting a need for standardized response criteria.
  • Different assessment criteria (like mRECIST and volumetric measurements) showed higher icORRs and stronger correlations with progression-free survival (icPFS) and overall survival (OS) compared to RANO-BM and RECIST.
  • The analysis suggests that mRECIST and volumetric criteria are reliable scales for future MBM trials, and response can be effectively measured even in patients with small lesions (<10 mm).
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The term autoinflammatory keratinization diseases (AIKDs) was recently proposed as a unifying concept for diseases characterized by inflammation in the epidermis and upper dermis which leads to hyperkeratosis, caused by genetic perturbations of the innate immune system. We present a case of a patient with hidradenitis suppurativa and porokeratosis, two AIKDs, followed by a review of these conditions as well as other AIKDs. This case was distinguished by hypertrophic porokeratoses involving cystic hair follicles, showing histopathologic features of both conditions within single biopsy specimens.

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Filsuvez (birch triterpenes) topical gel received approval in 2023 for the treatment of epidermolysis bullosa (EB) in pediatric patients (aged ≥6 months) and adults. It promotes wound healing by modulating inflammation, encouraging new tissue formation, and maintaining the skin barrier. In a randomized, double-blind, controlled, parallel-group, phase III trial (EASE, NCT03068780), 223 patients were randomly assigned to two groups: the first group received treatment with birch triterpenes topical gel (study gel, n = 109), and the second group received treatment with vehicle gel (n = 114).

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Zelsuvmi (berdazimer) topical gel has been approved recently for the treatment of molluscum contagiosum (MC) in patients aged ≥1 year. In three phase 3, randomized, double-blind, vehicle-controlled trials of similar design, berdazimer was investigated for the treatment of MC. Berdazimer or vehicle was applied once daily on MC lesions until complete lesion clearance was observed or for up to 12 weeks.

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Autoimmune diseases often exhibit a preclinical stage before diagnosis. Electronic health record (EHR) based-biobanks contain genetic data and diagnostic information, which can identify preclinical individuals at risk for progression. Biobanks typically have small numbers of cases, which are not sufficient to construct accurate polygenic risk scores (PRS).

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αβT cells protect vertebrates against many diseases, optimizing surveillance using mechanical force to distinguish between pathophysiologic cellular alterations and normal self-constituents. The multi-subunit αβT-cell receptor (TCR) operates outside of thermal equilibrium, harvesting energy via physical forces generated by T-cell motility and actin-myosin machinery. When a peptide-bound major histocompatibility complex molecule (pMHC) on an antigen presenting cell is ligated, the αβTCR on the T cell leverages force to form a catch bond, prolonging bond lifetime, and enhancing antigen discrimination.

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Introduction: Primary care providers or clinicians (PCPs) have the potential to assist dermatologists in screening patients at risk for skin cancer, but require training to appropriately identify higher-risk patients, perform skin checks, recognize and biopsy concerning lesions, interpret pathology results, document the exam, and bill for the service. Very few validated dermatology training programs exist for PCPs and those that are available focus primarily on one emphasis area, which results in variable efficacy and single-topic limited scope.

Methods: We have created a free, online, continuing education program (Melanoma Toolkit for Early Detection, MTED) that allows learners to choose from a variety of multimedia tools (image recognition, videos, written material, in-person seminars, self-tests, etc.

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