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Owing to the lack of awareness, this clinical presentation is often mistaken for other follicular dermatoses, including bacterial folliculitis, pityriasis rubra pilaris, keratosis pilaris, or follicular eczema.Leukemia cutis (LC) is a dermatologic manifestation of leukemia. Its clinical implications for the patient and the biological mechanism behind the manifestation of LC are unknown. The oncology community is increasingly utilizing mutations to classify a number of malignancies to prognosticate outcomes and to choose targeted therapies. A single-center, retrospective analysis of dermatopathology cases with a diagnosis of leukemia cutis was performed. Patients with genetic testing using the Columbia Combined Cancer Panel (a targeted sequencing protocol of 467 genes) or Genoptix (targeted sequencing protocol of 44 genes) were identified. The frequency of the presence of genetic mutations in LC patients was compared to AML patients from the COSMIC (Catalogue of Somatic Mutations in Cancer) database. Twenty nine cases were confirmed to have leukemia cutis, 22 of which had acute myeloid leukemia (AML). Genetic testing was available in 11 patients. Twelve different mutations were observed with particular enrichment for NPM1 and FLT3-TKD. Our original hypothesis was that patients with LC would display a distinct mutation profile. Ultimately, the distribution of mutations observed in our cohort of LC patients largely reflects the mutational profile seen in AML patients in general.Melanoma is responsible for nearly 9,000 deaths each year in the United States. Until the early 2000s, chemotherapeutic agents were the mainstay of treatment for metastatic disease. Currently approved treatments include therapies that block signal transduction pathways (BRAF inhibition), increase anti-tumor immune responses (CTLA-4 blockade), or stimulate tumor-infiltrating T cells (IL2). In recent years, various new strategies have emerged. Radiation therapy has been widely underutilized, but it can prime tumor cells that are distant from the field of radiation, a phenomenon termed the abscopal effect. Other therapies such as pembrolizumab disrupt the tumor cells’ typical mechanisms of T-cell avoidance. Various other treatments involving imiquimod, adoptive T-cell therapy, and vaccines are currently being studied and can play a role in metastatic melanoma treatment in the future. Herein, we review the past treatment modalities, currently approved treatments, and potentially effective options for the future. We also provide strengths of recommendation and level of evidence for each treatment.

There are no definite guidelines for the management of gastric lesions diagnosed as indefinite for dysplasia (IND) by endoscopic forceps biopsy (EFB). Therefore, this study aimed to evaluate the clinical outcomes of gastric IND and predictive factors for gastric neoplasm.

This study included 457 patients with a first diagnosis of gastric IND by EFB between January 2005 and December 2013. Patient characteristics and endoscopic and pathological data were reviewed and compared.

Of the 457 gastric IND patients, 128 (28%) were diagnosed with invasive carcinoma, 21 (4.6%) with high-grade dysplasia, 31 (6.8%) with low-grade dysplasia, and 277 (60.6%) as negative for dysplasia. Of lesions observed, 180 (39.4%) showed upgraded histology. Multivariate analysis revealed that surface erythema (odds ratio [OR], 2.804; 95% confidence interval [CI], 1.741 to 4.516), spontaneous bleeding (OR, 2.618; 95% CI, 1.298 to 5.279), lesion size ≥ 1 cm (OR, 5.762; 95% CI, 3.459 to 9.597), and depressed morphology (OR, 2.183; 95% IND patient has at two or more of these factors.The cephalic index (CI) is used in the evaluation of individuals with craniosynostosis. There is little agreement as to the normal range and stability of the CI during the fetal period, partly due to limited literature. We sought to determine the range, distribution and stability of the fetal CI in the second half of pregnancy. We also aimed to identify any relationship to delivery complications such as obstructed labor and malpresentation.The fetal head circumference, biparietal diameter (BPD) and occipitofrontal diameter (OFD) measurements were obtained from standard ultrasound images. Each of 4304 fetuses had measurements taken at morphology scan performed between 17 and 22 weeks’ gestation, and at growth scanning at 28 to 33 weeks’ gestation. The cephalic index was calculated using the formula CI = BPD/OFD × 100. The distribution of the CI at both scans is very close to a normal distribution. The mean CI at 17 to 22 weeks was 75.9 (SD, 3.7); the mean CI at 28 to 33 weeks was 77.8 (SD, 3.5). The mean change in CI was 1.9 (SD, 4.28), which is not statistically significantly different from zero (t = 0.656, P = 0.512, 95% confidence interval). No relationship was found between the CI in normal fetuses and delivery complications. There is a wide variation in the change in CI in the third trimester. A value below the normal range in the third trimester or a progressive reduction in CI during the latter half of pregnancy should provoke detailed scanning of the fetal cranial sutures to check for craniosynostosis.We report a case of anti-protein death 1-induced sarcoid-like reaction in a 63-year-old Caucasian male who was diagnosed with stage IV-M1a melanoma. He was initially treated with pembrolizumab monotherapy (Q3W) and had a complete response after 14 cycles. However, relapse was suspected 3 months later with appearance of hilar, mediastinal and hepatic hilar lymph nodes as well as a skin lesion. Biopsy of both the hilar lymph nodes and the skin lesion demonstrated sarcomatoid granulomatosis. Pembrolizumab was discontinued temporarily. While on F-FDG-PET/CT, all sarcoid-like lesions regressed in size and activity, a new hypermetabolic solitary skeletal lesion was detected in a lumbar vertebra, suspicious for metastasis. However, since the patient was asymptomatic, a watchful-waiting attitude was taken. During this period, a spontaneous and complete resolution of the metabolic activity was observed of the skeletal lesion. click here Until today, the patient remains in complete remission. Current case presents an atypical presentation and evolution of anti-PD-1-induced sarcoid-like reaction, illustrating the difficulty of differentiating it from disease progression.