scholarly journals An evaluation of the treatment of parapsoriasis with phototherapy

2013 ◽  
Vol 88 (2) ◽  
pp. 306-308 ◽  
Author(s):  
Ida Alzira Gomes Duarte ◽  
Karen Levy Korkes ◽  
Vanessa Alice M. Amorim ◽  
Clarice Kobata ◽  
Roberta Buense ◽  
...  
Keyword(s):  
T Cell ◽  
Early Stage ◽  
Cutaneous Lymphoma ◽  
General Tendency ◽  
Cure Rate ◽  
High Cure ◽  
The Subject ◽  
Cure Rates

Whether parapsoriasis represents an early stage of T-cell cutaneous lymphoma is still the subject of controversy. We evaluated the efficacy of phototherapy in the treatment of parapsoriasis and its relation with TCCL. Patients diagnosed with parapsoriasis and treated with phototherapy PUVA or UVB-NB were selected. Between 1 to 8 years following treatment the evolution of their disease was evaluated. In 62 patients the cure rate was 79.3% and 17.2% showed improvement of the lesions. Only two patients developed full blown T-cell cutaneous lymphoma. Phototherapy is an excellent treatment for parapsoriasis, with high cure rates, regardless of the type of phototherapy employed. Of the 62 patients under study, parapsoriasis showed no general tendency to progress to T-cell cutaneous lymphoma.

scholarly journals Morphologic Features of Cutaneous T-Cell Lymphomas Using Dermoscopy and High Frequency Ultrasound

2020 ◽  
Vol 10 (1) ◽  
pp. 17
Author(s):  
Iris Wohlmuth-Wieser ◽  
Joel M. Ramjist ◽  
Neil Shear ◽  
Raed Alhusayen
Keyword(s):  
T Cell ◽  
High Frequency ◽  
Early Stage ◽  
Skin Lesions ◽  
Diagnostic Tools ◽  
Skin Thickness ◽  
High Frequency Ultrasound ◽  
T Cell Lymphomas ◽  
Standardized Parameters ◽  
Frequency Ultrasound

The diagnosis of cutaneous T-cell lymphomas (CTCL) is frequently delayed by a median of three years and requires the clinical evaluation of an experienced dermatologist and a confirmatory skin biopsy. Dermoscopy and high-frequency ultrasound (HFUS) represent two non-invasive diagnostic tools. While dermoscopy is inexpensive and widely used for the diagnosis of melanoma and non-melanoma skin cancers, HFUS of skin lymphomas represents a novel diagnostic approach that is not yet implemented in the routine dermatologic practice. The aim of our study was to prospectively assess skin lesions of patients with either CTCL patches or plaques with dermoscopy and HFUS and to compare the findings with atopic dermatitis (AD) and psoriasis. Thirteen patients with an established diagnosis of CTCL, psoriasis, or AD were studied: Dermoscopy features including spermatozoa-like structures and the presence of white scales could assist in differentiating between early-stage CTCL and AD. HFUS measurements of the skin thickness indicated increased epidermal-, thickness in CTCL, and psoriasis compared with AD. Our results support the use of dermoscopy as a useful tool to diagnose CTCL. HFUS could augment the dermatologic assessment, but further studies will be needed to define standardized parameters.

scholarly journals The Clinical Spectrum of Primary Cutaneous CD4+ Small/Medium-Sized Pleomorphic T-Cell Lymphoproliferative Disorder: An Updated Systematic Literature Review and Case Series

Dermatology ◽  
2020 ◽  
Vol 237 (4) ◽  
pp. 618-628
Author(s):  
Philip Surmanowicz ◽  
Sean Doherty ◽  
Arunima Sivanand ◽  
Nikoo Parvinnejad ◽  
Jean Deschenes ◽  
...  
Keyword(s):  
T Cell ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Lymphoproliferative Disorder ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Cutaneous Lymphoma ◽  
World Health ◽  
Treatment Modalities ◽  
Systemic Treatments

<b><i>Background:</i></b> Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoproliferative disorder (SMPLPD) is a provisional entity within the 2016 World Health Organization classification of primary cutaneous lymphomas. The condition is currently classified as a lymphoproliferative disorder to emphasize its benign course and discourage aggressive, systemic treatment modalities. <b><i>Objective:</i></b> To provide a relevant synthesis for the dermatological practitioner on the prevalence, presentation, and treatment of SMPLPD. <b><i>Methods:</i></b> We conducted an updated systematic literature review and a retrospective chart review of diagnosed cases of SMPLPD from 2 Canadian academic cutaneous lymphoma centers. <b><i>Results:</i></b> A total of 23 studies with 136 cases were extracted from the systematic review and 24 patients from our retrospective chart review. SMPLPD proved relatively common accounting for 12.5% of all cutaneous T-cell lymphomas encountered in our cutaneous lymphoma clinics, second in frequency only to mycosis fungoides. The typical clinical presentation was that of an older individual (median age 59 years) with an asymptomatic solitary lesion on their upper extremity. The most common clinical differentials were cutaneous lymphoid hyperplasia, basal cell carcinoma, and lymphoma unspecified. T follicular helper markers were reliably detected. The main treatment modalities were surgical excision, local radiation therapy, and topical or intralesional steroids. Cure was achieved in the vast majority of cases. <b><i>Conclusions:</i></b> SMPLPD is an underdiagnosed T-cell lymphoma with an overtly benign clinical course. The condition has an excellent prognosis and responds well to skin-directed therapies. Practitioners should be aware of this condition to avoid aggressive systemic treatments.

scholarly journals State-of-the-Art Management of Germ Cell Tumors

2018 ◽  
pp. 319-323 ◽  
Author(s):  
Darren R. Feldman
Keyword(s):  
Germ Cell ◽  
State Of The Art ◽  
Early Stage ◽  
Germ Cell Tumors ◽  
High Stakes ◽  
Inappropriate Use ◽  
Common Mistake ◽  
Relative Rarity ◽  
Cure Rates ◽  
Perfect Storm

The state of the art management of germ cell tumors (GCT) in 2018 does not include novel agents targeting genomic alterations or exciting immunologic-based approaches but rather the avoidance of pitfalls in everyday practice. The relative rarity of GCT and high curability with correct management create the "perfect storm" for high-stakes errors to occur. This review focuses on several common pitfalls that should be avoided in staging and management of early-stage and advanced GCT in order to maximize patient outcomes. A particularly frequent misstep is to base treatment decisions on pre- rather than postorchiectomy tumor markers that, depending on marker directionality, can lead to either undertreatment with potentially inferior outcomes or overtreatment with excess toxicity. Another common mistake is the failure to consider the unique ability of GCT to differentiate and the distinct biology of teratoma (chemoresistance and lack of increased glucose uptake compared with normal tissue), which exerts a pervasive influence on nonseminoma management. This may lead to inappropriate use of PET scan to evaluate the postchemotherapy residual mass and, if negative, the conclusion that surgery is not needed whereas (FDG-negative) teratoma should be removed. It could also result in administration of additional unnecessary chemotherapy to patients with marker normalization but without robust radiographic response after 3 to 4 cycles of BEP. Finally, oncologists should strive to maintain standard chemotherapy doses, not substitute carboplatin for cisplatin, and refer to expert centers when expertise (e.g., RPLND) is not available locally in order to achieve optimal cure rates in advanced disease.

Lung Resection for Multidrug-Resistant Tuberculosis

2005 ◽  
Vol 13 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Rishen Naidoo ◽  
Anu Reddi
Keyword(s):  
Lung Resection ◽  
Postoperative Mortality ◽  
Multidrug Resistant ◽  
Cure Rate ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Traditional Drug ◽  
Localized Disease ◽  
Cure Rates

The emergence of multidrug-resistant tuberculosis poses a serious challenge to traditional drug therapy. In view of the relapse rate of up to 50% following medical management, there has been renewed interest in the role of surgery for this problem. We report our experience with lung resection for this condition. Over a 5-year period, resection was performed in 23 patients who were diagnosed with multidrug resistance after completing a course of standard chemotherapy and at least 3 months of second-line therapy. Pneumonectomy was performed in 17 patients and lobectomy in 6. There was no operative or postoperative mortality. Major complications developed in 4 patients (17.4%): 2 had post-pneumonectomy empyema and 2 underwent rethoracotomy for bleeding. Ten patients were sputum positive preoperatively, and only 1 remained positive after surgery. The patients were put on appropriate chemotherapy and followed up for 18 months. The cure rate was 95.6%. Pulmonary resection can be considered as an important adjunct to medical therapy in carefully selected patients: those who have localized disease with adequate pulmonary reserve, or who have multiple previous relapses, or whose sputum remains positive after 4 to 6 months of appropriate medical treatment. Surgery offers high cure rates with acceptable morbidity and mortality.

NEUROBLASTOMA SYMPATHETICUM

PEDIATRICS ◽  
1959 ◽  
Vol 23 (6) ◽  
pp. 1179-1191
Author(s):  
Robert E. Gross ◽  
Sidney Farber ◽  
Lester W. Martin
Keyword(s):  
Surgical Removal ◽  
Total Excision ◽  
Cure Rate ◽  
X Ray ◽  
Progressive Improvement ◽  
Infancy And Childhood ◽  
Bony Metastases ◽  
The Many ◽  
Aggressive Attack ◽  
Cure Rates

The treatment of patients with neuroblastoma does not lie solely in the province of a single specialty; it requires cooperation of pediatrician, surgeon, radiologist and tumor therapist. It is essential that they all be aware of the unique characteristics of this particular tumor if optimum results are to be obtained. The many factors found to influence the prognosis for a child with neuroblastoma are discussed. In those cases wherein there are no demonstrable metastases, the treatment of choice consists of total excision, followed by local x-ray irradiation; this has resulted in a cure rate of 88%. In those cases wherein total excision is not possible, partial surgical removal followed by x-ray irradiation and tumor chemotherapy has given a cure rate of 64%. In those cases where only biopsy has been performed, x-ray irradiation and chemotherapy has still given a salvage, with a cure rate of 38%. When there are metastases to the liver alone, about two-thirds of babies can be cured by x-ray therapy. Whenever bony metastases have appeared in any case, the prognosis is extremely poor, and it is rare for such an individual to survive, regardless of the form of therapy. An aggressive attack on neuroblastoma in infancy and childhood, combining sungeny, x-ray irradiation and tumor chemotherapy, has shown a progressive improvement in results. During the period 1950-1957, cure rates have risen to 36.7% for all patients entering the hospital, regardless of age of the patient on extent of the neoplasm. For babies under a year of age, cures have occurred in 56%, and if there were no demonstrable metastases to bone at the time of hospitalization, the cures have been 70%.

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