scholarly journals Total Body Photography and Sequential Digital Dermoscopy Imaging for Melanoma Surveillance in Patients Starting Natalizumab for Multiple Sclerosis

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Tyler Nussinow ◽  
Amanda Robinson ◽  
Biljana Beretich ◽  
Kathryn Stevens ◽  
Elizabeth Seiverling
Keyword(s):  
Multiple Sclerosis ◽  
Total Body ◽  
Melanoma Surveillance ◽  
Digital Dermoscopy

scholarly journals Total Body Photography and Sequential Digital Dermoscopy in Pregnant Women

2019 ◽  
pp. 126-131
Author(s):  
Gabriela M. Martins-Costa ◽  
Renato Bakos
Keyword(s):  
Differential Diagnosis ◽  
Cohort Study ◽  
Pregnant Women ◽  
Skin Type ◽  
Type Ii ◽  
Third Trimester ◽  
Melanocytic Nevi ◽  
Vascular Structures ◽  
Total Body ◽  
Digital Dermoscopy

Background: Melanocytic nevi can vary in size and number in pregnant women, and the differential diagnosis with melanoma may be challenging. Objectives: To describe changes in total body photography of pregnant women and dermoscopy aspects of their nevi. Methods: A prospective cohort study with 703 melanocytic nevi from 18 women was performed, comparing them in the first and third trimester of pregnancy. Images were analyzed between the 2 periods for changes in dermoscopic aspects. Results: Total body photography images indicated that 44% of patients had new lesions. Regarding the observed changes, there were symmetric or regular changes of the network (23% of cases), occurrence of new globules/dots (12.4%), new vascular structures (3.2%), new streaks (1.7%), and new structureless area (1.0%). Moreover, 55.0% of the nevi increased in size. Enlarging of the nevi was observed mostly on the abdomen (87.1%; P < 0.001) and showed more network changes (27.1%; P = 0.014) and formation of new globules and dots (16.0%; P < 0.001). Patients with a risk of developing melanoma presented more frequently enlarged nevi (45%; P = 0.019). The association between streak formation and skin type was significant (P = 0.012) and was more frequent in skin type II (2.7%), when compared with skin types III (1.3%) and IV (0%).

Metastatic melanoma patients: Prospective follow-up of pigmented lesions under vemurafenib by digital dermoscopy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9093-9093
Author(s):  
Marie Perier-Muzet ◽  
Stephane Dalle ◽  
Gerard Duru ◽  
Luc Thomas ◽  
Sebastien Debarbieux ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Second Primary ◽  
External Diameter ◽  
Inform Consent ◽  
Cutaneous Side Effects ◽  
Pigmented Lesions ◽  
Total Body ◽  
The Impact ◽  
Digital Dermoscopy

9093 Background: Vemurafenib is the first approved by the FDA BRAF V600 inhibitor for the treatment of metastatic melanoma. Many cutaneous side-effects such as squamous cell carcinoma, xerosis, photosensitivity are observed. We first reported the occurrence of second primary melanomas (SPM) under BRAF inhibition. These SPM were shown to be wild-type for BRAF. The exact occurrence of these changes is still unknown. We wanted then to explore prospectively the impact of vemurafenib on cutaneous pigmented lesions using sequential digital dermoscopy. Methods: We registered prospectively following inform consent the pigmented lesions of patients under vemurafenib. We examined the total body surface and captured from 9 to 134 pigmented lesions on 24 patients. Each single lesion was followed monthly from vemurafenib initiation to vemurafenib disruption due to disease progression. Dermoscopic modifications of the melanocytic lesions including external diameter, dermoscopical pattern, pigmentation, network thickness, dots distribution and keratosis appearance were analyzed. Results: The median duration of dermoscopic follow up was 6,9 months ( range from 2 to 16 months), 1098 pigmented lesions were included. At least one modification occurred in 56% of the lesions. Most frequent modifications were the occurrence of dark globules (56%), change in the pigmentation coloration (47%), variations in network thickness (32%), increase of the external size (20,1%), onset of black areas (14%), onset of keratosis (4,4%). Up to 5,3% of lesions spontaneously disappeared; 21 excisions were performed due to significant dermoscopic changes and revealed 10 early melanomas in 5/24 patients (20,8%). The 11 remaining lesions were benign. Conclusions: More than fifty percent of the patients under vemurafenib will experiment significant modifications on their pigmented lesions. In our experience 10/21 removed lesions were early melanomas that could not be otherwise diagnosed using naked-eyes examinations only. Digital dermoscopy is one of the tool that can be use to discriminate earlier the modifications. Such careful monitoring will improved the safety when evaluating BRAF inhibitors in adjuvant setting.

Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores

Blood ◽  
2003 ◽  
Vol 102 (7) ◽  
pp. 2373-2378 ◽  
Author(s):  
Richard K. Burt ◽  
Bruce A. Cohen ◽  
Eric Russell ◽  
Kenneth Spero ◽  
Akash Joshi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Progressive Disease ◽  
Progressive Multiple Sclerosis ◽  
Suppressive Therapy ◽  
Hematopoietic Stem ◽  
Immune Suppressive Therapy ◽  
Total Body

Abstract There were 21 patients with rapidly progressive multiple sclerosis (MS) treated on a phase 1/2 study of intense immune suppressive therapy and autologous hematopoietic stem cell (HSC) support with no 1-year mortality. Following transplantation, one patient had a confirmed acute attack of MS. Neurologic progression defined by the expanded disability status scale (EDSS) did not increase in disability by 1.0 or more steps in any of 9 patients with a pretransplantation EDSS of 6.0 or less. In 8 of 12 patients with high pretransplantation disability scores (EDSS &gt; 6.0), progressive neurologic disability as defined by at least a 1-point increase in the EDSS has occurred and was manifested as gradual neurologic deterioration. There were 2 patients with a pretransplantation EDSS of 7.0 and 8.0 who died from complications of progressive disease at 13 and 18 months following treatment. Our experience suggests that intense immune suppression using a total body irradiation (TBI)-based regimen and hematopoietic stem cell transplantation (HSCT) are not effective for patients with progressive disease and high pretransplantation disability scores. Further studies are necessary to determine the role of intense immune suppressive therapy and HSC support in ambulatory patients with less accumulated disability and more inflammatory disease activity. Specifically, more patients and longer follow-up would be required in patients with an EDSS of 6.0 or less before drawing conclusions on this subgroup. (Blood. 2003;102:2373-2378)

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