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Melanoma: HELP
Articles by Jane M. Grant Kels
Based on 42 articles published since 2009
(Why 42 articles?)
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Between 2009 and 2019, J. Grant-Kels wrote the following 42 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Guidelines of care for the management of primary cutaneous melanoma. 2019

Swetter, Susan M / Tsao, Hensin / Bichakjian, Christopher K / Curiel-Lewandrowski, Clara / Elder, David E / Gershenwald, Jeffrey E / Guild, Valerie / Grant-Kels, Jane M / Halpern, Allan C / Johnson, Timothy M / Sober, Arthur J / Thompson, John A / Wisco, Oliver J / Wyatt, Samantha / Hu, Shasa / Lamina, Toyin. ·Department of Dermatology, Stanford University Medical Center and Cancer Institute, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Electronic address: sswetter@stanford.edu. · Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Boston, Massachusetts. · Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan. · Division of Dermatology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. · Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas. · AIM at Melanoma Foundation, Plano, Texas. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pathology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York. · Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. · Division of Oncology, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington. · Department of Dermatology, Oregon Health and Science University, Portland, Oregon. · Decatur Dermatology, Decatur, Alabama. · Department of Dermatology, University of Miami Health System, Miami, Florida. · American Academy of Dermatology, Rosemont, Illinois. ·J Am Acad Dermatol · Pubmed #30392755.

ABSTRACT: The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.

2 Guideline AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. 2012

Anonymous2680736 / Anonymous2690736 / Anonymous2700736 / Anonymous2710736 / Anonymous2720736 / Connolly, Suzanne M / Baker, Diane R / Coldiron, Brett M / Fazio, Michael J / Storrs, Paul A / Vidimos, Allison T / Zalla, Mark J / Brewer, Jerry D / Begolka, Wendy S / Berger, Timothy G / Bigby, Michael / Bolognia, Jean L / Brodland, David G / Collins, Scott / Cronin, Terrence A / Dahl, Mark V / Grant-Kels, Jane M / Hanke, C W / Hruza, George J / James, William D / Lober, Clifford W / McBurney, Elizabeth I / Norton, Scott A / Roenigk, Randall K / Wheeland, Ronald G / Wisco, Oliver J. ·Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA. ·Dermatol Surg · Pubmed #22958088.

ABSTRACT: The appropriate use criteria process synthesizes evidence-based medicine, clinical practice experience, and expert judgment. The American Academy of Dermatology in collaboration with the American College of Mohs Surgery, the American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery has developed appropriate use criteria for 270 scenarios for which Mohs micrographic surgery (MMS) is frequently considered based on tumor and patient characteristics. This document reflects the rating of appropriateness of MMS for each of these clinical scenarios by a ratings panel in a process based on the appropriateness method developed by the RAND Corp (Santa Monica, CA)/University of California-Los Angeles (RAND/UCLA). At the conclusion of the rating process, consensus was reached for all 270 (100%) scenarios by the Ratings Panel, with 200 (74.07%) deemed as appropriate, 24 (8.89%) as uncertain, and 46 (17.04%) as inappropriate. For the 69 basal cell carcinoma scenarios, 53 were deemed appropriate, 6 uncertain, and 10 inappropriate. For the 143 squamous cell carcinoma scenarios, 102 were deemed appropriate, 7 uncertain, and 34 inappropriate. For the 12 lentigo maligna and melanoma in situ scenarios, 10 were deemed appropriate, 2 uncertain, and 0 inappropriate. For the 46 rare cutaneous malignancies scenarios, 35 were deemed appropriate, 9 uncertain, and 2 inappropriate. These appropriate use criteria have the potential to impact health care delivery, reimbursement policy, and physician decision making on patient selection for MMS, and aim to optimize the use of MMS for scenarios in which the expected clinical benefit is anticipated to be the greatest. In addition, recognition of those scenarios rated as uncertain facilitates an understanding of areas that would benefit from further research. Each clinical scenario identified in this document is crafted for the average patient and not the exception. Thus, the ultimate decision regarding the appropriateness of MMS should be determined by the expertise and clinical experience of the physician.

3 Editorial The role of sunscreen in the prevention of cutaneous melanoma and nonmelanoma skin cancer. 2019

Waldman, Reid A / Grant-Kels, Jane M. ·Dermatology Department, University of Connecticut Health Center, Farmington, Connecticut. · Dermatology Department, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: grant@uchc.edu. ·J Am Acad Dermatol · Pubmed #30012373.

ABSTRACT: -- No abstract --

4 Editorial Commentary: Factors associated with positive or equivocal margins of atypical intraepidermal melanocytic proliferations: True conundrum or imprecise language? 2016

Grant-Kels, Jane M. ·Department of Dermatology, University of Connecticut, Farmington, Connecticut. Electronic address: grant@uchch.edu. ·J Am Acad Dermatol · Pubmed #27646738.

ABSTRACT: -- No abstract --

5 Editorial The Case for Skin Cancer Screening With Total-Body Skin Examinations. 2016

Nahar, Vinayak K / Mayer, Jonathan E / Grant-Kels, Jane M. ·Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson2Department of Health, Physical Education, and Exercise Science, School of Allied Health Sciences, Lincoln Memorial University, Harrogate, Tennessee3Department. · Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Department of Dermatology, University of Connecticut Health Center and School of Medicine, Farmington. ·JAMA Oncol · Pubmed #27459540.

ABSTRACT: -- No abstract --

6 Editorial Estrogen receptor expression in cutaneous melanoma. 2009

Driscoll, Marcia S / Grant-Kels, Jane M. · ·Arch Dermatol · Pubmed #19153347.

ABSTRACT: -- No abstract --

7 Review "Sweetheart, you should have that looked at:" Ethical implications of treating family members. 2019

Grushchak, Solomiya / Grant-Kels, Jane M. ·Loyola University Chicago Stritch School of Medicine, Maywood, Illinois. · University of Connecticut Health Center Dermatology Department, Farmington, Connecticut. Electronic address: grant@uchc.edu. ·J Am Acad Dermatol · Pubmed #29307638.

ABSTRACT: -- No abstract --

8 Review Melanoma risk after in vitro fertilization: A review of the literature. 2018

Berk-Krauss, Juliana / Bieber, Amy Kalowitz / Criscito, Maressa C / Grant-Kels, Jane M / Driscoll, Marcia S / Keltz, Martin / Pomeranz, Miriam Keltz / Martires, Kathryn J / Liebman, Tracey N / Stein, Jennifer A. ·The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York; Yale School of Medicine, New Haven, Connecticut. · The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland. · Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York. · Department of Dermatology, Kaiser Permanente, Los Angeles, California. · The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address: jennifer.stein@nyumc.org. ·J Am Acad Dermatol · Pubmed #30055204.

ABSTRACT: BACKGROUND: The role of female sex hormones in the pathogenesis of malignant melanoma (MM) remains controversial. Although melanocytes appear to be hormonally responsive, the effect of estrogen on MM cells is less clear. Available clinical data does not consistently demonstrate that increased endogenous hormones from pregnancy or increased exogenous hormones from oral contraceptive pills and hormone replacement affect MM prevalence and outcome. OBJECTIVE: We sought to examine potential associations between in vitro fertilization (IVF) and melanoma. METHODS: A literature review was conducted. Primary outcomes were reported as associations between IVF and melanoma risk compared with the general population. Secondary outcomes included associations stratified by type of IVF regimen and subgroup, such as parous versus nulliparous patients. RESULTS: Eleven studies met our inclusion criteria. Five studies found no increased risk for MM among IVF users compared with the general population. Two studies found an increase in MM in clomiphene users, and 4 studies found an increase in MM among patients who were gravid or parous either before or after IVF. CONCLUSION: The reviewed studies do not reveal consistent patterns of association between IVF and MM among all infertile women. However, the data indicates a potential increased risk for MM in ever-parous patients treated with IVF. High-quality studies including a large number of MM cases that control for well-established MM risk factors are needed to adequately assess the relationship between IVF and MM, particularly among ever-parous women.

9 Review The new paradigm of systemic therapies for metastatic melanoma. 2017

Volpe, Virginia O / Klufas, Daniel M / Hegde, Upendra / Grant-Kels, Jane M. ·Department of Internal Medicine, Division of Oncology's Neag Cancer Center, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: grant@uchc.edu. ·J Am Acad Dermatol · Pubmed #28711086.

ABSTRACT: New treatments for metastatic melanoma work through distinct mechanisms: enhancing the immune response and blocking cellular proliferation. Agents that enhance the immune response include ipilimumab, pembrolizumb, and nivolumab; agents that block cellular proliferation include vemurafenib, dabrafenib, trametinib, cobimetinib, binimetinib, and selumetinib. The translational impact of laboratory discoveries has revolutionized management of metastatic melanoma and enhanced the prognosis of affected patients.

10 Review Application of Handheld Confocal Microscopy for Skin Cancer Diagnosis: Advantages and Limitations Compared with the Wide-Probe Confocal. 2016

Que, Syril Keena T / Grant-Kels, Jane M / Rabinovitz, Harold S / Oliviero, Margaret / Scope, Alon. ·Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. Electronic address: keenaq@gmail.com. · Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. · Department of Dermatology, University of Miami School of Medicine, 1295 NW 14th St., University of Miami South Bldg., Suites K-M, Miami, FL 33125, USA. · Department of Dermatology, Sheba Medical Center, Tel Hashomer, Ramat Gan 5262000, Affiliated with the Sackler School of Medicine, Tel Aviv University, Ramat Gan 52621, Israel. ·Dermatol Clin · Pubmed #27692452.

ABSTRACT: The clinical diagnosis of tumors on the curved surfaces of the face, around the eyes, and on the mucosal surfaces can be difficult, while biopsies and excisions can have functional and aesthetic consequences. To avoid unnecessary surgery, clinicians have been aiming to attain accurate noninvasive diagnosis of lesions at these sites. However, acquisition of high-quality images with dermoscopy and with traditional wide-probe reflectance confocal microscopy (WP-RCM) have been hampered with technical difficulties. This article discusses the technical parameters of the handheld reflectance confocal microscope and discusses its advantages and limitations compared with the WP-RCM.

11 Review Basics of Confocal Microscopy and the Complexity of Diagnosing Skin Tumors: New Imaging Tools in Clinical Practice, Diagnostic Workflows, Cost-Estimate, and New Trends. 2016

Que, Syril Keena T / Grant-Kels, Jane M / Longo, Caterina / Pellacani, Giovanni. ·Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. Electronic address: keenaq@gmail.com. · Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, MC 6231, Farmington, CT 06030-6231, USA. · Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, viale risorgimento, 80, 42100 Reggio Emilia, Italy. · Department of Dermatology, University of Modena and Reggio Emilia, via del Pozzo 71, Modena 41124, Italy. ·Dermatol Clin · Pubmed #27692444.

ABSTRACT: The use of reflectance confocal microscopy (RCM) and other noninvasive imaging devices can potentially streamline clinical care, leading to more precise and efficient management of skin cancer. This article explores the potential role of RCM in cutaneous oncology, as an adjunct to more established techniques of detecting and monitoring for skin cancer, such as dermoscopy and total body photography. Discussed are current barriers to the adoption of RCM, diagnostic workflows and standards of care in the United States and Europe, and medicolegal issues. The potential role of RCM and other similar technological innovations in the enhancement of dermatologic care is evaluated.

12 Review Pregnancy and melanoma. 2016

Driscoll, Marcia S / Martires, Kathryn / Bieber, Amy Kalowitz / Pomeranz, Miriam Keltz / Grant-Kels, Jane M / Stein, Jennifer A. ·Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland. · The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. · Department of Dermatology, University of Connecticut, Farmington, Connecticut. · The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York. Electronic address: jennifer.stein@nyumc.org. ·J Am Acad Dermatol · Pubmed #27646737.

ABSTRACT: Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma. The impact of hormonal changes during pregnancy and from iatrogenic hormones on melanoma is controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. In addition, hormone receptors are found on some melanomas. In spite of these observations, the preponderance of evidence does not support a poorer prognosis for pregnancy-associated melanomas. There is also a lack of evidence that oral contraceptives or hormone replacement therapy worsens melanoma prognosis.

13 Review Through the looking glass: Basics and principles of reflectance confocal microscopy. 2015

Que, Syril Keena T / Fraga-Braghiroli, Naiara / Grant-Kels, Jane M / Rabinovitz, Harold S / Oliviero, Margaret / Scope, Alon. ·Department of Dermatology at the University of Connecticut Health Center, Farmington, Connecticut. Electronic address: keenaq@gmail.com. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Department of Dermatology at the University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York. ·J Am Acad Dermatol · Pubmed #26051696.

ABSTRACT: Reflectance confocal microscopy (RCM) offers high-resolution, noninvasive skin imaging and can help avoid obtaining unnecessary biopsy specimens. It can also increase efficiency in the surgical setting by helping to delineate tumor margins. Diagnostic criteria and several RCM algorithms have been published for the differentiation of benign and malignant neoplasms. We provide an overview of the basic principles of RCM, characteristic RCM features of normal skin and cutaneous neoplasms, and the limitations and future directions of RCM.

14 Review Dysplastic nevus: Fact and fiction. 2015

Rosendahl, Cliff O / Grant-Kels, Jane M / Que, Syril Keena T. ·School of Medicine, The University of Queensland, Australia. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: keenaq@gmail.com. ·J Am Acad Dermatol · Pubmed #26037217.

ABSTRACT: The term "dysplastic nevus" (DN) implies that this nevus exists as a distinct and defined entity of potential detriment to its host. We examine the current data, which suggest that this entity exists as histologically and possibly genetically different from common nevus, with some overlapping features. Studies show that a melanoma associated with a nevus is just as likely to arise in a common nevus as in DN. Furthermore, there is no evidence that a histologically defined DN evolves into a melanoma or that the presence of 1 or more DN on an individual patient confers any increased melanoma risk. We suggest that the term "dysplastic nevus" be abandoned so that the focus can shift to confirmed and relevant indicators of melanoma risk, including high nevus counts and large nevus size.

15 Review Metastatic melanoma in the older patient: special considerations. 2013

Hegde, Upendra P / Grant-Kels, Jane M. ·Department of Medicine, Ray and Carol Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT 06030, USA. Uhegde@UCHC.edu ·Clin Dermatol · Pubmed #23608450.

ABSTRACT: Cancer is a disease of older age where genomic instability, impaired DNA repair, and weakened immune surveillance against cancer are recognized to play a causative role. Because the incidence of melanoma is increasing at a very fast pace in the elderly and there is a rapid expansion of the aging population, a large number of elderly patients with metastatic melanoma will be encountered in clinical practice. As a result, significant burden is expected to be placed on health care resources as effective treatment of this condition is sought. Because melanoma is an immunogenic tumor and promising immune-based treatments have acquired approval for treatment of metastatic melanoma, their successful use in elderly patients will require knowledge about aging and associated alterations in immune function. The spotlight will likely remain on antitumor immunity, its regulation and quality, and the profiles of the cytokines that shape the tumor microenvironment.

16 Review Melanoma in pregnancy. 2011

Jhaveri, Mamta B / Driscoll, Marcia S / Grant-Kels, Jane M. ·Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland, USA. ·Clin Obstet Gynecol · Pubmed #22031244.

ABSTRACT: Since the early 1950s clinicians have been concerned about the impact of pregnancy on malignant melanoma (MM). Case reports and case series described a grave prognosis for women diagnosed with MM during pregnancy. Today MM in pregnancy takes on enhanced significance as more women delay childbearing into their 30s and 40s, and the incidence of MM during pregnancy may be expected to increase. In addition, relative immunosuppression during pregnancy theoretically may favor the potential for MMs to behave more aggressively. This article compiles the most recent clinical, epidemiologic, and laboratory studies to guide clinicians in addressing the issue of melanoma in pregnancy. Herein we address the prognosis, characteristics, evaluation, treatment, and how to counsel women diagnosed with MM during pregnancy, including the potential consequences for the fetus. Overall, our analysis reveals that there is no effect on survival in women diagnosed with localized MM during pregnancy; likewise, pregnancies prior or subsequent to a diagnosis of MM do not impact prognosis. Strong epidemiologic evidence shows no enhanced risk of developing MM associated with oral contraceptive pill use. Although a smaller number of studies have addressed hormonal replacement therapy and risk of MM, these studies do not suggest a higher risk of MM. As for the fetus, risk of metastasis to the placenta and/or fetus is extremely low, and seems to occur exclusively in women with widely metastatic MM.

17 Review Metastatic melanoma in the older patient: immunologic insights and treatment outcomes. 2011

Hegde, Upendra P / Chakraborty, Nitya / Mukherji, Bijay / Grant Kels, Jane M. ·University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. uhegde@uchc.edu ·Expert Rev Pharmacoecon Outcomes Res · Pubmed #21476820.

ABSTRACT: Cutaneous melanoma (CM) is a highly curable skin cancer of melanocytes if diagnosed early. Unfortunately, its invasion into the deeper dermis increases the risk of it spreading to the lymph nodes and distant organs. Spread of metastatic melanoma (MM) to other organs is among one of the most dangerous conditions that is almost uniformly fatal for the majority of patients with the currently available treatment modalities. Since melanoma is an immunogenic tumor, developing novel immune strategies will continue to play a critical role in designing effective treatment modalities for those at high risk of recurrence and those with distant metastasis. While older age is believed to be a poor prognostic marker for CM, rapid expansion of the aging population and its projected increase in the coming decades is expected to result in a large number of elderly melanoma patients seeking treatment in all stages of disease. This will not only bring with it unique management challenges in this population, but also an increased burden on communities to provide financial and social resources. Comprehensive efforts will need to be directed towards early diagnosis, as well as developing safe and effective treatment. Renewed interest in the cancer immune surveillance theory coupled with recognition of aging-associated weaknesses in the immune system has put the spotlight on immunsenescence as a important risk factor for the rising incidence of CM in the aging population. Comprehensive assessment of the aging immune system might shed light, not only on weaknesses of individual components of the adaptive immune system, but also on the critical imbalances resulting from these weaknesses on anti-melanoma immunity. Identifying these imbalances might help harness novel immune-based treatment of MM in selected elderly patients. This article describes our experience of treating elderly patients with MM and the issues unique to them, with particular emphasis on insights into the aging immune system.

18 Review Melanoma in the elderly patient: relevance of the aging immune system. 2009

Hegde, Upendra P / Chakraborty, Nitya / Kerr, Philip / Grant-Kels, Jane M. ·Division of Hematology/Oncology, Department of Medicine, The Carole and Ray Neag Comprehensive Cancer Institute, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. uhegde@uchc.edu ·Clin Dermatol · Pubmed #19880041.

ABSTRACT: The rapidly expanding segment of the aging population with its rising incidence of cutaneous melanoma will present major challenges in therapeutic management. Immune strategies will be important in designing effective treatment of melanoma because it is a highly immunogenic tumor. Aging, however, is associated with dysregulation of the immune system and is likely to affect the success of melanoma treatment in the elderly population. This population represents an ideal in vivo model to study the effects of the aging immune system on the natural history of melanoma in the elderly. We review the epidemiology, histopathologic features, and treatment outcomes of elderly melanoma patients with reference to their immune function. Various components of the normal immune system are described, and the immune response to melanoma is recapitulated. Particular emphasis is placed on the growing understanding of the innate, adaptive, and regulatory arms of the aging immune system.

19 Review Childhood melanoma. 2009

Jen, Melinda / Murphy, Michael / Grant-Kels, Jane M. ·Department of Dermatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. ·Clin Dermatol · Pubmed #19880040.

ABSTRACT: Pediatric melanoma is rare but increasing in incidence. Because early diagnosis and treatment improves prognosis, clinicians need to include it as a possible diagnosis when evaluating a pigmented lesion in a pediatric patient. Some risk factors for melanoma include xeroderma pigmentosum, giant congenital melanocytic nevi, dysplastic nevus syndrome, atypical nevi, many acquired melanocytic nevi, family history of melanoma, and immunosuppression. Definitive treatment is with surgical excision. Adjuvant therapies such as chemotherapy, immunotherapy, and radiation therapy can be used in advanced cases.

20 Review Selection criteria for genetic assessment of patients with familial melanoma. 2009

Leachman, Sancy A / Carucci, John / Kohlmann, Wendy / Banks, Kimberly C / Asgari, Maryam M / Bergman, Wilma / Bianchi-Scarrà, Giovanna / Brentnall, Teresa / Bressac-de Paillerets, Brigitte / Bruno, William / Curiel-Lewandrowski, Clara / de Snoo, Femke A / Debniak, Tadeusz / Demierre, Marie-France / Elder, David / Goldstein, Alisa M / Grant-Kels, Jane / Halpern, Allan C / Ingvar, Christian / Kefford, Richard F / Lang, Julie / MacKie, Rona M / Mann, Graham J / Mueller, Kurt / Newton-Bishop, Julia / Olsson, Håkan / Petersen, Gloria M / Puig, Susana / Rigel, Darrell / Swetter, Susan M / Tucker, Margaret A / Yakobson, Emanuel / Zitelli, John A / Tsao, Hensin. ·Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112-5550, USA. sancy.leachman@hci.utah.edu ·J Am Acad Dermatol · Pubmed #19751883.

ABSTRACT: Approximately 5% to 10% of melanoma may be hereditary in nature, and about 2% of melanoma can be specifically attributed to pathogenic germline mutations in cyclin-dependent kinase inhibitor 2A (CDKN2A). To appropriately identify the small proportion of patients who benefit most from referral to a genetics specialist for consideration of genetic testing for CDKN2A, we have reviewed available published studies of CDKN2A mutation analysis in cohorts with invasive, cutaneous melanoma and found variability in the rate of CDKN2A mutations based on geography, ethnicity, and the type of study and eligibility criteria used. Except in regions of high melanoma incidence, such as Australia, we found higher rates of CDKN2A positivity in individuals with 3 or more primary invasive melanomas and/or families with at least one invasive melanoma and two or more other diagnoses of invasive melanoma and/or pancreatic cancer among first- or second-degree relatives on the same side of the family. The work summarized in this review should help identify individuals who are appropriate candidates for referral for genetic consultation and possible testing.

21 Article Reflectance confocal microscopy features of melanomas on the body and non-glabrous chronically sun-damaged skin. 2018

Shahriari, Neda / Grant-Kels, Jane M / Rabinovitz, Harold / Oliviero, Margaret / Scope, Alon. ·Department of Internal Medicine, St. Mary's Hospital, Waterbury, Connecticut. · Department of Dermatology, UCONN Health Center, Farmington, Connecticut. · Department of Dermatology, University of Miami Miller School of Medicine, Miami, Florida. · Sheba Medical Center and Sackler Faculty of Medicine, Medical Screening Institute, Tel Aviv University, Tel Aviv, Israel. ·J Cutan Pathol · Pubmed #29971811.

ABSTRACT: BACKGROUND: Melanoma remains a challenge to diagnose, especially when appearing on the background of chronically sun-damaged skin (CSDS). Our goal was to identify and quantify the reflectance confocal microscopy (RCM) features of melanoma on non-facial CSDS. METHODS: Included lesions were biopsy-proven melanomas, from anatomic sites other than the face, neck, scalp and acral skin, with histopathologic finding of solar elastosis in the underlying dermis. All included lesions underwent clinical, dermoscopic and RCM imaging, obtained in a standardized fashion, prior to biopsy. All images were retrospectively analyzed by four observers. RESULTS: We identified 33 melanomas from 33 patients with 63.6% male patients and overall mean age of 72.8 years. The salient RCM features included an atypical honeycomb or disarranged epidermal pattern (81.8%), pagetoid infiltration of the epidermis by both round and/or dendritic melanocytes (100%), focal proliferation of predominantly dendritic melanocytes as sheets (78.8%), foci with non-edged papillae (84.8%), junctional thickening (60.6%), areas of irregular ring or meshwork pattern (78.8%), and underlying thickened collagen bundles (51.5%). CONCLUSION: Non-facial CSDS melanomas share features similar to other melanoma types including pagetoid cells and non-edged papillae. The focal proliferation of dendritic pagetoid cells in sheets is similar to that seen in facial CSDS melanomas.

22 Article The student is in: Ethical concerns when dermatology patients refuse medical students. 2018

Tassavor, Michael / Grant-Kels, Jane M. ·Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. · Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: grant@uchc.edu. ·J Am Acad Dermatol · Pubmed #29678376.

ABSTRACT: -- No abstract --

23 Article Identification of microRNAs associated with invasive and aggressive phenotype in cutaneous melanoma by next-generation sequencing. 2017

Babapoor, Sankhiros / Wu, Rong / Kozubek, James / Auidi, Donna / Grant-Kels, Jane M / Dadras, Soheil S. ·Department of Genetics and Genome Sciences, University of Connecticut Health Center, Farmington, CT, USA. · CICATS Biostatics Center, University of Connecticut Health Center, Farmington, CT, USA. · Department of Dermatology, University of Connecticut Health Center, Farmington, CT, USA. ·Lab Invest · Pubmed #28218741.

ABSTRACT: A comprehensive repertoire of human microRNAs (miRNAs) that could be involved in early melanoma invasion into the dermis remains unknown. To this end, we sequenced small RNAs (18-30 nucleotides) isolated from an annotated series of invasive melanomas (average invasive depth, 2.0 mm), common melanocytic nevi, and matched normal skin (n=28). Our previously established bioinformatics pipeline identified 765 distinct mature known miRNAs and defined a set of top 40 list that clearly segregated melanomas into thin (0.75 mm) and thick (2.7 mm) groups. Among the top, miR-21-5p, let-7b-5p, let-7a-5p, miR-424-5p, miR-423-5p, miR-21-3p, miR-199b-5p, miR-182-5p, and miR-205-5p were differentially expressed between thin and thick melanomas. In a validation cohort (n=167), measured expression of miR-21-5p and miR-424-5p, not previously reported in melanoma, were significantly increased in invasive compared with in situ melanomas (P<0.0001). Increased miR-21-5p levels were significantly associated with invasive depth (P=0.038), tumor mitotic index (P=0.038), lymphovascular invasion (P=0.0036), and AJCC stage (P=0.038). In contrast, let-7b levels were significantly decreased in invasive and in situ melanomas compared with common and dysplastic nevi (P<0.0001). Decreased let-7b levels were significantly associated with invasive depth (P=0.011), Clark's level (P=0.013), ulceration (P=0.0043), and AJCC stage (P=0.011). These results define a distinct set of miRNAs associated with invasive and aggressive melanoma phenotype.

24 Article Pigmentation and Pregnancy: Knowing What Is Normal. 2017

Bieber, Amy Kalowitz / Martires, Kathryn J / Stein, Jennifer A / Grant-Kels, Jane M / Driscoll, Marcia S / Pomeranz, Miriam Keltz. ·Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York; the Department of Dermatology, University of Connecticut, Farmington, Connecticut; and the Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland. ·Obstet Gynecol · Pubmed #27926637.

ABSTRACT: Changes in melanocytic nevi during pregnancy are frequently attributed to the new hormonal milieu and are dismissed without concern for malignancy. Recent studies suggest that pregnancy itself does not induce significant change in nevi, and delays in the assessment of changing moles may contribute to the often more advanced nature of melanomas diagnosed during or soon after pregnancy. Nevi on the breasts and abdomen can grow as a result of skin expansion, but studies have found no significant changes in nevi located in more stable areas such as the back or lower extremities. There is also insufficient evidence to support the notion that nevi darken during pregnancy. As such, any changing nevus that would raise concern for malignancy in a nonpregnant patient should do so in a pregnant patient as well. Pregnancy can, however, induce physiologic pigmentary changes that are often worrisome to both patients and physicians. These benign changes include melasma, pigmentary demarcation lines, secondary areola, and linea nigra as well as other less common findings. It is important for physicians to recognize these changes as physiologic to provide adequate reassurance to their patients and avoid unnecessary stress.

25 Article Melanoma: Kids are not just little people. 2016

LaChance, Avery / Shahriari, Mona / Kerr, Philip E / Grant-Kels, Jane M. ·Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT. · Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT. Electronic address: grant@uchc.edu. ·Clin Dermatol · Pubmed #27968934.

ABSTRACT: Malignant melanoma can affect patients of any age. It has been well documented that the overall incidence of melanoma has increased in the past several decades, and this increase extends to the pediatric population (both preadolescent and, to a greater extent, adolescent children). Melanoma in adolescents, commonly defined as patients 11 to 19 years of age, behaves similarly to melanoma in adults; however, there are a number of distinct differences in the presentation and prognosis of melanoma in the preadolescent population. Though our treatment options for melanoma are increasing with the advent of novel drugs and clinical trials, the rarity of pediatric melanomas often excludes this population from clinical studies. The treatment options for the pediatric patient are predominantly based on adult clinical trials. Awareness of the differences in clinical presentation, as well as management of melanoma in younger patients compared with their adult counterparts, is crucial to guarantee prompt and appropriate care.

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