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Melanoma: HELP
Articles by Susana Puig
Based on 171 articles published since 2010
(Why 171 articles?)
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Between 2010 and 2020, S. Puig wrote the following 171 articles about Melanoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Guideline [Initial evaluation, diagnosis, staging, treatment, and follow-up of patients with primary cutaneous malignant melanoma. Consensus statement of the Network of Catalan and Balearic Melanoma Centers]. 2010

Mangas, C / Paradelo, C / Puig, S / Gallardo, F / Marcoval, J / Azon, A / Bartralot, R / Bel, S / Bigatà, X / Curcó, N / Dalmau, J / del Pozo, L J / Ferrándiz, C / Formigón, M / González, A / Just, M / Llambrich, A / Llistosella, E / Malvehy, J / Martí, R M / Nogués, M E / Pedragosa, R / Rocamora, V / Sàbat, M / Salleras, M. ·Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. cris_mangas@yahoo.es ·Actas Dermosifiliogr · Pubmed #20223155.

ABSTRACT: The consensus statement on the management of primary cutaneous melanoma that we present here was based on selection, discussion, review, and comparison of recent literature (including national and international guidelines). The protocols for the diagnosis, treatment, and follow-up used in the hospital centers throughout Catalonia and the Balearic Isles belonging to the Network of Catalan and Balearic Melanoma Centers were also considered. The main objective of this statement was to present the overall management of melanoma patients typically used in our region at the present time. As such, the statement was not designed to be an obligatory protocol for health professionals caring for this group of patients, and neither can it nor should it be used for this purpose. Professionals reading the statement should not therefore consider it binding on their practice, and in no case can this text be used to guarantee or seek responsibility for a given medical opinion. The group of dermatologists who have signed this statement was created 3 years ago with the aim of making our authorities aware of the importance of this complex tumor, which, in comparison with other types of cancer, we believe does not receive sufficient attention in Spain. In addition, the regular meetings of the group have produced interesting proposals for collaboration in various epidemiological, clinical, and basic applied research projects on the subject of malignant melanoma in our society.

2 Editorial A new era in melanoma. 2012

Puig, Susana. · ·Dermatol Ther · Pubmed #23046016.

ABSTRACT: -- No abstract --

3 Review Review of Clinical Evidence over 10 Years on Prevention and Treatment of a Film-Forming Medical Device Containing Photolyase in the Management of Field Cancerization in Actinic Keratosis. 2019

Puig, Susana / Granger, Corinne / Garre, Aurora / Trullàs, Carles / Sanmartin, Onofre / Argenziano, Giuseppe. ·Dermatology Department, Melanoma Unit, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. spuig@clinic.cat. · Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. spuig@clinic.cat. · Centro de Investigación en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain. spuig@clinic.cat. · Innovation and Development, ISDIN, Barcelona, Spain. · Department of Dermatology, Fundación Instituto Valenciano de Oncologia, Universidad Católica de Valencia San Vicente Martir, Valencia, Spain. · Dermatology Unit, Second University of Naples, Nuovo Policlinico (Edificio 9C), Via Pansini 5, 80131, Naples, Italy. ·Dermatol Ther (Heidelb) · Pubmed #30968311.

ABSTRACT: Actinic keratosis (AK) is a common pathology that afflicts sun-exposed areas of the skin. It predominantly affects older and fair-skinned individuals suggesting an accumulative damage attributable to chronic sun exposure. The prevalence of AK has risen in the past decades and is expected to continue to rise. Apart from visible hyperkeratotic, hyperplastic lesions, AK is also associated with the presence of subclinical lesions adjacent to tumor tissue, which has led to the use of the concept "cancerization field". Although lesion- and field-targeting treatments are currently available, many are associated with local side effects and recurrence of new lesions. This review provides information on AK pathophysiology and treatment options and summarizes the available clinical evidence supporting the use of Eryfotona AK-NMSC, a film-forming medical device with SPF 100+ containing the DNA repair enzyme photolyase, for managing AK, based on the analysis of the results of 228 patients treated with the product. FUNDING: ISDIN funded the Article Processing Charges.

4 Review Cutaneous toxicities of new treatments for melanoma. 2018

Boada, A / Carrera, C / Segura, S / Collgros, H / Pasquali, P / Bodet, D / Puig, S / Malvehy, J. ·Dermatology Department, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Crta/Canyet s/n., Badalona, 08016, Barcelona, Spain. aramboada@gmail.com. · Melanoma Unit, Dermatology Department, Hospital Clinic, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), CIBERER, Universitat de Barcelona, Barcelona, Spain. · Dermatology Department, Hospital del Mar, Parc de Salut Mar, Fundació Institut Mar d'Investigacions Mèdiques, Barcelona, Spain. · Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sidney, Australia. · Dermatology Department, Pius Hospital Valls, Institut d'Investigació Sanitària Pere Virgili Valls, Tarragona, Spain. · Dermatology Department, Hospital Universitari Vall d'Hebron, VHIR, Barcelona, Spain. ·Clin Transl Oncol · Pubmed #29799097.

ABSTRACT: New drugs against advanced melanoma have emerged during last decade. Target therapy and immunotherapy have changed the management of patients with metastatic disease. Along with its generalized use, drug toxicities have appeared and the skin is the target organ of a significant part of them. This revision summarizes the most common side effects and consensus management to improve the compliance of therapies and patients' quality of life. Among the BRAF inhibitors, main cutaneous side effects are photosensitivity, plantar hyperkeratosis, and the appearance of verrucal keratosis or squamous cell carcinoma. Special attention must be paid to the development of new primary melanomas or changes on nevi during BRAF inhibitor therapy. The most common cutaneous side effects of immunotherapy are rash, pruritus, and vitiligo. It remains controversial the possible role of these toxicities as markers of response to therapy.

5 Review Noninvasive imaging for nonmelanoma skin cancer. 2016

Giavedoni, Priscila / Puig, Susana / Carrera, Cristina. ·Department of Dermatology, Melanoma Unit, Hospital Clinic d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain. · Centro de Investigacion Biomedica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain. · Centro de Investigacion Biomedica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Barcelona, Spain. ccarrera@clinic.ub.ess. ·Semin Cutan Med Surg · Pubmed #26963115.

ABSTRACT: The development of noninvasive optical technologies is revolutionizing the diagnosis of skin tumors. Nonmelanoma skin cancer, the most frequent neoplasm, has become an important health and economic issue, and proper management can avoid unnecessary morbidity and mutilating treatment or relapses. Noninvasive treatment modalities and the recently approved systemic therapies for advanced basal cell carcinoma cases make noninvasive monitoring techniques necessary. Current knowledge, applications, and limitations of the tools most clinically implemented, such as dermoscopy, reflectance confocal microscopy, high frequency ultrasonography, and optical coherence tomography will be reviewed in this article. In addition to the improvement of diagnostic accuracy of skin cancer, using these tools individually or in combination facilitates better management of certain patients and tumors.

6 Review Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy. 2016

Kittler, Harald / Marghoob, Ashfaq A / Argenziano, Giuseppe / Carrera, Cristina / Curiel-Lewandrowski, Clara / Hofmann-Wellenhof, Rainer / Malvehy, Josep / Menzies, Scott / Puig, Susana / Rabinovitz, Harold / Stolz, Wilhelm / Saida, Toshiaki / Soyer, H Peter / Siegel, Eliot / Stoecker, William V / Scope, Alon / Tanaka, Masaru / Thomas, Luc / Tschandl, Philipp / Zalaudek, Iris / Halpern, Allan. ·Department of Dermatology, Medical University of Vienna, Vienna, Austria. Electronic address: harald.kittler@meduniwien.ac.at. · Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York. · Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy. · Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER ER), Instituto de Salud Carlos III, Barcelona, Spain. · University of Arizona Cancer Center, Tucson, Arizona. · Department of Dermatology and Venerology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria. · Sydney Melanoma Diagnostic Center, Sydney Cancer Center, Royal Prince Alfred Hospital, Camperdown, Australia. · Skin and Cancer Associates, Plantation, Florida. · Department of Dermatology, Klinikum München, Munich, Germany. · Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan. · Dermatology Research Center, University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia. · University of Maryland Medical Center, Baltimore Department of Veterans Affairs Medical Center, Baltimore, Maryland. · Department of Dermatology, University of Missouri Health Sciences Center, Columbia, Missouri. · Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Dermatology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. · Department of Dermatology, Keio University, Tokyo, Japan. · Service de Dermatologie, Center Hospitalier Universitaire de Lyon, Lyon, France. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. ·J Am Acad Dermatol · Pubmed #26896294.

ABSTRACT: BACKGROUND: Evolving dermoscopic terminology motivated us to initiate a new consensus. OBJECTIVE: We sought to establish a dictionary of standardized terms. METHODS: We reviewed the medical literature, conducted a survey, and convened a discussion among experts. RESULTS: Two competitive terminologies exist, a more metaphoric terminology that includes numerous terms and a descriptive terminology based on 5 basic terms. In a survey among members of the International Society of Dermoscopy (IDS) 23.5% (n = 201) participants preferentially use descriptive terminology, 20.1% (n = 172) use metaphoric terminology, and 484 (56.5%) use both. More participants who had been initially trained by metaphoric terminology prefer using descriptive terminology than vice versa (9.7% vs 2.6%, P < .001). Most new terms that were published since the last consensus conference in 2003 were unknown to the majority of the participants. There was uniform consensus that both terminologies are suitable, that metaphoric terms need definitions, that synonyms should be avoided, and that the creation of new metaphoric terms should be discouraged. The expert panel proposed a dictionary of standardized terms taking account of metaphoric and descriptive terms. LIMITATIONS: A consensus seeks a workable compromise but does not guarantee its implementation. CONCLUSION: The new consensus provides a revised framework of standardized terms to enhance the consistent use of dermoscopic terminology.

7 Review Methods of Melanoma Detection. 2016

Leachman, Sancy A / Cassidy, Pamela B / Chen, Suephy C / Curiel, Clara / Geller, Alan / Gareau, Daniel / Pellacani, Giovanni / Grichnik, James M / Malvehy, Josep / North, Jeffrey / Jacques, Steven L / Petrie, Tracy / Puig, Susana / Swetter, Susan M / Tofte, Susan / Weinstock, Martin A. ·Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. leachmas@ohsu.edu. · Department of Dermatology and Knight Cancer Institute, Oregon Health and Science University, 3125 SW Sam Jackson Park Road, L468R, Portland, OR, 97239, USA. cassidyp@ohsu.edu. · Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road NE, 1st Floor, Atlanta, GA, 30322, USA. schen2@emory.edu. · Department of Dermatology and Arizona Cancer Center, University of Arizona, 1515 N Campbell Avenue, Tucson, AZ, 85721, USA. ccuriel@email.arizona.edu. · Department of Dermatology, Harvard School of Public Health and Massachusetts General Hospital, Landmark Center, 401 Park Drive, 3rd Floor East, Boston, MA, 02215, USA. ageller@hsph.harvard.edu. · Laboratory of Investigative Dermatology, The Rockefeller University, 1230 York Avenue, New York, NY, 10065, USA. daniel.gareau@rockefeller.edu. · Department of Dermatology, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy. giovanni.pellacani@unimore.it. · Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Room 912, BRB (R-125), 1501 NW 10th Avenue, Miami, FL, 33136, USA. grichnik@miami.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. jmalvehy@clinic.ub.es. · University of California, San Francisco, 1701 Divisadero Street, Suite 280, San Francisco, CA, 94115, USA. jeffrey.north@ucsf.edu. · Department of Biomedical Engineering and Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. jacquess@ohsu.edu. · Department of Biomedical Engineering, Oregon Health and Science University, 3303 SW Bond Avenue, CH13B, Portland, OR, 97239, USA. petrie@ohsu.edu. · Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. spuig@clinic.ub.es. · Department of Dermatology/Cutaneous Oncology, Stanford University, 900 Blake Wilbur Drive, W3045, Stanford, CA, 94305, USA. sswetter@stanford.edu. · Department of Dermatology, Oregon Health and Science University, 3303 SW Bond Avenue, CH16D, Portland, OR, 97239, USA. toftes@ohsu.edu. · Departments of Dermatology and Epidemiology, Brown University, V A Medical Center 111D, 830 Chalkstone Avenue, Providence, RI, 02908, USA. maw@brown.edu. ·Cancer Treat Res · Pubmed #26601859.

ABSTRACT: Detection and removal of melanoma, before it has metastasized, dramatically improves prognosis and survival. The purpose of this chapter is to (1) summarize current methods of melanoma detection and (2) review state-of-the-art detection methods and technologies that have the potential to reduce melanoma mortality. Current strategies for the detection of melanoma range from population-based educational campaigns and screening to the use of algorithm-driven imaging technologies and performance of assays that identify markers of transformation. This chapter will begin by describing state-of-the-art methods for educating and increasing awareness of at-risk individuals and for performing comprehensive screening examinations. Standard and advanced photographic methods designed to improve reliability and reproducibility of the clinical examination will also be reviewed. Devices that magnify and/or enhance malignant features of individual melanocytic lesions (and algorithms that are available to interpret the results obtained from these devices) will be compared and contrasted. In vivo confocal microscopy and other cellular-level in vivo technologies will be compared to traditional tissue biopsy, and the role of a noninvasive "optical biopsy" in the clinical setting will be discussed. Finally, cellular and molecular methods that have been applied to the diagnosis of melanoma, such as comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH), and quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), will be discussed.

8 Review Update in genetic susceptibility in melanoma. 2015

Potrony, Miriam / Badenas, Celia / Aguilera, Paula / Puig-Butille, Joan Anton / Carrera, Cristina / Malvehy, Josep / Puig, Susana. ·1 Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain ; 2 Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain ; 3 Molecular Biology and Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, Barcelona, Spain. ·Ann Transl Med · Pubmed #26488006.

ABSTRACT: Melanoma is the most deadly of the common skin cancers and its incidence is rapidly increasing. Approximately 10% of cases occur in a familial context. To date, cyclin-dependent kinase inhibitor 2A (CDKN2A), which was identified as the first melanoma susceptibility gene more than 20 years ago, is the main high-risk gene for melanoma. A few years later cyclin-dependent kinase 4 (CDK4) was also identified as a melanoma susceptibility gene. The technologic advances have allowed the identification of new genes involved in melanoma susceptibility: Breast cancer 1 (BRCA1) associated protein 1 (BAP1), CXC genes, telomerase reverse transcriptase (TERT), protection of telomeres 1 (POT1), ACD and TERF2IP, the latter four being involved in telomere maintenance. Furthermore variants in melanocortin 1 receptor (MC1R) and microphthalmia-associated transcription factor (MITF) give a moderately increased risk to develop melanoma. Melanoma genetic counseling is offered to families in order to better understand the disease and the genetic susceptibility of developing it. Genetic counseling often implies genetic testing, although patients can benefit from genetic counseling even when they do not fulfill the criteria for these tests. Genetic testing for melanoma predisposition mutations can be used in clinical practice under adequate selection criteria and giving a valid test interpretation and genetic counseling to the individual.

9 Review Monitoring patients with multiple nevi. 2013

Puig, Susana / Malvehy, Josep. ·Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, IDIBAPS, Villarroel 170, Barcelona 08036, Spain. ·Dermatol Clin · Pubmed #24075545.

ABSTRACT: Early recognition is the most effective intervention to improve melanoma mortality. Early diagnosis of melanoma in atypical mole syndrome patients, however, may be challenging. Skin self-examination and periodic physician-based total-body skin examinations are recommended in atypical mole patients but dermoscopy, total-body photography, and digital dermatoscopy have been proved to improve accuracy in early detection of melanoma in these high-risk patients. Digital follow-up in atypical mole syndrome patients allows detection of new lesions and changes in preexisting lesions.

10 Review A clinico-dermoscopic approach for skin cancer screening: recommendations involving a survey of the International Dermoscopy Society. 2013

Argenziano, Giuseppe / Giacomel, Jason / Zalaudek, Iris / Blum, Andreas / Braun, Ralph P / Cabo, Horacio / Halpern, Allan / Hofmann-Wellenhof, Rainer / Malvehy, Josep / Marghoob, Ashfaq A / Menzies, Scott / Moscarella, Elvira / Pellacani, Giovanni / Puig, Susana / Rabinovitz, Harold / Saida, Toshiaki / Seidenari, Stefania / Soyer, H Peter / Stolz, Wilhelm / Thomas, Luc / Kittler, Harald. ·Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, Reggio Emilia 42100, Italy. Electronic address: g.argenziano@gmail.com. ·Dermatol Clin · Pubmed #24075542.

ABSTRACT: Dermoscopy is useful for skin cancer screening, but a detailed approach is required that integrates this tool into a rational clinical work flow. To investigate clinician perceptions and behavior in approaching patients with skin tumors, a survey was launched by electronic mail through the International Dermoscopy Society. After 4 months, the responses were analyzed and significant findings calculated. Considering the current approach of study participants in examining patients for skin cancer, an up-to-date system of triage is presented in this review, which aims to promote an improved diagnostic accuracy and more timely management of skin malignancy.

11 Review Dermoscopic criteria and melanocytic lesions. 2012

Roldán-Marín, R / Puig, S / Malvehy, J. ·Diagnosis Dermatologica, Barcelona, Spain. ·G Ital Dermatol Venereol · Pubmed #22481578.

ABSTRACT: Dermoscopy is a noninvasive, in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. By allowing visualization of sub-macroscopic pigmented structures that correlate with specific underlying histopathologic structures, dermoscopy provides a more powerful tool than the naked-eye examination for clinicians to determine the need to excise a lesion. This article reviews the principles of dermoscopy, the most common dermoscopic patterns associated with nevi and melanoma, and the factors influencing the nevus pattern in a given individual.

12 Review Dermoscopic criteria and basal cell carcinoma. 2012

Puig, S / Cecilia, N / Malvehy, J. ·Melanoma Unit, Dermatology Department, Barcelona Clinical Hospital, IDIBAPS, Barcelona, Spain. susipuig@gmail.com ·G Ital Dermatol Venereol · Pubmed #22481576.

ABSTRACT: Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white population. Dermoscopy is a method that improves diagnosis in pigmented and non-pigmented skin lesions, allowing early diagnosis, especially of incipient lesions. The classical dermoscopy algorithm for the diagnosis of BCC includes lack of pigment network and the presence of at least one of the following criteria: ulceration, maple-leaf like structure, blue-gray globules, blue-ovoid nests, arborizing vessels and spoke-wheel structures. The non-classical dermoscopic features of BCC include some criteria more frequently seen in superficial BCC such as pink-white areas, concentric structures, multiple erosions, multiple in-focus blue-gray dots and fine vessels. Recently, the dermoscopy of Fibroepithelioma of Pinkus has also been described with the presence of fine arborizing vessels, white streaks and gray-brown structureless areas. Some dermoscopic structures also present in BCC are just visible with polarized dermoscopy such as white shiny streaks or Chrysalides and Rosetas. Improved knowledge of all these criteria may avoid some diagnostic pitfalls and improve the early recognition of BCCs.

13 Review [Melanocytic nevi, melanoma, and pregnancy]. 2011

Borges, V / Puig, S / Malvehy, J. ·Unidad de Melanoma, Servicio de Dermatología, Hospital Clínic, Barcelona, Spain. valborges@hotmail.com ·Actas Dermosifiliogr · Pubmed #21530926.

ABSTRACT: Malignant melanoma is among the malignant tumors whose incidence has risen markedly in recent decades. For many years the medical community debated the potential adverse effects of female hormones (whether of exogenous or pregnancy-related endogenous origin), on melanocytic nevi and malignant melanoma. Given that women have been delaying pregnancy until their thirties or forties and that the incidence of malignant melanoma increases in those decades, the likelihood of this tumor developing during pregnancy has increased. Recent clinical and experimental evidence has suggested that pregnancy does not affect prognosis in malignant melanoma and that it does not seem to lead to significant changes in nevi. This review examines the relationship between malignant melanoma and hormonal and reproductive factors. Evidence was located by MEDLINE search (in PubMed and Ovid) for articles in English and Spanish for the period from 1966 to March 2010; additional sources were found through the reference lists of the identified articles.

14 Clinical Trial MAGE-A3 immunotherapeutic as adjuvant therapy for patients with resected, MAGE-A3-positive, stage III melanoma (DERMA): a double-blind, randomised, placebo-controlled, phase 3 trial. 2018

Dreno, Brigitte / Thompson, John F / Smithers, Bernard Mark / Santinami, Mario / Jouary, Thomas / Gutzmer, Ralf / Levchenko, Evgeny / Rutkowski, Piotr / Grob, Jean-Jacques / Korovin, Sergii / Drucis, Kamil / Grange, Florent / Machet, Laurent / Hersey, Peter / Krajsova, Ivana / Testori, Alessandro / Conry, Robert / Guillot, Bernard / Kruit, Wim H J / Demidov, Lev / Thompson, John A / Bondarenko, Igor / Jaroszek, Jaroslaw / Puig, Susana / Cinat, Gabriela / Hauschild, Axel / Goeman, Jelle J / van Houwelingen, Hans C / Ulloa-Montoya, Fernando / Callegaro, Andrea / Dizier, Benjamin / Spiessens, Bart / Debois, Muriel / Brichard, Vincent G / Louahed, Jamila / Therasse, Patrick / Debruyne, Channa / Kirkwood, John M. ·Department of Dermatooncology, Hotel Dieu Nantes University Hospital, Nantes, France. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia. · Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia. · Melanoma Sarcoma Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. · Service d'Oncologie Médicale, Hôpital François Mitterrand, Pau, France. · Skin Cancer Center Hannover, Department of Dermatology, Hannover Medical School, Hannover, Germany. · Petrov Research Institute of Oncology, St Petersburg, Russia. · Department of Soft Tissue, Bone Sarcoma, and Melanoma, Maria Sklodowska-Curie Institute, Oncology Center, Warsaw, Poland. · Department of Dermatology and Skin Cancers, La Timone APHM Hospital, Aix-Marseille University, Marseille, France. · Department of Skin and Soft Tissue Tumours, National Cancer Institute, Kiev, Ukraine. · Swissmed Centrum Zdrowia, Gdansk, Poland; Department of Surgical Oncology, Gdansk Medical University, Gdansk, Poland. · Dermatology Department, Hôpital Robert Debré, Université de Reims Champagne-Ardenne, Reims, France. · Department of Dermatology, Centre Hospitalier Universitaire, Tours, France; UFR de Médecine, Université François-Rabelais, Tours, France. · Melanoma Immunology and Oncology Group, Centenary Institute, University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, Sydney, NSW, Australia. · Dermato-oncology Department, General University Hospital, Prague, Czech Republic. · Columbus Clinic Center, Milan, Italy. · Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. · Département de Dermatologie, Centre Hospitalier Universitaire, Hôpital Saint-Éloi, Montpellier, France. · Department of Medical Oncology, Erasmus MC Cancer institute, Rotterdam, Netherlands. · Cancer Research Center, Moscow, Russia. · Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Seattle Cancer Care Alliance, University of Washington, Seattle, WA, USA. · Department of Oncology and Medical Radiology, Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine. · Centrum Medyczne Bieńkowski, Klinika Chirurgii Plastycznej, Bydgoszcz, Poland; Department of Oncological Surgery, Oncology Center, Bydgoszcz, Poland. · Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain. · Instituto de Oncología Ángel H Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina. · Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany. · Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands. · GlaxoSmithKline, Rixensart, Belgium. Electronic address: fernando.x.ulloa-montoya@GSK.com. · GlaxoSmithKline, Rixensart, Belgium. · GlaxoSmithKline, Rixensart, Belgium; Immunology Translational Medicine, UCB, Brussels, Belgium. · GlaxoSmithKline, Rixensart, Belgium; Biostatistics Department, Janssen Research & Development, Beerse, Belgium. · GlaxoSmithKline, Rixensart, Belgium; ViaNova Biosciences, Brussels, Belgium. · GlaxoSmithKline, Rixensart, Belgium; Laboratoires Servier, Paris, France. · GlaxoSmithKline, Rixensart, Belgium; University Hospitals Leuven, Leuven, Belgium. · UPMC Hillman Cancer Center, Pittsburgh, PA, USA. ·Lancet Oncol · Pubmed #29908991.

ABSTRACT: BACKGROUND: Despite newly approved treatments, metastatic melanoma remains a life-threatening condition. We aimed to evaluate the efficacy of the MAGE-A3 immunotherapeutic in patients with stage IIIB or IIIC melanoma in the adjuvant setting. METHODS: DERMA was a phase 3, double-blind, randomised, placebo-controlled trial done in 31 countries and 263 centres. Eligible patients were 18 years or older and had histologically proven, completely resected, stage IIIB or IIIC, MAGE-A3-positive cutaneous melanoma with macroscopic lymph node involvement and an Eastern Cooperative Oncology Group performance score of 0 or 1. Randomisation and treatment allocation at the investigator sites were done centrally via the internet. We randomly assigned patients (2:1) to receive up to 13 intramuscular injections of recombinant MAGE-A3 with AS15 immunostimulant (MAGE-A3 immunotherapeutic; 300 μg MAGE-A3 antigen plus 420 μg CpG 7909 reconstituted in AS01B to a total volume of 0·5 mL), or placebo, over a 27-month period: five doses at 3-weekly intervals, followed by eight doses at 12-weekly intervals. The co-primary outcomes were disease-free survival in the overall population and in patients with a potentially predictive gene signature (GS-positive) identified previously and validated here via an adaptive signature design. The final analyses included all patients who had received at least one dose of study treatment; analyses for efficacy were in the as-randomised population and for safety were in the as-treated population. This trial is registered with ClinicalTrials.gov, number NCT00796445. FINDINGS: Between Dec 1, 2008, and Sept 19, 2011, 3914 patients were screened, 1391 randomly assigned, and 1345 started treatment (n=895 for MAGE-A3 and n=450 for placebo). At final analysis (data cutoff May 23, 2013), median follow-up was 28·0 months [IQR 23·3-35·5] in the MAGE-A3 group and 28·1 months [23·7-36·9] in the placebo group. Median disease-free survival was 11·0 months (95% CI 10·0-11·9) in the MAGE-A3 group and 11·2 months (8·6-14·1) in the placebo group (hazard ratio [HR] 1·01, 0·88-1·17, p=0·86). In the GS-positive population, median disease-free survival was 9·9 months (95% CI 5·7-17·6) in the MAGE-A3 group and 11·6 months (5·6-22·3) in the placebo group (HR 1·11, 0·83-1·49, p=0·48). Within the first 31 days of treatment, adverse events of grade 3 or worse were reported by 126 (14%) of 894 patients in the MAGE-A3 group and 56 (12%) of 450 patients in the placebo group, treatment-related adverse events of grade 3 or worse by 36 (4%) patients given MAGE-A3 vs six (1%) patients given placebo, and at least one serious adverse event by 14% of patients in both groups (129 patients given MAGE-A3 and 64 patients given placebo). The most common adverse events of grade 3 or worse were neoplasms (33 [4%] patients in the MAGE-A3 group vs 17 [4%] patients in the placebo group), general disorders and administration site conditions (25 [3%] for MAGE-A3 vs four [<1%] for placebo) and infections and infestations (17 [2%] for MAGE-A3 vs seven [2%] for placebo). No deaths were related to treatment. INTERPRETATION: An antigen-specific immunotherapeutic alone was not efficacious in this clinical setting. Based on these findings, development of the MAGE-A3 immunotherapeutic for use in melanoma has been stopped. FUNDING: GlaxoSmithKline Biologicals SA.

15 Clinical Trial Adjuvant Pembrolizumab versus Placebo in Resected Stage III Melanoma. 2018

Eggermont, Alexander M M / Blank, Christian U / Mandala, Mario / Long, Georgina V / Atkinson, Victoria / Dalle, Stéphane / Haydon, Andrew / Lichinitser, Mikhail / Khattak, Adnan / Carlino, Matteo S / Sandhu, Shahneen / Larkin, James / Puig, Susana / Ascierto, Paolo A / Rutkowski, Piotr / Schadendorf, Dirk / Koornstra, Rutger / Hernandez-Aya, Leonel / Maio, Michele / van den Eertwegh, Alfonsus J M / Grob, Jean-Jacques / Gutzmer, Ralf / Jamal, Rahima / Lorigan, Paul / Ibrahim, Nageatte / Marreaud, Sandrine / van Akkooi, Alexander C J / Suciu, Stefan / Robert, Caroline. ·From the Gustave Roussy Cancer Campus Grand Paris and University Paris-Saclay, Villejuif (A.M.M.E., C.R.), Hospices Civils de Lyon Cancer Institute, Cancer Research Center of Lyon, Lyon University, Lyon (S.D.), and Aix-Marseille University, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille (J.-J.G.) - all in France · Netherlands Cancer Institute-Antoni van Leeuwenhoek (C.U.B., A.C.J.A.) and VU University Medical Center (A.J.M.E.), Amsterdam, and Radboud University Medical Center Nijmegen, Nijmegen (R.K.) - all in the Netherlands · Azienda Ospedaliera Papa Giovanni XXIII, Bergamo (M. Mandala), Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, Naples (P.A.A.), and Universita Degli Studi Di Siena-Policlinico le Scotte, Siena (M. Maio) - all in Italy · Melanoma Institute Australia, the University of Sydney, and Mater and Royal North Shore Hospitals (G.V.L.) and Westmead and Blacktown Hospitals, Melanoma Institute Australia and the University of Sydney (M.S.C.), Sydney, Princess Alexandra Hospital, University of Queensland, Brisbane (V.A.), Alfred Hospital (A.H.) and Peter MacCallum Cancer Centre (S. Sandhu), Melbourne, VIC, and Fiona Stanley Hospital-University of Western Australia-Edith Cowan University Perth, Perth (A.K.) - all in Australia · Cancer Research Center, Moscow (M.L.) · Royal Marsden Hospital, London (J.L.) · Hospital Clinic Universitari de Barcelona, Barcelona (S.P.) · Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland (P.R.) · University Hospital Essen, Essen and German Cancer Consortium, Heidelberg (D.S.), and the Skin Cancer Center, Department of Dermatology, Hannover Medical School, Hannover (R.G.) - all in Germany · Washington University School of Medicine, St. Louis (L.H.-A.) · Centre Hospitalier de l'Université de Montréal (CHUM), Centre de Recherche du CHUM, Montreal (R.J.) · Christie NHS Foundation Trust, Manchester, United Kingdom (P.L.) · Merck, Kenilworth, NJ (N.I.) · and the European Organization for the Research and Treatment of Cancer Headquarters, Brussels (S.M., S. Suciu). ·N Engl J Med · Pubmed #29658430.

ABSTRACT: BACKGROUND: The programmed death 1 (PD-1) inhibitor pembrolizumab has been found to prolong progression-free and overall survival among patients with advanced melanoma. We conducted a phase 3 double-blind trial to evaluate pembrolizumab as adjuvant therapy in patients with resected, high-risk stage III melanoma. METHODS: Patients with completely resected stage III melanoma were randomly assigned (with stratification according to cancer stage and geographic region) to receive 200 mg of pembrolizumab (514 patients) or placebo (505 patients) intravenously every 3 weeks for a total of 18 doses (approximately 1 year) or until disease recurrence or unacceptable toxic effects occurred. Recurrence-free survival in the overall intention-to-treat population and in the subgroup of patients with cancer that was positive for the PD-1 ligand (PD-L1) were the primary end points. Safety was also evaluated. RESULTS: At a median follow-up of 15 months, pembrolizumab was associated with significantly longer recurrence-free survival than placebo in the overall intention-to-treat population (1-year rate of recurrence-free survival, 75.4% [95% confidence interval {CI}, 71.3 to 78.9] vs. 61.0% [95% CI, 56.5 to 65.1]; hazard ratio for recurrence or death, 0.57; 98.4% CI, 0.43 to 0.74; P<0.001) and in the subgroup of 853 patients with PD-L1-positive tumors (1-year rate of recurrence-free survival, 77.1% [95% CI, 72.7 to 80.9] in the pembrolizumab group and 62.6% [95% CI, 57.7 to 67.0] in the placebo group; hazard ratio, 0.54; 95% CI, 0.42 to 0.69; P<0.001). Adverse events of grades 3 to 5 that were related to the trial regimen were reported in 14.7% of the patients in the pembrolizumab group and in 3.4% of patients in the placebo group. There was one treatment-related death due to myositis in the pembrolizumab group. CONCLUSIONS: As adjuvant therapy for high-risk stage III melanoma, 200 mg of pembrolizumab administered every 3 weeks for up to 1 year resulted in significantly longer recurrence-free survival than placebo, with no new toxic effects identified. (Funded by Merck; ClinicalTrials.gov number, NCT02362594 ; EudraCT number, 2014-004944-37 .).

16 Clinical Trial Should immediate lymphadenectomy be discontinued in patients with metastasis of a melanoma in the sentinel lymph node? Report of the results of the Multicenter Selective Lymphadenectomy Trial-II. 2018

Moreno-Ramírez, David / Vidal-Sicart, Sergi / Puig, Susana / Malvehy, Josep. ·Unidad de Melanoma, Servicio de Dermatología, Hospital Clínic, Barcelona, España. Electronic address: dmoreno@e-derma.org. · Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España. · Unidad de Melanoma, Servicio de Dermatología, Hospital Clínic, Barcelona, España. ·Med Clin (Barc) · Pubmed #29089120.

ABSTRACT: -- No abstract --

17 Article Up-Regulation of PARP1 Expression Significantly Correlated with Poor Survival in Mucosal Melanomas. 2020

Donizy, Piotr / Wu, Cheng-Lin / Mull, Jason / Fujimoto, Masakazu / Chłopik, Agata / Peng, Yan / Shalin, Sara C / Selim, M Angelica / Puig, Susana / Fernandez-Figueras, Maria-Teresa / Shea, Christopher R / Biernat, Wojciech / Ryś, Janusz / Marszalek, Andrzej / Hoang, Mai P. ·Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University, 50-556 Wroclaw, Poland. · Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan. · Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. · Department of Pathology, Wakayama Medical University, Wakayama 641-8510, Japan. · Department of Pathology, Poznan University Medical Sciences and Greater Poland Cancer Center, 61-701 Poznan, Poland. · Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. · Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA. · Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, 08036 Barcelona, Spain. · Department of Pathology, Hospital Universitari Germans Trias i Pujol, Hospital Universitari General de Catalunya, Grupo QuironSalud, Universitat Internacional de Catalunya, 08916 Barcelona, Spain. · Department of Medicine, Section of Dermatology University of Chicago, Chicago, IL 60637, USA. · Department of Pathology, Medical University of Gdansk, 80-210 Gdansk, Poland. · Department of Tumor Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 31-115 Krakow Branch, Poland. · Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. ·Cells · Pubmed #32380691.

ABSTRACT: INTRODUCTION: Mucosal melanoma is rare and associated with poorer prognosis in comparison to conventional melanoma subtypes. Little is known about the prognostic significance as well as possible associations between PARP1 and immunologic response in mucosal melanoma. METHODS: PARP1, PD-L1 and IDO1 immunostains were performed on 192 mucosal melanomas including 86 vulvar, 89 sinonasal, and 17 anorectal melanomas. RESULTS: By Kaplan-Meier analyses, high PARP1 expression correlated with worse overall and melanoma-specific survival (log-rank CONCLUSION: Increased expression of PARP1 is an independent negative prognostic marker in mucosal melanomas. The association between PARP1 and IDO1 and their combined adverse prognostic role raise the potential of combined therapy in mucosal melanoma.

18 Article Sutton Naevi as Melanoma Simulators: Can Confocal Microscopy Help in the Diagnosis? 2020

Brugués, Albert / Ribero, Simone / Martins da Silva, Vanessa / Aguilera, Paula / Garcia, Adriana P / Alós, Llucia / Malvehy, Josep / Puig, Susana / Carrera, Cristina. ·Dermatology Department, Hospital Clínic and Melanoma Group IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), ES-08036 Barcelona, Spain. ·Acta Derm Venereol · Pubmed #32318743.

ABSTRACT: Sutton naevi can sometimes present a challenging appearance with atypical presentation, also by dermoscopy. Reflectance confocal microscopy could help in making a diagnosis. This study prospectively collected two groups of Sutton nevi: the first one was composed by typical white halo naevi monitored for one year (13, 23%) and the second one was made up of atypical lesions excised in order to rule out melanoma, which were histologically diagnosed as Sutton naevi (21, 37%). These two groups of Sutton naevi were compared to a retrospectively collected cohort of thin melanomas with histologic regression features (23, 40%). On dermoscopy, atypical Sutton naevi and melanomas were indistinguishable. Reflectance confocal microscopy demonstrated significant differences at the dermo-epidermal junction: marked dermo-epidermal junction thickening and non-edged papilla were associated with melanoma, while the presence of nests was associated with Sutton naevi. However, reflectance confocal microscopy also detected marked intraepidermal pagetoid cells in Sutton naevi that were a combination of MelanA+ and CD1a+ cells. Sutton naevi can simulate melanoma, under both dermoscopy and reflectance confocal microscopy. Nevertheless, relevant confocal dermo-epidermal junction features and the clinical scenario can be helpful to make a final diagnosis, especially in those situations where melanoma must be ruled out.

19 Article Histologic features of melanoma associated with germline mutations of CDKN2A, CDK4, and POT1 in melanoma-prone families from the United States, Italy, and Spain. 2020

Sargen, Michael R / Calista, Donato / Elder, David E / Massi, Daniela / Chu, Emily Y / Potrony, Míriam / Pfeiffer, Ruth M / Carrera, Cristina / Aguilera, Paula / Alos, Llucia / Puig, Susana / Elenitsas, Rosalie / Yang, Xiaohong R / Tucker, Margaret A / Landi, Maria Teresa / Goldstein, Alisa M. ·Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. Electronic address: michael.sargen@nih.gov. · Department of Dermatology, Maurizio Bufalini Hospital, Cesena, Italy. · Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA. · Section of Pathological Anatomy, Department of Health Sciences, University of Florence, Florence, Italy. · Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA. · Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain. · Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. · Pathology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain. · Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. · Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. · Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD. ·J Am Acad Dermatol · Pubmed #32283231.

ABSTRACT: BACKGROUND: CDKN2A, CDK4, and POT1 are well-established melanoma-susceptibility genes. OBJECTIVE: We evaluated melanoma histopathology for individuals with germline mutations of CDKN2A, CDK4, and POT1. METHODS: We assessed histopathology for melanomas diagnosed in melanoma-prone families (≥2 individuals with melanoma) from the United States, Italy, and Spain. Comparisons between mutation carriers and non-carriers (no mutation) were adjusted for age, sex, Breslow depth, and correlations among individuals within the same family. RESULTS: Histologic slides were evaluated for 290 melanomas (139 from 132 non-carriers, 122 from 68 CDKN2A carriers, 10 from 6 CDK4 carriers, 19 from 16 POT1 carriers). Superficial spreading was the predominant subtype for all groups. Spitzoid morphology (>25% of tumor) was observed in the majority of invasive melanomas from POT1 carriers (10 of 15 [67%], P<.0001 vs. non-carriers). This finding was independently confirmed by three expert melanoma dermatopathologists in 9 of 15 (60%) invasive melanomas. In situ and invasive melanomas from CDKN2A and CDK4 carriers were histologically similar to melanomas from non-carriers. LIMITATIONS: Limited sample sizes for rare melanoma-susceptibility syndromes (CDK4, POT1) CONCLUSION: Spitzoid morphology was associated with POT1 mutations suggesting that telomere dysfunction (POT1 mutations) may contribute to Spitzoid differentiation in melanocytic tumors.

20 Article Age as a prognostic factor in thick and ultrathick melanomas without lymph node metastasis. 2020

Boada, A / Tejera-Vaquerizo, A / Ribero, S / Puig, S / Moreno-Ramírez, D / Osella-Abate, S / Cassoni, P / Malvehy, J / Podlipnik, S / Requena, C / Manrique-Silva, E / Rios Martin, J J / Ferrándiz, C / Nagore, E / Anonymous5991157. ·Dermatology Department. Hospital, Universitari Germans Trial i Pujol. Fundació Institut d'Investigació Germans Trias i Pujol. Badalona, Departament de Medicina, Universitat Autònoma de Barcelona, Spain. · Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain. · Medical Sciences Department. Section of Dermatology, University of Turin, Turin, Italy. · Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain. · Melanoma Unit. Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Section of Surgical Pathology, Medical Science Department, University of Turin, Turin, Italy. · Melanoma Unit. Dermatology Department. Hospital Clinic. Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. · Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department. Hospital, Universitario Virgen Macarena, Sevilla, Spain. ·J Eur Acad Dermatol Venereol · Pubmed #32259328.

ABSTRACT: The presence of regional metastasis is a predictor of worse survival in thick melanoma

21 Article Machine Learning in Melanoma Diagnosis. Limitations About to be Overcome. 2020

González-Cruz, C / Jofre, M A / Podlipnik, S / Combalia, M / Gareau, D / Gamboa, M / Vallone, M G / Faride Barragán-Estudillo, Z / Tamez-Peña, A L / Montoya, J / América Jesús-Silva, M / Carrera, C / Malvehy, J / Puig, S. ·Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España. · Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, España. · Laboratory of Investigative Dermatology, The Rockefeller University, Nueva York, EE. UU. · Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, España; CIBER en Enfermedades raras, Instituto de Salud Carlos III, Barcelona, España. · Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, España; CIBER en Enfermedades raras, Instituto de Salud Carlos III, Barcelona, España. Electronic address: susipuig@gmail.com. ·Actas Dermosifiliogr · Pubmed #32248945.

ABSTRACT: BACKGROUND: Automated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice. OBJECTIVE: To determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma. METHODS: Retrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis. RESULTS: Of the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis. DISCUSSION: Only 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show.

22 Article Diagnostic accuracy of pigmented labial macules by in vivo reflectance confocal microscopy and correlation among techniques. 2020

Gómez-Martín, Ignacio / Collgros, Helena / Ferguson, Peter M / Barreiro, Alicia / Guitera, Pascale / Andrades-López, Evelyn / Puig, Susana / Pujol, Ramon M / Barranco, Carlos / Alòs, Llúcia / Segura, Sonia. ·Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: nachgm@gmail.com. · Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. · Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. · Department of Dermatology, Hospital Clínic-Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain. · Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Melanoma Institute Australia and Central Clinical School, Sydney University, New South Wales, Australia. · Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain. · Department of Dermatology, Hospital Clínic-Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain. · Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Departament de Medicina de la UAB, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain. · Department of Pathology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain. · Department of Pathology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain. ·J Am Acad Dermatol · Pubmed #32147389.

ABSTRACT: BACKGROUND: Pigmented labial macules (PLMs) are clinical, dermoscopic, and histopathologic challenges. OBJECTIVE: To describe and evaluate the utility of reflectance confocal microscopy (RCM) in PLMs and to establish a correlation between dermoscopy, RCM, histopathology, and immunohistochemistry. METHODS: Prospective study of PLMs from 4 tertiary referral dermatology centers. The study included 51 biopsy specimen-proven PLMs. Dermoscopic, RCM images, and histopathologic preparations were evaluated for malignant criteria. Diagnostic accuracy of RCM for melanoma diagnosis, RCM Lip Score previously reported, and κ values between techniques were calculated. RESULTS: Included were 5 melanomas and 46 benign PLMs. Dermoscopically, melanomas exhibited more frequently ≥3 colors and ≥3 structures. With RCM, pagetoid spreading, epithelial disarray, continuous proliferation of atypical cells around papillae, nonhomogeneously distributed papillae, marked cellular atypia, and a higher number of dendritic cells per papillae were more frequent in melanomas. The RCM Lip Score was significantly higher in malignant lesions. Good κ values were observed in most of the evaluated features. A perfect sensitivity and specificity was obtained combining dermoscopy and RCM. LIMITATIONS: A low number of melanomas were obtained. CONCLUSIONS: RCM improves lip melanoma diagnosis, and the RCM Lip Score represents a useful tool for the evaluation of a PLM.

23 Article Microblotches on Dermoscopy of Melanocytic Lesions are Associated with Melanoma: A Cross-sectional Study. 2020

Lukoviek, Vania / Ferrera, Nuria / Podlipnik, Sebastian / Ertekin, Sümeyre Seda / Carrera, Cristina / Barreiro, Alicia / Chavez-Bourgeois, Marion / Perino, Francesca / Ortiz-Ruiz, Mauricio / Puig, Susana / Malvehy, Josep. ·Department of Dermatology, Melanoma Unit, Hospital Clínic of Barcelona, Barcelona, Spain. ·Acta Derm Venereol · Pubmed #32110813.

ABSTRACT: Numerous dermoscopic structures for the early detection of melanoma have been described. The aim of this study was to illustrate the characteristics of dermoscopic structures that are similar to blotches, but smaller (termed microblotches), and to evaluate their association with other well-known dermoscopic structures. A cross-sectional study design, including 165 dermoscopic images of melanoma was used to define microblotches, and 241 consecutive images of naevi from the HAM10000 database, were studied to evaluate the prevalence of this criterion in both groups. Microblotches were defined as sharply demarcated structures ≤1 mm, with geographical borders visible only with dermoscopy. Microblotches were present in 38.7% of the melanomas and 6.7% of the naevi. Moreover, microblotches were associated with an odds ratio (OR) of malignancy of 5.79, and were more frequent in invasive melanoma than in the in-situ subtype (OR 2.92). Histologically, they correspond to hyperpigmented parakeratosis or epidermal consumption. In conclusion, microblotches are related to melanomas. This finding could help dermatologists to differentiate between naevi and melanomas.

24 Article Factors associated with sentinel lymph node status and prognostic role of completion lymph node dissection for thick melanoma. 2020

Boada, Aram / Tejera-Vaquerizo, Antonio / Ribero, Simone / Puig, Susana / Moreno-Ramírez, David / Quaglino, Pietro / Osella-Abate, Simona / Cassoni, Paola / Malvehy, Josep / Carrera, Cristina / Pigem, Ramon / Barreiro-Capurro, Alicia / Requena, Celia / Traves, Victor / Manrique-Silva, Esperanza / Fernández-Orland, Almudena / Ferrandiz, Lara / García-Senosiain, Oihane / Fernández-Figueras, María T / Ferrándiz, Carlos / Nagore, Edurado / Anonymous2361127. ·Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain. Electronic address: aboada.germanstrias@gencat.cat. · Dermatology Department, Instituto Dermatológico GlobalDerm, Palma del Río, Córdoba, Spain. · Medical Sciences Department, Section of Dermatology, University of Turin, Turin, Italy. · Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Barcelona, Spain. · Melanoma Unit, Medical-&-Surgical Dermatology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. · Section of Surgical Pathology, Medical Science Department, University of Turin, Italy. · Dermatology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Pathology Department, Instituto Valenciano de Oncología, Valencia, Spain. · Plastic Surgery Department, Hospital Universitari Germans Trial i Pujol. Badalona, Spain. · Pathology Department, Hospital Universitari Germans Trial i Pujol. Badalona, Spain. · Dermatology Department, Hospital Universitari Germans Trial i Pujol, Institut d'investigació en ciències de la salut Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Spain. ·Eur J Surg Oncol · Pubmed #31594672.

ABSTRACT: INTRODUCTION: Sentinel lymph node (SLN) biopsy is useful for the prognostic stratification of patients with thick melanoma. Identifying which variables are associated with SLN involvement and establishing risk in different subgroups of patients could be useful for guiding the indication of SLN biopsy. The value of complete lymph node dissection (CLND) in patients with a positive SLN biopsy is currently under debate. MATERIALS AND METHODS: To identify factors associated with SLN involvement in thick melanoma we performed a multicentric retrospective cohort study involving 660 patients with thick melanoma who had undergone SLN biopsy. To analyze the role of CLND in thick melanoma patients with a positive SLN biopsy, we built a multivariate Cox proportional hazards model for melanoma-specific survival (MSS) and disease-free survival (DFS) and compared 217 patients who had undergone CLND with 44 who had not. RESULTS: The logistic regression analysis showed that age, histologic subtype, ulceration, microscopic satellitosis, and lymphovascular invasion were associated with nodal disease. The CHAID (Chi-squared Automatic Interaction Detection) decision tree showed ulceration to be the most important predictor of lymphatic involvement. For nonulcerated melanomas, the histologic subtype lentigo maligna melanoma was associated with a low rate of SLN involvement (4.3%). No significant differences were observed for DFS and MSS between the CLND performed and not-performed groups. Nodal status on CLND was associated with differences in DFS and MSS rates. CONCLUSION: We identified subgroups of thick melanoma patients with a low likelihood of SLN involvement. CLND does not offer survival benefit, but provides prognostic information.

25 Article Efficacy of novel immunotherapy regimens in patients with metastatic melanoma with germline 2020

Helgadottir, Hildur / Ghiorzo, Paola / van Doorn, Remco / Puig, Susana / Levin, Max / Kefford, Richard / Lauss, Martin / Queirolo, Paola / Pastorino, Lorenza / Kapiteijn, Ellen / Potrony, Miriam / Carrera, Cristina / Olsson, Håkan / Höiom, Veronica / Jönsson, Göran. ·Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden. · Department of Internal Medicine and Medical Specialties, University of Genoa and Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Department of Dermatology, LUMC, Leiden, The Netherlands. · Melanoma Unit, Dermatology Department, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain. · Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain. · Department of Oncology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. · Department of Clinical Medicine, Westmead Hospital and Macquarie University, Sydney, New South Wales, Australia. · Department of Oncology, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden. · Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands. ·J Med Genet · Pubmed #30291219.

ABSTRACT: BACKGROUND: Inherited RESULTS: Eleven of 19 carriers (58%) responded to the therapy, a significantly higher frequency than observed in clinical trials (p=0.03, binomial test against an expected rate of 37%). Further, 6 of the 19 carriers (32%) had complete response, a significantly higher frequency than observed in clinical trials (p=0.01, binomial test against an expected rate of 7%). In 118 melanomas with somatic CONCLUSION: Patients with

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