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Clinical Snippets
CLINICAL SNIPPETS
Trends in Nonmelanoma Skin Cancer The past four decades have witnessed increasing incidences of nonmelanoma skin cancers (NMSC), primarily basal cell carcinoma and squamous cell carcinoma. Because cancer registries often do not capture NMSC or record only the first tumor, the true disease burden may not be evident. Lieter and colleagues evaluated data from 1970-2012 from the Saarland and Schleswig-Holstein federal states in Germany. A continuous long-term increase in incidence of these cancers was observed, and linear extrapolation revealed that both the NMSC risk and disease burden are likely to increase through 2030 due to increased UV exposure and an aging population, while NMSC mortality is predicted to remain stable or even decrease. See page 1860.
Role of Dendritic Cell Subsets in Vaccine Response Recent evidence supporting the efficacy of intradermal (ID) immunization led Levin and colleagues to investigate the contributions of skin- and blood-derived antigen-presenting cells in the resultant development of T follicular helper (TFH) cells and germinal center B-cell responses. After removing the site of ID injection of antigen to restrict access of the antigen to lymph node dendritic cells and recruited blood cells, these investigators found a total absence of TFH and germinal center B-cell development. Furthermore, skin-migratory Langerhans cells facilitated the humoral immune response following ID injection. Effective vaccination via the ID route is dependent on migratory dendritic cells, including Langerhans cells. See page 1905.
Mutational Landscape Revealed The underlying mutational landscape of the rare and aggressive primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL-LT) has not been determined. Mareschal and colleagues performed whole exome sequencing and targeted nextgeneration sequencing of a cohort of 28 untreated PCLBCL-LT patients to ascertain a more comprehensive view of the genomic alterations involved in the pathogenesis of this lymphoma subtype. These findings validated previously documented alterations in MYD88, TNFAI3, PIM1, and CD79B and identified alterations in new candidate genes GNA13 and TBL1XR1. Alterations in genes that are involved in NF-kB and B-cell signaling pathways may ultimately guide therapeutic strategies based on personalized genetic analysis for relapsing PCLBCL-LT after immunochemotherapy. See page 1984. Journal of Investigative Dermatology (2017) 137, 1820. doi:10.1016/j.jid.2017.07.005
1820 Journal of Investigative Dermatology (2017), Volume 137
TREAT Registry Taskforce Recalcitrant atopic eczema accounts for more than 20% of total health loss due to skin conditions, and the need for comparative real-life clinical data for conventional and new therapies is real. The international TREatment of Atopic eczema (TREAT) Registry Taskforce recently conducted an international Delphi exercise involving 410 international dermatologists to establish a core set of domains and domain items to be captured by atopic eczema patient registries. These registries will be useful for harmonizing data collection on patients receiving systemic immunomodulatory therapies and will allow necessary longitudinal follow-up. These registries may also serve as a resource for biomarker discovery and pharmocogenetic research. See page 2014.
Understanding the Evolution of Common Melanocytic Nevi Melanocytic nevi are strongly associated with melanoma, with increased risk for melanoma with higher numbers of nevi. A systematic literature review by Plasmeijer and colleagues revealed limited scientific studies regarding the natural history of common melanocytic nevi in the general population. Of the two described studies, the US study documented a decline in the proportion of people over age 64 with 10 or more nevi, while the Turkish study did not find any change in nevus counts over a 12-month period in their study population, highlighting the need for additional longitudinal research of melanocytic nevus evolution. See page 2017.
ª 2017 The Society for Investigative Dermatology.
Trends in Nonmelanoma Skin Cancer The past four decades have witnessed increasing incidences of nonmelanoma skin cancers (NMSC), primarily basal cell carcinoma and squamous cell carcinoma. Because cancer registries often do not capture NMSC or record only the first tumor, the true disease burden may not be evident. Lieter and colleagues evaluated data from 1970-2012 from the Saarland and Schleswig-Holstein federal states in Germany. A continuous long-term increase in incidence of these cancers was observed, and linear extrapolation revealed that both the NMSC risk and disease burden are likely to increase through 2030 due to increased UV exposure and an aging population, while NMSC mortality is predicted to remain stable or even decrease. See page 1860.
Role of Dendritic Cell Subsets in Vaccine Response Recent evidence supporting the efficacy of intradermal (ID) immunization led Levin and colleagues to investigate the contributions of skin- and blood-derived antigen-presenting cells in the resultant development of T follicular helper (TFH) cells and germinal center B-cell responses. After removing the site of ID injection of antigen to restrict access of the antigen to lymph node dendritic cells and recruited blood cells, these investigators found a total absence of TFH and germinal center B-cell development. Furthermore, skin-migratory Langerhans cells facilitated the humoral immune response following ID injection. Effective vaccination via the ID route is dependent on migratory dendritic cells, including Langerhans cells. See page 1905.
Mutational Landscape Revealed The underlying mutational landscape of the rare and aggressive primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL-LT) has not been determined. Mareschal and colleagues performed whole exome sequencing and targeted nextgeneration sequencing of a cohort of 28 untreated PCLBCL-LT patients to ascertain a more comprehensive view of the genomic alterations involved in the pathogenesis of this lymphoma subtype. These findings validated previously documented alterations in MYD88, TNFAI3, PIM1, and CD79B and identified alterations in new candidate genes GNA13 and TBL1XR1. Alterations in genes that are involved in NF-kB and B-cell signaling pathways may ultimately guide therapeutic strategies based on personalized genetic analysis for relapsing PCLBCL-LT after immunochemotherapy. See page 1984. Journal of Investigative Dermatology (2017) 137, 1820. doi:10.1016/j.jid.2017.07.005
1820 Journal of Investigative Dermatology (2017), Volume 137
TREAT Registry Taskforce Recalcitrant atopic eczema accounts for more than 20% of total health loss due to skin conditions, and the need for comparative real-life clinical data for conventional and new therapies is real. The international TREatment of Atopic eczema (TREAT) Registry Taskforce recently conducted an international Delphi exercise involving 410 international dermatologists to establish a core set of domains and domain items to be captured by atopic eczema patient registries. These registries will be useful for harmonizing data collection on patients receiving systemic immunomodulatory therapies and will allow necessary longitudinal follow-up. These registries may also serve as a resource for biomarker discovery and pharmocogenetic research. See page 2014.
Understanding the Evolution of Common Melanocytic Nevi Melanocytic nevi are strongly associated with melanoma, with increased risk for melanoma with higher numbers of nevi. A systematic literature review by Plasmeijer and colleagues revealed limited scientific studies regarding the natural history of common melanocytic nevi in the general population. Of the two described studies, the US study documented a decline in the proportion of people over age 64 with 10 or more nevi, while the Turkish study did not find any change in nevus counts over a 12-month period in their study population, highlighting the need for additional longitudinal research of melanocytic nevus evolution. See page 2017.
ª 2017 The Society for Investigative Dermatology.