Abstract:
BACKGROUND:The treatment of melanoma in situ (MIS), particularly the lentigo maligna (LM) subtype, has been a controversial subject in the literature for over a decade. Surgical excision with 5 mm margins is the standard of care in the USA, while several variations of Mohs surgery are frequently used to treat clinically ill-defined lesions. Radiation is much less frequently used. Topical imiquimod has also been more recently proposed, in small case reports in the literature, as a therapy for MIS. However, controversies exist with all approaches. OBJECTIVE:To review the current literature regarding topical imiquimod, radiation therapy, surgical excision, and the various forms of Mohs surgery for MIS, focusing on the LM subtype. METHODS:A literature search was performed in the PubMed database using the following terms: "melanoma in situ,"lentigo maligna,"excisional surgery,"Mohs micrographic surgery,"radiation therapy," and "imiquimod." Articles relevant to the treatment of MIS were reviewed and reported herein. RESULTS:Studies of imiquimod therapy for MIS are hampered by small study numbers and short follow-up periods. The few, better-designed studies reveal relatively low cure rates. In addition, literature review reveals that a significant percentage of cases of MIS that are initially diagnosed as in situ disease by biopsy subsequently prove to have an invasive component upon complete excision. This finding suggests that topical therapy of any kind may be problematic. Studies of radiation therapy for MIS have relatively small numbers of patients and short follow-up. Multiple studies of excisional surgery have shown that 5 mm margins are often insufficient to clear the LM subtype of MIS due to unseen subclinical extension, accounting for this treatment's reported 8-20% recurrence rate. Finally, a number of variants of traditional frozen section Mohs surgery have been utilized to try and achieve complete peripheral margin assessment of clinically ill-defined LM lesions. All studies are retrospective, and most are single-institution and frequently single-operator, limiting the meaningfulness of their results. Nevertheless, they involve moderate numbers of patients, and many have at least a five year follow-up. Collectively, they suggest recurrence rates in the range of 0.5-3.0%. CONCLUSION:Topical imiquimod therapy appears to provide relatively low cure rates for MIS, and because some of these lesions contain an unrecognized invasive component, should be used with extreme caution to treat this disease. Radiation therapy may be a useful second-line therapy if surgery is contraindicated. Excisional surgery is an appropriate therapy for clinically well-defined MIS; however, margins larger than 5 mm may be required when treating larger or indistinct lesions. Finally, for clinically ill-defined LM arising on sun-damaged skin, especially in regions of aesthetic concern, some form of complete peripheral margin assessment - one of the various forms of Mohs surgery - may provide the highest cure rate and create the smallest surgical defect.
journal_name
Int J Dermatoljournal_title
International journal of dermatologyauthors
Erickson C,Miller SJdoi
10.1111/j.1365-4632.2010.04423.xsubject
Has Abstractpub_date
2010-05-01 00:00:00pages
482-91issue
5eissn
0011-9059issn
1365-4632pii
IJD4423journal_volume
49pub_type
杂志文章,评审abstract::There are 70.8 million persons displaced worldwide due to war, persecution, and violence. Eighty percent of displaced persons reside in low- and middle-income countries with limited healthcare resources. Cutaneous diseases are commonly reported among displaced persons owing to numerous interrelated factors such as ina...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/ijd.15063
更新日期:2020-07-19 00:00:00
abstract:BACKGROUND:Epidermoid cysts (EC) can occur anywhere in the body. In the head and neck region, they more often present in the midline between the submental region and the supra sternal notch. EC in the oral cavity are extremely rare and present as benign, slow growing lesions. METHODS:Records from College of Dental Sur...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2009.03490.x
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Though acral lentiginous melanoma (ALM) is a major type of malignant melanoma, no immunohistochemical study on this type of melanoma has been reported. OBJECTIVE:The purpose of this study is to analysis the immunohistochemical findings of ALM using routinely used immune markers. METHODS:An immunohistochemi...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1046/j.1365-4362.2003.01583.x
更新日期:2003-02-01 00:00:00
abstract::With more than 3 years' follow-up, dramatic clinical transfiguration of granuloma annulare was observed in a 59-year-old man with perforating granuloma annulare. The eruption was at first localized, then became generalized, developed perforations, and subsided in parallel with the improvement of associated diabetes me...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1985.tb05855.x
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:Several types of dermatofibroma (DF) have been identified dermatopathologically and with dermatoscopic correlation, the dermatopathology has been predictable in limited studies so far. We identify DFs with specific dermatoscopic structures and determine the respective dermatopathological correlates. METHODS...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/ijd.14559
更新日期:2020-01-01 00:00:00
abstract::With the advent of various new methods of treating psoriasis, it is necessary to remind physicians to consider an agent that is easy to administer, locally effective, relatively inexpensive, not time-consuming and without systemic toxic effects. Nineteen patients were treated with topical nitrogen mustard between 1972...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1979.tb05017.x
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:Ducatalon is a bipyridylium herbicide containing a mixture of diquat and paraquat, and is used in agriculture. Adverse reactions due to contact of this compound with the skin have rarely been described. CASE REPORTS:Two men were seen for severe pain due to extensive chemical burns in the perineal and scrota...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1995.tb04371.x
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Sequential treatment of actinic keratosis (AK) and cancerization field with cryotherapy and ingenol mebutate (IM) is widely used in clinical practice, however, the order of application of sequential treatment has not been examined yet. OBJECTIVE:To compare different sequential treatments of IM and cryothera...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/ijd.14164
更新日期:2018-10-01 00:00:00
abstract::The epidemiology of scabies for the last twelve years has been studied in Turkey. Information was obtained from three regions (Istanbul, Ankara and Erzurum) having different climates. There has been an increase in scabies in the years following 1969 in Ankara and Erzurum and from 1967 on in Istanbul. It reached its ma...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1980.tb01993.x
更新日期:1980-01-01 00:00:00
abstract::Nevus lipomatosus cutaneus superficialis (Hoffman-Zurhelle) is a distinct clinical entity. A case is reported in which the lesions were large, appeared early in childhood and were linear in distribution along the natal cleft. ...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1975.tb00110.x
更新日期:1975-05-01 00:00:00
abstract::A 30-year-old woman presented with an orange-yellow discoloration of the skin, most noticeable on the palms and soles and nasolabial folds; sclera appeared normal. The patient had observed the abnormal pigmentation of her skin 3 months earlier and noticed that it had become more evident after a sauna she had taken 2 d...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1992.tb03521.x
更新日期:1992-01-01 00:00:00
abstract::Affecting approximately 9.4% of the population worldwide, acne vulgaris is a common chronic inflammatory skin disease. Medical students are exposed to higher levels of stress and have a higher prevalence of acne. However, the risk factors and the impact of acne on medical students' mental health remains poorly underst...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/ijd.15280
更新日期:2020-10-31 00:00:00
abstract:BACKGROUND:Although the causes of striae distensae (SD) remain to be elucidated, the condition is known to relate to changes in the structures that provide the skin with its tensile strength and elasticity. OBJECTIVE:This study was conducted to evaluate whether premature birth is a risk factor for SD. METHODS:A total...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2011.04899.x
更新日期:2011-10-01 00:00:00
abstract::A 57-year-old woman with mycosis fungoides developed blisters within cutaneous plaques while receiving PUVA therapy and topical nitrogen mustard. Direct and indirect immunofluorescence studies showed the findings of bullous pemphigoid. Her bullous disease was controlled after cessation of these therapies and instituti...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1985.tb05751.x
更新日期:1985-04-01 00:00:00
abstract::Health authorities in the USA, Canada and Australia recommend a "no nit" policy, i.e. the immediate dismissal of all children who have head lice, eggs and/or nits on their hair from school, camp or child-care settings. These children would be readmitted to the institution only when all head lice, eggs and nits have be...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-4632.2006.02827.x
更新日期:2006-08-01 00:00:00
abstract::Punch grafting is an established treatment modality for management of localized, nonprogressive vitiligo resistant to conventional therapies.(1) In our set up, punch grafting is routinely carried out in focal vitiligo, segmental vitiligo and even in few cases of generalized vitiligo, especially when it is a serious co...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2004.01889.x
更新日期:2004-04-01 00:00:00
abstract::An 11-month-old male infant was referred to our clinic because of a painful ulcer of approximately 5 months' duration on the ventral surface of the tongue (Fig. 1). On physical examination, the lesion was circular (3 cm x 2 cm) with erythematous, raised, and indurated borders. No pathologic findings emerged from the l...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2004.02554.x
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Potent teratogenicity limits the use of isotretinoin among females of childbearing potential (FCBP). OBJECTIVE:To explore the current practice of dermatologists for pregnancy prevention when prescribing isotretinoin for FCBP. MATERIALS AND METHODS:A self-administered questionnaire was distributed to 160 de...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2011.04875.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Vitamin C has been used for the treatment of hyperpigmented diseases. However, there is no study available on hypopigmenting effect of multivitamin. OBJECTIVES:To investigate the inhibitory effects of multivitamin and vitamin C on melanogenesis. METHODS:We assessed the effect of multivitamin and vitamin C ...
journal_title:International journal of dermatology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-4632.2009.04336.x
更新日期:2010-02-01 00:00:00
abstract::A 5-year study of 668 patients with genital lesions revealed that teenagers and those in the age group of 20 to 40 are most vunerable. The poor, the uneducated and unmarried persons are at high risk. Chancroid and syphilis are the majority of cases. Inguinal bubo, herpes pregenitalis, condylomata acuminata, erosive ba...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract::Pityriasis lichenoides et varioliformis acuta (PLEVA), or Mucha-Habermann disease (MHD), is a cutaneous disorder evident with crops of erythematous macules and papules, usually on the trunk and flexural areas of the extremities. Its etiology remains unknown. PLEVA is speculated to be an inflammatory reaction triggered...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-4632.2008.03915.x
更新日期:2010-03-01 00:00:00
abstract::A case report of cutaneous onchocercias acquired during travels to Africa is presented. The salient epidemiologic, clinical, diagnostic, and therapeutic aspects are reviewed. Clinical and laboratory differences between onchocerciasis patients who are inhabitants of endemic areas and those who are occasional visitors t...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4632.2004.02203.x
更新日期:2005-02-01 00:00:00
abstract::Allergic reactions to insulin, although very common, are usually mild and self-limited. Many persistent effects can be corrected by simple means available to the discerning physician. In a few patients, however, they are severe and cause extreme morbidity or even mortality. These patients need to be recognized promptl...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1980.tb00277.x
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:Although disease severity, gender, body weight, and previous treatments have all been reported to affect clinical response of psoriasis vulgaris to narrowband ultraviolet B (NB-UVB) therapy, little information about possible local (lesional) influencing factors is available. OBJECTIVE:To assess correlations...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/ijd.13983
更新日期:2018-06-01 00:00:00
abstract::Challenge: Clinical and research responsibilities often leave little or no time to plan thoughtful teaching encounters with trainees. This "Teaching & Learning Tips" series is designed to be an accessible guide for dermatologists who want to improve their teaching skills. It is comprised of 12 articles about how to en...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/ijd.13751
更新日期:2017-11-01 00:00:00
abstract::In a consecutive series of 1,067 patients entered into the data base of the Melanoma Cooperative Group at New York University School of Medicine between 1972 and 1980, 120 men were of draft age (18-31 years) during World War II (1941-1945). Questionnaires were sent to these 120 individuals; 89 responded. Simultaneousl...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1984.tb01228.x
更新日期:1984-12-01 00:00:00
abstract::To date, various treatment modalities have failed to produce consistent improvement in patients having Behçet's disease. Recent reports in the literature, however, have shown promising results with the use of colchicine. Our patient, an 18-year-old white woman, satisfied the 1977 Istanbul Conference criteria for Behçe...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1982.tb01202.x
更新日期:1982-11-01 00:00:00
abstract::Acquired facial hyperpigmentation is a common problem among African patients, particularly women, where the causes of the dermatoses are identified largely from circumstantial evidence of exposure to known agents. These include hydroquinone-induced exogenous ochronosis from skin-bleaching creams, mercury deposits from...
journal_title:International journal of dermatology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-4362.1991.tb03848.x
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:The majority of lasers used for hair removal target melanin as the chromophore. In contrast with other cutaneous applications of lasers, lasers used for hair removal must generate a limited, controlled degree of thermal damage to permanently remove hairs. AIM:To remove excess back hair from two male patient...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1046/j.1365-4362.2001.01251.x
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Anetoderma has been reported in patients with HIV-1 disease. In patients with autoimmune disease, anetoderma has been associated with increased levels of antiphospholipid antibodies (APL) that include anticardiolipin antibodies (ACA) and lupus anticoagulant (LA). This has led to speculation tha...
journal_title:International journal of dermatology
pub_type: 杂志文章
doi:10.1111/j.1365-4362.1995.tb04442.x
更新日期:1995-06-01 00:00:00