Melanoma and pigmented lesions:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2002
|
| Schriftenreihe: | Dermatologic clinics
20,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 590 - 788 Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Melanoma and pigmented lesions |c Darrell S. Rigel, guest ed. |
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Datensatz im Suchindex
| _version_ | 1804129837549355008 |
|---|---|
| adam_text | CONTENTS
Dedication xjij
Alfred W. Knopf
Preface xv
Robert J. Friedman
Melanoma Incidence Trends 589
Caroline Bevona and Arthur J. Sober
This article describes melanoma as an important health concern because of its rapid and
continuous growth in many parts of the world. In the United States, a persistent increase
in incidence is seen, which has started to slow in recent years. In some countries, differ¬
ing trends are seen in younger people, with incidence and mortality rates leveling off or
decreasing in this population. This article describes that despite this leveling off,
melanoma incidence is likely to continue to rise in the near future, because rates are still
increasing in older people who comprise most of those afflicted with melanoma.
Risk Factors for the Development of Primary Cutaneous Malignant Melanoma 597
Rona M. MacKie
This article discusses that it is now possible to identify a small number of genes in which
identifiable abnormalities are associated with an increased risk of melanoma, and a
large number of phenotypic factors, which are associated with a lesser risk affecting a
very much larger proportion of the melanoma population. As with colon cancer, it seems
likely that there is a stepwise development of invasive malignant melanoma and that
interaction between genotype and environmental stimuli may be very different at each
successive stage of melanoma progression. The article discusses that unraveling these
steps is the current challenge.
The Effect of Sunscreen on Melanoma Risk 601
Darrell S. Rigel
The usage of sunscreens has grown dramatically worldwide over the past decade. This
article discusses that current data suggest that a regimen of sun protection that includes
protective clothing, avoiding midday sun, and regular use of broad spectrum high sun
protection factor sunscreen seems to be reducing melanoma incidence rates. This is the
VOLUME 20 • NUMBER 4 • OCTOBER 2002 vii
current recommendation of the American Academy of Dermatology and it is also the
recommendation that is best supported by existing data. This article reviews current sun¬
block and sunscreen preparations, exploring their problems and effectiveness.
Congenital Melanocytic Nevi: Evaluation and Management 607
Ashfaq A. Marghoob
This article discusses the care of patients with CMN, who often require a multidiscipli
nary approach involving pediatricians, family physicians, internists, dermatologists,
psychologists, plastic surgeons, neurologists, and radiologists. The cosmetic and psy
chosocial issues, combined with the knowledge of the increased risk of developing
melanoma or NCM, is a huge burden that many of these patients and their families have
to carry. This article describes the importance for physicians to help these patients and
families come to terms with these issues, as well as remind their patients and their family
members that although melanoma, NCM, or other complications can develop, most
affected individuals do not develop any complications. The article mentions that there are
many healthy, happy, functional adults with large, small, and multiple CMN alive today.
The Dilemma of the Dysplastic Nevus 617
Thomas G. Salopek
There are few areas in dermatology that provoke as much controversy as dysplastic
nevus. Over the past decade, there have been significant strides made in terms of under¬
standing the biology and etiology of the lesion. Distinct and reliable clinical and histo
logic features have been delineated. In this article, the management of patients with
dysplastic nevi and the role for dermoscopy, photographic surveillance, genetic map¬
ping and counseling, chemoprevention, and nevi removal are discussed.
Screening for Melanoma 629
Alan C. Geller
This article describes major screening studies of the past two decades, discusses the
evidence based screening recommendations, highlights the need to screen high risk and
previously unscreened populations, and concludes with suggestions for risk assessment
and physician nurse training in the skin cancer examination.
Dermoscopy: A Review 641
Caron M. Grin, Kent P. Friedman, and Jane M. Grant Kels
In this article, dermoscopy, an in vivo technique that allows the clinician to evaluate
subsurface structures, is described. Dermoscopy is used in the evaluation of pigmented
lesions of the skin and is a helpful tool in the differential diagnosis. This article discusses
research on dermoscopy, as well as other imaging techniques including confocal
microscopy, digital dermoscopy, and computer assisted diagnosis.
Prognostic Factors 647
Gary S. Rogers and Stephanie M. Braun
The American Joint Committee on Cancer has recently revised the staging system for
melanoma. In this article, prognostic factors for melanoma are discussed in order of
significance as outlined by the new staging system. In addition, other historically
viii CONTENTS
relevant prognostic factors are reviewed. The article concludes with a discussion of new
technology, which may aid in the future staging of melanoma patients.
The Pathology of Malignant Melanoma 659
Robert J. Friedman and Edward R. Heilman
This article discusses that much of what has been taught over the years concerning the
pathology of melanoma clearly may have little validity. Melanoma is viewed simply as a
malignant neoplasm comprised initially of a proliferation of atypical melanocytes within
the surface epithelium (epidermis). It has many features in common, regardless of
anatomic site. It spreads within the epidermis first for months, possibly years or even for
decades. At this stage (in situ) it is wholly curable if completely surgically excised. What
determines how long a given melanoma remains in situ is not clear. Once a given neo¬
plasm penetrates into the subjacent dermis, there are whole ranges of ill defined events
that act on its ability to continue to grow and develop the competence for metastasis.
Biopsy Techniques: Diagnosis of Melanoma 677
Neil A. Swanson, Ken K. Lee, Annalisa Gorman, and Han N. Lee
This article discusses that the biopsy of a suspicious pigmented lesion is critical to estab¬
lishing a correct and complete diagnosis. The biopsy allows the dermatopathologist to
accurately diagnose melanoma and to gauge maximum depth of invasion (and other his
tologic criterion). The article describes that an accurate diagnosis, in turn, influences the
extent of further necessary surgery or other adjuvant therapy. Furthermore, choosing the
appropriate biopsy technique provides adequate cosmetic results. Excisional biopsies
should extend to the subcutaneous fat by means of a punch biopsy, a fusiform ellipse, or
a saucerization. Incisional biopsies can be performed in certain circumstances, but
should be done so with caution because sampling error may lead to missed diagnosis or
inaccurate histologic criterion, such as depth.
Surgical Approaches to Malignant Melanoma: Practical Guidelines 681
Richard L. Shapiro
Practical guidelines for the surgical approach to malignant melanoma are discussed in
detail. Topics include diagnosis and proper biopsy technique; the appropriate preopera
tive metastatic workup; width of excision margins; treatment of the regional lymph
nodes including cutaneous lymphoscintigraphy, intraoperative lymphatic mapping, and
sentinel lymphadenectomy; postoperative follow up schedules; management of local
recurrence including surgical resection, isolated limb perfusion, intralesional therapy,
adjuvant immunotherapy; management of special clinical situations including subungal
melanoma, plantar melanoma, melanoma on the face, melanoma in pregnancy, and the
treatment of lesions of uncertain diagnosis.
Mohs Micrographic Surgery for the Treatment of Melanoma 701
John A. Carucci
Maintaining the delicate balance between rumor clearance and preservation of function
and cosmesis presents a challenge in the treatment of cutaneous melanoma. This article
focuses on Mohs micrographic surgery as a treatment option for melanoma. The basic
principles of microscopically controlled excision as applied to melanoma are discussed,
as are modifications of Mohs micrographic surgery, including the use of formalin fixed
specimens and special stains.
CONTENTS ix
Chemotherapy Approaches to Melanoma 709
Anna C. Pavlick
This article discusses that the activity of chemotherapeutic drugs against metastatic
melanoma is limited. Dacarbazine as a single agent is the standard treatment for metasta¬
tic disease. Several clinical trials have combined this drug with immunomodulators to try
to improve response rates. Novel agents, such as antisense proteins, proteasome inhibitors,
and new chemotherapeutic drugs, offer exciting areas of exploration. Clearly, enrollment
into a controlled clinical trial is the best option for metastatic melanoma patients.
Radiation Therapy of Malignant Melanoma 713
Jay S. Cooper
This article discusses that previously considered radioresistant, malignant melanomas
clearly have been shown to respond either to conventional or high dose per fraction
radiation therapy. Approximately one fourth of palliatively irradiated malignant
melanomas respond completely and another one third respond substantially. Some
physicians have controlled small volume macroscopic tumors by radiation therapy, but
such treatment has not gained wide acceptance. Elective irradiation of anatomic sites
considered likely to harbor microscopic size tumor unquestionably decreases the risk of
local regional recurrence. The inability of available systemic therapies, however, to pre¬
vent the appearance of distant metastases limits the current impact of such treatment.
Vaccines for Melanoma 717
Jean Claude Bystryn
Melanoma vaccines are now an accepted, but still experimental, treatment for patients
who have been rendered clinically free of disease by surgical resection but are at high risk
of recurrence and in selected patients with advanced but still limited disease. There
seems to be a correlation between the ability of melanoma vaccines to stimulate antime
lanoma cellular or antibody immune responses and improved clinical outcome.
Accordingly, this article describes a number of strategies that are now being pursued to
improve the clinical effectiveness of this first generation of vaccines by improving their
ability to stimulate antimelanoma immunity. To establish the true effectiveness of vac¬
cines in the treatment of malignant melanoma, several large, prospectively randomized
phase III studies are currently being conducted. Criteria that can be used currently to
evaluate the relative effectiveness of different vaccine formulations are discussed.
Unusual Melanoma Types 727
Jason K. Rivers
This article describes that the diagnosis of melanoma has improved with such tools as
epiluminescence microscopy. There remain, however, a number of unusual types of
melanoma that are difficult to diagnose by virtue of their atypical or subtle morphology.
The prognosis of these melanomas is often worse than for their more typical counter¬
parts, often because of a delay in diagnosis. An appreciation of some of these unusual
forms of melanoma which helps the clinician to diagnose these lesions earlier, thereby
reducing patient morbidity and death is also discussed.
Computer Aided Melanoma Diagnosis 735
Marek Elbaum
This article presents a snapshot of fast moving research into the application of digital
imaging technology to in vivo computer aided diagnosis of early melanoma. It is written
x CONTENTS
from the perspective of a researcher with a keen interest in bringing this technology to
physicians offices. The primary emphasis is on reviewing the existing literature, supple¬
mented by unpublished material relating to a particular system and as yet unpublished
research studies.
Update on Botulinum Toxin for Facial Aesthetics 749
Jennifer Clay Cather, J. Christian Cather and Alan Menter
In the last one and a half decades the use of botulinum toxin has revolutionized facial
rejuvenation. This article reviews the different types of botulinum toxin, their common
mode of action, and the latest injection techniques used by dermatologists for facial reju¬
venation. The use of botulinum toxin will continue to evolve and will be commonplace
after it is approved for glabellar lines.
Index 763
CONTENTS xi
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| spelling | Melanoma and pigmented lesions Darrell S. Rigel, guest ed. Philadelphia [u.a.] Saunders 2002 XIV S., S. 590 - 788 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Dermatologic clinics 20,4 Botulinum Toxins therapeutic use Melanoma Nevus Rigel, Darrell S. Sonstige oth Dermatologic clinics 20,4 (DE-604)BV000004924 20,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010210465&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Melanoma and pigmented lesions Dermatologic clinics Botulinum Toxins therapeutic use Melanoma Nevus |
| title | Melanoma and pigmented lesions |
| title_auth | Melanoma and pigmented lesions |
| title_exact_search | Melanoma and pigmented lesions |
| title_full | Melanoma and pigmented lesions Darrell S. Rigel, guest ed. |
| title_fullStr | Melanoma and pigmented lesions Darrell S. Rigel, guest ed. |
| title_full_unstemmed | Melanoma and pigmented lesions Darrell S. Rigel, guest ed. |
| title_short | Melanoma and pigmented lesions |
| title_sort | melanoma and pigmented lesions |
| topic | Botulinum Toxins therapeutic use Melanoma Nevus |
| topic_facet | Botulinum Toxins therapeutic use Melanoma Nevus |
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