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This Month in Archives of Dermatology
July 2007

Treatment of Recurrent SCC of the Skin With Cetuximab

Author Affiliations
 

ROBIN L.TRAVERSMD

Arch Dermatol. 2007;143(7):837. doi:10.1001/archderm.143.7.837
Treatment of Recurrent SCC of the Skin With Cetuximab

Squamous cell carcinoma (SCC) represents approximately 15% of all nonmelanoma skin cancers. Few therapeutic options exist for patients with advanced SCCs, and progressive disease leads to substantial morbidity and mortality. Cetuximab is a recombinant, human-mouse chimeric antibody that competitively inhibits epidermal growth factor, a tyrosine-kinase receptor richly expressed by SCCs. In this case series, Bauman et al describe 2 elderly patients with extensive, in-transit recurrence of SCC following surgery and irradiation who demonstrated excellent responses to cetuximab. The drug was well tolerated with the exception of an acneiform rash requiring dose reduction in 1 patient.

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Incidence of Cutaneous T-Cell Lymphoma in the United States, 1973-2002

The incidence of cutaneous T-cell lymphoma (CTCL) was last examined extensively using data for 1973 through 1992 and including only cases of mycosis fungoides and Sézary syndrome. In this study from 13 population-based cancer registries of the Surveillance Epidemiology and End Results Program of the National Cancer Institute, Criscione and Weinstock investigated incidence trends for the entire group of diseases classified as CTCL from 1973 to 2002. These data may be useful in planning public health strategies, identifying risk factors, and understanding the causes of CTCL.

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Sun-Related Factors, Betapapillomavirus, and Actinic Keratoses

Actinic keratoses (AKs) are sun-induced skin tumors that are strongly associated with squamous cell carcinomas (SCCs). In addition to solar radiation, epidemiologic and molecular data support the causative role of Betapapillomavirus in AKs. In this prospective, community-based cohort study, McBride et al measured the prevalence of Betapapillomavirus DNA in eyebrow hair follicle cells at baseline, documented subsequent sun exposure over the next 7 years, and then measured the prevalence of AKs. These data lend further support to the concept that Betapapillomavirus enhances the effects of increasing age, sun-sensitive phenotypes, and high-dose UV radiation to further increase the risk of developing AKs.

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Breaking Strength of Barbed Polypropylene Sutures

Barbed sutures have been approved by the US Food and Drug Administration for facial lifting procedures. Polypropylene is the most commonly used substrate from which barbs are shaved to extend outward in a helical array. The process of creating these barbs decreases the effective diameter of the suture and thus its strength. In this rater-blinded controlled trial, Rashid et al compared the fiber strength of barbed and nonbarbed suture, demonstrating that the breaking strength of barbed 2.0 polypropylene suture was intermediate between that of 2.0 and 3.0 nonbarbed suture. These data suggest that manufacturers of barbed suture are conservative in their estimate that the strength of 2.0 polypropylene is comparable to that of 4.0 nonbarbed suture. Surgeons may be reassured that rupture is unlikely, even with inadvertent application of excessive force.

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Endemic Pemphigus Vulgaris

Pemphigus vulgaris, pemphigus foliaceous, and its endemic form, fogo selvagem, each possess distinct clinical, histologic, epidemiologic, and serologic features. Pemphigus foliaceous and fogo selvagem are identical clinically, histologically, and serologically, but the epidemiologic features of fogo selvagem are distinctive. In this case series, Rocha-Alvarez et al describe 8 patients with a mucocutaneous disease that clinically and histologically was consistent with pemphigus vulgaris, but with the epidemiologic features of fogo selvagem. Serologic evaluation of these patients revealed autoantibodies against desmoglein 3 and desmoglein 1, providing serologic evidence of a new endemic variant of pemphigus vulgaris.

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