Oral nicotinamide is an affordable over-the-counter supplement with demonstrated benefit in the treatment of a range of skin conditions, most notably AK and NMSC.
Skin cancer, the most common human cancer, is now a global epidemic. The most prevalent form of nonmelanoma skin cancer is basal cell carcinoma (BCC), the incidence of which continues to increase prompting development of new treatment modalities designed to add or complement current therapies.
Sirolimus, also known as rapamycin (SRL, Rapamune®), was approved in 1999 by the US Food and Drug Administration to prevent graft rejection in renal transplantation. This articles reviews Sirolimus, its pharmacokinetics, mechanism of action, and indication.
A summary of the most comprehensive and up to date guideline for treating non-melanoma skin cancer in Canada. Background, primary prevention, actinic keratosis, managing basal cell carcinoma, and squamous cell carcinoma, are covered.
The Pigmented Lesion Assay (PLA) is a gene expression test that helps rule out melanoma and has the potential to reduce the need for surgical biopsies of atypical pigmented skin lesions.
Skin cancer, particularly squamous cell carcinoma (SCC), continues to be a significant cause of morbidity and even mortality in organ transplant recipients (OTRs). As the number of organ transplant patients continues to increase, dermatologists will be faced with the challenge of diagnosing and managing their skin cancers.
Epidermal growth factor receptor (EGFR) inhibitors are an increasingly important treatment option for metastasized cancer in patients. We present an overview of the various cutaneous side-effects associated with EGFR inhibition and discuss their respective therapeutic options.
Cutaneous Reactions to Anticancer Agents Targeting the Epidermal Growth Factor Receptor: A Dermatology-Oncology Perspective
The epidermal growth factor receptor (EGFR) is often overexpressed or dysregulated in solid tumors. Targeting the EGFR-mediated signaling pathway has become routine practice in the treatment of lung, pancreatic, head and neck, and colon carcinomas.
There are many new immunotherapeutics that have been approved or are in clinical and pre-clinical trials to expand our arsenal in the treatment of melanoma and other previously difficult to treat malignancies.
Cosmetic products containing ultraviolet light filtering agents are rapidly being developed and entering the marketplace. This article reviews formulary attributes, effective photoprotection, adherence, and behavior modification.
Solid organ transplant recipients have an increased incidence of skin cancer, resulting in significant morbidity and mortality post-transplantation. This article studies systemic retinoids, and other chemopreventative agents for high risk patients.
Why is Mohs Surgery considered the world's gold standard treatment for BCC and SCCs? Dr. Bryce Cowan explains the types of cancers that are typically treated with Mohs surgery, and why the procedure has such as high cure rate.
A variety of novel therapeutic modalities have recently become available for patients with cutaneous T cell lymphoma (CTCL). Here, we offer a brief overview of these agents and discuss their place in the spectrum of current therapies for CTCL.
Melanoma is an aggressive skin cancer with a generally poor prognosis at Stage III-IV disease. Discussion centres around clinical trial data from phase I-III studies of Nivolumab (Opdivo®), a human monoclonal antibody which prevents immune inhibition by interacting with PD-1 on tumor cells.
In Canada, there are only a very limited number of qualified Mohs surgeons at this stage, but that number is growing. The health care system in Canada is run at the provincial level, and currently there are only a limited number of facilities where Mohs surgeons can practice at.
If a patient has skin cancer removed with Mohs Surgery, will they see another cancer, or a recurrence of the same cancer again? Unfortunately, the answer is that yes it's highly likely.
Metastatic Melanoma: Optimizing Outcomes by Managing Dermatologic Toxicities Associated with Novel Therapies
The last couple of years have seen the beginning of a new era in the treatment of metastatic melanoma. This article focuses on BRAF inhibitors and immune modulators which have demonstrated an overall survival benefit, and the importance of limiting adverse events.
An overview and update of skin treatments introduced in 2015: Quick overview of drug name, indications and regulatory status. Deoxycholic acid injection, 5-fluorouracil 0.5% + salicylic acid 10% solution, Adapalene 0.3% + benzoyl peroxide 2.5% gel, and more are covered.
Patients often wonder why Mohs is not the standard treatment for invasive melanoma, the most dangerous of skin cancers. Dr. Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.
Methyl aminolevulinate-hydrochloride cream (Metvix® [in Canada] and Metvixia® [in the US], Galderma) in combination with photodynamic therapy (PDT) provides an effective treatment option for actinic keratoses (AKs), superficial basal cell carcinoma (sBCC), and Bowen’s disease (BD).
Genetic predisposition to melanoma and nonmelanoma skin cancer extends far beyond the Fitzpatrick phenotype classification scheme. Testing aimed at improving prognostication may serve to limit the influence of certain risk factors.
In the third video of the Mohs Surgery series, plastic surgeon Dr. Bryce Cowan explains in further detail the combined process of surgical excision and real-time histological analysis of the excised tissue.
Canadian Skin Management in Oncology (CaSMO) Algorithm for Patients With Oncology Treatment-Related Skin Toxicities
The CaSMO (Canadian Skin Management in Oncology) algorithm focuses on general skincare measures to prevent or reduce the severity of cancer-treatment-related cutaneous toxicities.
Skin cancer in organ transplant recipients is a serious problem that manifests as increased squamous cell carcinoma in long-term patients. Education, surveillance, and management of skin cancers in high risk patients are discussed in this article.
A very common question from patients concerning Mohs Surgery is “Will I need reconstruction surgery?” Dr. Bryce Cowan explains why reconstruction surgery is necessary to optimize the final outcome, and outlines the process and importance of this with some examples.
Treatment of metastatic melanoma using traditional chemotherapy regimens has been disappointing. However, recent work with agents that modify the host’s immune system (e.g., interleukins) have provided limited but encouraging results. Interleukins are a group of molecules involved in immune cell signaling.
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