Cancer of the Skin: Expert Consult, 2nd Edition

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Online and in print, Cancer of the Skin, edited by Drs. Rigel, Robinson, Ross, Friedman, Cockerell, Lim, Stockfleth, and Kirkwood, is your complete, multimedia guide to early diagnosis and effective medical and surgical treatment of melanoma and other skin cancers. Thoroughly updated with 11 new chapters, this broad-based, comprehensive reference provides you with the latest information on clinical genetics and genomics of skin cancer, targeted therapy for melanoma, the Vitamin D debate concerning the risks and benefits of sun exposure, and other timely topics. A new, multi-disciplinary team of contributors and editors comprised of leading experts in this field offers truly diverse perspectives and worldwide best practices. The complete text-including 900 full-color, downloadable images and 6 procedural videos-can be accessed online at www.expertconsult.com. Broaden your understanding of all aspects of skin cancer-from the underlying biology to clinical manifestations of the disease to diagnosis, and medical and surgical treatment-with this easy-to-use, comprehensive, multimedia reference. See conditions as they appear in practice with guidance from detailed full-color images and step-by-step procedural videos. Stay current with the latest advancements and therapies! 11 new chapters cover clinical genetics and genomics of skin cancer, targeted therapy for melanoma, the Vitamin D debate concerning the risks and benefits of sun exposure, and other essential topics. Get truly diverse perspectives and worldwide best practices from a new, multi-disciplinary team of contributors and editors comprised of the world's leading experts Access the complete text online-including image bank and video library-at www.expertconsult.comDiagnose skin cancer effectively using a multimedia reference with a multi-disciplinary approach and the latest content and techniques.

Author(s): Darrell S. Rigel MD, June K. Robinson MD, Merrick I. Ross MD, Robert Friedman MD MSc (Med), Clay J Cockerell, Henry Lim, Eggert Stockfleth MD PhD, John M Kirkwood MD
Edition: 2nd Edition
Publisher: Elsevier Health Sciences
Year: 2011

Language: English
Pages: 714
Tags: Медицинские дисциплины;Онкология;

Cover......Page 1
Front matter......Page 2
Copyright......Page 6
Foreword......Page 9
Preface......Page 10
List of Contributors......Page 11
Dedication & Acknowledgements......Page 16
Mechanisms Of Cancer Growth And Metastasis......Page 17
Initial transformation and propagation......Page 18
Neoplastic angiogenesis and lymphangiogenesis......Page 20
Local extension and entry into venolymphatic channels......Page 21
Immune system evasion and survival
in the general circulation......Page 22
Arrest, extravasation, and proliferation within metastatic sites......Page 23
Future Outlook......Page 24
References......Page 25
Basal Cell Carcinoma......Page 28
The hedgehog pathway......Page 29
Other syndromes......Page 30
RAS gene defects in SCC......Page 31
CDKN2A and CDK4 gene defects......Page 32
RAS and RAF gene defects in melanoma......Page 34
Alternative genetic loci in melanoma......Page 35
References......Page 36
Structure and Function of the Melanocyte......Page 39
Structure and Function
of the Melanosome......Page 42
Melanin Biosynthesis and Its Regulation......Page 45
The melanin biosynthetic pathway......Page 46
Melanogenesis-related proteins and other melanoma-associated antigens......Page 47
Regulation of melanin biosynthesis......Page 49
Effects of ultraviolet radiation......Page 52
References......Page 54
Epidemiology......Page 56
Quality of life (QoL)......Page 57
Indirect costs......Page 58
References......Page 59
Descriptive Epidemiology......Page 60
Melanoma mortality......Page 63
Keratinocyte carcinomas......Page 64
Squamous cell carcinoma incidence......Page 65
Social impact......Page 66
Dermatofibrosarcoma protuberans......Page 67
Interventional Epidemiology......Page 68
References......Page 69
Ultraviolet radiation......Page 72
Genetic influences and molecular mechanisms......Page 76
Viruses......Page 77
Immunosuppression and iatrogenic factors......Page 78
Smoking......Page 79
References......Page 80
Personal risk factors......Page 82
Interventions to modify sun protection behaviors......Page 83
Parental role......Page 84
Skin self-examination and partner-assisted skin examination......Page 85
Primary care physicians and skin cancer detection......Page 86
References......Page 87
Principles and Rationale for Chemoprevention of Non-Melanoma Skin Cancers......Page 89
mTOR pathway......Page 90
Principles and Rationale for Melanoma Chemoprevention......Page 91
References......Page 94
Mechanisms......Page 96
UV filters in sunscreen products......Page 97
Other UVB filters......Page 98
Inorganic sunscreens......Page 99
Sunscreen application......Page 100
Seeking shade......Page 101
Sunglasses......Page 102
References......Page 103
Risk factors......Page 105
Clinical appearance......Page 106
Progression or transformation......Page 107
Histopathology and classification schemes......Page 108
Treatment and prevention......Page 109
Radiation, arsenical and tar keratoses......Page 110
Scars, chronic inflammation, and chronic infection......Page 111
Cutaneous Squamous Cell Carcinoma In Situ And Its Variants......Page 112
References......Page 113
Pathogenesis......Page 115
Clinical Presentation Of Bcc......Page 117
Superficial (multicentric) BCC......Page 118
Premalignant fibroepithelioma of Pinkus......Page 119
Histology......Page 120
Solid BCC......Page 121
BCC with squamous metaplasia (basosquamous or metatypical carcinoma)......Page 122
Fibroepithelioma of Pinkus......Page 123
Superficial BCC......Page 124
Morpheic BCC......Page 125
Eccrine and apocrine epithelioma......Page 126
Basaloid hyperplasia in dermatofibroma......Page 127
Ultrastructural features of BCC......Page 128
Curettage and electrodesiccation......Page 129
Radiation therapy......Page 131
Lasers......Page 132
Combination therapy......Page 133
‘Field fire’ BCC......Page 134
Perineural BCC......Page 135
References......Page 136
Epidemiology......Page 140
Pathogenesis......Page 141
Clinical Features......Page 142
Patient Evaluation, Diagnosis, And Differential Diagnosis......Page 146
Pathology......Page 147
Tumor depth......Page 150
Treatment......Page 151
Prevention......Page 153
References......Page 154
Microcystic adnexal carcinoma......Page 156
Adenoid cystic carcinoma......Page 157
Porocarcinoma......Page 158
Malignant mixed tumor......Page 159
Apocrine adenocarcinoma......Page 160
Aggressive digital papillary adenocarcinoma......Page 161
Tricholemmomal carcinoma......Page 162
Matrical carcinoma......Page 163
Future Outlook......Page 164
References......Page 165
Pathogenesis and etiology......Page 166
Pathology......Page 167
Epidemiology......Page 168
Patient evaluation, diagnosis
and differential diagnosis......Page 169
Pathology......Page 170
Treatment......Page 171
References......Page 172
Epidemiology......Page 173
Natural history......Page 174
Histopathologic diagnosis......Page 175
Clinical features......Page 176
Treatment......Page 177
Pathologic diagnosis......Page 178
Pathologic diagnosis......Page 179
Clinical features......Page 180
Surveillance......Page 181
References......Page 183
Clinical Findings......Page 184
Classic KS......Page 185
Epidemic (AIDS-related) KS......Page 186
Non-epidemic gay-related KS in MSM......Page 187
Histopathology......Page 188
Systemic organ evaluation......Page 189
Topical therapy......Page 190
Other therapies......Page 191
Future Outlook......Page 192
References......Page 193
Profound immune suppression......Page 195
Staging and prognosis......Page 196
Radiologic imaging studies......Page 197
Histology......Page 198
Treatment......Page 199
Future Outlook......Page 200
References......Page 201
Pathogenesis And Etiology......Page 202
Retiform hemangioendothelioma and endovascular papillary angioendothelioma (Dabska’s tumor)......Page 203
Composite hemangioendothelioma......Page 204
Intermediate Grade Angiosarcomas (Epithelioid Hemangioendothelioma)......Page 205
High-Grade Angiosarcomas......Page 207
Glomangiosarcomas......Page 208
Pathogenesis and etiology......Page 212
Patient evaluation, diagnosis and differential diagnosis......Page 213
Introduction......Page 214
Pathology......Page 215
Treatment......Page 217
Pathology......Page 218
Kaposi sarcoma......Page 219
Cutaneous epithelial neoplasms
in HIV patients......Page 220
References......Page 221
Actinic reticuloid......Page 223
Lymphomatoid contact dermatitis......Page 225
Persistent nodular arthropod bite reactions......Page 226
Lymphocytoma cutis......Page 227
Other pseudolymphomas......Page 228
References......Page 232
Pathogenesis And Etiology......Page 233
Clinical Features......Page 234
Diagnosis, Staging And Pathology......Page 236
Prognosis......Page 241
Topical therapy......Page 242
Other therapy......Page 244
References......Page 245
History......Page 247
Etiology And Pathogenesis: Genes, Environment, And Biology......Page 248
Clinical Features......Page 250
Histology......Page 254
Management......Page 256
References......Page 259
Pathogenesis And Etiology......Page 262
Natural history......Page 263
Spontaneous regression......Page 264
Subtypes of CMN: speckled lentiginous nevi and congenital blue nevi......Page 268
Risk of melanoma and other malignancies
in patients with large CMN......Page 270
Management of small and
medium-sized CMN......Page 272
Management of large CMN......Page 273
References......Page 275
The Many Faces of Melanoma......Page 278
References......Page 287
History Of Melanoma Diagnosis......Page 288
Clinical characteristics of early melanoma......Page 289
Seborrheic keratosis......Page 291
The clinical examination......Page 292
Self-examination of the skin......Page 293
References......Page 296
Ajcc Melanoma Staging System – Overview......Page 298
Prognostic Factors In Primary Melanoma (Stages I And Ii)......Page 299
Primary tumor ulceration......Page 300
Clark level of invasion......Page 303
N classification (stage III)......Page 304
Evolution of stage III disease......Page 305
Other variables......Page 306
Distant Metastases......Page 307
Future Outlook......Page 308
References......Page 309
Natural history of melanoma:
histologic aspects......Page 311
Appropriate biopsy technique......Page 314
Histopathologic criteria for melanoma......Page 315
Acrolentiginous melanoma......Page 317
Desmoplastic melanoma......Page 318
Verrucous melanoma......Page 320
Nevoid melanoma......Page 321
Spindle cell melanoma......Page 322
Congenital nevi biopsied in neonates
and young children......Page 323
Completely regressed melanoma......Page 324
‘Atypical’ melanocytic proliferations......Page 325
Special stains and immunohistochemical stains......Page 327
Ulceration......Page 328
Histologic satellite metastases of melanoma......Page 330
References......Page 331
Initial assessment......Page 334
Surgical management......Page 336
Adjuvant therapy......Page 338
Follow-up......Page 339
References......Page 341
Pathogenesis And Etiology......Page 343
Influence of pregnancy on the prognosis of MM......Page 344
Patient Evaluation And Diagnosis......Page 346
Future Outlook......Page 347
References......Page 348
Gene Identification......Page 350
Patient selection criteria......Page 351
Testing factors......Page 352
Pathogenic mutation is identified:......Page 353
Variant of uncertain significance is identified:......Page 354
Future Outlook......Page 355
References......Page 356
Pathology......Page 357
Variants of Spitz nevus......Page 360
Differentiation From Melanoma......Page 362
Challenges in differential diagnosis......Page 363
References......Page 364
Phototherapy......Page 365
Chemotherapy and immunosuppressive agents......Page 367
Biologic agents......Page 369
References......Page 370
Clinical features......Page 373
Treatment......Page 374
Clinical features......Page 375
Introduction......Page 376
History......Page 377
Epidermodysplasia Verruciformis......Page 378
Bazex–Dupré–Christol, Rombo, and Scleroatrophic syndromes......Page 379
References......Page 380
Ectopic ACTH-producing tumors......Page 383
Carcinoid syndrome......Page 386
Hypertrichosis lanuginosa acquisita......Page 387
Acanthosis nigricans......Page 388
Primary systemic amyloidosis......Page 389
Sweet syndrome (acute febrile neutrophilic dermatosas)......Page 390
Immunobullous disorders......Page 391
Multicentric reticulohistiocytosis......Page 392
Future Outlook......Page 393
References......Page 394
Mucositis......Page 395
Epidermal growth factor receptor inhibitors......Page 396
Anthracyclines......Page 398
Future Outlook......Page 399
References......Page 400
Dermoscopic Equipment......Page 402
Non-pigmented BCCs......Page 403
Squamous Cell Carcinoma......Page 404
Melanoma......Page 405
Seven-point checklist......Page 406
CASH algorithm......Page 407
Dermoscopic patterns of melanoma......Page 408
Dermoscopic patterns of atypical nevi......Page 411
References......Page 415
Dermoscopy......Page 416
Multispectral digital dermoscopy
image analysis......Page 417
Magnetic Resonance Imaging (Mri)......Page 420
References......Page 421
Principles Of Reflectance Confocal Microscopy......Page 423
Non-Melanoma Skin Cancers......Page 425
Reflectance confocal microscopy of actinic keratosis and squamous cell carcinoma......Page 427
Basal cell carcinoma......Page 429
Melanocytic Neoplasms......Page 431
RCM of melanocytic nevi......Page 432
Melanoma......Page 434
Rcm In Margin Mapping And Monitoring Of Treatment Of Skin Cancer......Page 437
References......Page 444
Epidermal Genetic Information
Retrieval (Egir)......Page 445
Egir Genomic Characterization Of Melanoma, Nevi, And Normal Skin......Page 446
Further Development......Page 447
Future Outlook......Page 448
References......Page 449
Types of biopsies......Page 450
Anesthesia......Page 451
Biopsy Techniques – Illustrated......Page 452
Shave biopsy:......Page 453
Fusiform ellipse:......Page 454
Diagnosis Of Melanoma......Page 455
References......Page 457
The curette......Page 459
Electrodesiccation and curettage technique......Page 460
Cure rates......Page 462
Contraindications......Page 464
References......Page 465
Basic Principles......Page 466
Equipment......Page 467
Techniques......Page 468
Clinical considerations......Page 470
Clinical applications......Page 471
Fractional versus segmental cryosurgery......Page 473
Postoperative Care And Expected
Side Effects......Page 474
Complications......Page 475
Long-term reactions......Page 476
References......Page 477
5-fluorouracil......Page 478
Imiquimod......Page 482
Diclofenac......Page 484
Photodynamic Therapy......Page 485
Bexarotene......Page 486
Ingenol mebutate......Page 487
Calcipotriol......Page 488
Future Outlook......Page 489
References......Page 490
Mechanism of action......Page 493
Basal cell carcinoma......Page 495
Cutaneous T-cell lymphoma......Page 496
Adverse events......Page 497
Mechanism of action......Page 498
Nodular basal cell carcinoma......Page 500
Bowenoid papulosis......Page 504
Malignant melanoma......Page 505
Resiquimod......Page 507
Ingenol mebutate......Page 508
References......Page 509
History......Page 513
Mechanism of action......Page 514
Topical Pdt Therapy......Page 516
Actinic keratoses......Page 518
Basal cell carcinoma......Page 519
Cutaneous T-cell lymphoma......Page 520
Future Outlook......Page 521
References......Page 522
Minimizing infectious complications......Page 524
Planning An Excision......Page 525
Clinical, Surgical, And
Histologic Margins......Page 526
Tumor appearance......Page 527
Surgical margins for squamous cell carcinoma......Page 528
References......Page 529
Description Of Procedure......Page 531
The use of special stains......Page 532
Contraindications......Page 533
Melanoma in situ......Page 534
Microcystic adnexal carcinoma......Page 537
Angiosarcoma......Page 538
Safety......Page 539
References......Page 540
Disseminated Squamous Cell Carcinoma......Page 542
Disseminated Merkel Cell Carcinoma......Page 545
Future Outlook......Page 546
References......Page 547
Excision Margin Trials......Page 548
WHO Melanoma Program Trial No. 10 (melanoma <2 mm, margins 1 vs 3 cm)......Page 549
The Intergroup Melanoma Surgical Trial (melanomas 1.0–4.0 mm, margins 2 vs 4 cm)......Page 551
Melanoma in situ......Page 552
Head and neck melanoma......Page 553
Excision of atypical melanocytic lesions......Page 554
Routine wound closure......Page 555
Melanoma of digits......Page 556
Mohs Surgery In Melanoma......Page 557
References......Page 558
History and rationale......Page 560
Scientific support for the sentinel
node concept......Page 561
Technical advances......Page 562
SLN biologic and prognostic significance......Page 563
Does early node dissection impart
a survival benefit?......Page 564
Histologic examination of SLNs......Page 565
Patient selection for SLN biopsy......Page 566
Potential increased risk of in-transit metastasis – a possible ‘biologic’ complication?......Page 567
Pre-surgical planning......Page 568
Cervical lymphadenectomy......Page 569
Incision and surgical technique......Page 570
Incision and surgical technique......Page 571
Concurrent disease in more than
one regional lymph node basin......Page 572
References......Page 573
Planning Reconstructive Surgery For Skin Cancer......Page 575
Skin grafts......Page 576
Reconstruction of the head and neck
......Page 577
Scalp reconstruction......Page 578
Forehead reconstruction......Page 579
Nasal reconstruction......Page 582
Ear reconstruction......Page 583
Reconstruction of the thorax......Page 584
Reconstruction of The
Pelvis/Perineum Area
......Page 586
Reconstruction of The Upper and Lower Extremities
......Page 588
Reconstructing defects on the foot......Page 589
References......Page 591
Field size......Page 592
The concept of equivalent dose......Page 593
Dose, time, fractionation......Page 594
Cosmetic considerations......Page 595
Treatment Of Malignant Melanoma......Page 598
Treatment Of Kaposi Sarcoma......Page 599
AIDS-related KS......Page 600
T-cell lineage......Page 601
Future Outlook......Page 602
References......Page 603
What stages of disease are appropriately considered ‘high risk’ for adjuvant treatment?......Page 605
Interferons......Page 606
Biology and proposed mechanisms of antitumor activity of type I IFNs......Page 608
Adjuvant IFN for cutaneous melanoma – phase I and II trials to optimize the route, dose, and toxicity profile......Page 609
Role of dose, route, and duration of IFN-a therapy in melanoma......Page 614
Candidate biomarkers of therapeutic
benefit with IFN-α......Page 615
Indications And Contraindications For Ifn......Page 616
Alternatives to high-dose IFN-a2b therapy......Page 617
Next Phases Of Development
Of Adjuvant Therapies......Page 618
References......Page 619
Types Of Vaccines......Page 622
Patient Selection For Vaccine Therapy......Page 624
Clinical Trials......Page 625
Current Vaccine Therapy Trials......Page 626
References......Page 627
Targets In Metastatic Melanoma......Page 629
Targeting melanoma cell surface molecules......Page 630
Targeting intracellular molecules......Page 631
Targeting angiogenesis and extracellular matrix......Page 633
Future Outlook......Page 635
References......Page 638
Ultrasound......Page 639
PET scan......Page 640
Chest X-ray......Page 641
Mri......Page 642
References......Page 643
Biochemotherapy......Page 645
Immunotherapy......Page 646
Targeted therapies......Page 647
Future Outlook......Page 648
References......Page 649
Epidemiology......Page 650
Pathogenesis......Page 651
Squamous cell carcinoma......Page 653
Melanoma......Page 656
HUMAN IMMUNODEFICIENCY VIRUS/aCQUIRED IMMUNODEFICIENCY DISEASE......Page 657
References......Page 658
History Of Intentional Tanning......Page 660
Mechanisms Of Indoor Tanning......Page 661
Effects Of Indoor Tanning......Page 662
Indoor Tanning And Skin Cancer......Page 663
Future Outlook......Page 664
References......Page 665
Vitamin D In Health And Disease......Page 666
Vitamin D and cancers......Page 667
All-cause mortality......Page 669
Risks of sun exposure......Page 670
References......Page 671
Image Capture Overview......Page 673
Studio design and equipment......Page 674
Close-Up Photography......Page 675
Image Capture And Management Software......Page 676
References......Page 677
Prevalence Of Psychological Distress
In Patients With Skin Cancer......Page 678
Post-traumatic stress......Page 679
Change in coping and support
over the illness trajectory......Page 680
Communication Skills And Strategies......Page 681
Future Outlook......Page 682
References......Page 683
Duty......Page 684
Damages......Page 685
Adverse Events And Complications In Skin Cancer Treatment......Page 686
Communication......Page 687
Special Medicolegal Issues In Skin Cancer Treatment (Dermatopathology)......Page 688
References......Page 690
A......Page 693
B......Page 694
C......Page 695
D......Page 697
E......Page 698
F......Page 699
H......Page 700
I......Page 701
L......Page 702
M......Page 703
N......Page 706
P......Page 707
R......Page 709
S......Page 710
T......Page 712
W......Page 713
Z......Page 714