What's new in skin cancer? An analysis of guidelines and systematic reviews published in 2008-2009

ArticleinClinical and Experimental Dermatology 36(5):453-8 · July 2011with9 Reads
DOI: 10.1111/j.1365-2230.2011.04087.x · Source: PubMed
This review summarizes clinically important findings from 17 systematic reviews and 2 guidelines on skin cancer indexed between April 2008 and April 2009. Melanoma primary-prevention measures, such as education, are more likely to be successful in younger children than adolescents, and general population screening for melanoma by whole-body examination is not currently supported by the evidence. A large systematic review of melanoma and pregnancy concluded that pregnancy does not affect prognosis. Two systematic reviews imply that sunburn later in life also increases the risk of melanoma, and that it is just as important as sunburn early in life. Three systematic reviews discussed the role of positron emission tomography and sentinel lymph-node biopsy for melanoma staging, but produced conflicting results. Superior diagnostic accuracy of dermatoscopy over naked-eye examination for melanoma was found in one review, while a second implied nonsignificantly higher sensitivity of computer-based diagnostic methods over dermatoscopy for melanoma but with reduced specificity. There were no identified randomized controlled trials of treatments for unresectable recurrent melanoma, and a review of immunotherapy with vaccines for melanoma failed to prove improved overall and disease-free survival. Guidelines for the management of basal cell carcinoma call for risk stratification, based on numerous factors including tumour size, site and histological subtype. Squamous cell carcinoma of the ear has been shown to spread to regional lymph nodes more commonly than to other sites, and may be predicted by depth of invasion, tumour size, cellular differentiation and completeness of excision.
    • "A similar resource summarising SRs on acne vulgaris has been produced and maintained since 2007, and is available from the website for the Centre of Evidence Based Dermatology, University of Nottingham (www.nottingham.ac.uk/ dermatology). This mapping of SRs has been used to produce clinical evidence updates in acne [12][13][14], and similar updates have been published for psoriasis [15,16] and skin cancer [17,18]. This paper provides an opportunity to direct healthcare practitioners and researchers to the relevant SRs on AE for different topic areas, and to highlight some of the key messages to have emerged from the last 13 years of AE research. "
    [Show abstract] [Hide abstract] ABSTRACT: Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT) database (www.greatdatabase.org.uk) and key clinical messages are summarised here. A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36%) were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1%) was on mechanism, 37 (29%) were on epidemiology, 40 (31%) were on eczema prevention, 29 (23%) were on topical treatments, 31 (24%) were on systemic treatments, and 24 (19%) were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83%) searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%). This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care.
    Full-text · Article · Mar 2013
  • [Show abstract] [Hide abstract] ABSTRACT: Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. Whilst metastasis from BCC is extremely rare, metastasis from high-risk SCC may be fatal. In this article, we review the aetiology, diagnosis and management of NMSC.
    Article · Jan 2012
  • [Show abstract] [Hide abstract] ABSTRACT: Background: According to the World Health Organization, the incidence of skin cancer has tripled in the past two decades, reason enough to study the epidemiology of this cancer in our country. Objectives: To determine the prevalence of cutaneous malignant neoplasms in patients consulted in the Department of Dermato-Oncology Pascua Dermatological Center for the period January 2004 to December 2011. To determine the clinical and epidemiological characteristics of patients and histopathological variety of injuries. Material and methods: We performed a retrospective, descriptive trial over a period of 8 years. Information was collected from clinical records based on the variables: sex, age, skin phototype, clinical diagnosis and histology. We included all patients with confirmed diagnosis of skin cancer. We organized the information into a computer database and compared it with the provisions of national and worldwide literature. Results: 2185 records were reviewed with a total of 4743 lesions histologically confirmed. The neoplasm was the most frequent basal cell carcinoma, with a prevalence of 74% (with a predominance of superficial tumors and clinical variety, respectively), followed by squamous cell carcinoma with 14% (nodular keratotic and Bowen's disease), and malignant melanoma with 3% (variety nodular acral lentiginous). Other neoplasms found were sarcomas, lymphomas and cutaneous dermatofibroma protuberans. Basal cell carcinoma and squamous cell predominated in the seventh decade of life (26 and 24% respectively), malignant melanoma was observed in the sixth decade (20%) and other neoplasms in the fifth decade. In the histopathological findings the most common varieties were: Solid Basal Cell Carcinoma, well-differentiated squamous cell carcinoma, lentigo maligna melanoma, Kaposi's sarcoma and cutaneous B-cell lymphoma. Neoplasms were found in all body segments, including the mucous membranes. Most lesions were found in sun-exposed areas. Conclusions: The results of this study agree with those reported in the literature, except for the increased frequency of neoplasms in females. We agree with the information reported in our country.
    Article · Jan 2012
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