Over the past decades, thermoablative techniques for the therapy of localized tumors have gained importance in the treatment of patients not eligible for surgical resection Anecdotal reports have described spontaneous distant tumor regression after thermal ablation, indicating a possible involvement of the immune system, hence an induction of antitumor immunity after thermoinduced therapy In recent years, a growing body of evidence for modulation of both adaptive and innate immunity, as well as for the induction of danger signals through thermoablation, has emerged Induced immune responses, however, are mostly weak and not sufficient for the complete eradication of established tumors or durable prevention of disease progression, and combination therapies with immunomodulating drugs are being evaluated with promising results This article aims to summarize published findings on immune modulation through radiofrequency ablation, cryoablation, microwave ablation therapy, high-intensity focused ultrasound, and laser-induced thermotherapy

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More Than Just Tumor Destruction: Immunomodulation by Thermal Ablation of Cancer

Oral potentially malignant disorders (OPMD) are chronic conditions, which have a higher risk of transformation to oral squamous cell carcinoma. The aim of this systematic review and meta-analysis was to answer the question: "What is the prevalence of oral potentially malignant disorders among adults?" Studies reporting the prevalence of these conditions (leukoplakia, erythroplakia, oral submucous fibrosis [OSMF], and actinic cheilitis) were selected, only studies in which a clinical assessment and histopathological confirmation were performed were included. Of the 5513 studies, 22 met the inclusion criteria for qualitative and quantitative analyses. The risk of bias (RoB) of the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Seven studies were classified as high risk, 12 as moderate risk, and 3 as low RoB. The meta-analysis showed that the prevalence of OPMD was 4.47% (95% CI = 2.43-7.08). The most prevalent OPMDs were OSMF (4.96%; 95% CI = 2.28-8.62) and leukoplakia (4.11%; 95% CI = 1.98-6.97). OPMDs were identified more commonly in males (59.99%; 95% CI = 41.27-77.30). Asian and South American/Caribbean populations had the highest prevalence rates of 10.54% (95% CI = 4.60-18.55) and 3.93% (95% CI = 2.43-5.77), respectively. The overall prevalence of OPMD worldwide was 4.47%, and males were more frequently affected by these disorders. The prevalence of OPMD differs between populations; therefore, further population-based studies may contribute to the better understanding of these differences.

Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis

Cheilitis granulomatosa (CG) is a cosmetically disturbing and persistent idiopathic lip swelling. It is one manifestation of orofacial granulomatosis (OFG), which is a clinical entity describing facial and oral swelling in the setting of non-caseating granulomatous inflammation and in the absence of systemic disease such as Crohn’s disease and sarcoidosis. CG can occur by itself or as part of the Melkersson–Rosenthal syndrome, which includes facial palsy and a plicated tongue. Other proposed causes of OFG include dietary allergens such as cinnamon and benzoates. Similar orofacial swelling may be an early manifestation of Crohn’s disease or sarcoidosis, and so clinical history is important in diagnosis. The cause of CG has not been wholly elucidated, but a current hypothesis holds that a random influx of inflammatory cells is responsible. Other granulomatous and edematous causes of lip swelling must be investigated prior to diagnosis. Options for treatment include dietary modifications, antibiotics, systemic or intralesional corticosteroids, and surgery, although treatment is not always necessary. CG should be considered in the differential of persistent lip swelling.

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Cheilitis Granulomatosa: A Review

Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is a rare genetic disorder that predisposes individuals to multiple cutaneous leiomyomas, renal cell carcinomas, and in women, uterine leiomyomas. Also known as Reed syndrome, it is caused by a germline heterozygous mutation of the fumarate hydratase tumor suppressor gene. HLRCC is associated with significant morbidity because of pain from cutaneous and uterine leiomyomas, the cutaneous pain often of unique character. Although genetic testing is currently considered the criterion standard to diagnose HLRCC, newer immunohistochemistry markers may provide rapid and cost effective alternatives to genetic testing. Because of the potentially aggressive nature of renal cell carcinomas that develop as early as in childhood, close annual cancer surveillance is desirable in individuals with HLRCC. In this review, we offer an update and an approach to the diagnosis, management, and renal cancer surveillance in HLRCC.

Hereditary leiomyomatosis and renal cell cancer syndrome: An update and review

Oral microbiota are among the most diverse in the human body. More than 700 species have been identified in the mouth, and new sequencing methods are allowing us to discover even more species. The anatomy of the oral cavity is different from that of other body sites. The oral cavity has mucosal surfaces (the tongue, the buccal mucosa, the gingiva, and the palate), hard tissues (the teeth), and exocrine gland tissue (major and minor salivary glands), all of which present unique features for microbiota composition. The connection between oral microbiota and diseases of the human body has been under intensive research in the past years. Furthermore, oral microbiota have been associated with cancer development. Patients suffering from periodontitis, a common advanced gingival disease caused by bacterial dysbiosis, have a 2-5 times higher risk of acquiring any cancer compared to healthy individuals. Some oral taxa, especially Porphyromonas gingivalis and Fusobacterium nucleatum, have been shown to have carcinogenic potential by several different mechanisms. They can inhibit apoptosis, activate cell proliferation, promote cellular invasion, induce chronic inflammation, and directly produce carcinogens. These microbiota changes can already be seen with potentially malignant lesions of the oral cavity. The causal relationship between microbiota and cancer is complex. It is difficult to accurately study the impact of specific bacteria on carcinoma development in humans. This review focuses on the elucidating the interactions between oral cavity bacterial microbiota and cancer. We gather literature on the current knowledge of the bacterial contribution to cancer development and the mechanisms behind it.

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Oral Microbiota and Cancer Development.

Introduction. So far there have been no papers analyzing the incidence of ‘non-pathological’ lesions or normal variants on the male external genitalia. Subsequently, the number of patients consulted due to the presence of such lesions remains unknown. The aim of the study was to estimate the incidence of normal variants in patients who were consulted due to lesions on the skin or mucosa of the male external genitalia. Material and methods. The study group consisted of 400 males, aged 3-91, who were consulted due to lesions on the genitalia in the Department of Dermatology, Venereology and Allergology of the Medical University of Gdansk. results. The most common lesions were hyperpigmentation of the median raphe of the penis and scrotum (85.6%), pearly penile papules (24%), and prominent veins (24%). Sebaceous hyperplasia or ectopic sebaceous glands were revealed in 9% of patients, respectively. Melanocytic nevi were diagnosed with similar frequency (9.5%), whereas skin tags more rarely (7%). Other ‘nonpathological’ lesions were diagnosed in a considerably lower number of patients. In 32 patients (8% of all patients) the reason of admission to the Clinic was just the presence of some ‘non-pathological’ lesions. Pearly penile papules were found to be the most common condition, occurring in 78.1% patients. Conclusions. Normal variants represent a substantial percentage of generally asymptomatic lesions and the only indication for their removal is cosmetic discomfort or venerophobia.

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Normal variants in patients consulted in the Dermatology Clinic for lesions of the male external genitalia

Introduction: Leukoplakia is the most common potentially malignant condition of the oral cavity. Aim: Epidemiological and clinical analysis of patients with oral leukoplakia (OL) diagnosed and treated in the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk. Material and methods: The study was retrospective and prospective. Among 55 911 patients diagnosed and treated in the Department in 1999–2009, 204 people with OL were selected. The material includes 104 women and 100 men with an average age of 58.1. Most of the patients were in the age group of 50–70 years, average age was 58.1. Results: The most common concomitant disease was diabetes. More than 88% of the patients declared occurrence of OL predisposing development factors (50.49% – cigarette smoking). Three hundred and twenty foci of OL were found among patients. Homogeneous OL dominated (72.05%). Multifocal OL was diagnosed in 58.3% of patients. The most common location of lesions was buccal mucosa (52.2%). Cancers developed on the basis of OL in 7 patients (3.43%). The percentage of malignant transformation was 12.19% for untreated patients and 1.41% for treated patients. The floor of the oral cavity was proven to be the location of the highest risk of oral squamous cell carcinoma. Patients with diabetes may be more likely to develop OL. The risk of malignant transformation is relatively high. In our material it was equal to 3.43%. Conclusions: Cigarette smoking is the most important factor, which can influence the effectiveness of treatment.

https://www.termedia.pl/Journal/-7/pdf-22338-10?filename=Oral premalignant.pdf

Oral premalignant lesions: epidemiological and clinical analysis in the northern Polish population.

1028 © 2008 The Authors JEADV 2008, 22, 1003–1030 Journal compilation © 2008 European Academy of Dermatology and Venereology 2 Sobianek M, Wlodarkiewicz A, Zelazny I, Nowicki R, Michajlowski I, Sokolowska-Wojdylo M. Successful Treatment of Melkersson–Rosenthal syndrome with dapsone and triamcinolone injections. J Eur Acad Dermatol Venereol 2008. 3 Cocuroccia B, Gubinelli E, Annessi G, Zambruno G, Girolomoni G. Persistent unilateral orbital and eyelid oedema as a manifestation of Melkersson–Rosenthal syndrome. J Eur Acad Dermatol Venereol 2005; 19: 107–111. 4 Prantera C, Argentieri R, Mangiarotti R, Levenstein S. Dapsone and remission of Crohn’s disease. Lancet 1988; 1: 536. 5 Van der Kooi K, Davis MDP, McCloskey G. Chronic edema of the lips-a rare but real problem. A report of 3 cases and their response to therapy. J Am Acad Dermatol 2005; 53: 875–877. 6 Rozen TD. Melkersson–Rosenthal syndrome presenting as a new daily persistent headache: relief with dapsone. Cephalgia 2001; 21: 924–925.

Successful treatment of Melkersson-Rosenthal syndrome with dapsone and triamcinolone injections.

40 mg of triamcinolone once a week for a total of three administration (Kenacort R, Bristol-Myers Squibb) with modified release associated to lidocaine 2% because the administration is very painful. We immediately noticed an improvement with resolution of the symptoms. Follow-up was performed at 1, 3, 6, and 12 months and no recurrence was found (Fig. 2). So, in our opinion, intralesional triamcinolone is sufficient and efficient in the treatment of CG, and dapsone may perhaps improve neurological symptoms of MRS.

What is the most effective treatment of cheilitis granulomatosa in Melkersson–Rosenthal syndrome?

© 2009 The Authors JEADV 2009, 23, 954–982 Journal compilation © 2009 European Academy of Dermatology and Venereology dermatomyositis. The mechanism of calcinosis in dermatomyositis is unclear, but it may be caused by the release of calcium from the cytosol in damaged muscle cells. However, a high intracellular calcium concentration is more essential than is muscle damage for calcinosis in dermatomyositis, since calcinosis can develop prior to myositis.4 Dysfunctional transport of calcium would therefore contribute to the pathogenesis of both dermatomyositis and keratosis follicularis. In summary, we describe here a patient with both keratosis follicularis and dermatomyositis. Our findings suggest that disordered intracellular transport of calcium may have a role in the development of both conditions. To clarify their association, studies characterizing the nature of the abnormality underlying impaired calcium transport by the SR/ER in dermatomyositis are needed.

Igor Michajłowski

Papers

Normal variants in patients consulted in the Dermatology Clinic for lesions of the male external genitalia

Oral premalignant lesions: epidemiological and clinical analysis in the northern Polish population.

Successful treatment of Melkersson-Rosenthal syndrome with dapsone and triamcinolone injections.

What is the most effective treatment of cheilitis granulomatosa in Melkersson–Rosenthal syndrome?

Topical treatment of bowenoid papulosis of the penis with imiquimod