At 6 months, overall survival was 84% (95% confidence interval [CI], 78 to 89) in the vemurafenib group and 64% (95% CI, 56 to 73) in the dacarbazine group. In the interim analysis for overall survival and final analysis for progression-free survival, vemurafenib was associated with a relative reduction of 63% in the risk of death and of 74% in the risk of either death or disease progression, as compared with dacarbazine (P<0.001 for both comparisons). After review of the interim analysis by an independent data and safety monitoring board, crossover from dacarbazine to vemurafenib was recommended. Response rates were 48% for vemurafenib and 5% for dacarbazine. Common adverse events associated with vemurafenib were arthralgia, rash, fatigue, alopecia, keratoacanthoma or squamous-cell carcinoma, photosensitivity, nausea, and diarrhea; 38% of patients required dose modification because of toxic effects. Conclusions Vemurafenib produced improved rates of overall and progression-free survival in patients with previously untreated melanoma with the BRAF V600E mutation. (Funded by Hoffmann–La Roche; BRIM-3 ClinicalTrials.gov number, NCT01006980.)

/pdf/improved-survival-with-vemurafenib-in-melanoma-with-braf-4rigjjinh0.pdf

Improved Survival with Vemurafenib in Melanoma with BRAF V600E Mutation

https://air.unimi.it/bitstream/2434/566817/2/3768.full.pdf

WHO-EORTC classification for cutaneous lymphomas.

/pdf/nccn-clinical-practice-guidelines-in-oncology-hepatobiliary-1kpacqqvi8.pdf

NCCN clinical practice guidelines in oncology: hepatobiliary cancers.

EXECUTIVE SUMMARYSoft-tissue infections are common, generally of mild tomodest severity, and are easily treated with a variety ofagents. An etiologic diagnosis of simple cellulitis is fre-quently difﬁcult and generally unnecessary for patientswith mild signs and symptoms of illness. Clinical as-sessment of the severity of infection is crucial, and sev-eral classiﬁcation schemes and algorithms have beenproposed to guide the clinician [1]. However, mostclinical assessments have been developed from eitherretrospective studies or from an author’s own “clinicalexperience,” illustrating the need for prospectivestudieswith deﬁned measurements of severity coupled to man-agement issues and outcomes.Until then, it is the recommendation of this com-mittee that patients with soft-tissue infection accom-panied by signs and symptoms of systemic toxicity (e.g.,fever or hypothermia, tachycardia [heart rate,

/pdf/practice-guidelines-for-the-diagnosis-and-management-of-skin-4b42oom5lk.pdf

Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion.

/pdf/practice-guidelines-for-the-diagnosis-and-management-of-skin-3yst6uf27k.pdf

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America

Efficacy of imiquimod on external anogenital warts in HIV-infected patients previously treated by highly active antiretroviral therapy.

Background

The incidence of melanoma is increasing worldwide, causing significant economic burden at community and individual levels Ultraviolet radiation, from natural sunlight or artificial sources, is the main environmental, modifiable risk factor for melanoma



Objectives

The present analysis assesses the profile of sun exposure in the French population as well as the level of awareness about ultraviolet risk and protection



Methods

The survey was conducted via telephone interviews in September and October 2011 In total, 1502 respondents were questioned about their own sun exposure with the question “do you ever, even occasionally, spend time in the sun, during leisure-time, vacation or your professional occupation?” They were also asked about sun protection measures used: protective clothing, a hat or sunscreen



Results

More than three respondents out of four (78%) declared exposing themselves to the sun, with an average of 113 days per year Of these, 38% did not use appropriate sun protection measures We identified the following characteristics of individuals declaring high sun exposure: chiefly men under the age of 40, higher socio-professional levels, and adults with no children Individuals who make a poor use of protective measures are mostly men and of low educational levels Individuals declaring low sun exposure were chiefly: women, individuals over the age of 60, and those with no professional activity The high sun protection population comprises mostly: women, higher socio-professional levels, with no specific age-group profile



Conclusions

Analysis of the EDIFICE Melanoma survey provides information about the attitudes of the French population towards sun exposure The most frequent contexts of sun exposure and the associated socio-demographic characteristics of the population with at-risk attitudes regarding sun exposure are identified This deeper insight into the profile of at-risk populations will allow interventions to be more accurately targeted, thus potentially improving public health benefits

https://www.onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.12895

Sun exposure profile in the French population. Results of the EDIFICE Melanoma survey.

We report on a patient presenting with cutaneous leucocytoclastic vasculitis in association with sarcoidosis. Detailed investigations did not show evidence of infectious or neoplastic diseases. Vasculitis was therefore considered to be secondary to sarcoidosis. A review of 4 other previously reported cases reveals a common presentation with the association of vasculitic skin lesions with deep cutaneous nodules, mediastinal lymph nodes and arthritis. The role of antibody response in leucocytoclastic vasculitis is discussed.

Sarcoidosis associated with leucocytoclastic vasculitis. A case report and review of the literature.

B. Crickx et coll. ont rapporte pour la premiere fois aux Journees Dermatologiques de Paris de 1991 (1) une nouvelle eruption au cours du lupus systemique. Il s'agissait de 2 cas de pustulose amicrobienne brutale, tres particuliere par la predominance des lesions dans les plis et l'existence d'une atteinte muqueuse. P. Orberlin et coll. ont rapporte la meme annee un cas similaire (2). Nous en rapportons un nouveau cas survenant chez une jeune fille atteinte d'une erythroblastopenie auto-immune

[Amicrobial pustulosis and systemic lupus erythematosus: a case].

Background The role of sentinel lymph node (SLN) biopsy in melanoma care remains controversial and is not included in most guidelines for the management of melanoma in Europe.



Objective  To evaluate the practice of SLN biopsy for melanoma.



Methods  In 2008, a self-administered questionnaire was mailed to physicians in 49 hospitals in France.



Results  Questionnaires were returned by 34 (69.3%). A median number of 90 new cases of melanoma were treated each year per centre. SLN biopsy was performed routinely in 21 (61.7%) centres. The practice of SLN biopsy for melanoma was recommended in the local guidelines in 53% of centres. The proportion of patients reported as undergoing SLN biopsy for melanoma was significantly higher in centres with local guidelines than in centres without local guidelines (33.4 ± 21.4% vs. 13.1 ± 21.8%; P = 0.003). Where the local guidelines recommended SLN biopsy (n = 21), it was advocated in the case of Breslow thickness ≥1.0 mm (76%) and/or ulceration of the primary melanoma (38%) and/or histological regression of the primary melanoma (24%).



Conclusion  Our study may be considered representative of SLN practice in France. Contrary to current national guidelines for melanoma care in France, SLN biopsy is routinely recommended in the majority of centres. Our study shows that the practice of SLN biopsy for melanoma is increasingly performed in patients with intermediate Breslow melanoma.

Philippe Saiag

Papers

Efficacy of imiquimod on external anogenital warts in HIV-infected patients previously treated by highly active antiretroviral therapy.

Sun exposure profile in the French population. Results of the EDIFICE Melanoma survey.

Sarcoidosis associated with leucocytoclastic vasculitis. A case report and review of the literature.

[Amicrobial pustulosis and systemic lupus erythematosus: a case].

Sentinel lymph node biopsy for melanoma is becoming a consensus: a national survey of French centres involved in melanoma care in 2008