Seminars in cutaneous medicine and surgery
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Semin Cutan Med Surg · Jun 2014
Current and emerging nonsurgical treatment options for hidradenitis suppurativa.
Several nonsurgical strategies for managing hidradenitis suppurativa (HS) are used that are successful in many patients. The overall goals of pharmacologic therapy are to clear or reduce the number and extent of current lesions and to prevent new lesions from forming. ⋯ Among the agents most commonly used are topical and systemic antibiotics and intralesional and systemic corticosteroids. Within the past decade, clinical experience with biologic agents-principally, tumor necrosis factor inhibitors-has been described, and the results of clinical trials with these agents in patients with HS have been promising.
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Semin Cutan Med Surg · Jun 2014
ReviewCurrent status and future directions of molecularly targeted therapies and immunotherapies for melanoma.
Key molecular and immunological insights over the past decade have radically changed the face of therapy in melanoma. Whereas 5 years ago, treatment for advanced melanoma was restricted to the alkylating agent dacarbazine and the immunostimulants interleukin-2 and interferon-α-2b, today the therapeutic menu includes precise therapies that target key determinants in oncogenic pathways and immune checkpoints. In this chapter, we will review the current status and future directions of targeted therapies for melanoma directed at mitogen-activated pathways and immune checkpoints.
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Three inhibitors of tumor necrosis factor (TNF) currently are approved for the treatment of psoriasis: etanercept, infliximab, and adalimumab. The other two TNF inhibitors, golimumab and certolizumab pegol, have shown efficacy against plaque psoriasis in clinical trials of psoriatic arthritis (PsA). This article reviews the most recent evidence on the efficacy and safety of the TNF inhibitors in psoriasis, with special attention to preventing and managing immunogenicity.
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Semin Cutan Med Surg · Dec 2012
ReviewThe role of molecular testing in the diagnosis of cutaneous soft tissue tumors.
A number of soft tissue tumors are characterized by recurring genetic abnormalities. The identification of these abnormalities has advanced our understanding of the biology of these tumors and has led to the development of molecular tests that are helpful diagnostically. This review will focus on the application of molecular diagnostic testing in select mesenchymal tumors of the dermis and subcutis.
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Semin Cutan Med Surg · Dec 2012
Molecular platforms utilized to detect BRAF V600E mutation in melanoma.
Metastatic melanoma (MM) is a deadly skin disease refractory to standard chemotherapy. Despite numerous clinical and pathological parameters derived to guide patient management, clinical outcomes in melanoma patients remain difficult to predict. There is a critical need to delineate the important biomarkers typical of this disease. ⋯ The cobas Mutation Test has been designed specifically to detect BRAF V600E mutations, and the analytic performance of this assay has demonstrated >99% sensitivity in the detection of BRAF V600E mutation when compared with the Sanger sequencing method and confirmed with the next-generation sequencing 454-pyrosequencing technology. The lower limit of detection of the percentage of mutant alleles in a tissue sample for the cobas test is less than 4%-5%. Some cross-reactivity with other variants of mutant BRAF was seen with the cobas V600 platform; however, this clinical test offers highly sensitive reproducible BRAF V600E mutation analysis in formalin-fixed paraffin-embedded tumor samples.