Catching Cancer Early: The Importance of Dermato-Oncology Screening
Abstract
:Simple Summary
Abstract
1. Introduction
- Early diagnosis and monitoring of patients with cutaneous neoplasms
- High-risk population (Table 1)
- Cutaneous paraneoplastic disorders, i.e., Leser-Trélat syndrome, complex genetic syndromes, pyoderma gangrenosum, lymphocytic infiltrates
2. Malignant Skin Tumors
2.1. Malignant Melanoma
Melanoma Screening | |||
---|---|---|---|
Possible Advantages | Implications | Possible Disadvantages | Implications |
Early diagnosis of primary skin tumors | Lower morbidity, mortality and associated costs | Overdiagnosis; Negative psychological impact on the patient | Anxiety and possibly depression associated with repeated screening visits |
Identification of in-transit metastases | Evaluation of the surgical approach—better prognosis The volume of the metastases at the time of diagnosis has prognostic significance [31] | Negative impact on the health system | Overuse of human and material resources |
Identification of adenopathies | The number and maximum diameter of lymph nodes influence the cure rate in stage II [31] | ||
Identification of distant metastases | Evaluation of the surgical approach—better prognosis |
2.2. Basal Cell Carcinoma
2.3. Squamous Cell Carcinoma
2.4. Pre-Carcinomatous/High-Risk Skin Lesions
2.5. Cutaneous Neoplasms in Immunocompromised Patients
- Their frequency, diversity, atypia, and aggressiveness are much higher compared to the general population;
- Mortality and morbidity are significant;
- There are no guidelines for the management of these scenarios.
- Duration of immunosuppression/age of transplantation—in transplanted patients, a 12-fold higher relative risk was observed in those over 55 years old compared to those under 34 years old [66];
- Primary immunosuppression: epidermodysplasia verruciformis—X-linked genodermatosis associated with HPV infection; Wiskott-Aldrich syndrome—immunodeficiency associated with autoimmunity and eczema; Netherton syndrome; neurofibromatosis type I; ichthyosiform erythroderma associated with atopy, asthma, and food allergies [53,70];
- Secondary immunosuppression: HIV infection; drug-induced immunosuppression (transplantation/autoimmune diseases/inflammatory diseases); patients in end-stage organ disease [53].
- MM: 20% more frequent recurrences in patients with pre-transplant MM [76]; second most common donor-transmitted cancer [77], which is associated with severe prognosis because 80% rapidly metastasize [78,79]; 2.6× more frequent de novo MM in HIV patients [80]/chronic lymphocytic leukemia patients: 2–7× more frequent [81].
- Pre-transplant screening for pre-carcinomatous skin lesions and possible identification of Human Herpes Virus-8 infection [82].
- Post-transplant screening:
- ○
- Education (photoprotection/total body self-examination/early diagnosis)—all patients;
- ○
- Dermatological screening: at least every 12 months, stratified by risk groups for all patients depending on the age of the transplantation, skin phototype, personal history of skin neoplasia, and childhood sunburns.
- Patients with premalignant/malignant skin lesions with low risk require annual screening, and those with high risk—screening at 3, 6, or 12 months, depending on the type of neoplasm.
3. Conclusions
4. Future Directions
Author Contributions
Funding
Conflicts of Interest
References
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High-Risk Criteria | Details |
---|---|
Skin phototype | Fitzpatrick I-III [2] |
Light eyes, light or red hair | |
Tanning | Blistering sunburns/indoor tanning |
Nevus count | ≥50 common nevi |
Pre-carcinomatous or high-risk skin lesions | Ephelides, chronic actinic skin damage, atypical nevi, giant congenital nevi |
Personal history of: | |
| |
| |
| |
| |
| Primary or secondary immunodeficiency (e.g., organ transplant recipients) |
Family history of MM | First-degree relatives |
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Stătescu, L.; Cojocaru, E.; Trandafir, L.M.; Ţarcă, E.; Tîrnovanu, M.C.; Heredea, R.E.; Săveanu, C.I.; Tarcău, B.M.; Popescu, I.A.; Botezat, D. Catching Cancer Early: The Importance of Dermato-Oncology Screening. Cancers 2023, 15, 3066. https://doi.org/10.3390/cancers15123066
Stătescu L, Cojocaru E, Trandafir LM, Ţarcă E, Tîrnovanu MC, Heredea RE, Săveanu CI, Tarcău BM, Popescu IA, Botezat D. Catching Cancer Early: The Importance of Dermato-Oncology Screening. Cancers. 2023; 15(12):3066. https://doi.org/10.3390/cancers15123066
Chicago/Turabian StyleStătescu, Laura, Elena Cojocaru, Laura Mihaela Trandafir, Elena Ţarcă, Mihaela Camelia Tîrnovanu, Rodica Elena Heredea, Cătălina Iulia Săveanu, Bogdan Marian Tarcău, Ioana Adriana Popescu, and Doru Botezat. 2023. "Catching Cancer Early: The Importance of Dermato-Oncology Screening" Cancers 15, no. 12: 3066. https://doi.org/10.3390/cancers15123066
APA StyleStătescu, L., Cojocaru, E., Trandafir, L. M., Ţarcă, E., Tîrnovanu, M. C., Heredea, R. E., Săveanu, C. I., Tarcău, B. M., Popescu, I. A., & Botezat, D. (2023). Catching Cancer Early: The Importance of Dermato-Oncology Screening. Cancers, 15(12), 3066. https://doi.org/10.3390/cancers15123066