Vemurafenib induced clinical response in more than half of patients with previously treated BRAF V600E–mutant metastatic melanoma.

Vemurafenib significantly improved survival at 6 months in patients with metastatic melanoma in the BRIM-3 trial, but its effectiveness in patients previously treated with other drugs and its longer-term efficacy were undetermined. Investigators conducted this updated, phase 2 trial of vemurafenib in 132 patients with BRAF V600–mutant metastatic melanoma who had received other prior treatment.

Ingenol mebutate gel was significantly more effective than vehicle alone.

Actinic keratoses (AKs) are extremely common lesions that affect nearly 40 million individuals in the United States alone and many more worldwide. Conversion rates of AKs to nonmelanoma skin cancers are estimated to range from 6% to 10% over a 10-year period. Field therapy of the entire area of sun-damaged skin is frequently performed in patients with extensive AKs. Although highly effective, most forms of field therapy require prolonged treatment and cause a protracted irritant reaction, sometimes quite strong. Ingenol mebutate, the active ingredient of sap of Euphorbia peplus, has been in long use in Australia for many skin conditions. These investigators conducted two manufacturer-supported trials of the safety and efficacy of a 0.015% concentrate of ingenol mebutate gel for AKs of the face and scalp in 547 patients with extensive actinic damage and multiple AKs.

Tanning Beds and the Rising Incidence of Basal Cell Carcinoma in Women

Even a little tanning bed exposure can increase skin cancer risk.

Infection may trigger this condition, activating autoreactive lymphocytes to respond not only to the infecting entity but also to hnRNP-A2/B1 proteins.

Behçet disease (BD) is a chronic multisystem disease that often involves vasculitis and thromboses; these manifestations suggest that the immune system may be targeting autoantigens in the endothelial cells. Indeed, antibodies reacting with endothelial cell substrates occur in the sera of patients with BD. Often, the mouths of patients with BD are colonized by Streptococcus sanguis, and intradermal skin tests with streptococcal antigens often elicit strong delayed hypersensitivity reactions, suggesting that infectious agents may play an etiopathologic role.

Although human cancers express antigens recognized by the immune system, immune responses don't always control tumor growth; tumor cells may adapt to avoid immune surveillance.

Although melanoma is one of the few spontaneously regressing solid tumors, tumor-specific T cells are often suppressed through inhibitory signals between lymphocyte and melanoma cell. The co-inhibitory molecule B7-H1 is often overexpressed on tumor cells. It impairs T-cell responses through binding of its co-inhibitory receptor PD-1, which is highly expressed on tumor-infiltrating lymphocytes. Investigators examined B7-H1 expression in melanocytic tumors to investigate a link between native, tumor-infiltrating lymphocytes (TILs) and B7-H1 levels.

Nonmelanoma Skin Cancer Rates: A Worldwide Problem

Cancer registries should include squamous cell and basal cell carcinomas to make trends in these common cancers visible.

Basal Cell Carcinomas of the Ear Are More Aggressive Than Those Sited Elsewhere

An aggressive phenotype was found in 57% of ear BCCs versus 38% of cheek BCCs.

Trametinib showed a meaningful benefit for treating BRAF-mutated melanoma in a phase III trial.

About 50% of melanomas harbor activating mutations in BRAF. The protein kinase BRAF activates the MEK kinase, which, some evidence suggests, has a central role in both BRAF- and NRAS-mutated melanomas and may be an effective therapeutic target in many tumors, even those without BRAF V600E mutations. In phase I and II trials, trametinib, a small-molecule inhibitor of MEK1 and MEK2, caused tumors to regress and disease to stabilize in V600E or V600K BRAF-mutated melanomas.

Rash Decisions: Atypical Exanthems in 260 Consecutive Patients

Awareness of morphologic pattern and of seasonal viruses may help with a difficult diagnosis.

Distraction techniques, including video viewing, before procedures can be helpful for children.

Viral warts are a common cutaneous infection in children. Liquid nitrogen cryotherapy, often used in adults, is not well tolerated by young children because of pain. Distraction techniques can decrease anxiety and pain in children undergoing procedures. Investigators performed an observational study to assess children aged 2 to 6 years for anxiety before undergoing cryotherapy for cutaneous warts. The first phase had no intervention. In the second phase, children watched an age-appropriate video (Barney or Kung Fu Panda) before cryotherapy. The modified Yale preoperative anxiety scale (m-YPAS) was administered 2 minutes before cryotherapy. The necessary treatment time, restraint requirements, and caregiver feedback were also noted.