Skin Cancer Foundation

Targeted therapies (TT) improve outcomes in BRAF-mutant melanoma. Pre-clinical data suggest that anticoagulation (AC) and platelet aggregation inhibition (PAI) may have antitumoral effects. We evaluated the impact of concomitant AC or PAI on outcomes in patients receiving TT. We analyzed 1296 patients with unresectable stage III-IV BRAF-mutant melanoma treated with BRAF plus MEK inhibitors (2016-2024) in the prospective multicenter ADOReg registry. Patients were categorized as receiving no antithrombotic therapy (ATT; n = 1125), PAI (n = 73; acetylsalicylic acid or clopidogrel), or AC (n = 98; direct oral anticoagulants, low-molecular-weight heparin, or vitamin K antagonists). Median follow-up was 1.3 years. Compared with patients without ATT, those receiving AC had significantly improved 12-month progression-free survival (PFS; HR 0.55, 95 % CI 0.39-0.78, p = 0.001) and overall survival (OS; HR 0.35, 95 % CI 0.19-0.64, p = 0.001). Direct oral anticoagulants showed the most pronounced PFS benefit (HR 0.40, 95 % CI 0.25-0.64, p < 0.001). PAI was not associated with a significant difference in PFS, but multivariable Cox regression indicated a reduced hazard of death (HR 0.48, 95 % CI 0.27-0.87, p = 0.015). Concomitant AC, particularly factor Xa-inhibiting direct oral anticoagulants, was associated with improved survival in melanoma patients undergoing TT. These findings support prospective trials evaluating AC as concomitant therapy in advanced melanoma.

Neoadjuvant ipilimumab plus nivolumab has become standard therapy for stage III melanoma based on the NADINA trial, although long-term data are lacking. In the phase 2 PRADO cohort of OpACIN-neo, 99 patients with stage III macroscopic melanoma received this regimen. Here we report first-time 5-year survival data: 71% event-free survival, 74% relapse-free survival, 79% distant metastasis-free survival and 86% overall survival. Ongoing grade 1-2 immune-related adverse events occurred in 69% of patients alive, predominantly vitiligo and hypothyroidism. Major pathologic response (MPR), high tumor mutational burden (TMB), high interferon-gamma (IFNγ) signature and programmed cell death ligand 1 (PD-L1) expression of 1% or higher were associated with favorable outcomes. Combined high TMB, IFNγ and PD-L1 expression yielded 100% MPR and 100% 5-year event-free survival, whereas triple low expression had only 18% MPR and 41% event-free survival. Our findings demonstrate favorable long-term outcomes for patients with an MPR and identify IFNγ and PD-L1 as promising baseline biomarkers. ClinicalTrials.gov identifier: NCT02977052 .

BackgroundHansen’s disease (HD, leprosy), caused by Mycobacterium leprae and M. lepromatosis, remains endemic in parts of the southeastern United States with increasing incidence in Florida. In 2023, Florida accounted for 23 of 225 U.S. cases. The nine-banded armadillo is a known reservoir for M. leprae with mounting evidence of its role in transmission. M. leprae has also shown viability in soil, prompting examination of environmental exposures. Therefore, we aimed to explore environmental exposures in those with HD versus household contactsTable 1.Demographic Characteristics of Index Cases & ContactsTable 2.Environmental Exposures for Index Cases & ContactsMethodsWe recruited participants from private dermatology clinics in East/Central Florida. Eligible individuals included those diagnosed with HD in the past 10 years and household contacts who lived with them for at least 6 months prior to diagnosis and treatment. Structured questionnaires were administered to collect data on age, sex, residence history, travel, and environmental exposure, including soil and armadillo contact.ResultsWe enrolled 36 individuals: 24 with HD and 12 household contacts without HD. Participants had a median age of 72 (53, 92); 20 (55%) were female. All individuals were U.S. born or were residents for 50+ years. 19 (79%) index cases and 3 (27%). Contacts reported regular soil contact (p=0.003). 16 (67%) index cases and 4 (36%) contacts reported gardening (p=0.07). 5 (21%) index cases and 2 (18%) contacts reported touching armadillos (p=0.6), 3 (13%) index cases and 2 (18%) contacts reported trapping them (p=0.5), and 2 (8.3%) index cases reported hunting them (p=0.4). 1 contact (8.3%) reported travel to a high-risk country for HD (p=0.3).ConclusionThis study showed frequent exposure to soil in those with HD that statistically differed from contacts. Typical risk factors like travel to, foreign residence in, or immigration from risk areas were absent. Armadillo contact did not differ greatly between cases and contacts, suggesting that the environmental route may be important in the epidemiologic triangle between humans and armadillos. Considering the ongoing detection of HD in Florida, particularly in East/Central Florida, future studies should continue to elucidate the role of contact with animal and environmental exposures in transmission.DisclosuresAll Authors: No reported disclosures

Black Salve is an escharotic used in alternative medicine for the treatment of a variety of skin conditions, including benign growths and skin cancers. These products are readily available on the Internet, are unregulated, and are used by patients seeking non-surgical cures. We present a case study of a basal cell carcinoma (BCC) self-treated with this agent. The patient meticulously documented every step of treatment, providing invaluable information for medical professionals in understanding, counseling, and properly managing such clinical scenarios involving escharotic use.

Patients treated with a 1726-nm laser showed significant improvement in moderate-to-severe acne for ≥6 months in a prospective study. One-year follow-up data are presented. In this prospective institutional review board-approved study, patients underwent 3 treatments with a 1726-nm laser, 2-5 weeks apart. Inflammatory lesion counts and Investigator's Global Assessment scores were assessed at baseline, 3 months, and 1 year after treatment. Adverse events, treatment satisfaction, and self-confidence were assessed. Of 104 patients with Fitzpatrick skin types II-VI and moderate-to-severe acne, 89 and 71 patients, respectively, attended 12- and 52-week visits. At 12 weeks, 79.8% demonstrated ≥50% improvement in inflammatory lesion counts, which increased to 91.5% at 52 weeks. The proportion of patients with clear or almost clear Investigator's Global Assessment scores increased from 36.0% at 3 months to 66.2% at 52 weeks. Treatment was well tolerated: Mild erythema and edema occurred in 100% and 98.1% of patients, respectively. No blistering, crusting, or hypo- or hyperpigmentation were observed. Patient satisfaction and self-confidence improved at both follow-up timepoints. No control group; reliance on image assessment; open-label design. The seboselective 1726-nm laser is an effective and well-tolerated therapy for reducing moderate-to-severe facial acne for at least 1 year.

Skin quality is a multidimensional concept encompassing four emergent perceptual categories (EPCs): firmness, surface evenness, tone evenness, and glow. Microfocused Ultrasound with Visualization (MFU-V; Ulthera System) is a non-invasive device FDA-cleared for lifting and tightening of the skin in specific areas. Through the generation of thermal coagulation points at defined depths, MFU-V initiates neocollagenesis and elastin remodeling, which may support improvements in features related to overall skin quality. To evaluate clinical and preclinical evidence for the impact of MFU-V across the four EPCs of skin quality, including firmness, surface evenness, tone evenness, and glow. A structured narrative review was conducted across PubMed, Google Scholar, and Cochrane databases. Of 703 unique records screened, 67 studies met inclusion criteria. Eligible studies evaluated MFU-V, alone or in combination, reporting outcomes mapped to one or more EPCs of skin quality. MFU-V demonstrated consistent improvements in firmness (n = 52 studies), including elasticity and tautness, with sustained effects beyond 6 months. Improvements in surface evenness (n = 35) included wrinkle reduction, pore refinement, and scar remodeling. Effects on tone evenness (n = 4) were observed in melasma and erythema models, with good tolerance in Fitzpatrick skin types III-VI. Glow (n = 4) was indirectly supported by improved texture and structure. Combination protocols involving MFU-V and fillers or neuromodulators reported positive outcomes. Adverse events were rare and transient. MFU-V provides a safe and versatile platform for enhancing multiple aspects of skin quality. Its effects are well supported in firmness and texture, with emerging evidence for tone and glow. The integration of EPC-based outcomes may inform individualized treatment planning and future research.

Abstract Background Post-operative complications such as bleeding, hematoma formation and abnormal healing may be mitigated by withholding selected over-the-counter products including dietary supplements. Little is known about patients’ knowledge on this subject. Objective To assess participants’ baseline knowledge about common over-the-counter supplements, vitamins, herbal/botanical products as well as other substances (e.g., alcohol) that can be associated, if ingested, with an increased risk of bleeding during outpatient surgical procedures. Methods A survey administered to a willing consecutive sample of adults regarding their: baseline knowledge about possible bleeding risks associated with commonly taken dietary supplements and products; personal use of supplements and alcohol; history of post-procedural bleeding or healing issues; and personal demographic characteristics. Results One hundred and two participants completed the survey (93% response rate). Overall knowledge of risks was low (average score = 8/56 = 14%). Gender, supplement usage or non-usage, and use of prescription anticoagulants did not significantly impact score. Increasing age was negatively correlated with score. 69% of participants reported routinely taking supplements of any kind. 88% thought receiving information on this topic before surgical procedures about supplements that could affect procedure-related bleeding would be helpful. Conclusion Most participants were unaware of the potential bleeding risks of common dietary supplements but wanted education on the topic. Pre-operative education that encourages patients to hold selected supplements and other ingested substances may reduce peri-operative bleeding risk associated with cutaneous surgery.