Marcel W. Bekkenk

Amsterdam University Medical Centers

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Albert Wolkerstorfer

University of Amsterdam

Rosalie M. Luiten

Amsterdam University Medical Centers

Nicoline F. Post

University of Amsterdam

Barbara Horváth

University Medical Center Groningen

Rein Willemze

Leiden University Medical Center

Maarten H. Vermeer

Leiden University Medical Center

Nanja van Geel

Ghent University Hospital

Phyllis I. Spuls

University of Amsterdam

Janny E. Lommerts

Amsterdam University Medical Centers

Menno A. de Rie

University of Amsterdam

Cooperative Institutions

John Wiley & Sons (United States)

223

Oxfam

207

Hudson Institute

203

John Wiley & Sons (United Kingdom)

198

University of Amsterdam

192

Amsterdam University Medical Centers

182

Academic Medical Center

121

Liechtenstein Institute

108

Leiden University Medical Center

Vrije Universiteit Amsterdam

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Reference method for digital surface measurement of target lesions in vitiligo: a comparative analysis

British Journal of Dermatology (2018)

Nanja van Geel D. Vandendriessche Elise Vandersichel Sofie De Schepper Lynda Grine

BackgroundObjective measurement of target lesions in vitiligo is important for clinical practice and trials, yet no preferred tool has been defined. Reported digital tools have shortcomings related to feasibility aspects and often lack information on validity, reliability and responsiveness. Moreover, studies are not yet based on ultraviolet (UV) photography.

Vitiligo

Intra-rater reliability

10.1111/bjd.17190

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Citations (17)

Contributors

Elsevier eBooks (2023)

Ethan G. Aguilar Farah Asa’ad Kiandokht Bashiri Rasheedunnisa Begum Marcel W. Bekkenk

10.1016/b978-0-323-85389-7.09987-7

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Citations (0)

Incidence of mycosis fungoides and Sézary syndrome in the Netherlands in the last two decades

European Journal of Cancer (2021)

Rosanne Ottevanger Digna de Bruin Rein Willemze Patty M. Jansen Marcel W. Bekkenk

Cutaneous T-cell lymphoma

Cutaneous lymphoma

10.1016/s0959-8049(21)00684-5

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Citations (0)

Clinicopathologic studies underlying the WHO-EORTC classification and new guidelines for the treatment of cutaneous lymphomas

Marcel W. Bekkenk

Primary cutaneous lymphoma form a seperate group of non-Hodgkin lymphoma. Apart from the usual nodal presentation of a lymphoma, less frequently a lymphoma develops in an extranodal site. The skin is, after the gastrointestinal tract, the most frequent site of extranodal lymphoma. If the skin is the primary site of involvement, i.e. no extracutaneous sites are involved at diagnosis, these lymphomas are called primary cutaneous lymphoma. In this thesis different types of primary cutaneous lymphoma are evaluated and discussed. In chapter 2 a large group of primary cutaneous CD30+ lympoproliferations is described and compared with a group of systemic CD30+ ALCL with skin localisations. Lymphomatoid papulosis and primary cutaneous CD30+ CTCL are closely related conditions and should be considered as a spectrum, with a comparable, excellent, prognosis. Multiagent chemotherapy (MAC) could not induce long lasting remissions, in fact all patients treated with MAC developed one or more (cutaneous) relapses. Therefor MAC is only indicated in case of extracuteneous localisations. In chapter 3 a group of CD30-negative T-cell lymphomas presenting in the skin that could not be diagnosed as MF, SS or SPTL are evaluated. In this group there were few survivors, apart from a rare group of patients with primary cutaneous lymphoma with small-medium sized CD4+/CD8-neoplastic T-cells (less than 30% large cells). In particular, patients with localized disease had an excellent prognosis. In chapter 4 haematological malignancies presenting in the skin and expressing CD56 were collected, both from the Dutch cutaneous lymphoma group and literature. In general these types of malignancies had a poor prognosis, except for patients with primary cutaneous CD30+ LPD, that showed a similar good prognosis as CD56-negative cases. Most cases belonged to the group of nasal-type NK/T-cell lymphoma and the group of CD4+, CD56+ hematodermic neoplasm (formerly also designated as blastic NK-cell lymphoma. In addition, CD56 was expressed in some SPTL, rare primary cutaneous CD30-negative large T-cell lymphomas, skin localisations of acute myeloid leukemia and CD30+ CTCL. In most of these groups CD56 expression did not affect prognosis. However, in SPTL CD56 expression proved a marker for gamma/delta T-cell origin and these cases showed a poorer prognosis as compared to SPTL with an alpha/beta phenotype (that were usually CD56-negative). In the new WHO-EORTC classiﬁcation the category of SPTL only includes cases with an alpha/beta-positive phenotype, whereas cases with a gamma/delta positive phenotype are included in the provisional category of cutaneous gamma/delta-positive T-cell lymphoma. In chapter 5 a rare case of lymphomatoid papulosis with CD56-expression was presented and the frequency of co-expression of CD56 in primary cutaneous CD30+ LPD was analyzed. CD56 expression was found in approximately 10% of CD30+ LPD (both LyP and primary CD30+ CTCL). However, these CD56+ cases were not found to have a different prognosis from CD56 negative cases. In chapter 6 a European multicenter study on primary cutaneous large B-cell lymphomas is presented. Patients with primary cutaneous large B-cell lymphoma of the leg showed a poorer prognosis as patients with primary cutaneous follicle center cell lymphoma (PCFCCL). Moreover, round cell morphology was identiﬁed as a poor prognostic parameter. Although this was closely related to presentation on the leg(s), also in the group of PCFCCL the presence of a predominance of cells with round nuclei (centroblasts and immunoblasts) was associated with a poorer prognosis. The results of this study contributed to a new category in the WHO-EORTC classiﬁcation, designated primary cutaneous large B-cell lymphoma (PCLBCL), leg-type, indicating that both patients with the classical presentation on the leg(s) as patients showing the same morphology and immunophenotype (bcl-2+, Mum-1/ IRF4+) on other sites are included in this group. Presentation with multifocal lesions proved to be a poor prognostic parameter for PCLBCL-leg-type, but not for PCFCCL. In chapter 7 treatment results in multifocal primary CBCL were analyzed. The main question in this study was if PCFCCL presenting with multifocal skin lesions should be treated with MAC. The study showed that MAC is only indicated in PCLBCL, leg-type and not in (multifocal) PCFCCL. Radiotherapy on multiple sites appeared equally effective as MAC in these patients. In chapter 8 the frequency of CNS-involvement in CBCL patients of the Dutch cutaneous lymphoma group. was evaluated. The frequency was low. Only 4/140 patients with a primary CBCL developed CNS involvement in the course of their disease. Interestingly 3 of these 4 patients were PCFCCL, a lymphoma usually with an excellent prognosis. Only 4 disease related deaths were reported in this group of which 3 with CNS involvement. The reason for this relatively high prevalence of CNS involvement in PCFCCL is unclear. The studies presented in this thesis have provided important information, which has contributed to the recent development of the WHO-EORTC classiﬁcation. Moreover, they have contributed to updated guidelines for the treatment of the different types of primary cutaneous lymphomas, as presented in TABLE 2 in chapter 9.

Lymphomatoid papulosis

Cutaneous lymphoma

Large-cell lymphoma

CD43

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Pitfalls in diagnosing primary cutaneous aggressive epidermotropic CD 8 ⁺ T‐cell lymphoma

British Journal of Dermatology (2018)

N.J. Deenen Lianne Koens Elisabeth H. Jaspars Maarten H. Vermeer Rein Willemze

Primary (astronomy)

10.1111/bjd.17252

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Citations (8)

047 Validation of the Self-Assessment Vitiligo Extent Score (SA-VES) as a patient reported outcome

Journal of Investigative Dermatology (2016)

Nanja van Geel Janny E. Lommerts Marcel W. Bekkenk C.A.C. Prinsen Viktoria Eleftheriadou

Vitiligo

Patient-reported outcome

Clinical Practice

10.1016/j.jid.2016.06.064

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Citations (1)

Prognostic Factors in Primary Cutaneous Large B-Cell Lymphomas: A European Multicenter Study

Journal of Clinical Oncology (2001)

Florent Grange Marcel W. Bekkenk Janine Wechsler Chris J.L.M. Meijer Lorenzo Cerroni

PURPOSE: Most primary cutaneous B-cell lymphomas have an excellent prognosis. However, primary cutaneous large B-cell lymphomas (PCLBCLs) of the leg have been recognized as a distinct entity with a poorer prognosis in the European Organization for Research and Treatment of Cancer (EORTC) classification. This distinction on the basis of site has been debated. Our aim was to identify independent prognostic factors in a large European multicenter series of PCLBCL. PATIENTS AND METHODS: The clinical and histologic data of 145 patients with PCLBCL were evaluated. According to the EORTC classification, 48 patients had a PCLBCL of the leg and 97 had a primary cutaneous follicle center-cell lymphoma (PCFCCL). Data from both groups were compared. Univariate and multivariate analyses of specific survival were performed using a Cox proportional hazards model. RESULTS: Compared with PCFCCL, PCLBCL-leg were characterized by an older age of onset, a more recent history of skin lesions, a more frequent predominance of tumor cells with round nuclei and positive bcl-2 staining, and a poorer 5-year disease-specific survival rate (52% v 94%; P < .0001). Univariate survival analysis in the entire study group showed that older age, a more recent onset of skin lesions, the location on the leg, multiple skin lesions, and the round-cell morphology were significantly related to death. In multivariate analysis, the round-cell morphology (P < .0001), the location on the leg (P = .002), and multiple skin lesions (P = .01) remained independent prognostic factors. The round-cell morphology was an adverse prognostic factor both in PCLBCL-leg and in PCFCCL, whereas multiple skin lesions were associated with a poor prognosis only in patients with PCLBCL-leg. CONCLUSION: With site, morphology, and number of tumors taken into account, guidelines for the management of PCLBCL are presented.

Univariate analysis

Cutaneous lymphoma

10.1200/jco.2001.19.16.3602

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Citations (266)

Poor agreement between the automated risk assessment of a smartphone application for skin cancer detection and the rating by dermatologists

Journal of the European Academy of Dermatology and Venereology (2019)

Yul Ri Chung Allison Sande Kees-Peter de Roos Marcel W. Bekkenk E Haas

Abstract Background Several smartphone applications (app) with an automated risk assessment claim to be able to detect skin cancer at an early stage. Various studies that have evaluated these apps showed mainly poor performance. However, all studies were done in patients and lesions were mainly selected by a specialist. Objectives To investigate the performance of the automated risk assessment of an app by comparing its assessment to that of a dermatologist in lesions selected by the participants. Methods Participants of a National Skin Cancer Day were enrolled in a multicentre study. Skin lesions indicated by the participants were analysed by the automated risk assessment of the app prior to blinded rating by the dermatologist. The ratings of the automated risk assessment were compared to the assessment and diagnosis of the dermatologist. Due to the setting of the Skin Cancer Day, lesions were not verified by histopathology. Results We included 125 participants (199 lesions). The app was not able to analyse 90 cases (45%) of which nine BCC , four atypical naevi and one lentigo maligna. Thirty lesions (67%) with a high and 21 with a medium risk (70%) rating by the app were diagnosed as benign naevi or seborrhoeic keratoses. The interobserver agreement between the ratings of the automated risk assessment and the dermatologist was poor (weighted kappa = 0.02; 95% CI −0.08‐0.12; P = 0.74). Conclusions The rating of the automated risk assessment was poor. Further investigations about the diagnostic accuracy in real‐life situations are needed to provide consumers with reliable information about this healthcare application.

Kappa

Medical assessment

Cancer Detection

10.1111/jdv.15873

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Citations (12)

Recommendations for the Optimal Radiation Dose in Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma: A Report of the Dutch Cutaneous Lymphoma Group

International Journal of Radiation Oncology*Biology*Physics (2017)

Rutger C. Melchers Rein Willemze Laurien A. Daniëls Karen J. Neelis Marcel W. Bekkenk

10.1016/j.ijrobp.2017.08.010

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Citations (23)