Livers of rabbits that received 25 mg of cortisone for 1, 2, 3, and 6 days were studied chemically and histologically. Under this stimulus, nitrogen content decreased and carbohydrate content increased in the livers. The PNA and DNA per g of liver both decreased but the ratio of PNA/DNA rose steadily with increasing number of days of cortisone administration. Analysis of livers of 2 animals killed 9 days after cessation of cortisone injection indicated repletion of DNA, PNA, and nitrogen. The nucleic acid composition of the kidneys was not altered by cortisone. A number of alternate explanations for the observations are advanced.
The disease course of BRAF (v-raf murine sarcoma viral oncogene homolog B1)-mutant melanoma has been drastically improved by the arrival of targeted therapies. NRAS (neuroblastoma RAS viral oncogene homolog)-mutated melanoma represents 15–25% of all metastatic melanoma patients. It currently does not have an approved targeted therapy. Metastatic patients receive immune-based therapies as first-line treatments, then cytotoxic chemotherapy like carboplatin/paclitaxel (C/P), dacarbazine (DTIC) or temozolomide (TMZ) as a second-line treatment. We will review current preclinical and clinical developments in NRAS-mutated melanoma, and analyze ongoing clinical trials that are evaluating the benefit of different targeted and immune-based therapies, either tested as single agents or in combination, in NRAS-mutant melanoma.
Acrodermatitis continua of Hallopeau (ACH) is a rare form of chronic acral pustular eruption. Considered to be a variant of pustular psoriasis, it is a refractory condition that may not respond to conventional treatments. We report herein the case of a 53-year-old patient whose ACH was refractory to all conventional systemic treatment modalities and to anti-tumour necrosis factor. Because he had increased plasma levels of interleukin (IL)-1β, he received anakinra for 7 weeks, without further improvement however. Achievement of complete response was obtained with ustekinumab 90 mg s.c. every 12 weeks combined with acitretin; the plasma level of IL-1β concomitantly returned to normal. This case report is associated with a review on recent data on ACH treatment with biological agents, including anakinra and ustekinumab.
Background Recent evidence suggests that melanoma is a family of different tumours with varying abilities to grow and metastasize. Trends in melanoma epidemiology show a strong increase in the incidence of thin melanoma, with no corresponding increase in mortality or incidence of thick melanoma. We initially evaluated five cases and found that none had baseline features suggestive of melanoma; excision was performed based on slight changes visible only in side‐by‐side comparisons of dermoscopic images. Objectives To assess the clinico‐dermoscopic features and the growth patterns of melanomas that were excised after a follow‐up of 1 year or more due to their inconspicuous features at the baseline consultation. Methods In a multicentre, retrospective study of histopathologically confirmed melanomas excised after follow‐up, we analysed dermoscopic images obtained at the initial consultation and compared them with images obtained at the last follow‐up consultation. Images were analysed and graded using standard algorithms and scored for changes in size, symmetrical or asymmetrical structural change, and development of new melanoma‐specific criteria. An overall score reflecting the amount of change was calculated for each lesion. Results Our series consisted of 103 melanomas. After a median follow‐up of 20 months, most lesions were still in situ or early invasive (median Breslow thickness of 0·48 mm), with only three lesions showing tumour thickness of 1 mm or more. The most frequent baseline characteristics were asymmetrical pigmentation (78·6% of lesions), reticular overall pattern (62·1%), and regression features (35·9%). Most melanomas (58·3%) showed minor to moderate changes over time, with < 2 mm size increase, with asymmetrical structural change, and without development of new melanoma‐specific criteria. Major changes were visible only after a mean follow‐up of 33 months. Conclusions This study provides evidence for the existence of a subgroup of slow‐growing melanomas, which may explain the increase in the incidence of thin melanoma, despite stable rates of thick melanoma and melanoma‐associated mortality.
