Allan C. Halpern

Guest Editor for the following articles:

Dec
2010
Vol. 29. No. 4

Pathways to Melanoma

Hensin Tsao, MD | Justin M. Ko, MD, MBA | Nicole F. Velez, MD

Melanoma is one of the most aggressive and yet poorly understood of human malignancies. Advances in genomics has allowed a more nuanced understanding of the disease, moving beyond the traditional dysplastic nevus-to-melanoma model and identifying multiple divergent oncogenic pathways leading to melanoma. An understanding of the molecular mechanisms driving melanoma has opened the doors for the development of targeted therapeutic approaches. As we enter the era of personalized medicine, it will be critical for clinicians to both appreciate and be able to determine the molecular profile of their patients’ melanoma because this profile will guide risk stratification, genetic counseling, and treatment customization. A review of the divergent pathways of melanoma development is presented here, with a particular emphasis on recently identified mutations, and their implications for patient care.
Semin Cutan Med Surg 29:210-217 © 2010 Published by Elsevier Inc.

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Mar
2008
Vol. 27. No. 1

DNA Microarray Technology in Dermatology

Manfred Kunz, MD

In recent years, DNA microarray technology has been used for the analysis of gene expression patterns in a variety of skin diseases, including malignant melanoma, psoriasis, lupus erythematosus, and systemic sclerosis. Many of the studies described herein confirmed earlier results on individual genes or functional groups of genes. However, a plethora of new candidate genes, gene patterns, and regulatory pathways have been identified. Major progresses were reached by the identification of a prognostic gene pattern in malignant melanoma, an immune signaling cluster in psoriasis, and a so-called interferon signature in systemic lupus erythematosus. In future, interference with genes or regulatory pathways with the use of different RNA interference technologies or targeted therapy may not only underscore the functional significance of microarray data but also may open interesting therapeutic perspectives. Large-scale gene expression analyses may also help to design more individualized treatment approaches of cutaneous diseases. Semin Cutan Med Surg 27:16-24 © 2008 Elsevier Inc. All rights reserved.

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Jun
2009
Vol. 28. No. 2

Management of Hyperpigmentation in Darker Racial Ethnic Groups

Pearl E. Grimes, MD

Dyschromias, in particular hyperpigmentation, are major issues of concern for people of
color. Pigmentary disorders such as melasma and postinflammatory hyperpigmentation
(PIH) can cause psychological and emotional distress and can pose a negative impact on
a person’s health-related quality of life. The precise etiology of these conditions is unknown.
Therapies for melasma and PIH target various points during the cycle of melanin
production and degradation. Therapies for these conditions include topical agents and
resurfacing procedures. Hydroquinone remains the gold standard of topical agents. Other
efficacious agents include kojic acid, azelaic acid, mequinol, and retinoids. Cosmeceutical
agents include licorice, arbutin, soy, N-acetyl glucosamine, and niacinamide. Resurfacing
procedures that have been used to treat melasma and PIH include chemical peels, microdermabrasion,
lasers, and intense pulsed light. These procedures are best used in combination
with topical bleaching agents. Given the propensity of darker skin to hyperpigment,
resurfacing procedures should be used with care and caution. Maximal results are best
achieved with repetitive, superficial, resurfacing modalities. In addition, ultraviolet protective
measures such as broad-spectrum sunscreens are fundamental to the successful
management of these conditions.
Semin Cutan Med Surg 28:77-85 © 2009 Elsevier Inc. All rights reserved.

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Dec
2010
Vol. 29. No. 4

Dermoscopy of Benign and Malignant Neoplasms in the Pediatric Population

A.A. Marghoob, MD | Christoph Lanschuetzer, MD | Helen C. Haliasos, MD | Helmut Hinter, MD | Iris Zalaudek, MD | Josep Malvehy, MD | Rainer Hofmann-Wellenhof, MD | Ralph P. Braun, MD

Dermoscopy is a noninvasive technique that enables visualization of subsurface colors and structures within the skin that are imperceptible to the naked eye. The dermatoscope allows
the physician to examine both the macroscopic and microscopic primary morphology of skin lesions, identify subtle clinical clues, confirm naked-eye clinical diagnoses, and monitor treatment progress while posing little threat to the young patient. Dermoscopic findings have been formulated into diagnostic criteria that assist experienced clinicians in differentiating benign and malignant neoplasms. In this review, clinical morphology of melanocytic nevi and melanoma in the pediatric population is examined and the relevant dermoscopic findings and histopathologic correlates that aid in the diagnosis and management of these lesions are described.
Semin Cutan Med Surg 29:218-231 © 2010 Published by Elsevier Inc.

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Mar
2008
Vol. 27. No. 1

Technological Bases for Teledermatopathology: State of the Art

Domingo DeAgustín, MD, PhD | Jose Sanmartín, BSci, PhD | Juan Seoane, MD, DDS, MPDH, PhD | Pablo Varela-Centelles, DDS, MMedSci | Santiago Vidal, MD, PhD

Teledermatopathology can be defined as a telemedicine application related to histological
diagnosis of cutaneous specimens. Its development and implementation around the world
is very heterogeneous due to the wide range of existing geographical, social and healthcare
conditions. This paper reviews the technological bases for static (use of images generated
at one side, stored on a computer, and then transmitted to another site for a second
diagnosis) and dynamic teledermatopathology (interaction between an user located on a
remote area and a histological video image captured from a microscopy which allows
navigation across the slide) as well as for virtual microscopy.
The use of teledematopathology could increase the healthcare standard and the accessibility
to the health care system in developing countries. However, some limitations related
to economic, medico-legal and technical issues still remain, particularly when dealing with
inflammatory skin diseases.
Semin Cutan Med Surg 27:25-31 © 2008 Elsevier Inc. All rights reserved.

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