Please find the power point (ppt.) on everything that you need to know about Malignant melanoma in very simple language by Sunil kumar Daha from very reliable references. Especially focused on surgical interventions. Thank you
Please find the power point (ppt.) on everything that you need to know about Malignant melanoma in very simple language by Sunil kumar Daha from very reliable references. Especially focused on surgical interventions. Thank you
Squamous cell carcinoma of skin | management -all medical aspects.martinshaji
Squamous cell carcinoma of the skin is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface. They tend to grow slowly and usually occur on sun-exposed areas of the body, such as the face, ears, neck, lips, and backs of the hands.
this is a detailed discussion on the topic
please comment
thank u
Melanoma
Cutaneous Melanoma
also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.
Classification Of Melanoma
I : De novo melanoma
A. Melanoma in situ (MIS)
B. Lentigo maligna melanoma (LMM)
C. Superficial spreading melanoma (SSM)
D. Nodular melanoma (NM)
E. Acral-lentiginous melanoma (ALM)
F. Melanoma of the mucous membranes
G. Desmoplastic melanoma
II Melanoma arising from precursors
Melanoma arising in dysplastic nevomelanocytic nevi
B. Melanoma arising in congenital nevomelanocytic nevi
C. Melanoma arising in common NMN
Etiology And Pathogenesis
The etiology and pathogenesis of cutaneous melanoma are unknown.
Epidemiologic studies demonstrate a role for genetic predisposition and sun exposure in melanoma development.
The major genes involved in melanoma development reside on chromosome 9p21.
Etiology
UVR, mostly of the UVB spectrum (290–320 nm) that induces mutations in suppressor genes. The propensity for multiple BCC may be inherited. Associated with mutations in the PTCH gene in many cases.
Predisposing Factors
Genetic markers (CDKN2a mutation)
Skin type I/II
Family history of dysplastic nevi or melanoma
Personal history of melanoma
Ultraviolet irradiation, particularly sunburns during childhood and intermittent burning exposures
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Six Signs of Malignant Melanoma (ABCDE Rule):
A- Asymmetry in shape—one-half unlike the other half.
B- Border is irregular—edges irregularly scalloped, notched, sharply defined.
C- Color is not uniform; mottled—haphazard display of colors; all shades of brown, black, gray, red, and white.
D- Diameter is usually large.
E- Elevation is almost always present and is irregular—surface distortion is assessed by side-lighting. others use E for Enlargement— a history of an increase in the size of lesion is one of the most important signs of malignant melanoma.
Lentigo Maligna Melanoma (LMM)
Early Detection of Melanoma and Other Skin CancersSummit Health
This lecture provides an overview of skin cancer including risks, early detection, and treatment. Learn to identify the early signs of skin cancer. Melanoma and non-melanoma skin tumors will be discussed and prevention of skin cancer will be emphasized.
Squamous cell carcinoma of skin | management -all medical aspects.martinshaji
Squamous cell carcinoma of the skin is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Squamous cell carcinomas may appear as flat reddish or brownish patches in the skin, often with a rough, scaly, or crusted surface. They tend to grow slowly and usually occur on sun-exposed areas of the body, such as the face, ears, neck, lips, and backs of the hands.
this is a detailed discussion on the topic
please comment
thank u
Melanoma
Cutaneous Melanoma
also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes.
Classification Of Melanoma
I : De novo melanoma
A. Melanoma in situ (MIS)
B. Lentigo maligna melanoma (LMM)
C. Superficial spreading melanoma (SSM)
D. Nodular melanoma (NM)
E. Acral-lentiginous melanoma (ALM)
F. Melanoma of the mucous membranes
G. Desmoplastic melanoma
II Melanoma arising from precursors
Melanoma arising in dysplastic nevomelanocytic nevi
B. Melanoma arising in congenital nevomelanocytic nevi
C. Melanoma arising in common NMN
Etiology And Pathogenesis
The etiology and pathogenesis of cutaneous melanoma are unknown.
Epidemiologic studies demonstrate a role for genetic predisposition and sun exposure in melanoma development.
The major genes involved in melanoma development reside on chromosome 9p21.
Etiology
UVR, mostly of the UVB spectrum (290–320 nm) that induces mutations in suppressor genes. The propensity for multiple BCC may be inherited. Associated with mutations in the PTCH gene in many cases.
Predisposing Factors
Genetic markers (CDKN2a mutation)
Skin type I/II
Family history of dysplastic nevi or melanoma
Personal history of melanoma
Ultraviolet irradiation, particularly sunburns during childhood and intermittent burning exposures
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Number (>50) and size (>5 mm) of melanocytic nevi
Congenital nevi
Number of dysplastic nevi (>5)
Dysplastic melanocytic nevus syndrome
Immune suppression (debatable)
Six Signs of Malignant Melanoma (ABCDE Rule):
A- Asymmetry in shape—one-half unlike the other half.
B- Border is irregular—edges irregularly scalloped, notched, sharply defined.
C- Color is not uniform; mottled—haphazard display of colors; all shades of brown, black, gray, red, and white.
D- Diameter is usually large.
E- Elevation is almost always present and is irregular—surface distortion is assessed by side-lighting. others use E for Enlargement— a history of an increase in the size of lesion is one of the most important signs of malignant melanoma.
Lentigo Maligna Melanoma (LMM)
Early Detection of Melanoma and Other Skin CancersSummit Health
This lecture provides an overview of skin cancer including risks, early detection, and treatment. Learn to identify the early signs of skin cancer. Melanoma and non-melanoma skin tumors will be discussed and prevention of skin cancer will be emphasized.
Introduction .
Statics.
Risk factors.
survival rate.
Staging , Grading.
Special investigations.
WHO Classification .
Most common Benign and Malignant salivary gland Tumors
Clinical presentation and prognosis.
Surgical Treatment .
Summary.
Salivary gland tumors account for 2% to 6.5% of all head and neck neoplasms, are more common in female with a peak incidence in their 60s and 70s, but can occur in all age groups.
The majority of neoplasms occur in the parotid, and pleomorphic adenoma is the most common benign tumor and mucoepidermoid carcinoma the most common malignant tumor.
Irregular margins, bony invasions, the presence of metastatic lymph nodes and perineural spread can all be signs of malignancy.
Necrosis can also characterize malignancy.
Benign tumors were more common than malignant ones.
The prevalent benign tumor was PA, and the prevalent malignant tumors were ACC and MEC.
The smaller the gland more likely that a mass is malignant.
Dr Patrick Treacy on Diagnosis and Treatment of Malignant Melanoma Dr. Patrick J. Treacy
A 23-year-old Siberian female patient presented with a changing lesion on her abdomen. The patient stated the lesion was present for about two years and it started
off from within a freckle, which started to grow larger and somewhat darken in appearance. It had the clinical appearance of a melanoma and the dermoscopy three-point checklist (designed to allow non-experts not to miss detection of melanomas) was used to determine whether this had a high likelihood of malignancy. It included:
Asymmetry: asymmetry of colour and structure in one or
two perpendicular axes
Atypical network: pigment network with irregular holes
and thick lines
Blue-white structures: there was some evidence of blue-
white veil and regression structures
Dr Patrick Treacy shares some of his most challenging cases.
This month he talks about treating Cutaneous Malignant Melanoma. Melanoma, also known as malignant melanoma, is a type of cancer that develops from the pigment-containing cells known as melanocytes. They typically occur in the skin but may rarely occur in the mouth, intestines, or eye. In women they most commonly occur on the legs, while in men they are most common on the back. Sometimes they develop from a mole with concerning changes including an increase in size, irregular edges, change in color, itchiness, or skin breakdown
Hello! Today we prepared for you a biology capstone project example. If you need more go to https://www.capstonewritingservice.com/biology-capstone-project-ideas/
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Understanding how intermittent fasting may not only help weight loss but have multiple other health benefits including life prolongation, preventing cancer and dementia
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Malignant
Melanoma
Accounting for about 3 to 4% of
all diagnosed skin
cancers, melanoma begins in the
melanocytes, cells within the
epidermis that give skin its color.
The incidence is rising by 3% a
year.
3. Most Common Skin Cancers in 2013
Basal Cell : 2,800,000 (78%)
Squamous: 700,000 (20%)
Melanoma:
76,690 (2%)
Between 40 and 50 percent of Americans
who live to age 65 will have either BCC or
SCC at least once, about 2% will get
melanoma
19. 45 yo man with
‘mole’ on his back
for years presented
with headaches
and was found to
have widespread
(brain, liver, lung, b
owel spread) liver
biopsy showed
metastatic
melanoma
20. 45 yo man with
‘mole’ on his back
for years presented
with headaches
and was found to
have widespread
(brain, liver, lung, b
owel spread) liver
biopsy showed
metastatic
melanoma
21.
22. Possible signs and
symptoms of melanoma
A is for Asymmetry: One half of a mole or birthmark
does not match the other.
B is for Border: The edges are
irregular, ragged, notched, or blurred.
C is for Color: The color is not the same all over and
may include shades of brown or black, or sometimes
with patches of pink, red, white, or blue.
D is for Diameter: The spot is larger than 6 millimeters
across (about ¼ inch – the size of a pencil
eraser), although melanomas can sometimes be smaller
than this.
E is for Evolving: The mole is changing in
size, shape, or color.
31. Stage Distribution for Melanoma –
US 2000-2011 from NCDB
45
41%
40
35
30
25
23%
20
12.5%
15
8%
10
3.85%
5
0
Stage 0
Stage I
Stage II
Stage III
Stage IV
32. Stage (Clark’s level or Breslow
Depth)
Current stage system is based
on depth of invasion
33. Clark Classification (Level of
Invasion)
Level I: Lesions involving only the epidermis
(in situ melanoma); not an invasive lesion.
Level II: Invasion of the papillary dermis but
does not reach the papillary-reticular dermal
interface.
Level III: Invasion fills and expands the
papillary dermis but does not penetrate the
reticular dermis.
Level IV: Invasion into the reticular dermis but
not into the subcutaneous tissue.
Level V: Invasion through the reticular dermis
into the subcutaneous tissue.
45. Treatment Guidelines
• Early stages: wide local excision
• More advanced: wide local
excision plus sentinel node
biopsy, then based on the
pathology consider research
trial, observation or interferon
• Metastatic: clinical trial, possible
radiation and systemic therapy
46. Treatment Guidelines
• Early stages: wide local excision
• More advanced: wide local
excision plus sentinel node
biopsy, then based on the
pathology consider research
trial, observation or interferon
• Metastatic: clinical trial, possible
radiation and systemic therapy
47.
48. Treatment Guidelines
• Early stages: wide local excision
• More advanced: wide local
excision plus sentinel node
biopsy, then based on the
pathology consider research
trial, observation or interferon
• Metastatic: clinical trial, possible
radiation and systemic therapy
56. Treatment Guidelines
• Early stages: wide local excision
• More advanced: wide local
excision plus sentinel node
biopsy, then based on the
pathology consider research
trial, observation or interferon
• Metastatic: clinical trial, possible
radiation and systemic therapy
59. Treatment Guidelines
• Early stages: wide local excision
• More advanced: wide local
excision plus sentinel node
biopsy, then based on the
pathology consider research
trial, observation or interferon
• Metastatic: clinical trial, possible
radiation and systemic therapy
60. Systemic Therapy for
Melanoma
• Until recently the only approved
drugs were chemotherapy
(dacarbazine DTIC 9% response)
or toxic immunotherapy with
interleukin-2 (IL-2 response rate
16%)
61. Activating definition of molecular subtypes
of melanoma and provided potential drug
targets.
BRAF are the most frequent mutation in cutaneous
melanoma. Approximately 40% to 60%
Oncogenic NRAS mutation in 15% to 20% of melanomas
c-KIT mutation, or increased copy number, is associated
with mucosal and acral melanomas (which comprise 6%
to 7% of melanomas in Caucasians but are the most
common subtype in the Asian population).
CDK4 mutations have been described in approximately
4% of melanomas and are also more common in acral
and mucosal melanomas.
63. Systemic Therapy for
Melanoma
Targeted therapies that block oncogenic
pathways.
BRAF inhibitors (vemurafenib or
debrafenib) MEK inhibitors (trametinib) or
KIT inhibitors (imatinib)
64.
65. Systemic Therapy for
Melanoma
Drugs that disrupt immunologic
checkpoints
CTLA-4 (cytotoxic T-lymphocyte antigen
4) : ipilimumab and tremelimumab
or PD-1 (programmed death-1) receptor:
nivolumab, lambrolizumab also PD-L1
(the ligand for PD-1)
66. Median overall survival in the YERVOY (ipilimumab)
group was 10 months
YERVOY is the only metastatic melanoma therapy
proven in a phase 3 study to deliver a durable longterm survival benefit at 2 years for 24% of
patients, with some patients still alive up to 4.5
years*2
77. Cellular Classification of Melanoma
Following is a list of clinicopathologic cellular subtypes of
malignant melanoma. These should be considered
descriptive terms of historic interest only as they do not
have independent prognostic or therapeutic significance.
Superficial spreading.
Nodular.
Lentigo maligna.
Acral lentiginous (palmar/plantar and subungual).
Miscellaneous unusual types:
Mucosal lentiginous (oral and genital).
Desmoplastic.
Verrucous.
78. Melanoma Calculators
Melanoma staging tool here
Memorial Sloan Kettering clinic has lymph
node calculators for melanoma here
Mayo clinic calculator for the benefit of
adjuvant interferon here
NCI, the risk of getting it melanoma here
MGH has calculators for melanoma (survival
and risk of lymph node spread) here
Prognosis for melanoma here
Risk of getting melanoma from Harvard here
aboutcancer.com/melanoma_calculators