Publications by authors named "Ditte M Saunte"

20 Publications

  • Page 1 of 1

Mammary Hidradenitis Suppurativa Lesions - A Suggestion for Phenotyping.

Acta Dermatovenerol Croat 2021 Jul;29(2):72-79

Rune Kjærsgaard Andersen, MD, Department of Dermatology University Hospital Zealand, Roskilde, Sygehusvej 10, 4000 Roskilde, Denmark;

Background: Hidradenitis suppurativa (HS) is an under-diagnosed chronic inflammatory skin disease of the pilosebaceous unit of apocrine gland-rich parts of the body. The mammary area is the fourth most HS-affected area and, as typical lesions include non-fluctuating nodules, abscesses, and tunnels/sinus tracts, mammary HS is often mistaken for other mammary "boils", such as sub-areolar and granulomatous non-lactating breast abscesses. Our objective was to present a spectrum of mammary HS lesions, explore a possible classification, and expose mammary HS as a possible differential diagnosis to non-lactational breast abscesses.

Methods: A cross-sectional study on current and newly-referred patients treated for HS affecting the mammary area. Anamnestic information, subjective outcome measures, and lesion counts including anatomical location were collected. Patients with similar morphologies were grouped, and characteristics for the groups were investigated.

Limitations: We were not aware of the number of morphologies we would find, and as a result the study did not have sufficient power to show significant differences after correction for multiple testing.

Results: We found three morphologically different subtypes of mammary HS; the Sternal, the Frictional, and the Nodule types. These groups differed in anatomical lesion characteristics and other patient characteristics. Furthermore, we found a fourth Mixed type - a combination of the other three.

Conclusion: Differential diagnosis between mammary HS and sub-areolar or granulomatous non-fluctuating non-lactating breast abscess is most easily performed by assessing the precise anatomical location of the lesion and determining if the mammary lesion is the only lesion present or if similar lesions exist in other HS-specific areas.
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July 2021

Tinea Capitis Caused by Microsporum audouinii: Lessons from a Swedish Community Outbreak.

Acta Derm Venereol 2021 Aug 26. Epub 2021 Aug 26.

Department of Dermatology, Hospital of Västmanland Västerås, SE-72 189 Västerås, Sweden. E-mail:

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http://dx.doi.org/10.2340/00015555-3909DOI Listing
August 2021

The use of prescriptions for antibiotics and antifungals in Danish blood donors with dry skin.

J Cosmet Dermatol 2021 May 12. Epub 2021 May 12.

Department of Dermatology, Faculty of Health and Medical Sciences, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark.

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http://dx.doi.org/10.1111/jocd.14207DOI Listing
May 2021

The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa: Results of a prospective European cohort study.

J Am Acad Dermatol 2021 08 20;85(2):369-378. Epub 2021 Jan 20.

Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands. Electronic address:

Background: Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes.

Objective: To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin.

Methods: A prospective, international cohort study performed between October 2018 and August 2019.

Results: In total, 63.6% of the included 283 patients received oral tetracyclines, and 36.4% were treated with clindamycin and rifampicin. Both groups showed a significant decrease in International Hidradenitis Suppurativa Severity Score System from baseline (both P < .001). The Hidradenitis Suppurativa Clinical Response (HiSCR) was achieved in 40.1% and 48.2% of patients, respectively (P = .26). Patient characteristics or disease severity were not associated with the attainment of HiSCR or the minimal clinically important differences for the Dermatology Life Quality Index and pain.

Limitations: Cohort study. Respectively, 23.9% and 19.4% of patients had to be excluded from the HiSCR analysis for the tetracycline and combination therapy group because of a low abscess and nodule count at baseline.

Conclusion: This study shows significant efficacy of both tetracycline treatment and clindamycin and rifampicin combination therapy after 12 weeks in patients with hidradenitis suppurativa. No significant differences in efficacy were observed between the 2 treatments, regardless of disease severity.
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http://dx.doi.org/10.1016/j.jaad.2020.12.089DOI Listing
August 2021

Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management.

G Ital Dermatol Venereol 2020 Oct 7. Epub 2020 Oct 7.

European Academy of Dermatology and Venereology (EADV), Lugano, Switzerland.

Introduction: Interleukin 17A (IL-17A) is a pro-inflammatory cytokine produced by helper T cells (Th17) and other cells of the immune system and exerts pleiotropic effects on multiple cell lines. The role of IL-17 in the pathogenesis of numerous inflammatory disorders is well-documented. IL-17 activates signalling through the IL-17 receptor, which induces other proinflammatory cytokines, antimicrobial peptides, and neutrophil chemokines that are important for antifungal activity.

Evidence Acquisition: Healthy levels of IL-17 can protect the host against extracellular bacterial and fungal infections in mucous membranes and epithelia. IL-17 deficiency reduces control of certain infections, while excessive IL-17 can produce unwanted inflammatory effects.

Evidence Synthesis: Although the efficacy of the therapeutic blockade of this cytokine has been proven in several autoimmune diseases such as psoriasis and psoriatic arthritis, this strategy could also exacerbate fungal infections in such patients. Therefore, a better understanding of IL-17-mediated immunity to Candida is necessary for the development of autoimmune therapeutics that maintain antifungal immunity.

Conclusions: In this review, we include a study of the new anti-IL-17 biological agents (secukinumab, ixekizumab, and bromalizumab ) used for moderate-to-severe psoriasis and psoriatic arthritis treatment in clinical practice, as well as pivotal trials with bimekizumab. We study the relationship of these biological agents and the appearance of candidiasis in its various clinical forms.
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http://dx.doi.org/10.23736/S0392-0488.20.06580-3DOI Listing
October 2020

Can we clinically identify patients at risk of malignant transformation of skin tumors in Brooke-Spiegler syndrome?

Acta Dermatovenerol Alp Pannonica Adriat 2020 Sep;29(3):133-140

Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.

Brooke-Spiegler syndrome (BSS) is a rare inherited autosomal dominant disease characterized by the development of multiple adnexal cutaneous neoplasms. BSS has been linked to mutations in CYLD gene, which is a tumor suppressor gene located on chromosome 16q12-q13. An increased risk of malignant transformation of adnexal cutaneous tumors in BSS patients has been reported. However, no reported genetic markers identify patients at risk of cutaneous malignancy. This study reviews published cases of BSS to investigate the role of clinical parameters as biomarkers of skin malignancy. A comprehensive review of the clinical aspects of BSS is based on 55 case reports. Our analysis revealed only age as a predictor of malignancy; however, this is also a general risk factor for development of malignancy and therefore of limited value as a screening tool. The study highlights the need for standardized clinical follow-up of patients.
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September 2020

An increase in use of antifungals for superficial infections in Denmark during 1997-2018.

APMIS 2021 01 19;129(1):32-34. Epub 2020 Oct 19.

Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.

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http://dx.doi.org/10.1111/apm.13083DOI Listing
January 2021

-Associated Skin Diseases, the Use of Diagnostics and Treatment.

Front Cell Infect Microbiol 2020 20;10:112. Epub 2020 Mar 20.

St. Johns Institute of Dermatology, Kings College London, London, United Kingdom.

Yeasts of the genus, , formerly known as , are lipophilic yeasts, which are a part of the normal skin flora (microbiome). colonize the human skin after birth and must therefore, as commensals, be normally tolerated by the human immune system. The yeasts also have a pathogenic potential where they can, under appropriate conditions, invade the stratum corneum and interact with the host immune system, both directly but also through chemical mediators. The species distribution on the skin and the pathogenetic potential of the yeast varies between different related diseases such as head and neck dermatitis, seborrheic dermatitis, pityriasis versicolor, and folliculitis. The diagnostic methods used to confirm the presence of yeasts include direct microcopy, culture based methods (often a combination of morphological features of the isolate combined with biochemical test), molecular based methods such as Polymerase Chain Reaction techniques, and Matrix Assisted Laser Desorption/Ionization-Time Of Flight mass spectrometry and the chemical imprint method Raman spectroscopy. Skin diseases caused by are usually treated with antifungal therapy and if there are associated inflammatory skin mechanisms this is often supplemented by anti-inflammatory therapy. The aim of this paper is to provide an overview of related skin disease, diagnostic methods and treatment options.
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http://dx.doi.org/10.3389/fcimb.2020.00112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098993PMC
June 2021

A Hundred Years of Diagnosing Superficial Fungal Infections: Where Do We Come From, Where Are We Now and Where Would We Like To Go?

Acta Derm Venereol 2020 Apr 20;100(9):adv00111. Epub 2020 Apr 20.

Superficial fungal infections have been known for hundreds of years. During the 20th century new diagnostic methods were developed and the taxonomy changed several times, which, unfortunately, resulted in many fungi having several names (synonyms). The taxonomy is important, as species-specific identification guides clinicians when choosing the most appropriate antifungal agent, and provides an indication of the source of infection (anthropophilic, zoophilic or geophilic). Traditional diagnostic tests (direct microscopy, culture and histopathology) are still widely used, but molecular-based methods, such as PCR, have many advantages, and increasingly supplement or replace conventional methods. Molecular-based methods provide detection of different genus/species spectra. This paper describes recent changes in dermatophyte taxonomy, and reviews the currently available diagnostics tools, focusing mainly on commercially available PCR test systems.
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http://dx.doi.org/10.2340/00015555-3467DOI Listing
April 2020

Psoriasis as a comorbidity of hidradenitis suppurativa.

Int J Dermatol 2020 Feb 8;59(2):216-220. Epub 2019 Oct 8.

Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.

Background: Hidradenitis suppurativa (HS) and psoriasis (PSO) appear to share important pathogenic elements; in spite of this, the co-occurrence of the two has been widely unexplored.

Methods: To explore the co-occurrence of HS and PSO, we recorded the number of patients attending the outpatient clinic at the Department of Dermatology, Zealand University Hospital, Roskilde, Denmark, for the ICD10 diagnosis HS (DL73.2) or PSO (DL40.0, DL40.3, DL40.4, DL40.8, and DL40.9). Data were further compared with previously reported Danish national prevalence rates for HS and PSO.

Results: A total of 1,036 patients were included from the outpatient clinic: 440 HS, 624 PSO, and 28 with both diagnoses. In total 6.4% of HS patients had PSO, and 4.5% of PSO patients had HS. HS patients had OR = 2.99 (95% CI 2.04-4.38) of having PSO as compared to the background population. For PSO patients, they had OR = 2.56 (95% CI 1.74-3.77).

Discussion: We found a strong association between HS and PSO, which implies a possible comorbidity between PSO and HS that has not previously been properly elucidated. Such a connection could be a common inflammatory pathway driven by the increased secretion of IL-12/23 and TNFα that is a hallmark of both diseases.
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http://dx.doi.org/10.1111/ijd.14651DOI Listing
February 2020

Emerging Terbinafine Resistance in : Clinical Characteristics, Squalene Epoxidase Gene Mutations, and a Reliable EUCAST Method for Detection.

Antimicrob Agents Chemother 2019 10 23;63(10). Epub 2019 Sep 23.

Unit of Mycology, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark

In recent years, cases involving terbinafine-resistant isolates have been reported increasingly, particularly in India. We present 14 cases of terbinafine treatment failure in -infected Danish patients due to acquired resistance. Patients infected with ( = 12) or ( = 2) with elevated terbinafine MICs during 2013-2018 were included. Antifungal susceptibility testing (AFST) was performed following a modified EUCAST E.Def 9.3.1 method (5 days of incubation) with or without cycloheximide and chloramphenicol (CC) supplementation of the growth medium. The squalene epoxidase (SE) target gene was sequenced, and 3-dimensional enzyme homology modeling was performed. Most patients (12/14 [86%]) were male. The mean age was 53.5 years (range, 11 to 77 years). The mean duration of infections was 4.8 years at the time of resistance detection. Prior systemic terbinafine treatment was documented for all patients, and topical therapy for 62% (information was missing in one case). Overall, nine isolates (64%) displayed high terbinafine resistance (MICs, 4 to >8 mg/liter), while two (14%) displayed moderate (MICs, 1 to 2 mg/liter) and three (21%) displayed low (MICs, 0.125 to 0.25 mg/liter) terbinafine resistance compared with control isolates. MICs generated with or without CC supplementation were similar, but CC prevented contamination. Known and novel SE amino acid substitutions (F397L, L393F, L393S, F415S, H440Y F484Y, and I121M V237I) were detected in resistant but not control isolates. Three-dimensional homology modeling suggested a role of the novel I121M and V237I alterations. Terbinafine resistance has been detected in Denmark using a modified EUCAST method, which facilitated susceptibility testing of dermatophytes. Action is needed for this emerging public health problem.
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http://dx.doi.org/10.1128/AAC.01126-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761549PMC
October 2019

Pediatric toxic epidermal necrolysis treated successfully with infliximab.

Pediatr Dermatol 2019 May 4;36(3):342-345. Epub 2019 Mar 4.

Departments of Dermatology, Zealand University Hospital, Roskilde, Denmark.

Successful management of toxic epidermal necrolysis (TEN) with tumor necrosis factor-α inhibitors has been described in adults. We present a case of a 7-year-old boy with infection-associated TEN, diagnosed by typical clinical and histopathological features, most likely caused by Mycoplasma pneumoniae. Treatment with a single dose of infliximab 5 mg/kg intravenously on day 5 after the onset of symptoms was followed by cessation of all blister formation over 3 days and complete resolution within a week. Sequelae were mild, consisting of postinflammatory hyperpigmentation and dry eyes.
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http://dx.doi.org/10.1111/pde.13778DOI Listing
May 2019

The Follicular Skin Microbiome in Patients With Hidradenitis Suppurativa and Healthy Controls.

JAMA Dermatol 2017 09;153(9):897-905

Department of Dermatology, Zealand University Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, Denmark.

Importance: Although the pathogenesis of hidradenitis suppurativa (HS) remains enigmatic, several factors point to potential involvement of the cutaneous microbiome. Insight into the cutaneous microbiome in HS using next-generation sequencing may provide novel data on the microbiological diversity of the skin.

Objective: To investigate the follicular skin microbiome in patients with HS and in healthy controls.

Design, Setting, And Participants: This case-control study obtained punch biopsy specimens from patients with HS (lesional and nonlesional) and healthy controls between October 1, 2014, and August 1, 2016. Data were analyzed from March to November 2016. Patients with HS were recruited from the Department of Dermatology, Zealand University Hospital, Roskilde, Denmark. Biopsy specimens were analyzed at the Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark. None of the participants received any antibiotics (systemic or topical therapy) within 1 month before the study. In patients with HS, biopsy specimens were obtained from lesional skin (axilla or groin) and nonlesional skin. Only nodules containing at least 1 visible hair follicle were biopsied. Biopsy specimens from healthy controls were obtained from the axilla only.

Main Outcomes And Measures: The different microbiomes were investigated using next-generation sequencing targeting 16S and 18S ribosomal RNA.

Results: The skin microbiome was characterized in 30 patients with HS (mean [SD] age, 46.9 [14.0] years; 19 [63% female]) and 24 healthy controls (mean [SD] age, 32.2 [12.0] years; 13 [54% female]). The next-generation sequencing data provided a previously unreported (to our knowledge) characterization of the skin microbiome in HS. The study demonstrated that the microbiome in HS differs significantly from that in healthy controls in lesional and nonlesional skin. Overall, the following 5 microbiome types were identified: Corynebacterium species (type I), Acinetobacter and Moraxella species (type II), Staphylococcus epidermidis (type III), Porphyromonas and Peptoniphilus species (type IV), and Propionibacterium acnes (type V). In lesional skin, microbiome types consisted predominantly of type I or type IV. Microbiome type IV was not detected in healthy controls. Several taxa, including Propionibacterium, showed a significantly higher relative abundance in healthy controls vs HS skin, indicating that Propionibacterium may be part of the pathogenesis in HS.

Conclusions And Relevance: The study findings suggest a link between a dysbiotic cutaneous microbiome and HS.
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http://dx.doi.org/10.1001/jamadermatol.2017.0904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710430PMC
September 2017

Myosin-1E interacts with FAK proline-rich region 1 to induce fibronectin-type matrix.

Proc Natl Acad Sci U S A 2017 04 27;114(15):3933-3938. Epub 2017 Mar 27.

Department of Dermatology, Mayo Clinic, Rochester, MN 55905;

Focal adhesion kinase (FAK) is a nonreceptor tyrosine kinase involved in development and human disease, including cancer. It is currently thought that the four-point one, ezrin, radixin, moesin (FERM)-kinase domain linker, which contains autophosphorylation site tyrosine (Y) 397, is not required for in vivo FAK function until late midgestation. Here, we directly tested this hypothesis by generating mice with FAK Y397-to-phenylalanine (F) mutations in the germline. We found that Y397F embryos exhibited reduced mesodermal fibronectin (FN) and osteopontin expression and died during mesoderm development akin to FAK kinase-dead mice. We identified myosin-1E (MYO1E), an actin-dependent molecular motor, to interact directly with the FAK FERM-kinase linker and induce FAK kinase activity and Y397 phosphorylation. Active FAK in turn accumulated in the nucleus where it led to the expression of osteopontin and other FN-type matrix in both mouse embryonic fibroblasts and human melanoma. Our data support a model in which FAK Y397 autophosphorylation is required for FAK function in vivo and is positively regulated by MYO1E.
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http://dx.doi.org/10.1073/pnas.1614894114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393228PMC
April 2017

Intralesional triamcinolone for flares of hidradenitis suppurativa (HS): A case series.

J Am Acad Dermatol 2016 Dec 28;75(6):1151-1155. Epub 2016 Sep 28.

Department of Dermatology at Roskilde Hospital, Roskilde, Denmark.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Standard practice of managing acute flares with corticosteroid injection lacks scientific evidence.

Objective: We sought to assess the outcomes of routine treatment using intralesional triamcinolone (triamcinolone acetonide 10 mg/mL) in the management of acute flares in HS.

Methods: This was a prospective case series evaluating the effect of intralesional corticosteroids for alleviation of acute flares in HS. Physician- and patient-reported outcomes were noted.

Results: Significant reductions in physician-assessed erythema (median score from 2-1, P < .0001), edema (median score from 2-1, P < .0001), suppuration (median score from 2-1, P < .0001), and size (median score from 3-1, P < .0001) was demonstrated at follow-up. A significant difference in patient-reported pain visual analog scale scores occurred after 1 day (from 5.5-2.3, P < .005) and from day 1 to day 2 (from 2.3-1.4, P < .002).

Limitations: Small study size, open single-arm design, and short follow-up time are the limitations of this study.

Conclusion: Intralesional injection of corticosteroids is perceived as beneficial by physicians and patients in the management of HS flares by reducing pain after 1 day and signs of inflammation approximately 7 days later.
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http://dx.doi.org/10.1016/j.jaad.2016.06.049DOI Listing
December 2016

Normal Skin Microbiota is Altered in Pre-clinical Hidradenitis Suppurativa.

Acta Derm Venereol 2017 Feb;97(2):208-213

Department of Dermatology, University Hospital Zealand, Faculty of Health and Medical Sciences, University of Copenhagen, DK-4000 Roskilde, Denmark.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels (sinus tracts) and scarring involving the intertriginous regions. The clinical course of HS is compatible with a biofilm-driven disease, and biofilm has been described in lesional HS skin. We therefore hypothesized that clinically unaffected HS skin would also have an increased presence of biofilm compared with that of healthy controls. We conducted a case-control study, investigating the morphology of the axillary skin microbiota. Peptide nucleic acid - fluorescence in situ hybridization probes were used in combination with confocal laser scanning microscopy. Significant differences were found in both distribution and quantity of the cutaneous microbiota in clinically non-affected axillary skin of patients with HS compared with healthy controls. Surprisingly, we detected fewer bacteria and less biofilm in patients with HS. The reduced microbiota in patients with HS may play an important role in the early course of the disease.
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http://dx.doi.org/10.2340/00015555-2503DOI Listing
February 2017

Dermatophyte Prevalence in Tools of 43 Hairdressing Salons in Copenhagen.

Acta Derm Venereol 2016 08;96(6):846-7

Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Køgevej 7-13, DK-4000 Roskilde, Denmark.

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http://dx.doi.org/10.2340/00015555-2388DOI Listing
August 2016

Pain in Hidradenitis Suppurativa: A Pilot Study.

Acta Derm Venereol 2016 May;96(4):554-6

Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Køgevej 7-13, DK-4000 Roskilde, Denmark.

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http://dx.doi.org/10.2340/00015555-2308DOI Listing
May 2016

Lasers and Intense Pulsed Light Hidradenitis Suppurativa.

Dermatol Clin 2016 Jan 12;34(1):111-9. Epub 2015 Sep 12.

Department of Dermatology, Karolinska University Hospital, 171 76 Solna, Stockholm, Sweden.

Lasers and intense pulsed light (IPL) treatment are useful for the treatment of hidradenitis suppurativa (HS). Carbon dioxide lasers are used for cutting or vaporization of the affected area. It is a effective therapy for the management of severe and recalcitrant HS with persistent sinus tract and scarring, and can be performed under local anesthesia. HS has a follicular pathogenesis. Lasers and IPL targeting the hair have been found useful in treating HS by reducing the numbers of hairs in areas with HS. The methods have few side effects, but the studies are preliminary and need to be repeated.
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http://dx.doi.org/10.1016/j.det.2015.08.001DOI Listing
January 2016

Tumor Cell Adhesion As a Risk Factor for Sentinel Lymph Node Metastasis in Primary Cutaneous Melanoma.

J Clin Oncol 2015 Aug 6;33(23):2509-15. Epub 2015 Jul 6.

Alexander Meves, Ekaterina Nikolova, Joel B. Heim, Edwin J. Squirewell, Clark C. Otley, Louis A. Schenck, Amy L. Weaver, and Vera J. Suman, Mayo Clinic, Rochester, MN; Mark A. Cappel, Mayo Clinic, Jacksonville, FL; Mark R. Pittelkow, Mayo Clinic, Scottsdale, AZ; and Nille Behrendt, Ditte M. Saunte, and Jorgen Lock-Andersen, Hospital Roskilde, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Purpose: Less than 20% of patients with melanoma who undergo sentinel lymph node (SLN) biopsy based on American Society of Clinical Oncology/Society of Surgical Oncology recommendations are SLN positive. We present a multi-institutional study to discover new molecular risk factors associated with SLN positivity in thin and intermediate-thickness melanoma.

Patients And Methods: Gene clusters with functional roles in melanoma metastasis were discovered by next-generation sequencing and validated by quantitative polymerase chain reaction using a discovery set of 73 benign nevi, 76 primary cutaneous melanoma, and 11 in-transit melanoma metastases. We then used polymerase chain reaction to quantify gene expression in a model development cohort of 360 consecutive thin and intermediate-thickness melanomas and a validation cohort of 146 melanomas. Outcome of interest was SLN biopsy metastasis within 90 days of melanoma diagnosis. Logic and logistic regression analyses were used to develop a model for the likelihood of SLN metastasis from molecular, clinical, and histologic variables.

Results: ITGB3, LAMB1, PLAT, and TP53 expression were associated with SLN metastasis. The predictive ability of a model that included these molecular variables in combination with clinicopathologic variables (patient age, Breslow depth, and tumor ulceration) was significantly greater than a model that only considered clinicopathologic variables and also performed well in the validation cohort (area under the curve, 0.93; 95% CI, 0.87 to 0.97; false-positive and false-negative rates of 22% and 0%, respectively, using a 10% cutoff for predicted SLN metastasis risk).

Conclusion: The addition of cell adhesion-linked gene expression variables to clinicopathologic variables improves the identification of patients with SLN metastases within 90 days of melanoma diagnosis.
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http://dx.doi.org/10.1200/JCO.2014.60.7002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979232PMC
August 2015
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