Cutaneous melanoma (CM) is a malignant tumor formed from pigment-producing cells called melanocytes. It is one of the most aggressive and fatal forms of skin malignancy. In the last decades, CM’s incidence has gradually risen, with 351,880 new cases in 2015. Since the 1960s, its incidence has increased steadily, in 2019, with approximately 96,000 new cases. A greater understanding of early diagnosis and management of CM is urgently needed because of the high mortality rates due to metastatic melanoma. Timely detection of melanoma is crucial for successful treatment, but diagnosis with histopathology may also pose a significant challenge to this objective. Early diagnosis and management are essential and contribute to better survival rates of the patient. To better control this malignancy, such information is expected to be particularly useful in the early detection of possible metastatic lesions and the development of new therapeutic approaches. This article reviews the available information on the early diagnosis and management of CM and discusses such information’s potential in facilitating the future prospective.
Objective: Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. Methods: In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. Results: Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. Conclusion: In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.
Atopic dermatitis (AD) is a prevalent protracted inflammatory skin condition that affects approximately 12% of children globally. Topical remedies, such as pharmacologic and nonpharmacologic management, and off-label systemic medicines, have traditionally been used to treat pediatric AD patients. To minimize comorbidities, sleep disturbances, pruritus, and signs of inflammation and improve the patient’s quality of life, it is vital to optimize severe AD management in pediatric patients. Treatment resistance can be caused by a variety of circumstances, including deficient obedience or inappropriate medicine usage, a shortage of adequate pharmaceuticals, hypersensitivity reciprocation to local application of therapeutics, cutaneous infections, and other infuriating ecological provoking factors. If these elements are eliminated, a skin biopsy is required to exclude other AD-like cutaneous disorders. New regimens that target peculiar avenues with improved proficiency and promise minimal adverse events have resulted from recent developments and understanding of the etiology of AD. Although the condition of most patients improves quickly with this treatment, some do not respond well. In this review, the author discusses the management of treatment-resistant atopic dermatitis, with an emphasis on the pediatric population.
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