DOCSLIB.ORG

Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin Comparative Effectiveness Review Number 199 Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin e Comparative Effectiveness Review Number 199 Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin (with addendum) Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00002-I Prepared by: Brown Evidence-based Practice Center Providence, RI Investigators: Aaron Drucker, M.D. Gaelen P. Adam, M.L.I.S. Valerie Langberg, M.S. Abhilash Gazula, M.P.H. Bryant Smith, M.P.H. Farah Moustafa, M.D. Martin A. Weinstock, M.D., Ph. D. Thomas A. Trikalinos, M.D. AHRQ Publication No. 17(18)-EHC033-EF December 2017 Key Messages Purpose of Review Assess comparative effectiveness and safety of treatments for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Key Messages • Comparative evidence on treatment of BCC and SCC is limited. Many comparisons were evaluated in one or two randomized controlled trials only. • Surgery and radiotherapy have lower recurrence rates for BCC than interventions that destroy lesions with heat or cold, photodynamic therapy (PDT), or curettage. • There is moderate confidence that PDT for BCC is associated with better cosmetic outcomes than surgery. • Serious adverse events, events leading to treatment discontinuation, and treatment site infections were uncommon with all treatments for BCC. • Recurrence rates for SCC in situ were lower with PDT and cryotherapy than with drugs. Evidence was insufficient to draw conclusions for other treatments. ii This report is based on research conducted by the Brown Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00002-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report. The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients. This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders. AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied. This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program Web site at www.effectivehealthcare.ahrq.gov. Search on the title of the report. Persons using assistive technology may not be able to fully access information in this report. For assistance contact [email protected]. Suggested citation: Drucker A, Adam GP, Langberg V, Gazula A, Smith B, Moustafa F, Weinstock MA, Trikalinos TA. Treatments for Basal Cell and Squamous lC Cel arcinoma of the Skin. Comparative Effectiveness Review No. 199. (Prepared by the Brown Evidence- based Practice Center under Contract No. 290-2015-00002-I.) AHRQ Publication No. 17(18)- EHC033-EF. Rockville, MD: Agency for Healthcare Research and Quality; December 2017. www.effectivehealthcare.ahrq.gov/reports/final.cfm. DOI: https://doi.org/10.23970/AHRQEPCCER199 iii Preface The Agency for Healthcare Research and Quality (AHRQ), through its Evidence-based Practice Centers (EPCs), sponsors the development of systematic reviews to assist public- and private-sector organizations in their efforts to improve the quality of health care in the United States. These reviews provide comprehensive, science-based information on common, costly medical conditions, and new health care technologies and strategies. Systematic reviews are the building blocks underlying evidence-based practice; they focus attention on the strength and limits of evidence from research studies about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews can help clarify whether assertions about the value of the intervention are based on strong evidence from clinical studies. For more information about AHRQ EPC systematic reviews, see www.effectivehealthcare.ahrq.gov/reference/purpose.cfm. AHRQ expects that these systematic reviews will be helpful to health plans, providers, purchasers, government programs, and the health care system as a whole. Transparency and stakeholder input are essential to the Effective Health Care Program. Please visit the Web site (www.effectivehealthcare.ahrq.gov) to see draft research questions and reports or to join an email list to learn about new program products and opportunities for input. If you have comments on this systematic review, they may be sent by mail to the Task Order Officer named below at: Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20857, or by email to [email protected]. Gopal Khanna, M.B.A. Arlene S. Bierman, M.D., M.S. Director Director Agency for Healthcare Research and Quality Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality Stephanie Chang, M.D., M.P.H. Director Lionel Bañez, M.D. Evidence-based Practice Center Program Task Order Officer Center for Evidence and Practice Improvement Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality iv Key Informants In designing the study questions, the EPC consulted several Key Informants who represent the end-users of research. The EPC sought the Key Informant input on the priority areas for research and synthesis. Key Informants are not involved in the analysis of the evidence or the writing of the report. Therefore, in the end, study questions, design, methodological approaches, and/or conclusions do not necessarily represent the views of individual Key Informants. Key Informants must disclose any financial conflicts of interest greater than $10,000 and any other relevant business or professional conflicts of interest. Because of their role as end-users, individuals with potential conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any conflicts of interest. The list of Key Informants who provided input to this report follows: Sarah Arron, M.D. William Higgins, M.D., M.Be. Dermatologist/Associate Professor Assistant Professor of Dermatology University of California Brown University San Francisco, CA Providence, RI Melody J. Eide, M.D. M.P.H. Eleni Linos, M.D. Dermatologist/Assistant Professor of Dermatologist/Health Services Researcher Medicine University of California University of South Dakota Sanford School San Francisco, CA of Medicine Rapid City Medical Center Dr. Yakub Puthawala, M.D. Rapid City, SD Radiation Oncologist Chief of Brachytherapy Services Charles Hayley Rhode Island Hospital Medical Director/Medicaid, Providence, RI Noridian Lawrence, KS Patients (2) Rhode Island Names withheld for privacy protection v Technical Expert Panel In designing the study questions and methodology at the outset of this report, the EPC consulted several technical and content experts. Broad expertise and perspectives were sought. Divergent and conflicting opinions are common and perceived as healthy scientific discourse that results in a thoughtful, relevant systematic review. Therefore, in the end, study questions, design, methodologic approaches, and/or conclusions do not necessarily represent the views of individual technical and content experts. Technical Experts must disclose any financial conflicts of interest greater than $10,000 and any other relevant business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals with potential conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. The list of Technical Experts who provided input to this report follows. Sarah Arron, M.D.* Rapid City, SD Dermatologist/Associate Professor University of California Charles Hayley San Francisco, CA Medical Director/Medicaid, Noridian Elizabeth Toni Barnes, M.D.* Lawrence, KS Department of Radiation Oncology University of Toronto William Higgins, M.D., M.Be.
Load more

Recommended publications
  • AHFS Pharmacologic-Therapeutic Classification System
    AHFS Pharmacologic-Therapeutic Classification System Abacavir 48:24 - Mucolytic Agents - 382638 8:18.08.20 - HIV Nucleoside and Nucleotide Reverse Acitretin 84:92 - Skin and Mucous Membrane Agents, Abaloparatide 68:24.08 - Parathyroid Agents - 317036 Aclidinium Abatacept 12:08.08 - Antimuscarinics/Antispasmodics - 313022 92:36 - Disease-modifying Antirheumatic Drugs - Acrivastine 92:20 - Immunomodulatory Agents - 306003 4:08 - Second Generation Antihistamines - 394040 Abciximab 48:04.08 - Second Generation Antihistamines - 394040 20:12.18 - Platelet-aggregation Inhibitors - 395014 Acyclovir Abemaciclib 8:18.32 - Nucleosides and Nucleotides - 381045 10:00 - Antineoplastic Agents - 317058 84:04.06 - Antivirals - 381036 Abiraterone Adalimumab; -adaz 10:00 - Antineoplastic Agents - 311027 92:36 - Disease-modifying Antirheumatic Drugs - AbobotulinumtoxinA 56:92 - GI Drugs, Miscellaneous - 302046 92:20 - Immunomodulatory Agents - 302046 92:92 - Other Miscellaneous Therapeutic Agents - 12:20.92 - Skeletal Muscle Relaxants, Miscellaneous - Adapalene 84:92 - Skin and Mucous Membrane Agents, Acalabrutinib 10:00 - Antineoplastic Agents - 317059 Adefovir Acamprosate 8:18.32 - Nucleosides and Nucleotides - 302036 28:92 - Central Nervous System Agents, Adenosine 24:04.04.24 - Class IV Antiarrhythmics - 304010 Acarbose Adenovirus Vaccine Live Oral 68:20.02 - alpha-Glucosidase Inhibitors - 396015 80:12 - Vaccines - 315016 Acebutolol Ado-Trastuzumab 24:24 - beta-Adrenergic Blocking Agents - 387003 10:00 - Antineoplastic Agents - 313041 12:16.08.08 - Selective
    [Show full text]
  • Erythema Ab Igne Erythema Ab Igne
    gyöngyösi quark 10/18/13 8:48 Page 1 BÔRGYÓGYÁSZATI ÉS VENEROLÓGIAI SZEMLE • 2013 • 89. ÉVF. 5. 127–131. • DOI 10.7188/bvsz.2013.89.5.3 Erythema ab igne Erythema ab igne GYÖNGYÖSSY ORSOLYA DR., DARÓCZY JUDIT DR. Egyesített Szent István és Szent László Kórház – Rendelôintézet, Bôrgyógyászati Szakrendelô és Lymphoedema Rehabilitációs osztály, Budapest ÖSSZEFOGLALÁS SUMMARY Az erythema ab igne jelentése „bôrpír a tûztôl”. A bôr- Erythema ab igne means „redness from fire”. tünetek az ismétlôdô, 43-47 C fokos hôhatásra alakulnak Symptoms resulting from prolonged or repeated exposure ki. Régebben kályha, sugárzó hô okozta a tüneteket, újab- to moderate heat. The heat source used to be stove, and ban laptop, ágymelegítô hatása is bizonyított. A klinikai other infrared radiation, nowadays the role of laptop tüneteket retikuláris pigmentáció, petechiák, hólyagok, computer, hot blanket and many others are proved. The atypikus sebek jellemzik. Három észlelt esetben lehetôség clinical symptomes are reticular hyperpigmentation, volt az eltérô klinikai megjelenés bemutatására. A bôr petechia, blisters, aypical ulcers. Three different cases mikrocirkulációs zavara lézer-Doppler módszerrel igazol- show the variant clinical manifestation. Pathologic ható. A szerzôk elsôként vetik fel, hogy a bôrtünet kialaku- dermal microcirculation was verified with Laser Doppler lása a bôr kapillárisainak a hôhatásra adott kóros reak- examination. The authors first raised the relationship ciójával függhet össze. A ritkán diagnosztizált kórkép between abnormal capillary respond to heat and the onset felismerése azért fontos, mert az ismétlôdô vagy folyama- of skin symptoms. It is important to be familiar with this tos hám irritáció következtében elszarusodó laphámrák rarely diagnosed disease because the chronic epidermal keletkezhet és Merkel sejtes carcinomát is leírtak.
    [Show full text]
  • Photodynamic Therapy with Methyl Aminolevulinate for Primary Nodular Basal Cell Carcinoma: Results of Two Randomized Studies
    Clinical trial Photodynamic therapy with methyl aminolevulinate for primary nodular basal cell carcinoma: results of two randomized studies Peter Foley, MBBS, BMedSc, MD, FACD, Michael Freeman, MBBS, FACD, Alan Menter, MB, FAAD, Gregory Siller, MBBS, FACD, Rokea A. El-Azhary, MD, PhD, FAAD, Kurt Gebauer, MBBS, FACD, Nicholas J. Lowe, MD, FAAD, Michael T. Jarratt, MD, FAAD, Dedee F. Murrell, BMBCh, MD, FAAD, Phoebe Rich, MD, FAAD, David M. Pariser, MD, FAAD, Allan R. Oseroff, MD, PhD, FAAD, Ross Barnetson, MD, FRACP, FACD, Christopher Anderson, MBBS, FACD, Steven Kossard, MBBS, FACD, Lawrence E. Gibson, MD, FAAD, and Whitney D. Tope, MPhIL, MD, FAAD From the Department of Medicine Abstract (Dermatology), The University of Background Data suggest that photodynamic therapy using topical methyl aminolevulinate Melbourne, St. Vincent’s Hospital (MAL PDT) may be a noninvasive alternative to excisional surgery for nodular basal cell Melbourne, Fitzroy, Vic., Suite 5 ACH carcinoma (BCC). In the studies described here, we investigated the histologic response, House, Benowa and Department of Dermatology, Princess Alexandra tolerability, and cosmetic outcome with MAL PDT for primary nodular BCC (£ 5 mm in depth). Hospital, Woolloongabba, Qld, Fremantle Methods Two multicenter, randomized, double-blind studies with similar design and Dermatology, Fremantle, WA, and procedures were conducted. After surface debridement and minor tumor debulking, MAL cream Department of Dermatology, St. George 160 mg/g (66 patients with 75 lesions) or placebo cream (65 patients with 75 lesions) was applied Hospital, University of New South Wales, for 3 h, followed by illumination with broad-spectrum red light (75 J/cm2, 570–670 nm).
    [Show full text]
  • Pattern of Skin Tumours in Kashmir Valley of North India: a Hospital Based Clinicopathological Study
    International Journal of Information Research and Review, February 2015 International Journal of Information Research and Review Vol. 2, Issue, 02, pp. 376-381 February, 2015 Research Article PATTERN OF SKIN TUMOURS IN KASHMIR VALLEY OF NORTH INDIA: A HOSPITAL BASED CLINICOPATHOLOGICAL STUDY 1,*Peerzada Sajad, 2Iffat Hassan, 3Ruby Reshi, 4Atif Khan and 5Waseem Qureshi 1MBBS, MD Senior Resident, Postgraduate Department of Dermatology, GMC Srinagar, India 2Associate Professor and Head Postgraduate Department of Dermatology, STD and Leprosy GMC Srinagar, 3Associate professor and Head Postgraduate Department of Pathology GMC Srinagar, 4Scholar, PostgraduateIndia Department of Dermatology, STD and Leprosy GMC Srinagar, 5Chief physician and Registrar Academics, Government Medical College Srinagar, India India India ARTICLE INFO ABSTRACT Article History: Background: Earlier studies have shown that the incidence of all varieties of skin cancers is lower Received 27th November, 2014 among Indians due to the protective effects of melanin.However the pattern of skin cancers in kashmir Received in revised form valley is different from the rest of India due to the presence of Kangri cancer. 20th December, 2014 Objective: Our aim was to assess the distribution pattern of skin tumours among ethnickashmiri Accepted 30th January, 2015 population presenting to a tertiary care hospital in Kashmir and comparison of clinical diagnosis with st Published online 28 February, 2015 histopathological confirmation. Methods: This study was a prospective hospital based which was conducted over a one year period Keywords: on patients’ attending the outpatient department of Dermatology of our hospital and presenting with Non-Melanoma Skin Cancers, clinical features suspicious of benign or malignant skin tumours .All the relevant investigations Benign, including a skin biopsy were done in every individual patient to determine the type of tumour.
    [Show full text]
  • BC Cancer Benefit Drug List September 2021
    Page 1 of 65 BC Cancer Benefit Drug List September 2021 DEFINITIONS Class I Reimbursed for active cancer or approved treatment or approved indication only. Reimbursed for approved indications only. Completion of the BC Cancer Compassionate Access Program Application (formerly Undesignated Indication Form) is necessary to Restricted Funding (R) provide the appropriate clinical information for each patient. NOTES 1. BC Cancer will reimburse, to the Communities Oncology Network hospital pharmacy, the actual acquisition cost of a Benefit Drug, up to the maximum price as determined by BC Cancer, based on the current brand and contract price. Please contact the OSCAR Hotline at 1-888-355-0355 if more information is required. 2. Not Otherwise Specified (NOS) code only applicable to Class I drugs where indicated. 3. Intrahepatic use of chemotherapy drugs is not reimbursable unless specified. 4. For queries regarding other indications not specified, please contact the BC Cancer Compassionate Access Program Office at 604.877.6000 x 6277 or [email protected] DOSAGE TUMOUR PROTOCOL DRUG APPROVED INDICATIONS CLASS NOTES FORM SITE CODES Therapy for Metastatic Castration-Sensitive Prostate Cancer using abiraterone tablet Genitourinary UGUMCSPABI* R Abiraterone and Prednisone Palliative Therapy for Metastatic Castration Resistant Prostate Cancer abiraterone tablet Genitourinary UGUPABI R Using Abiraterone and prednisone acitretin capsule Lymphoma reversal of early dysplastic and neoplastic stem changes LYNOS I first-line treatment of epidermal
    [Show full text]
  • Aminolevulinic Acid (ALA) As a Prodrug in Photodynamic Therapy of Cancer
    Molecules 2011, 16, 4140-4164; doi:10.3390/molecules16054140 OPEN ACCESS molecules ISSN 1420-3049 www.mdpi.com/journal/molecules Review Aminolevulinic Acid (ALA) as a Prodrug in Photodynamic Therapy of Cancer Małgorzata Wachowska 1, Angelika Muchowicz 1, Małgorzata Firczuk 1, Magdalena Gabrysiak 1, Magdalena Winiarska 1, Małgorzata Wańczyk 1, Kamil Bojarczuk 1 and Jakub Golab 1,2,* 1 Department of Immunology, Centre of Biostructure Research, Medical University of Warsaw, Banacha 1A F Building, 02-097 Warsaw, Poland 2 Department III, Institute of Physical Chemistry, Polish Academy of Sciences, 01-224 Warsaw, Poland * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel. +48-22-5992199; Fax: +48-22-5992194. Received: 3 February 2011 / Accepted: 3 May 2011 / Published: 19 May 2011 Abstract: Aminolevulinic acid (ALA) is an endogenous metabolite normally formed in the mitochondria from succinyl-CoA and glycine. Conjugation of eight ALA molecules yields protoporphyrin IX (PpIX) and finally leads to formation of heme. Conversion of PpIX to its downstream substrates requires the activity of a rate-limiting enzyme ferrochelatase. When ALA is administered externally the abundantly produced PpIX cannot be quickly converted to its final product - heme by ferrochelatase and therefore accumulates within cells. Since PpIX is a potent photosensitizer this metabolic pathway can be exploited in photodynamic therapy (PDT). This is an already approved therapeutic strategy making ALA one of the most successful prodrugs used in cancer treatment. Key words: 5-aminolevulinic acid; photodynamic therapy; cancer; laser; singlet oxygen 1. Introduction Photodynamic therapy (PDT) is a minimally invasive therapeutic modality used in the management of various cancerous and pre-malignant diseases.
    [Show full text]
  • A Synopsis of Cancer
    A SYNOPSIS OF CANCER GENESIS AND BIOLOGY BY WILFRED KARK M.B., B.Ch., F.R.C.S. Assistant Surgeon, Johannesburg Hospital; Lecturer in Clinical Surgery and Surgical Pathology, University of Witwatersr and; Lieut.-Col. R. A.M.C. ; Vice-President of the College of Physicians, Surgeons, and Gynaecologists of South Africa, and Chairman of its Examinations and Credentials Committee WITH A FOREWORD BY Sir ARTHUR PORRITT, Bt. K.C.M.G., K.C.V.O. .C.B.E., F.R.C.S. BRISTOL: JOHN WRIGHT & SONS LTD 1966 (§) JOHN WRIGHT & SONS LTD., 1966 Distribution by Sole Agents: United States of America: The Williams ώ Wilkins Company, Baltimore Canada: The Macmillan Company of Canada Ltd., Toronto PRINTED IN GREAT BRITAIN BY JOHN WRIGHT & SONS LTD., AT THE STONEBRIDGE PRESS, BRISTOL PREFACE THE disciplines involved in research into the genesis and biology of cancer are growing ever wider, and the detail of study is becoming increasingly deep. It is not surprising that the practitioner of medicine finds it difficult to maintain an appreciation of advances, and to co­ ordinate and apply the results of basic research to his own sphere of work. Not only does this imply the possibility of deficiencies in therapy, but it results in a serious and fundamental loss to the sum total of possible avenues of exploration of cancer. The lack of application and correlation of the results of investigation and experiment to the observa­ tion and management of patients suffering from cancer detracts from the practitioner's understanding of the disease and reduces his potential contribution to knowledge of the subject.
    [Show full text]
  • Oregon Health Authority Division of Medical Assistance Programs Addendum a - Final OPPS Apcs for CY 2012 Effective October 1, 2012
    Oregon Health Authority Division of Medical Assistance Programs Addendum A - Final OPPS APCs for CY 2012 Effective October 1, 2012 Relative APC Group Title SI Weight 0001 Level I Photochemotherapy S 0.5042 0002 Fine Needle Biopsy/Aspiration T 1.6115 0003 Bone Marrow Biopsy/Aspiration T 3.5702 0004 Level I Needle Biopsy/ Aspiration Except Bone Marrow T 4.5746 0005 Level II Needle Biopsy/Aspiration Except Bone Marrow T 8.1566 0006 Level I Incision & Drainage T 1.4206 0007 Level II Incision & Drainage T 13.1250 0008 Level III Incision and Drainage T 20.5648 0012 Level I Debridement & Destruction T 0.3878 0013 Level II Debridement & Destruction T 0.8785 0015 Level III Debridement & Destruction T 1.4989 0016 Level IV Debridement & Destruction T 2.7592 0017 Level V Debridement & Destruction T 21.6661 0019 Level I Excision/ Biopsy T 4.4238 0020 Level II Excision/ Biopsy T 8.2746 0021 Level III Excision/ Biopsy T 17.0074 0022 Level IV Excision/ Biopsy T 23.2662 0028 Level I Breast Surgery T 25.5054 0029 Level II Breast Surgery T 33.4070 0030 Level III Breast Surgery T 44.8999 0031 Smoking Cessation Services X 0.2997 0034 Mental Health Services Composite S 2.7295 0035 Vascular Puncture and Minor Diagnostic Procedures X 0.2691 0037 Level IV Needle Biopsy/Aspiration Except Bone Marrow T 15.3499 0039 Level I Implantation of Neurostimulator Generator S 216.7598 0040 Level I Implantation/Revision/Replacement of Neurostimulator Electrodes S 63.7616 0041 Level I Arthroscopy T 29.6568 0042 Level II Arthroscopy T 57.0137 0045 Bone/Joint Manipulation Under
    [Show full text]
  • Environmental Terminology in the Language Of
    “Raindrops” describe the pattern of hypopigmented areas ENVIRONMENTAL TERMINOLOGY IN THE LANGUAGE OF DERMATOLOGY within larger areas of hyperpigmentation associated with Patricia Ting, BSc& Benjamin Barankin, MD arsenic -induced pigmentation Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada Background: Arsenic exposure often results in pigmentary changes (hyper- and/or hypopigmentation) and multiple punctate keratoses on the palms and soles. The latter may ABSTRACT develop into skin cancers (i.e. Bowen's, squamous cell, basal cell carcinoma). The source of inorganic arsenicals comes Communication in dermatology is based upon the accurate morphological description of cutaneous lesions. To facilitate this goal, dermatologists have adopted Multicentric reticulohistiocytosis (MRH) is a multi-system from agricultural, environmental (well water), industrial (glass interesting and descriptive terminology to portray dermatoses that are difficult to depict and visualize, including frequently e ncountered objects in nature disorder with distinct cutaneous lesions of 2 to 10 cm non- workers, miners), and medicinal (herbal) remedies. and natural phenomena. Many of these descriptions are able to effectively create rich visual imagery, and they are useful aids f or learning and recall. Many tender papules or nodules on the upper trunk and extremities, have stood the test of time. For example, varicella has been described as “dewdrops on a rose petal” and linear palmoplantar lesions of pachydermoperiotosis Pathophysiology : Arsenicals may increase susceptibility to hands and nail base that range in color from shades of yellow have been depicted as a “wind blown desert” of rippling sand. The “Christmas tree” pattern has been classically used to describe pityriasis rosea while the to red.
    [Show full text]
  • Pub 100-04 Medicare Claims Processing
    Department of Health CMS Manual System & Human Services (DHHS) Pub 100-04 Medicare Claims Centers for Medicare Processing & Medicaid Services (CMS) Transmittal 2128 Date: DECEMBER 29, 2010 Change Request 7275 SUBJECT: January 2011 Update of the Ambulatory Surgical Center (ASC) Payment System I. SUMMARY OF CHANGES: This Recurring Update Notification describes changes to and billing instructions for various payment policies implemented in the January 2011 ASC update. As appropriate, this notification also includes updates to the Healthcare Common Procedure Coding System (HCPCS). EFFECTIVE DATE: January 1, 2011 IMPLEMENTATION DATE: January 3, 2011 Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated) R=REVISED, N=NEW, D=DELETED-Only One Per Row. R/N/D CHAPTER / SECTION / SUBSECTION / TITLE N/A III. FUNDING: For Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs): No additional funding will be provided by CMS; Contractor activities are to be carried out within their operating budgets. For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the Contracting Officer.
    [Show full text]
  • APPENDICES: a Systematic Review of Photodynamic Therapy in the Treatment of Pre-Cancerous Skin Conditions, Barrett's Oesophagu
    Health Technology Assessment 2010; Vol. 14: No.371 Health Technology Assessment 2010; Vol. 14: No. 37 Appendix 5 Pre-cancerous skin scoping Appendix 6 Appendices Go to main text Skin cancer scoping Appendix 7 Barrett’s oesophagus scoping Appendix 8 Oesophageal cancer scoping A systematic review of photodynamic Appendix 9 therapy in the treatment of pre- Lung cancer scoping cancerous skin conditions, Barrett’s Appendix 10 oesophagus and cancers of the biliary Biliary tract cancer scoping Appendix 11 tract, brain, head and neck, lung, Brain cancer scoping oesophagus and skin Appendix 12 Head and neck cancer scoping D Fayter, M Corbett, M Heirs, D Fox Appendix 13 and A Eastwood Actinic keratosis data extraction Appendix 14 Bowen’s disease data extraction Appendix 15 Basal cell carcinoma data extraction Appendix 16 Barrett’s oesophagus data extraction Appendix 17 Oesophageal cancer data extraction Appendix 18 Lung cancer data extraction Appendix 19 Biliary tract cancer data extraction Appendix 20 Brain cancer data extraction Appendix 21 July 2010 Head and neck cancer data extraction 10.3310/hta14370 Health Technology Assessment NIHR HTA programme www.hta.ac.uk HTA How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below). Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.
    [Show full text]
  • Methyl-Aminolevulinate-Based-Photodynamic-Therapy-O 2019 Photodiagnosis-And.Pdf
    Photodiagnosis and Photodynamic Therapy 26 (2019) 295–299 Contents lists available at ScienceDirect Photodiagnosis and Photodynamic Therapy journal homepage: www.elsevier.com/locate/pdpdt Methyl aminolevulinate-based photodynamic therapy of Bowen´s disease: Observational study of 21 lesions T ⁎ Clara Gómeza, , Marian Cobosb, Enrique Alberdib a Institute of Physical Chemistry Rocasolano, Spanish National Research Council, CSIC, Madrid, Spain b Private clinic of Dr. Alberdi, Madrid, Spain ARTICLE INFO ABSTRACT Keywords: Background: Although surgical removal is the treatment of choice in Bowen's disease (BD), there are cases in Photodynamic therapy which by age, comorbidities, use of anticoagulants, location, cosmetic result, or size, it is preferable to use other Methyl aminolevulinate treatments such as cryotherapy, 5-fluorouracil cream, imiquimod 5% cream or photodynamic therapy (PDT). ’ Bowen s disease Efficacy of PDT in BD is supported by substantial research and clinical data. Objectives: This study aimed to evaluate the long term effectiveness of methyl aminolevulinate-PDT (MAL/PDT) on a wide range of Bowen lesions in different locations and sizes. Methods: Patients diagnosed with BD were treated in 3 sessions with a 4-week interval in between with MAL/ PDT between January 2016 and January 2017 in a private clinic. Clinical response and relevant patient and tumour characteristics were analyzed during the first year after start of the PDT sessions. Results: In total, 21 BD lesions in 18 patients were included in the study. Complete regression (CR) after 3rd PDT session was 87.5% and 100% at the 6-month follow-up. Treatment was well tolerated and local adverse reactions were very scarce.
    [Show full text]