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The color of the skin is influenced by a number of pigments, including melanin, carotene, and hemoglobin. Recall that melanin is produced by cells called melanocytes, which are found scattered throughout the stratum basale of the epidermis. The melanin is transferred to the keratinocytes via melanosomes.
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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
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The epidermis is made of four or five layers of epithelial cells, depending on its location in the body. From deep to superficial, these layers are the stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum.
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Melanoma cutáneo

Georgina V Long1, Susan M Swetter2, Alexander M Menzies3

  • 1Melanoma Institute Australia, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Department of Medical Oncology, Mater Hospital, Sydney, NSW, Australia.

Lancet (London, England)
|July 27, 2023
PubMed
Resumen
Este resumen es generado por máquina.

El melanoma cutáneo, un cáncer de piel en aumento, a menudo está relacionado con la exposición a los rayos UV. Los tratamientos avanzados, incluida la inmunoterapia, han mejorado significativamente las tasas de supervivencia de los pacientes con melanoma.

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Área de la Ciencia:

  • Dermatología
  • En el campo de la oncología

Sus antecedentes:

  • La incidencia de melanoma cutáneo está aumentando, especialmente en las poblaciones de piel clara.
  • La exposición a la radiación ultravioleta es un factor de riesgo primario, aunque algunos subtipos de melanoma no están relacionados con los rayos UV.
  • El diagnóstico se basa en la evaluación clínica e histopatológica de los tumores primarios, que pueden ser pigmentados o amelanoticos.

Objetivo del estudio:

  • Proporcionar una visión general del diagnóstico y tratamiento del melanoma cutáneo.
  • Para destacar los avances en las terapias sistémicas para el melanoma avanzado.
  • Hacer hincapié en la importancia de la atención multidisciplinaria en casos complejos.

Principales métodos:

  • Revisión de los criterios clínicos e histopatológicos para el diagnóstico del melanoma primario.
  • Descripción de las modalidades de tratamiento, incluida la escisión amplia, la inmunoterapia, la terapia dirigida y la radioterapia.
  • Discusión de las terapias farmacológicas sistémicas para el melanoma avanzado y metastásico.

Principales resultados:

  • La escisión amplia es el tratamiento principal para el melanoma localizado, con márgenes basados en el grosor del tumor.
  • Las terapias sistémicas, particularmente los inhibidores del punto de control inmune, han mejorado dramáticamente la supervivencia en el melanoma avanzado desde 2011.
  • El tratamiento del melanoma avanzado, especialmente con metástasis cerebrales, requiere enfoques complejos y multidisciplinarios.

Conclusiones:

  • El diagnóstico precoz y el tratamiento adecuado, incluida la cirugía y las terapias adyuvantes, son cruciales para el tratamiento del melanoma.
  • Las terapias farmacológicas sistémicas representan un gran avance en el tratamiento del melanoma avanzado, mejorando significativamente los resultados de los pacientes.
  • La atención integrada y multidisciplinaria es esencial para optimizar el manejo de casos complejos de melanoma.