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  • 1
    Online Resource
    Online Resource
    DP03 (P23) Primary penile melanoma and penile lichen sclerosus
    Oxford University Press (OUP) ; 2023
    In:  British Journal of Dermatology Vol. 188, No. Supplement_4 ( 2023-06-26)
    Details
    In: British Journal of Dermatology, Oxford University Press (OUP), Vol. 188, No. Supplement_4 ( 2023-06-26)
    Abstract: The association between squamous cell malignancies and genital lichen sclerosus (GLSc) is well established. There is an increasing literature regarding the relationship of GLSc with genital malignant melanoma (MM). While there have been several reported cases of vulvar melanoma associated with lichen sclerosus (LSc), there have been fewer cases published with regard to male genital (M)GLSc and penile (Pe)MM. The aims of this study were to explore the relationship between PeMM and MGLSc by reviewing all cases managed by our multidisciplinary service over a period of 11 years. All patients known to our tertiary urology and male genital dermatology service with a diagnosis of penile MM and where histology was available for review were identified over an 11-year period (2011–2022). Two independent dermatologists reviewed the clinical records and photographs where available. Two independent mutually blinded histopathologists reviewed the histology and recorded features of GLSc where present. In cases of discordance between histopathologists, a third independent histopathologist reviewed the cases. Eleven patients were identified for inclusion in the study. Overall, GLSc was present on histopathology in nine of 11 cases (82%). Findings were concordantly positive in five cases and concordantly negative in one case. In cases of discordant findings (n = 5), the third histopathologist determined GLSc to be present in four cases and absent in one case. Clinical photographs were available for three cases, and clinical features of GLSc were seen in all of them; they also all had positive histopathological findings. Clinical notes, including electronic notes and letters, were available for review in eight cases. Symptoms in keeping with GLSc were mentioned in only one case, and signs suggestive of GLSc were documented in three cases. Penile MM is a rare entity accounting for 0.7% of penile cancer and 0.1% of MM cases. Like other malignancies, MM is a multifactorial disease caused by a combination of environmental factors and altered host responses contributing to an alteration of regulatory processes. Although ultraviolet exposure is important in the pathogenesis of extragenital MM, this cannot be a factor for genital disease. However, specific risk factors for genital MM have not yet been elucidated. To our knowledge, there have only been three previously documented cases (all from our group) of PeMM coexisting with GLSc. In this present study, finding of GLSc in nine of 11 men with PeMM is suggestive of a causative relationship. We postulate that this is related to chronic melanocytic distress created by chronic inflammation secondary to LSc.
    Type of Medium: Online Resource
    ISSN: 0007-0963 , 1365-2133
    URL: Article
    DOI: 10.1093/bjd/ljad113.216
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004086-6
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  • 2
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    Genital lichen sclerosus and melanoma; a systematic review
    Wiley ; 2023
    In:  Skin Health and Disease Vol. 3, No. 2 ( 2023-04)
    Details
    In: Skin Health and Disease, Wiley, Vol. 3, No. 2 ( 2023-04)
    Abstract: Lichen sclerosus (LSc) is a chronic, inflammatory, destructive skin disease with a predilection for the genitalia (GLSc). An association with vulval (Vu) and penile (Pe) squamous carcinoma (SCC) is now well established but melanoma (MM) has only rarely been reported complicating GLSc. Methods We have performed a systematic literature review of GLSc in patients with genital melanoma (GMM). Only articles that mentioned both GMM and LSc affecting either the penis or vulva were included. Results Twelve studies with a total of 20 patients were included. Our review shows that an association of GLSc with GMM has been more frequently reported in women and female children than men viz, 17 cases compared with three. It is notable that five of the cases (27.8%) concerned female children aged under twelve. Discussion These data suggest a rare association between GLSc and GMM. If proven, there arise intriguing questions about pathogenesis and consequences for counselling of patients and follow‐up.
    Type of Medium: Online Resource
    ISSN: 2690-442X , 2690-442X
    URL: Issue
    URL: Article
    DOI: 10.1002/ski2.v3.2
    DOI: 10.1002/ski2.198
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 3056511-X
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  • 3
    Online Resource
    Online Resource
    P23 Primary penile melanoma and penile lichen sclerosus
    Oxford University Press (OUP) ; 2023
    In:  British Journal of Dermatology Vol. 188, No. Supplement_4 ( 2023-06-26)
    Details
    In: British Journal of Dermatology, Oxford University Press (OUP), Vol. 188, No. Supplement_4 ( 2023-06-26)
    Abstract: The association between squamous cell malignancies and genital lichen sclerosus (GLSc) is well established. There is an increasing literature regarding the relationship of GLSc with genital malignant melanoma (MM). While there have been several reported cases of vulvar melanoma associated with lichen sclerosus (LSc), there have been fewer cases published with regard to male genital (M)GLSc and penile (Pe)MM. The aims of this study were to explore the relationship between PeMM and MGLSc by reviewing all cases managed by our multidisciplinary service over a period of 11 years. All patients known to our tertiary urology and male genital dermatology service with a diagnosis of penile MM and where histology was available for review were identified over an 11-year period (2011–2022). Two independent dermatologists reviewed the clinical records and photographs where available. Two independent mutually blinded histopathologists reviewed the histology and recorded features of GLSc where present. In cases of discordance between histopathologists, a third independent histopathologist reviewed the cases. Eleven patients were identified for inclusion in the study. Overall, GLSc was present on histopathology in nine of 11 cases (82%). Findings were concordantly positive in five cases and concordantly negative in one case. In cases with discordant findings (n = 5), the third histopathologist determined GLSc to be present in four cases and absent in one case. Clinical photographs were available for three cases and clinical features of GLSc were seen in all of them; they also all had positive histopathological findings. Clinical notes, including electronic notes and letters, were available for review in eight cases. Symptoms in keeping with GLSc were mentioned in only one case, and signs suggestive of GLSc were documented in three cases. Penile MM is a rare entity accounting for 0.7% of penile cancer and 0.1% of MM cases. Like other malignancies, MM is a multifactorial disease caused by a combination of environmental factors and altered host responses contributing to an alteration of regulatory processes. Although ultraviolet exposure is important in the pathogenesis of extragenital MM, this cannot be a factor for genital disease. However, specific risk factors for genital MM have not yet been elucidated. To our knowledge, there have only been three previously documented cases (all from our group) of PeMM coexisting with GLSc. This present study finding of GLSc in 9 of 11 men with PeMM, is suggestive of a causative relationship. We postulate that this is related to chronic melanocytic distress created by chronic inflammation secondary to LSc.
    Type of Medium: Online Resource
    ISSN: 0007-0963 , 1365-2133
    URL: Article
    DOI: 10.1093/bjd/ljad113.051
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004086-6
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  • 4
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    Negative impact of the pandemic on hospital admissions, morbidity and early mortality for acute cirrhosis decompensation
    BMJ ; 2023
    In:  BMJ Open Gastroenterology Vol. 10, No. 1 ( 2023-01), p. e001071-
    Details
    In: BMJ Open Gastroenterology, BMJ, Vol. 10, No. 1 ( 2023-01), p. e001071-
    Abstract: The global pandemic has diverted resources away from management of chronic diseases, including cirrhosis. While there is increasing knowledge on COVID-19 infection in liver cirrhosis, little is described on the impact of the pandemic on decompensated cirrhosis admissions and outcomes, which was the aim of this study. Methods A single-centre, retrospective study, evaluated decompensated cirrhosis admissions to a tertiary London hepatology and transplantation centre, from October 2018 to February 2021. Patients were included if they had an admission with cirrhosis decompensation defined as new-onset jaundice or ascites, infection, encephalopathy, portal hypertensive bleeding or renal dysfunction. Results The average number of admissions stayed constant between the pre-COVID-19 (October 2018–February 2020) and COVID-19 periods (March 2020–February 2021). Patients transferred in from secondary centres had consistently higher severity scores during the COVID-19 period (UK Model for End-Stage Liver Disease 58 vs 54; p=0.007, Model for End-Stage Liver Disease-Sodium 22 vs 18; p=0.006, EF-CLIF Acute Decompensation (AD) score 55.0 vs 51.0; p=0.055). Of those admitted to the intensive care without acute-on-chronic liver failure, there was a significant increase in AD scores during the COVID-19 period (58 vs 48, p=0.009). In addition, there was a trend towards increased hospital readmission rates during the COVID-19 period (29.5% vs 21.5%, p=0.067). When censored at 30 days, early mortality postdischarge was significantly higher during the COVID-19 period (p 〈 0.001) with a median time to death of 35 days compared with 62 days pre-COVID-19. Discussion This study provides a unique perspective on the impact that the global pandemic had on decompensated cirrhosis admissions. The findings of increased early mortality and readmissions, and higher AD scores on ICU admission, highlight the need to maintain resourcing for high-level hepatology care and follow-up, in spite of other disease pressures.
    Type of Medium: Online Resource
    ISSN: 2054-4774
    URL: Article
    DOI: 10.1136/bmjgast-2022-001071
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2884818-4
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  • 5
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    Student’s Mental Wellbeing in the Current Normal
    International Journal of Research Publications ; 2021
    In:  International Journal of Research Publications Vol. 90, No. 1 ( 2021-11-16)
    Details
    In: International Journal of Research Publications, International Journal of Research Publications, Vol. 90, No. 1 ( 2021-11-16)
    Type of Medium: Online Resource
    ISSN: 2708-3578
    URL: Journal
    URL: Article
    DOI: 10.47119/27083578
    DOI: 10.47119/IJRP1009011220212532
    Language: Unknown
    Publisher: International Journal of Research Publications
    Publication Date: 2021
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  • 6
    Online Resource
    Online Resource
    Primary penile melanoma and genital lichen sclerosus
    Wiley ; 2023
    In:  Skin Health and Disease
    Details
    In: Skin Health and Disease, Wiley
    Abstract: There is a well‐established association between squamous cell cancer and genital lichen sclerosus (GLSc). Although there have been several reported cases of vulval melanoma (MM) associated with LSc, particularly in the paediatric population, fewer cases of male genital (M) GLSc and penile (Pe)MM have been published. Objectives The aim of this study was to explore further the relationship between PeMM and MGLSc by reviewing all the cases managed by our multidisciplinary service over a finite period. Methods All patients known to our tertiary urology and male genital dermatology service with a diagnosis of PeMM and where histology was available for review were identified over an 11‐year period (2011–2022). The histology was reviewed by two independent, mutually ‘blinded’ histopathologists. Photographs and clinical notes, where available, were retrospectively reviewed by two independent dermatologists for signs or symptoms of LSc. Results Eleven patients with PeMM were identified for review. Histopathological examination found evidence of LSc in nine patients, and review of clinical photos corroborated the presence of LSc in three. Overall, features of LSc were present in nine out of eleven cases (82%). Conclusion The presence of LSc in 9 out of 11 cases of PeMM is suggestive of a causative relationship between LSc and PeMM. This may be due to chronic melanocytic distress created by chronic inflammation secondary to LSc.
    Type of Medium: Online Resource
    ISSN: 2690-442X , 2690-442X
    URL: Article
    DOI: 10.1002/ski2.274
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 3056511-X
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  • 7
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    Online Resource
    The negative impact of the pandemic on hospital admissions, morbidity and 30-day mortality for acute cirrhosis decompensation: a tertiary care perspective
    Elsevier BV ; 2022
    In:  Journal of Hepatology Vol. 77 ( 2022-07), p. S889-
    Details
    In: Journal of Hepatology, Elsevier BV, Vol. 77 ( 2022-07), p. S889-
    Type of Medium: Online Resource
    ISSN: 0168-8278
    URL: Article
    DOI: 10.1016/S0168-8278(22)02069-4
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2027112-8
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