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Incidence of malignant neoplasms in renal transplant recipients: Association between transplantation and the incidence of skin cancer
Krásová, Martina ; Göpfertová, Dana (advisor) ; Dlhý, Jozef (referee) ; Vašků, Vladimír (referee)
Aims: To determine the incidence of skin cancer and other malignancies in renal transplant recipients (RTRs) transplanted in the largest transplant center in the Czech Republic. To identify the distribution of risk factors involved in the skin cancer development and to derive the optimal strategy for dermatological screening in the Czech transplant population. Materials and methods: A cohort study was performed on the group of 797 patients after kidney transplantation, who were referred for dermatological examination in the time period from January 2013 to January 2016. Standardized morbidity ration (SMR) was analyzed and calculated for different types of cancer developed in the posttransplant period. Results: 192 cases of malignancies were diagnosed in 86 RTRs (10,8 %). Nonmelanoma skin cancer (NMSC) was the most frequent type of cancer with SMR = 6,42 (P = 0,000), followed by renal cancer with SMR = 5,9 (P = 0,000), malignant melanoma with SMR = 2,59 (P = 0,080) and prostate cancer with SMR = 1,21 (P = 0,593). The risk to develop NMSC was significantly higher in the group where cyclosporine has been used besides tacrolimus, mycophenolatemophetil and steroids as well as in the group treated with the combination without cyclosporine (SMR = 9,62, P = 0,001 and SMR = 5,18, P = 0,000). Furthermore,...
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Phototherapy in dermatovenereology - methods and mechanisms
Benáková, Nina ; Cetkovská, Petra (advisor) ; Ditrichová, Dagmar (referee) ; Pavel, Stanislav (referee) ; Vašků, Vladimír (referee)
I choose the topic of phototherapy because of my longlasting interest in this field. Phototherapy is defined as the therapeutic use of light, primarily ultraviolet light. The mode of action on the skin is described as photobiological one and it has been continuously investigated. At its most basic level phototherapy represents the application of energy to skin, which means the delivery of photons to chromophores, the absorbtion of photons in chromophores and the biologic reaction of photon's absorbed energy. This causes the formation of heat and various biochemical effects in the skin. Previously the main role of UV light in phototherapy was thought to be the antimitotic and antiproliferative. Nowadays it is clear that beside them the mode of action is rather immunomodulatory and immunosuppressive. Further possible mechanism of the UV light are detected with increasing investigation of the immune system of skin. The rules and usages of phototherapy in practice at individual dermatological departments and offices differ and there is a need to improve and/or coordinate the protocols in order to reach the optimal risk/benfit ratio. That was one of the reasons for conducting the epidemiological study Phototherapy in Czech Republic. The results shows phototherapy to be an available and relative...
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Chronic Inflammation and Metabolic Syndrom in Patients with Psoriasis
Vachatová, Simona ; Ettler, Karel (advisor) ; Vašků, Vladimír (referee) ; Tichý, Martin (referee)
Psoriasis is a chronic recurrent inflammatory disease. Genetic and immunological factors are involved in development of psoriasis. Psoriasis is associated with numerous comorbidities including metabolic syndrome (MetS). Adipocytokines produced by white adipose tissue may be involved in the pathogenesis of psoriasis. Adipocytokines could serve as a missing link in the association between psoriasis and obesity/MetS. The most important adipokines include adiponectin, leptin and resistin. Adiponectin is expressed by adipocytes and has a high anti- inflammatory potential. Leptin is a protein produced in adipose tissue and is an important part in regulating energy metabolism. It has a pro-inflammatory effect. Polypeptide resistin is produced by macrophages and monocytes of the visceral adipose tissue. It was named for its ability to induce insulin resistence. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is also product of macrophages, that can be served as a marker for cardiovascular risk. Increased smoking rates in patients with psoriasis is associated with their reduced quality of life. In addition, smoking of tobacco cigarettes is closely associated with MetS: smokers have an increased risk of MetS. Between psoriasis and smoking has also been demonstrated a direct link. Smoking is a well-recognized cause...
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Photodynamic therapy and diagnostic in dermatology
Kacerovská, Denisa ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Ettler, Karel (referee) ; Vašků, Vladimír (referee)
Background Based on news about hypericin (HYP) as a potent photosensitizer with promising photobiological activities, we decided to try it as a topically applied photosensitizer in photodynamic therapy (PDT). Objective The aim of this single-centre, prospective study was to investigate the effectiveness of topical HYP-PDT treatment for non melanoma skin cancer. Methods The study was carried out on 34 patients (20 male and 14 women in the 32 to 83 years age range) with actinic keratoses (AK), basal cell carcinoma (BCC) and Bowen's disease. The patients were treated once a week with HYP in a glycerol solution and a red light dose of 75 J/cm2 for 6 weeks on average. Results The percentage of complete clinical response was 50% for AKs, 24% in patients with superficial BCC and 40% in patients with Bowen's disease. Complete clinical response did not occur in the group with nodular BCCs. A complete histological response rate was found out in 12% of patients with superficial BCCs and 80% in the patients with Bowen's disease. No control biopsies were performed after the treatment of AKs. All patients complained of burning and pain sensations during irradiation. Conclusion The topical HYP-PDT is a promising treatment for non melanoma skin cancer although the results of our study were less successful in...
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New Diagnostic Methods in Dermatology: Non-invasive Diagnosis of Non-melanoma Skin Cancer
Kříž, Martin ; Arenberger, Petr (advisor) ; Pavel, Stanislav (referee) ; Vašků, Vladimír (referee)
Non-melanoma skin cancer (NMSC) is the most prevalent cancer in the light-skinned population. New less- or non-invasive treatments are increasingly used for NMSC patients, making the development of non-invasive diagnostic technologies highly relevant. The scope of this work is to present data on the current state-of-art in diagnostic methods for NMSC and actinic keratosis. Different key words were searched through scientific search-engines. Results of the two of our studies are presented. Encouraging results from the reviewed diagnostic trials have suggested a high diagnostic accuracy for many of the new technologies. New imaging technologies have the capability of providing new or additional data or enough information in vivo to understand of NMSC development and to help the clinical diagnostics. Some of the new technologies, especially the high frequency ultrasonography described in the paper have the potential to be used in the daily praxis of NMSC diagnostic. The fluorescence diagnostic brings in our point of view a great merit in second line diagnostics of advanced and not clear cases.
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Incidence of malignant neoplasms in renal transplant recipients: Association between transplantation and the incidence of skin cancer
Krásová, Martina ; Göpfertová, Dana (advisor) ; Dlhý, Jozef (referee) ; Vašků, Vladimír (referee)
Aims: To determine the incidence of skin cancer and other malignancies in renal transplant recipients (RTRs) transplanted in the largest transplant center in the Czech Republic. To identify the distribution of risk factors involved in the skin cancer development and to derive the optimal strategy for dermatological screening in the Czech transplant population. Materials and methods: A cohort study was performed on the group of 797 patients after kidney transplantation, who were referred for dermatological examination in the time period from January 2013 to January 2016. Standardized morbidity ration (SMR) was analyzed and calculated for different types of cancer developed in the posttransplant period. Results: 192 cases of malignancies were diagnosed in 86 RTRs (10,8 %). Nonmelanoma skin cancer (NMSC) was the most frequent type of cancer with SMR = 6,42 (P = 0,000), followed by renal cancer with SMR = 5,9 (P = 0,000), malignant melanoma with SMR = 2,59 (P = 0,080) and prostate cancer with SMR = 1,21 (P = 0,593). The risk to develop NMSC was significantly higher in the group where cyclosporine has been used besides tacrolimus, mycophenolatemophetil and steroids as well as in the group treated with the combination without cyclosporine (SMR = 9,62, P = 0,001 and SMR = 5,18, P = 0,000). Furthermore,...
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New Diagnostic Methods in Dermatology: Non-invasive Diagnosis of Non-melanoma Skin Cancer
Kříž, Martin ; Arenberger, Petr (advisor) ; Pavel, Stanislav (referee) ; Vašků, Vladimír (referee)
Non-melanoma skin cancer (NMSC) is the most prevalent cancer in the light-skinned population. New less- or non-invasive treatments are increasingly used for NMSC patients, making the development of non-invasive diagnostic technologies highly relevant. The scope of this work is to present data on the current state-of-art in diagnostic methods for NMSC and actinic keratosis. Different key words were searched through scientific search-engines. Results of the two of our studies are presented. Encouraging results from the reviewed diagnostic trials have suggested a high diagnostic accuracy for many of the new technologies. New imaging technologies have the capability of providing new or additional data or enough information in vivo to understand of NMSC development and to help the clinical diagnostics. Some of the new technologies, especially the high frequency ultrasonography described in the paper have the potential to be used in the daily praxis of NMSC diagnostic. The fluorescence diagnostic brings in our point of view a great merit in second line diagnostics of advanced and not clear cases.
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Phototherapy in dermatovenereology - methods and mechanisms
Benáková, Nina ; Cetkovská, Petra (advisor) ; Ditrichová, Dagmar (referee) ; Pavel, Stanislav (referee) ; Vašků, Vladimír (referee)
I choose the topic of phototherapy because of my longlasting interest in this field. Phototherapy is defined as the therapeutic use of light, primarily ultraviolet light. The mode of action on the skin is described as photobiological one and it has been continuously investigated. At its most basic level phototherapy represents the application of energy to skin, which means the delivery of photons to chromophores, the absorbtion of photons in chromophores and the biologic reaction of photon's absorbed energy. This causes the formation of heat and various biochemical effects in the skin. Previously the main role of UV light in phototherapy was thought to be the antimitotic and antiproliferative. Nowadays it is clear that beside them the mode of action is rather immunomodulatory and immunosuppressive. Further possible mechanism of the UV light are detected with increasing investigation of the immune system of skin. The rules and usages of phototherapy in practice at individual dermatological departments and offices differ and there is a need to improve and/or coordinate the protocols in order to reach the optimal risk/benfit ratio. That was one of the reasons for conducting the epidemiological study Phototherapy in Czech Republic. The results shows phototherapy to be an available and relative...
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|
|
Photodynamic therapy and diagnostic in dermatology
Kacerovská, Denisa ; Pizinger, Karel (advisor) ; Arenberger, Petr (referee) ; Ettler, Karel (referee) ; Vašků, Vladimír (referee)
Background Based on news about hypericin (HYP) as a potent photosensitizer with promising photobiological activities, we decided to try it as a topically applied photosensitizer in photodynamic therapy (PDT). Objective The aim of this single-centre, prospective study was to investigate the effectiveness of topical HYP-PDT treatment for non melanoma skin cancer. Methods The study was carried out on 34 patients (20 male and 14 women in the 32 to 83 years age range) with actinic keratoses (AK), basal cell carcinoma (BCC) and Bowen's disease. The patients were treated once a week with HYP in a glycerol solution and a red light dose of 75 J/cm2 for 6 weeks on average. Results The percentage of complete clinical response was 50% for AKs, 24% in patients with superficial BCC and 40% in patients with Bowen's disease. Complete clinical response did not occur in the group with nodular BCCs. A complete histological response rate was found out in 12% of patients with superficial BCCs and 80% in the patients with Bowen's disease. No control biopsies were performed after the treatment of AKs. All patients complained of burning and pain sensations during irradiation. Conclusion The topical HYP-PDT is a promising treatment for non melanoma skin cancer although the results of our study were less successful in...
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