Biomedical subjects

Carl V Washington

Publications and source records attributed to Carl V Washington.

4 recordsLinked to original sources

PubMed2007

Interferon Alfa-2b or not 2b? Significant differences exist in the decision-making process between melanoma patients who accept or decline high-dose adjuvant interferon Alfa-2b treatment.

BACKGROUND: Patients with thick (Breslow>4 mm) primary melanoma and/or regional nodal metastasis have a high risk of tumor recurrence. High-dose adjuvant interferon (IFN) alfa-2b offers /=50% risk of recurrence/disease-related mortality and offered IFN. Telephone surveys delineated reasons behind patients' decisions to accept IFN. RESULTS: Acceptors, 60 of 135 (45%), decided to take IFN alfa-2b whereas 75 of 135 (55%) declined. Being female (OR, 2.4; 95% CI, 1.17-5.03; p=.017) and positive SLN status (OR, 2.2; 95% CI, 1.01-4.97; p=.048) were strongly associated with patients who chose IFN. Acceptors of IFN were younger, more influenced by physicians, and less affected by depression and side effect profile (p<.05 for all). Decliners were more concerned by strained relationships with family and social life (p<.05). CONCLUSIONS: Gender and positive SLN were predictive of high-risk melanoma patients' acceptance of IFN treatment. Physician insight into melanoma patients' therapeutic decision-making process can guide patients through this difficult disease.

Adult↗

PubMed2004

Keloids demonstrate high-level epidermal expression of vascular endothelial growth factor.

BACKGROUND: Keloids are a major cause of morbidity, and arise after operation, injury, or cutaneous infection. Clinically, keloids differ from hypertrophic scars in that they grow beyond the original borders of the injury. Keloids occur most commonly for patients of African and Asian descent, and treatment options are multiple, indicating that there is no entirely satisfactory treatment for keloids. Angiogenesis inhibition has been shown to be effective in treatment of malignancy in both animal models and human beings. OBJECTIVE: We sought to determine whether keloids produce the potent angiogenic factor vascular endothelial growth factor (VEGF). METHODS: We performed in situ hybridization for VEGF on keloid tissue and normal skin. RESULTS: Our study demonstrated abundant production of VEGF in keloids and, surprisingly, the major source of VEGF was the overlying epidermis. CONCLUSIONS: Our results suggest that the overlying epidermis is the major source of keloid angiogenesis. These findings demonstrate that keloids are angiogenic lesions. Topical antiangiogenic therapy, directed at either down-regulating epidermal VEGF or inhibiting keratinocyte-derived VEGF activity on its endothelial receptors, may be useful in the treatment of keloids.

Epidermis↗

PubMed2003

Acral lentiginous melanoma mimicking benign disease: the Emory experience.

BACKGROUND: Plantar and subungual melanoma exhibits a higher misdiagnosis rate relative to other anatomic sites. Misdiagnosis and delay in diagnosis are statistically associated with poorer patient outcome. Awareness of atypical presentations of acral melanoma may, thus, be important to decrease misdiagnosis rates and improve patient outcome. METHODS: We conducted a retrospective case review of plantar or lower-extremity subungual melanoma performed at Winship Cancer Center, a tertiary care, referral center affiliated with Emory University, between 1985 and 2001. RESULTS: A total of 53 cases of plantar or lower-extremity subungual melanoma were identified. Of 53 cases with a final diagnosis of melanoma, 18 were initially misdiagnosed. Misdiagnoses included wart, callous, fungal disorder, foreign body, crusty lesion, sweat gland condition, blister, nonhealing wound, mole, keratoacanthoma, subungual hematoma, onychomycosis, ingrown toenail, and defective/infected toenail. Of the 18 misdiagnosed cases, 9 were clinically amelanotic. CONCLUSION: Awareness that amelanotic variants of acral melanoma may assume the morphology of benign hyperkeratotic dermatoses may increase the rate of correct diagnosis and improve patient outcome.

Adult↗

PubMedDate not supplied

Multiple, clustered dermatofibroma: a rare clinical variant of dermatofibroma.

BACKGROUND: Although patients with one to two dermatofibromas are common, cases of "multiple" dermatofibromas (more than 15 lesions) are rare and may occur in the context of altered or normal immune function. Patients with multiple dermatofibromas clustered in one anatomic area, by contrast, are strikingly rare. OBJECTIVE: The aim of our study was to present an additional case of multiple, clustered dermatofibroma (MCDF) and to summarize the literature concerning this entity. METHODS: We performed a MEDLINE (1960-2001) database search using keywords "dermatofibroma" AND "clustered" OR "agminated" OR "grouped." RESULTS: Five case reports were identified using this search strategy. These cases demonstrated substantial similarity in clinical features and behavior, specifically, the presence of pruritic symptoms, no clear inciting incident, an early active growth phase followed by stabilization, predilection for the lower extremity, and no report of sarcomatous transformation. CONCLUSION: Despite an active early growth phase, MCDF appears to follow a benign clinical course, with no report of sarcomatous transformation at up to 20 years followup.

Adult↗