The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Ernesto Gonzalez - One of the best experts on this subject based on the ideXlab platform.
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treatment of Nevus spilus with the q switched ruby laser
Dermatologic Surgery, 1997Co-Authors: Joop M. Grevelink, Salvador Gonzalez, Rowena Bonoan, Chitralada Vibhagool, Ernesto GonzalezAbstract:Background Q-switched lasers have shown to be effective in the removal of unwanted cutaneous pigmentation. Benign cutaneous pigmented lesions represent a heterogeneous group. Nevus spilus is a relatively uncommon pigmented lesion characterized by dark, hyperpigmented dots scattered over a tan-colored macule. Objective A cohort of patients with Nevus spilus was studied to determine the effects of Q-switched ruby and Q-switched Nd:YAG laser treatment on clearance of pigment and to evaluate potential side effects. Methods Six patients with Nevus spilus were treated with the Q-switched ruby laser (QSR). In addition, three lesions received a test treatment with the Q-switched Nd:YAG (QSYAG) laser at 532 or 1064 nm. The results of treatment were documented during follow up visits. Results Most lesions showed a near-complete or complete response to laser treatment. In one case partial hyperpigmentation occurred after treatment and in one case no follow-up could be obtained. In the three cases that received both QSR and QSYAG laser treatment, the QSR laser was shown to be the most effective in removing pigment. Conclusion Nevus spilus can be treated effectively with the Q-switched ruby laser.
Paul A Khavari - One of the best experts on this subject based on the ideXlab platform.
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Decreased Expression of the Chromatin Remodeler ATRX Associates with Melanoma Progression
2020Co-Authors: Kavita Y Sarin, Jennifer M. Mcniff, Shirley Kwok, Paul A KhavariAbstract:spili. HRAS mutations have recently been demonstrated in a number of hamartomatous cutaneous neoplasms including epidermal nevi and Nevus sebaceous (Groesser et al., 2012; Hafner et al., 2012; Levinsohn et al., 2012; Sun et al., 2013). When these alterations occur early in development or affect multiple cell lineages, they can result in developmental syndromes called ‘RASopathies,’ such as Schimmelpenning, epidermal Nevus syndrome, and phacomatosis pigmentokeratotica (Hafner and Groesser, 2013). The HRAS point mutation (c.37G-4C, p.Gly13Arg), in particular, appears to be overrepresented among HRAS mutations in these cutaneous congenital conditions. This mutation allows constitutive activation of RAS pathway likely facilitating the development of secondary neoplasms through accrual of additional genetic alterations. Our finding adds sporadic Nevus spilus to the spectrum of congenital cutaneous lesions that harbor activating mutations in HRAS. In Nevus spilus, we speculate that the melanocytic neoplasms that arise from these tan patches likely acquire additional genetic alterations that enable progression. Indeed, we have recently demonstrated such a secondary change through amplification of HRAS in Spitz nevi arising out of a Nevus spilus (Sarin et al., 2013). However, the secondary mutations that give rise to the diverse spectrum of melanocytic neoplasms have not yet been identified. The knowledge of the genetic basis of Nevus spilus represents a further step towards understanding the genetic etiology underlying melanocytic neoplasms. In addition, these lesions represent a unique opportunity to study the genetic alterations that allow progression from a Nevus spilus to a Nevus or melanoma in the setting of constitutive RAS/MAPK activation.
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activating hras mutation in agminated spitz nevi arising in a Nevus spilus
JAMA Dermatology, 2013Co-Authors: Kavita Y Sarin, Charles D Bangs, Athena M Cherry, Susan M Swetter, Paul A KhavariAbstract:Importance Spitz nevi are benign melanocytic proliferations that can sometimes be clinically and histopathologically difficult to distinguish from melanoma. Agminated Spitz nevi have been reported to arise spontaneously, in association with an underlying Nevus spilus, or after radiation or chemotherapy. However, to our knowledge, the genetic mechanism for this eruption has not been described. Observations We report a case of agminated Spitz nevi arising in a Nevus spilus and use exome sequencing to identify a clonal activating point mutation in HRAS (GenBank 3265) (c.37G→C) in the Spitz nevi and underlying Nevus spilus. We also identify a secondary copy number increase involving HRAS on chromosome 11p, which occurs during the development of the Spitz nevi. Conclusions and Relevance Our results reveal an activating HRAS mutation in a Nevus spilus that predisposes to the formation of Spitz nevi. In addition, we demonstrate a copy number increase in HRAS as a “second hit” during the formation of agminated Spitz nevi, which suggests that both multiple Spitz nevi and solitary Spitz nevi may arise through similar molecular pathways. In addition, we describe a unique investigative approach for the discovery of genetic alterations in Spitz nevi.
Kunihiko Tamaki - One of the best experts on this subject based on the ideXlab platform.
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Treatment of 153 Japanese patients with Q-switched alexandrite laser
Lasers in Medical Science, 2007Co-Authors: Shinji Kagami, Akihiko Asahina, Rei Watanabe, Yoshihiro Mimura, Akira Shirai, Naoko Hattori, Takahiro Watanabe, Kunihiko TamakiAbstract:We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient for Nevus spilus/café-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year of age, was treated after 5 years of age, was located on the face, was oval with a smooth border, and the patient was male. This approach was equally effective for senile lentigo, Nevus of Ota, and Mongolian spots, but less effective for acquired bilateral Nevus of Ota-like macules. Some patients with sacral Mongolian spots or those with light-colored, senile lentigo developed severe post-inflammatory hyperpigmentation after treatment. As a whole, good therapeutic outcome was achieved after multiple treatment sessions. However, the use of other lasers or other treatment modalities should be considered to treat Nevus spilus/café-au-lait spots.
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treatment of 153 japanese patients with q switched alexandrite laser
Lasers in Medical Science, 2007Co-Authors: Shinji Kagami, Akihiko Asahina, Rei Watanabe, Yoshihiro Mimura, Akira Shirai, Naoko Hattori, Takahiro Watanabe, Kunihiko TamakiAbstract:We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient for Nevus spilus/cafe-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year of age, was treated after 5 years of age, was located on the face, was oval with a smooth border, and the patient was male. This approach was equally effective for senile lentigo, Nevus of Ota, and Mongolian spots, but less effective for acquired bilateral Nevus of Ota-like macules. Some patients with sacral Mongolian spots or those with light-colored, senile lentigo developed severe post-inflammatory hyperpigmentation after treatment. As a whole, good therapeutic outcome was achieved after multiple treatment sessions. However, the use of other lasers or other treatment modalities should be considered to treat Nevus spilus/cafe-au-lait spots.
Fumio Kaneko - One of the best experts on this subject based on the ideXlab platform.
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treatment of Nevus spilus using a ruby laser system with a dual pulse width
European Journal of Dermatology, 1995Co-Authors: H Gunji, T Tateshita, Fumio KanekoAbstract:Nevus spilus, including cafe au lait spots and Becker's Nevus, is known to have a high recurrence rate following treatment with dermabrasion, cryotherapy or laser irradiation the- rapy. To minimize recurrence, treatment was performed in this study using a ruby laser with short pulses of 240 μs and long pulses of 1 ms. This therapy was seen to be highly effective as demonstrated by clinical results obtained in 46 cases, and was particularly useful in treating cases of Becker's Nevus. The addition of short pulse treatment permitted destruction of melanocytes and/or phagocytosing cells within relatively deep dermis and in skin follicles, resulting in improvements in the efficacy of this method. The protocol was further improved with additiona laser treatment using short pulses of 10 J/cm 2 , 3 weeks after the first irradiation. The efficacy of this treatment was judged excellent or good in 36 out of 46 cases (78.3%). However, Nevus spilus on the head and neck regions especially in young patients under 20 years of age, failed to respond well to treatment, as judged by the high rate of recurrence.
Shinji Kagami - One of the best experts on this subject based on the ideXlab platform.
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Treatment of 153 Japanese patients with Q-switched alexandrite laser
Lasers in Medical Science, 2007Co-Authors: Shinji Kagami, Akihiko Asahina, Rei Watanabe, Yoshihiro Mimura, Akira Shirai, Naoko Hattori, Takahiro Watanabe, Kunihiko TamakiAbstract:We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient for Nevus spilus/café-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year of age, was treated after 5 years of age, was located on the face, was oval with a smooth border, and the patient was male. This approach was equally effective for senile lentigo, Nevus of Ota, and Mongolian spots, but less effective for acquired bilateral Nevus of Ota-like macules. Some patients with sacral Mongolian spots or those with light-colored, senile lentigo developed severe post-inflammatory hyperpigmentation after treatment. As a whole, good therapeutic outcome was achieved after multiple treatment sessions. However, the use of other lasers or other treatment modalities should be considered to treat Nevus spilus/café-au-lait spots.
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treatment of 153 japanese patients with q switched alexandrite laser
Lasers in Medical Science, 2007Co-Authors: Shinji Kagami, Akihiko Asahina, Rei Watanabe, Yoshihiro Mimura, Akira Shirai, Naoko Hattori, Takahiro Watanabe, Kunihiko TamakiAbstract:We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient for Nevus spilus/cafe-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year of age, was treated after 5 years of age, was located on the face, was oval with a smooth border, and the patient was male. This approach was equally effective for senile lentigo, Nevus of Ota, and Mongolian spots, but less effective for acquired bilateral Nevus of Ota-like macules. Some patients with sacral Mongolian spots or those with light-colored, senile lentigo developed severe post-inflammatory hyperpigmentation after treatment. As a whole, good therapeutic outcome was achieved after multiple treatment sessions. However, the use of other lasers or other treatment modalities should be considered to treat Nevus spilus/cafe-au-lait spots.