Vol 4-4 Original Research Article

Superficial Radiotherapy: Long Term Follow-Up of Highly Selected Basal and Squamous Cell Carcinomas in Skin Cancer Patients

Superficial radiotherapy (SRT) treatment for non-melanoma skin cancer has been reported to yield variable cure rates. When patients are highly selected, adequate margins of treatment are chosen, and hypofractionation is avoided, cure rates of SRT can approach that of Mohs surgery.

The objective of this study is to evaluate long term results of our center’s SRT selection criteria and define proper decision-making parameters of optimal candidates for treatment, and to review the literature. A retrospective chart analysis was done of all SRT cases from 2012-2018. Location, size, type and depth of the treated tumors were defined. Treatment energy, fractionation, and radiation field size were documented. Recurrences and complications were analyzed. Of 131 treated lesions treated, head and neck lesions (105, 80%) were the most common location, primarily on the lower nose (60, 46%). Of 122 lesions analyzed for recurrence, 2 (1.6%) recurred, with a mean follow-up time of 5 years. Acute ulcerations in 29 (28%) head and neck lesions, 5 (63%) trunk lesions, and 9 (50%) leg lesions occurred. Delayed ulcerations occurred in 5 (28%) leg lesions. In conclusion, when patients are highly selected, long-term SRT cure rates up to 98% can be achieved.

DOI: 10.29245/2767-5092/2022/4.1261 View / Download Pdf
Vol 4-4 Mini Review Article

The 2022 Global Monkeypox Outbreak: A Focused Review

The first human infection with monkeypox virus was reported in 1970, and infections have subsequently been recorded in endemic areas such as Central and West Africa or linked to international travel to these regions. However, the emergence of the 2022 monkeypox outbreak has involved multiple non-endemic countries and continents without links to travel to endemic areas. The first cases in the current outbreak were reported in May of 2022. The primary mode of transmission is atypical and is thought to occur through direct contact with infected skin lesions. The rapid increase in case numbers prompted the World Health Organization to declare this disease outbreak as a public health emergency of international concern. Robust efforts are being made by global public health authorities to develop effective antiviral treatment options and vaccination strategies to reduce the spread of this disease. The objective of this manuscript is to provide a comprehensive review of the 2022 mpox outbreak with respect to its unique epidemiology, clinical features, complications, and management options.

DOI: 10.29245/2767-5092/2022/4.1166 View / Download Pdf
Vol 4-4 Letter to the Editor

Racial and Ethnic Disparities in Androgenetic Alopecia Clinical Trials in the United States

Introduction: Androgenetic alopecia (AGA) is the most common type of hair loss worldwide and is estimated to affect about 80 million people in the United States. Recent trends suggest that incidence and severity of the disease are increasing across all genders and races. Randomized controlled trials (RCTs) involving diverse patient populations are necessary to individualize treatment.

Objective: Evaluate enrollment and subgroup analysis of people falling in racial/ethnic minority groups in phase II and III RCTs for AGA published in the United States within the past 10 years.

Methods: We examined completed published phase II and III randomized, double-blind, placebo-controlled trials investigating AGA. Race/ethnicity data was extracted for each RCT using US Census Bureau guidelines.

Results: 20 total RCTs with a total of 1855 participants were included in the analysis. 8 (40%) of RCTs included race/ethnicity data. Among these, 3 (15%) studies included only race and 5 (25%) included both. The majority of study patients were white (n= 862/1063, 81.1%) followed by African American (n=127/1063, 11.9%) and Asian (n=33/1063, 3.1%). Six (0.56%) patients identified as American Indian/Alaska Natives, 5 (0.47%) as Hawaiian/Pacific Islander, and 16 (1.5%) as another race or race was unknown. Ethnicity was reported in 5 (25%) of trials, totaling 317 participants; 60 (18.9%) patients identified as Hispanic.

Conclusions: Non-Caucasian patients remain underrepresented in RCTs despite AGA being a highly prevalent condition, reducing the generalizability of trial outcomes to the general population. Future RCTs should update definitions of race/ethnicity and include more diversity among AGA patients.

DOI: 10.29245/2767-5092/2022/4.1164 View / Download Pdf