Melanoma: Panizzon R

Dummer R, Panizzon R, Bloch PH, Burg G, Anonymous00029. · Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland. · Dermatology. · Pubmed #15604544 No free full text.

Abstract: Melanoma is the most common lethal cutaneous neoplasm. In order to harmonize treatment and follow-up of melanoma patients, guidelines for the management of melanoma in Switzerland have been inaugurated in 2001. These have been approved by all Swiss medical societies involved in the care of melanoma patients. New data necessitated changes concerning the safety margins (reduction to maximally 2 cm) and modifications of the recommendations of follow-up.

Dummer R, Bösch U, Panizzon R, Bloch PH, Burg G, Anonymous00035. · Department of Dermatology, University Hospital of Zürich, Switzerland. · Dermatology. · Pubmed #11549807 No free full text.

Abstract: Melanoma is the most common lethal cutaneous neoplasm. There is major controversy over the best management of this malignancy. In order to harmonize treatment and follow-up of melanoma patients, guidelines for the management of melanoma in Switzerland have been inaugurated. They have been approved by all Swiss medical societies involved in the care of melanoma patients.

Autier P, Doré JF, Négrier S, Liénard D, Panizzon R, Lejeune FJ, Guggisberg D, Eggermont AM. · Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. · J Natl Cancer Inst. · Pubmed #10433619 links to  free full text

Abstract: BACKGROUND: In epidemiologic studies, sunscreen use is associated with increased risk of cutaneous melanoma, basal cell skin cancer, and higher numbers of nevi. It has been proposed that sunscreens may encourage prolonged sun exposure because they delay sunburn occurrence. We examined whether, under habitual conditions of sunscreen use, the sun-protection factor (SPF) had an influence on sun-exposure duration. METHODS: Before the 1997 summer holidays, we randomly assigned 87 French and Swiss participants who were 18-24 years of age to receive an SPF 10 or an SPF 30 sunscreen. Neither medical personnel nor study participants were aware of their sunscreen assignment. Participants were asked to complete daily records of their sun exposure. To avoid influencing the recreational sun-exposure habits of the study participants, no recommendation was made about sun exposure or sun protection. Furthermore, participants were told that the trial end point was the number of pigmented skin lesions before and after the holidays. One subject was lost to follow-up. All statistical tests were two-sided. RESULTS: The SPF 10 (n = 44) and SPF 30 (n = 42) groups had equivalent mean holiday durations (19.4 days versus 20.2 days) and mean quantities of sunscreen used (72.3 g versus 71.6 g). The mean cumulative sun exposures for the two groups were 58.2 hours and 72.6 hours, respectively (P =.011). The mean daily durations of sunbathing were 2.6 and 3.1 hours, respectively (P =.0013), and, for outdoor activities, they were 3.6 and 3.8 hours, respectively (P =.62). There was no difference in sunburn experience between the two groups. CONCLUSIONS: Use of higher SPF sunscreen seems to increase the duration of recreational sun exposure of young white Europeans.

Guillod J, Schmid-Saugeon P, Décaillet F, Panizzon R, Kunt M, Thiran JP. · Department of Dermatology, University Hospital, Lausanne, Switzerland. · Stud Health Technol Inform. · Pubmed #14663971 No free full text.

Abstract: Proprietary systems for dermoscopy images analysis are available to improve the diagnosis and follow-up of the pigmented skin lesions. Their performance seems comparable with that of a human expert. Progress in computer-aided classification of melanocytic lesions depends notably on judicious choices of the algorithms dedicated to the extraction of signs from the dermoscopy images and of the method which combines these signs to classify the lesions. To allow the researcher's community to benefit from their large set of elementary algorithms already available for dermoscopy, we set up a system accessible through the Internet which: allows the engineers to register their algorithms while preserving their secrecy: their programs run on their own server; lets a user to define its own sequence of image analysis and to apply it to its images: the system automatically calls the appropriate remote programs; makes possible and stimulates the synergy of worldwide researchers in order to validate algorithms of images analysis best suited to achieve the correct diagnosis and to track the malignant melanoma; makes these techniques available to the greatest number of users through the Web and thus to support a mass screening; reduces the maintenance of the system to the minimum: it requires users only an Internet browser and engineers to follow a simple widespread standardised interface for distributed programs. Various problems should be addressed: the lack of standardisation of images acquisition: algorithms based on relative colours are best suited to this system; the copyrights on images and algorithms; charging the use of remote computer resources. This system allows for an international collaborative work in the fight against the malignant melanoma by offering a conceptual and technical platform of teledermoscopy. It is intended to support synergy between the engineers and the users implied in the diagnosis and teaching of dermoscopy.

Farshad A, Burg G, Panizzon R, Dummer R. · Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, CH-8091 Zurich, Switzerland. · Br J Dermatol. · Pubmed #12072074 No free full text.

Abstract: BACKGROUND: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are the most common melanocytic neoplasms on sun-exposed skin of elderly patients. OBJECTIVES: To perform a retrospective study of 150 patients with LM and LMM treated with radiotherapy using Grenz or soft X-rays. METHODS: The information recorded and analysed included gender, age, diagnosis, size of the lesion, localization, X-ray treatment, recurrence rate, other skin malignancies and non-dermatological neoplasms. RESULTS: The 150 patients comprised 78 women and 72 men (mean age 70 years). Ninety-three patients had LM, 54 had LMM and three had both neoplasms. Ninety per cent of lesions were located on the face. Treatment was with Grenz rays in 96 patients with LM and 11 with LMM (70%) and with soft X-rays in 46 patients with LMM (30%). Three patients were treated using both modalities. One hundred and one patients were followed up for at least 2 years after radiotherapy (mean 8 years). The mean time to recurrence was 45.6 months, and the recurrence rate was 7% (seven of 101). Other skin malignancies were observed in 65 of 150 patients, including basal cell carcinoma in 23 (35%) and actinic keratosis in 20 (31%). Four patients developed internal cancers. CONCLUSIONS: The study showed that radiotherapy of LM and LMM was curative. In particular, radiotherapy proved to be an excellent treatment for elderly patients. Owing to the high incidence of other skin cancers, LM patients need careful follow-up.

Berret J, Liardet S, Scaletta C, Panizzon R, Hohlfeld P, Applegate LA. · Laboratory of Oxidative Stress and Aging, University Hospital, CHUV, Lausanne, Switzerland. · Dermatology. · Pubmed #12037448 No free full text.

Abstract: BACKGROUND: The hazards due to sun exposure are well known. Many recent studies have emphasized the protection against the harmful effects of the sun by the use of sunscreens and, moreover, by staying in the shade and wearing long-sleeved shirts, hats and sunglasses. Switzerland has one of the highest rates of skin cancer induction in Europe and the incidence of melanoma in Switzerland is constantly increasing with an incidence of 10-12/100,000 inhabitants/year. Interestingly, some studies have evoked the possibility that sunscreen use can increase the risk of melanoma by increasing overall sun exposure. OBJECTIVE AND METHODS: In this context, the aim of our study was to estimate the amount of sun exposure of children, and their parents, living in Switzerland and to give a description of how they protect themselves against sun irradiation. Questionnaires were provided to pediatricians in every state (canton) in Switzerland and were given to families coming for consultation. RESULTS: A total of 328 forms including 1,285 individuals were returned from most of the cantons in Switzerland. The majority of the Swiss families had 2 children under 16 years of age with middle-aged parents (30-45 years) and a central European skin type (light skin of type II-III, brown or blue eyes, and brown to blond hair). An important sun exposure was noted even though the population seems to be conscious of the associated dangers. Sunscreens were the first-line defense against sun exposure with clothing and shielding oneself from the sun not being highly used. Moreover, sunscreens tended to be misused with most people applying them at the beach or swimming pool (instead of 15 min before exposure) and few applications throughout the day. CONCLUSIONS: Prevention should imperatively be emphasized for lower overall sun exposure as sunscreens are primarily used at the beach and not in routine daily exposure. In addition, it is agreed that prevention campaigns would be better directed towards children because up to 80% of detrimental sun exposure occurs during childhood.