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DermView: Innovations in the Treatment of Vitiligo

 and joined the MJH Life Sciences team in September 2019. She graduated from Cleveland State University in 2018 with a bachelor's degree in journalism and promotional communications. She enjoys yoga, hand embroidery, and trying new restaurants. You can reach her at 

Suneel Chilukuri, MD, FAAD, FACMS, director of cosmetic surgery with Refresh Dermatology in Houston, Texas, shares new techniques for lower eyelid rejuvenation at the current Maui Derm for Dermatologists meeting held in Maui, Hawaii.  He discusses advances in the aesthetics area, different techniques, and how to avoid complications. 

Videos

Suneel Chilukuri, MD, discusses lower eyelid rejuvenation, including avoiding complications, in his presentation at the Maui Derm for Dermatologists meeting. 

Suneel Chilukuri, MD, on Lower Eyelid Rejuvenation 

Suneel Chilukuri, MD, FAAD, FACMS, director of cosmetic surgery with Refresh Dermatology in Houston, Texas, shares what he believes are big inovations in dermatology at the current Maui Derm for Dermatologists meeting held in Maui, Hawaii.  He discusses advances in hyperpigmentation treatments, such as using laser based technology, and how patients may need guidance in these new areas. 

Suneel Chilukuri, MD, discusses new innovations in dermatology, including hyperpigmentation, in his presentation at the Maui Derm for Dermatologists meeting. 

Suneel Chilukuri, MD, New Inovations in Hyperpigmentation

Robert S. Kirsner, MD, PhD, chairman and Harvey Blank professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine in Miami, Florida, shares his pearls for greater efficacy in his presentation at the current Maui Derm for Dermatologists meeting held in Maui, Hawaii. His pearls included: letting evidence guide decisions, debriding the wound edge along with the wound, using microbes to improve healing, and more.

Robert S. Kirsner, MD, PhD, discusses new and tried-and-true wound healing methods in his presentation at the Maui Derm for Dermatologists meeting. 

Robert S. Kirsner, MD, PhD,’s Wound Healing Pearls

and joined the MJH Life Sciences team in April 2021. She graduated from Kent State University in 2018 with a bachelor's degree in journalism and a minor in sociology. Linda used to work as a creative writer for 

 and was a technical writer/regulatory specialist/purchasing agent at GM Industrial before coming on to the team. She enjoys reading, traveling, and learning new perspectives. You can reach her at 

A group of researchers investigated the risk of COVID-19 in individuals with atopic dermatitis (AD) in a research letter published in the 

Journal of the American Academy of Dermatology

The research was conducted using the Symphony Health-derived data from the COVID-19 Research Database, and it was controlled for demographic factors and comorbidities known or speculated to be COVID-19 risk factors and assess the risk of contracting COVID-19 in adults with AD treated with dupilumab (Dupixent; Sanofi and Regeneron).

The patients included in the data were aged 20 years or older and all had to have at least 2 diagnoses of AD prior to January 1, 2020, were included in the AD cohort. Patients with no record of AD diagnosis prior to January 1, 2020, were randomly placed in the control group in a 10:1 size ratio compared with the AD group, according to the article. Of note, individuals without known ethnicity or race, type of payment, and/or sex were then excluded. Only laboratory-confirmed cases of COVID-19 between January 1, 2020, and April 17, 2021, were identified.

The AD and non-AD cohorts included 39,417 and 397,293 patients, respectively, the article continued. Poisson regression revealed a crude COVID-19 incidence rate ratio (IRR) of 1.41 (95% CI 1.34-1.48) for adults with AD compared with adults without AD. After adjusting for demographic factors and baseline comorbidities, the IRR remained statistically significant but was reduced to 1.18 (95% CI 1.12-1.24).

A sensitivity analysis which included the participants with missing race or ethnicity, sex, and/or type of payment (to account for selection bias), found the risk of COVID-19 associated with AD remained unchanged (adjusted IRR 1.18).

“In another sensitivity analysis (to address potential type I error) including subjects aged 20-65 years with zip codes in California or New York and excluding subjects with comorbidities associated with COVID-19 (n = 32,857), the adjusted IRR point estimate was higher (1.31, 95% CI 1.11-1.53) than that in the main analysis,” the researchers wrote.

It was found that dupilumab was associated with lower risk of contracting COVID-19 (adjusted IRR 0.66, 95% CI 0.52-0.83) compared with no systemic medication and AD patients on dupilumab showed significantly lower associated risk of contracting COVID-19 infection compared with AD subjects exposed to prednisone, cyclosporine, and/or azathioprine. The investigation was limited by the inability to account for treatment duration and establish a strong causal relationship. Additionally, the assessment of disease burden according to diagnostic codes might have missed individuals who never underwent COVID-19 laboratory testing.

“In this large population-based study, we found small increased risk of contracting COVID-19 to be associated with AD in adults,” researcher wrote. “However, adult AD subjects had a higher prevalence of baseline comorbidities, previously identified as COVID-19 risk factors, compared with adults without AD. Our results were attenuated after adjusting for baseline comorbidities, suggesting that residual confounding may explain the remaining association.”

Wu is or has been an investigator, consultant, or speaker for AbbVie, Almirall, Amgen, Arcutis, Aristea Therapeutics, Boehringer Ingelheim, Bristol–Myers Squibb, Dermavant, Dr Reddy's Laboratories, Eli Lilly, Galderma, Janssen, LEO Pharma, Mindera, Novartis, Regeneron, Sanofi Genzyme, Solius, Sun Pharmaceutical, UCB, Valeant Pharmaceuticals North America LLC, and Zerigo Health.

Egeberg has received research funding from Pfizer, Eli Lilly, Novartis, Bristol-Myers Squibb, AbbVie, Janssen Pharmaceuticals, the Danish National Psoriasis Foundation, the Simon Spies Foundation, and the Aage Bang's Foundation, and honoraria as consultant and/or speaker from AbbVie, Almirall, Leo Pharma, Galápagos NV, Sun Pharmaceuticals, Samsung Bioepis Co, Ltd, Pfizer, Eli Lilly, Novartis, Galderma, Dermavant, UCB, Mylan, Bristol–Myers Squibb, and Janssen Pharmaceuticals.

Thyssen has been an advisor, speaker, or investigator for AbbVie, LEO Pharma, Regeneron, Pfizer, Sanofi Genzyme, Almirall, and Eli Lilly. Dr Ge and 

Authors Martin, Liu, and Thatiparthi have no conflicts of interest to declare.

Wu JJ, Martin A, Liu J, et al. The risk of COVID-19 infection in patients with atopic dermatitis: A retrospective cohort study. Journal of the American Academy of Dermatology. 2022;86(1):243-245. doi:10.1016/j.jaad.2021.09.061

Articles

A retrospective cohort study in a research letter published in the Journal of the American Academy of Dermatology examined the risk between atopic dermatitis and COVID-19 risk. 

COVID-19 Risk and AD

John Jesitus is a medical writer based in Westminster, CO.

A long-term study of 2 British cohorts with atopic dermatitis (AD) reveals 4 distinct disease patterns occurring between birth and midlife. These patterns include a newly identified subtype that increases in probability with age and is associated with poor general and mental health.

 The study appeared online September 1 in 

“We’ve seen high rates of [AD] among adults. Yet we don’t fully understand the disease course from childhood,” says lead author Katrina Abuabara, MD, MA, MSCE. She is Associate Professor of Dermatology, University of California San Francisco, and Associate Adjunct Professor of Epidemiology, University of California, Berkeley, School of Public Health.

AD studies commonly focus on children, she says, perhaps following them into teen years. “But understanding that transition and whether the adults we see with [AD] also had it when they were children is very important for understanding what causes, triggers, and perpetuates the disease. There may be different subtypes that we need to treat differently.”

Investigators analyzed data from the 1958 National Child Development Study (NCDS) and the 1970 British Cohort Study (BCS70), each including more than 17,000 patients. Each cohort had subsequent waves of follow-up occurring at approximately 5- to 10-year intervals. Excluding follow-up years and patients without AD data, the study population included 15,939 and 14,966 subjects, respectively.

The proportions of patients who reported eczema at one or more time points in the NCDS and BCS70 cohorts were 16.7% and 24.4%, respectively. Using latent class analysis and other methods, investigators divided respondents with AD into 4 classes grouped by probability of AD with age—88% to 91% of patients had rare or no eczema symptoms. The corresponding proportions of patients with decreasing, increasing, and persistently high probability of reporting eczema with age were 4%, approximately 5%, and 2% to 3%, respectively.

“The key take-home message is that many people have later-onset disease. Traditionally, we thought of [AD] as a disease exclusively of early childhood onset. But when you extend the window of observation into midlife, there’s a very large group of people who are more likely to have symptoms as they get older.”

The study’s findings are relevant clinically, she says, because when adults present with new-onset eczema, dermatologists often worry that they have missed something. “While it’s appropriate to rule out other causes of the condition, it’s helpful for clinicians and patients to know that it’s not unusual develop disease later on.”

As expected, early-life factors that differentiated groups with eczema from the rare/no eczema group included gender, region of residence, social class, 

 tobacco smoke exposure, and breast-feeding. Compared with the rare/no AD subgroup, female gender was associated with higher odds of the high and increasing AD subtypes, and lower odds of the decreasing subtype.

Additionally, patients from higher social classes and those who were breast-fed were more likely to fall into the high and decreasing AD subgroups. Somewhat counterintuitively, Abuabara adds, breast-feeding was associated with a higher risk of all eczema subtypes, while 

 smoking exposure was linked with lower odds of the high-probability subtype.

Medical literature shows mixed results regarding breast-feeding, smoking, and AD.

 “There there are very clear health risks of smoking during pregnancy, and very clear benefits of breast-feeding. The results we found should not be interpreted as implying otherwise,” she says.

Also somewhat surprising, Abuabara adds, is that in comparisons between all subgroups, only female gender was associated with increased risk of the high-probability versus the decreasing subtype (odds ratio (OR) 1.99; 95% confidence interval (CI) 1.66 to 2.38). “It would be nice to offer parents more information about which subtype their child is most likely to have and what the future will likely hold. Unfortunately, the factors that we often measure in early life don’t seem to reliably predict the different disease courses.”

Having AD conferred increasing odds of other atopic diseases such as asthma and rhinitis in midlife. Patients in the high AD subtype were by far most likely to develop these illnesses over time. However, investigators found that the newly identified subtype was less likely to be associated with asthma and rhinitis. “Because those are part of the diagnostic criteria,” Abuabara says, “it’s important for clinicians to know that it’s possible to have adult-onset eczema and not necessarily have atopic comorbidity.”

Regarding other comorbidities, patients with increasing AD likelihood over time reported poor general health and mental health in midlife. Compared to the rare/no eczema subgroup, ORs for the increasing group were 1.29 (95% CI 1.09 to 1.53) and 1.45 (95% CI 1.23 to 1.72), respectively.

Clinicians must recognize that these patients’ inflammation may be more than skin deep, Abuabara adds. “As we have more research on comorbidities and screening recommendations, these may be the patients that we need to screen more carefully or treat more aggressively.”

The finding of poor general and mental health for the increasing AD subgroup moreover indicates that AD duration and activity may augur outcomes and should be included in studies of AD comorbidities, she says. “If you just examine everyone who’s an adult with eczema and their risk of cardiovascular disease, for example, you may be obscuring some important differences.” Possibly, Abuabara explains, patients with later-onset AD may have a subtype that is at higher risk for cardiovascular comorbidities compared to people whose AD has improved or continued into adulthood.

“Another take-home point is that for a subgroup of patients, the probability of eczema remains high into adulthood. Many older textbooks talk about how most kids with eczema get better by adolescence. There is an increasing recognition that this is an episodic disease that can continue beyond adolescence for a subset of patients.”

The study’s main limitation reflects its statistical strength, Abuabara says, in that researchers lacked detailed information on disease severity and other clinical parameters over time. However, investigators followed 2 cohorts including more than 30,000 individuals for nearly 50 years. “So it’s a trade-off.” Investigators were willing to sacrifice some detail, she says, because a large cohort with long-term follow-up was essential to their objectives.

In previous research, Abuabara and colleagues identified differences between patients who reported childhood-onset versus adult-onset AD.

 “We initially had looked at the simple binary classification of whether people first reported symptoms before or after adulthood,” she says. “That’s important clinically because we often think of childhood versus adult-onset disease.” The current paper uses data from a large population at multiple time points to add the nuance of how the probability of eczema development looks over time.

“In general, we are moving towards trying to understand subtypes of atopic dermatitis in many different ways. There’s a lot of work on endotypes or looking at how gene expression profiles differ between subgroups of patients.”

The present study represents a piece of this work, she says.

“We know that eczema is a heterogeneous disease. And as we get better at understanding all the different subtypes, hopefully we’ll get better at more precisely treating those subtypes. As we have more immunomodulatory drugs on the market—and many on the way—I envision a day when we’ll have methods to better identify which patients would most benefit from which treatments. Some of that will have to do with disease course.”

1. Abuabara K, Ye M, Margolis DJ, et al. Patterns of atopic eczema disease activity from birth through midlife in 2 British birth cohorts [published online ahead of print, 2021 Sep 1]. 

. 2021;10.1001/jamadermatol.2021.2489. doi:10.1001/jamadermatol.2021.2489

2.Friedman NJ, Zeiger RS. The role of breast-feeding in the development of allergies and asthma. 

. 2005;115(6):1238-1248. doi:10.1016/j.jaci.2005.01.069

3.Kantor R, Kim A, Thyssen JP, Silverberg JI. Association of atopic dermatitis with smoking: a systematic review and meta-analysis. 

. 2016;75(6):1119-1125.e1. doi:10.1016/j.jaad.2016.07.017

4. Abuabara K, Ye M, McCulloch CE, et al. Clinical onset of atopic eczema: results from 2 nationally representative British birth cohorts followed through midlife. 

. 2019;144(3):710-719. doi:10.1016/j.jaci.2019.05.040

5. Butler DC, Simpson E, Guttman-Yassky E, et al. The atopic dermatitis spectrum disorder. Recognizing the clinical heterogeneity in patients with atopic related skin conditions in order to improve therapeutic decision-making and outcomes: an expert panel consensus statement [published online ahead of print, 2021 Aug 16]. 

. 2021;1-3. doi:10.1080/09546634.2021.1966356

6.Nattkemper LA, Tey HL, Valdes-Rodriguez R, et al. The genetics of chronic itch: gene expression in the skin of patients with atopic dermatitis and psoriasis with severe itch. 

. 2018;138(6):1311-1317. doi:10.1016/j.jid.2017.12.029

Abuabara reports grants from Pfizer and personal fees from Target RWE during the time of but unrelated to the study.

A long-term study of 2 British cohorts with atopic dermatitis (AD) reveals 4 distinct disease patterns occurring between birth and midlife.

Atopic dermatitis through midlife

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Neal Bhatia, MD, highlights the most exciting new drugs and therapies in atopic dermatitis and psoriasis in his presentation at the current Maui Derm for Dermatologists meeting.

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New Indications, Mechanisms Drive Second-Line Treatments

Patients suffering from a wide range of dermatologic diseases can benefit from the new and exciting therapies and treatment modalities that have recently become available.

Hyperpigmentation requires dermatologists to take a multimodal approach and be familiar with a menu of treatments, according to a presentation given at Maui Derm for Dermatologists 2022, held January 24 to 28, 2022 in Maui Hawaii, and virtual.

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Linda Stein Gold, MD, and Matthew Zirwas, MD, share some advice for clinicians on how to discuss JAK inhibitors with patients.

Hormonal Acne Treatments: Balance the Rewards, Risks

Julie Harper, MD, of the Dermatology and Skin Care Center of Birmingham, Alabama explained the use, side effects, and risks of spironolactone and oral contraceptives in a presentation at the current Maui Derm for Dermatologists meeting in Maui, Hawaii.

Linda Stein Gold, MD, Talks Psoriasis in 2022

Linda Stein Gold, MD, discusses psoriasis in 2022, in her presentation at the current Maui Derm for Dermatologists meeting.

Androgenetic Alopecia Study Reveals Unmet Treatment Needs

A poster presentation from Follica at the 2022 Winter Clinical Dermatology Conference and 2022 Maui Derm for Dermatology meeting found that 56% of survey responders did not seek treatment for their hair loss, and that 19% of respondents who attempted treatment quit because of lack of efficacy or cost.

Improve patient outcomes in wound healing with the best practices of time-honored and cutting-edge approaches.

A retrospective cohort study in a research letter published in the Journal of the American Academy of Dermatology examined the risk between atopic dermatitis and COVID-19 risk.

Robert S. Kirsner, MD, PhD, discusses new and tried-and-true wound healing methods in his presentation at the Maui Derm for Dermatologists meeting.

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Risankizumab Receives FDA Approval for Active Psoriatic Arthritis

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Suneel Chilukuri, MD, on Lower Eyelid Rejuvenation

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Survey finds racism in nursing still an issue

Nearly half of the respondents say there is widespread racism in nursing.

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Weekly Roundup: January 24-28

Poll

Keith A. Reynolds is contributing author for 

After the nation has been rocked by protests over racial justice, there is still work to do in the healthcare industry.

, a national survey of nurses from the National Commission to Address Racism in Nursing found that more than half of respondents report there is widespread 

 in the field. Of the 5,600 respondents, 63 percent of nurses say they have personally experienced an act of 

 in the workplace. Of these, 66 percent say that racist act was transgressed by a peer with 60 percent say it was transgressed by a manager or supervisor.

“My colleagues and I braced ourselves for these findings. Still, we are disturbed, triggered, and unsettled by the glaring data and heartbroken by the personal accounts of nurses,” Ernest J. Grant, commission co-lead and president of the American Nurses Association. “We are even more motivated and committed to doing this important work justice. Racism and those individuals who do not commit to changing their ways but continue to commit racist acts have absolutely no place in the nursing profession.”

The majority, 81 percent, of nurses who reported witnessing an act of racism in the workplace say that it was directed towards a peer. Meanwhile 57 percent of nurses say they have challenged 

 in their workplace, but 64 percent say their efforts have resulted in no change, according to the release.

Sixty-nine percent of Hispanic respondents, 73 percent of Asian respondents, and 74 percent of respondents who were members of other communities of color reported having personally experienced racism in their workplace. Among Black nurses, 72 percent say that there is a lot of racism in nursing, compared to 29 percent of white nurses. An overwhelming 92 percent of Black respondents say they have personally experienced racism in the workplace from their leaders. 66 percent have experienced it from their peers, and 68 experienced it from patients, the release says.

“The acts of exclusion, incivility, disrespect and denial of professional opportunities that our nurses have reported through this survey, especially our Black, Hispanic and Asian nurses, is unacceptable,” Adrianna Nava, commission co-lead and president of the National Association of Hispanic Nurses, says in the release. “Racism is a trauma that leaves a lasting impact on a person’s mental, spiritual, and physical health as well as their overall quality of life. As the largest health care workforce in the country, we must come together to address racism in nursing as the health of our nation depends on the health and well-being of our nurses.”

This was orginially posted in our sister publication Medical Economics. 

The FDA has approved risankizumab-rzaa (Skyrizi; AbbVie) for the treatment of adults with active psoriatic arthritis (PsA), according to a 

Risankizumab-rzaa is an inflammatory pathway interleukin(IL)-23 inhibitor and this is the second indication that it is being approved for. It is also approved for the treatment of adults with moderate to severe plaque psoriasis in 2019. This most recent approval is based on the results of the KEEPsAKE-1 (NCT03675308) and KEEPsAKE-2 (NCT03671148) trials.

"In the pivotal KEEPsAKE trials, SKYRIZI demonstrated improvements across a number of psoriatic arthritis symptoms, including joint pain, enthesitis and dactylitis," said Alan J. Kivitz, MD, CPI, founder and medical director of the Altoona Center for Clinical Research and Altoona Arthritis and Osteoporosis Center in Pennsylvania and KEEPsAKE clinical trial investigator, in the aforementioned release. "This approval provides both dermatologists and rheumatologists with an option that helps improve skin and joint symptoms in patients with active psoriatic arthritis, alongside a quarterly dosing schedule that may fit their patients' lifestyle."

The KEEPsAKE-1 and KEEPsAKE-2 trials were phase 3 studies assessing the efficacy and safety of the therapy in adults with PsA as well as those who had responded inadequately or with intolerance to biologic therapy and/or disease-modifying antirheumatic drugs (DMARDs).

The primary endpoint sought by KEEPsAKE investigators was an American College of Rheumatology 20% improvement (ACR20) response at week 24. Data showed:

In KEEPsAKE-1 and KEEPsAKE-2, 57.3% and 51.3% of patients receiving risankizumab achieved the primary endpoint of ACR20 response at week 24, respectively, versus 33.5%and 26.5% receiving placebo. Risankizumab also demonstrated improvements in ACR50 and ACR70 responses compared to placebo at week 24.

Risankizumab showed improvements in other key manifestations of PsA compared to placebo at week 24, including improvements in dactylitis and enthesitis for patients with pre-existing dactylitis and enthesitis.

Patients with coexistent plaque psoriasis receiving risankizumab-rzaa saw improvements in the skin lesions of psoriasis, compared to placebo, as measured by the Psoriasis Area Severity Index (PASI 90) at week 24.

Risankizumab showed a statistically significant improvement in physical function, compared to placebo, as measured by the Health Assessment Questionnaire-Disability Index at week 24, with a mean difference of 0.20 in KEEPsAKE-1 and 0.16 in KEEPsAKE-2

The rates of adverse events (AEs) leading to discontinuation for patients. treated with risankizumab was 0.8% and 0.9% in both trials, respectively. For those on placebo, the discontinuation rates were 0.8% and 2.3%, respectively.

Thomas Hudson, MD, senior vice president of Research and Development and chief scientific officer of AbbVie, emphasized the benefit of a cross-indicated biologic approved for patients with potentially both plaque psoriasis and PsA.

"Patients often do not suspect a connection between their psoriasis skin symptoms and the joint pain, swelling and stiffness they may be experiencing, potentially leading to a delay in diagnosis and treatment of psoriatic arthritis," said Thomas Hudson, MD, senior vice president of research and development and chief scientific officer with AbbVie. "We're proud to expand the use of SKYRIZI to patients with psoriatic arthritis who are living with the debilitating combination of skin and joint symptoms."

1. U.S. FDA Approves Second Indication for SKYRIZI® (risankizumab-rzaa) to Treat Adults with Active Psoriatic Arthritis. Published January 21, 2022. Accessed January 28, 2022. https://news.abbvie.com/news/press-releases/us-fda-approves-second-indication-for-skyrizi-risankizumab-rzaa-to-treat-adults-with-active-psoriatic-arthritis.htm?view_id=2421

Integrating the combined ability of 2 independently validated algorithms using 31-gene expression profile (GEP) test (Castle Biosciences Inc) with clinicopathologic features may play a role in predicting the individual risk of sentinel lymph node (SLN) risk and recurrence-free survival (RFS) according to a poster presented at Maui Derm for Dermatologists 2022, being held Jan. 24-28, 2022, in Maui, Hawaii.

Using artificial intelligence (AI), an algorithm was created from 1,398 cases to determine the likelihood of SLN positivity. It was validated in a separate cohort of 1,674 cases (i31-GEP-SLNB). A different algorithm for personalized survival predictions for RFS, distant metastasis-free survival (DMFS), and melanoma-specific survival (MSS) was developed from 1,581 cases and were validated in an independent cohort of 523 cases (i31-GEP-outcomes). Based on the available data, 98% of patients in the validation cohort did not receive programmed cell death protein (PD)-1, cytotoxic T-lymphocyte-associated protein (CTLA)-4, or BRAF/MEK adjuvant therapy, according to the poster.

Risk cut-off point was created to align with the National Comprehensive Cancer Network (NCCN) guidelines. The decided cut-off were the midpoints between stage IIA and IIB (RFS: 69.8%; DMFS: 82.6%). All outcomes with i31-GEP-outcomes predicted RFS or DMFS higher than the cut-off were classified as low risk. Otherwise, they were classified as high risk.

To determine the prognostic value of both algorithms, 433 patients that were not used in either algorithm development were then analyzed by i31-GEP- SLNB, followed by i31-GEP-outcomes.

The 5-year RFS for patients with SLN negative populations were:

Low risk (n=172): 86.7% (81.2-92.7%) with a 95% CI. There were 10.5% (18/172) that experienced recurrences.

SLN Negative (n=215): 79.2% (73.4-85.5%) with a 95% CI. There were 17.7% (38/215) that experienced recurrences.

High Risk (n=43): 47.7% (33.6-67.7%) with a 95% CI. There were 46.5% (20/43) that experienced recurrences.

The 5-year RFS for patients with SLN positive populations were:

Low risk (n=16): 85.9% (69.5-100%) with a 95% CI. There were 18.8% (3/16) that experienced recurrences.

SLN positive (n=83): 48.7% (37.6-63.1%) with a 95% CI. There were 45.8% (38/83) that experienced recurrences.

High risk (n=67): 37.9% (25.8-55.6%) with a 95% CI. There were 52.2% (35/67) that experienced recurrences.

Comparing this data for the 5-year RFS and DMFS for patients with stage IIB-IIC disease shows that the low-risk group for both RFS and DMFS had 0% recurrences or distant metastases. In the stage IIB/IIC group, 34.7% and 26.5%, respectively, experienced recurrences or distant metastases. In the high-risk group, 45.9% and 58.3%, respectively, experienced recurrences or distant metastases.

The data showed that the i31-GEP for SLNB algorithm identified 31.2% (135/433) of patients with a less than 5% likelihood of SLN positivity and these patients had high survival rates. This means that these patients could safely forego SLNB, according to researchers.

 Also, in the SLN negative population, 20% of patients identified as high risk by the i31-GEP result and had 5- year RFS rates that were identical to patients with stage III disease (47.7% vs. 48.7%, respectively).

“Overall, using NCCN treatment recommendations, the i31-GEP test identified 44.8% (194/433) of patients need to add how they were identified and what this meant.Take that from results or conclusions,” the authors concluded.

Castle Biosciences to present data at Maui Derm for Dermatologists 2022. BioSpace. Published January 24, 2021. Accessed January 27, 2022. 

https://www.biospace.com/article/castle-biosciences-to-present-data-at-maui-derm-for-dermatologists-2022/

Martin, B. Taylor, N. Whitman, E. et al. Integrating the 31-gene expression profile and clinicopathologic data to determine the risk of sentinel lymph node positivity and recurrence-free survival in cutaneous melanoma. Presented at: Maui Derm 2022; January 24 to 28, 2022; Wailea, Hawaii.