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Melanoma: Clinical Updates and Perspectives
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Melanoma: Clinical Updates and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 February 2025 | Viewed by 3182

Special Issue Editors

Dr. Loredana Ungureanu

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Guest Editor
Department of Dermatology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
Interests: melanoma; dermoscopy; dermato-oncology; adnexal disorders; dermato-surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Simona C. Şenilǎ

E-Mail Website
Guest Editor
Department of Dermatology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.
Interests: melanoma; dermoscopy; dermato-oncology; hair diseases; dermato-surgery; cutaneous lymphomas

Special Issue Information

Dear Colleagues,

In recent years, major advances have been made in the diagnosis and treatment of melanoma, leading to an improvement in the overall survival rate of melanoma patients. Early and accurate diagnosis is crucial to improving clinical outcomes, as an early misdiagnosis can significantly reduce a patient’s chance of survival. The development of dermoscopy, confocal microscopy and other non-invasive techniques helps dermatologists diagnose early melanoma, although none of these techniques are 100% accurate. On the other hand, systems based on artificial intelligence (AI), particularly deep learning, are being increasingly studied, as the use of AI might lead to more precise and faster diagnoses.

Advances in our understanding of the pathophysiology of melanoma have enabled the identification of its implications in terms of clinical features and the development of therapy. Immune checkpoint therapy and targeted therapy have changed melanoma prognosis, although the ineffectiveness of therapeutic measures suggests that much remains to be understood about the mechanism of response and resistance to these drugs. Detecting molecular markers, such as genetic or immune alterations, has emerged as an innovative diagnostic and prognostic prediction method that guides therapeutic decisions.

The aim of this Special Issue is to highlight recent advances in the context of the diagnosis, treatment and prediction of the prognosis for melanoma.

Dr. Loredana Ungureanu
Dr. Simona C. Şenilǎ
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • melanoma
  • diagnosis
  • prognosis
  • therapy
  • perspectives

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Published Papers (3 papers)

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Research

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9 pages, 870 KiB  
Article
Frequency of BRAF Mutations in Dysplastic Nevi, Lentigo Maligna, and Melanoma In Situ
by Ivana Prkačin, Ivan Šamija, Nika Filipović, Matej Vucić, Majda Vučić, Nikola Ferara and Mirna Šitum
J. Clin. Med. 2024, 13(16), 4799; https://doi.org/10.3390/jcm13164799 - 15 Aug 2024
Viewed by 1042
Abstract
Background: In melanomas, mutations in the BRAF gene are common and their occurrence represents an early oncogenic event. Our goal was to determine and compare the frequency of BRAF gene mutations in dysplastic nevi (ND) and melanomas in situ (MIS), as well as [...] Read more.
Background: In melanomas, mutations in the BRAF gene are common and their occurrence represents an early oncogenic event. Our goal was to determine and compare the frequency of BRAF gene mutations in dysplastic nevi (ND) and melanomas in situ (MIS), as well as whether there is a correlation between the presence of BRAF gene mutations and various anamnestic, clinical, and histopathologic variables. Methods: A total of 175 patients—106 with ND, 41 with MIS, and 28 with lentigo maligna (LM) were included in the study. DNA was extracted from tissue samples and analyzed using the competitive allele-specific TaqMan chain reaction by polymerase in real time to detect the presence of BRAF V600E and V600K mutations. The data were compared with anamnestic, clinical, and histopathological data. Results: There is a statistically significant correlation between the presence of BRAF mutation and the diagnosis of melanoma in situ (χ2 test, χ2 = 29.17, p < 0.0001). Patients with LM had a significantly lower incidence of BRAF mutations compared to patients with ND and MIS. There was a significant correlation between the presence of a BRAF mutation and tumor localization, as well as the age of the patient, but no statistically significant correlation between the presence of a BRAF mutation and sex, tumor size, or previous melanoma diagnosis. Conclusions: BRAF mutations in ND are essentially required; however, they are an insufficient oncogenic trigger for the development of melanoma. This research contributes to a better understanding of the etiopathogenesis of melanoma and the role of ND as possible precursor lesions. Full article
(This article belongs to the Special Issue Melanoma: Clinical Updates and Perspectives)
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Review

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15 pages, 312 KiB  
Review
Lentigo Maligna Treatment—An Update
by Loredana Ungureanu, Alina Florentina Vasilovici, Ioana Irina Trufin, Adina Patricia Apostu and Salomea-Ruth Halmágyi
J. Clin. Med. 2024, 13(9), 2527; https://doi.org/10.3390/jcm13092527 - 25 Apr 2024
Cited by 1 | Viewed by 1636
Abstract
Lentigo maligna (LM) is a melanoma in situ that is prevalent in chronically sun-damaged skin. Characterized by a slow growth pattern and high mutation rates due to chronic UV exposure, LM poses diagnostic and therapeutic challenges, particularly given its tendency to mimic other [...] Read more.
Lentigo maligna (LM) is a melanoma in situ that is prevalent in chronically sun-damaged skin. Characterized by a slow growth pattern and high mutation rates due to chronic UV exposure, LM poses diagnostic and therapeutic challenges, particularly given its tendency to mimic other skin lesions and its occurrence in cosmetically sensitive areas. Its diagnosis is based on an integrated approach using dermoscopy and reflectance confocal microscopy (RCM). Despite its slow progression, LM can evolve into lentigo maligna melanoma (LMM), making its treatment necessary. Treatment modalities encompass both surgical and non-surgical methods. Surgical treatments like Wide Local Excision (WLE) and Mohs Micrographic Surgery (MMS) aim for clear histological margins. WLE, a standard melanoma surgery, faces challenges from LM’s subclinical extensions, which increase the recurrence risk. MMS, effective for large or poorly defined lesions, is defined by precise margin control while considering cosmetic outcomes. Non-surgical options, including radiotherapy and imiquimod, are alternatives for non-surgical candidates. Radiotherapy has been effective since the 1950s, offering good control and cosmetic results, especially for older patients. Imiquimod, an immunomodulator, shows promise in treating LM, though its application remains off-label. The increasing incidence of LM/LMM necessitates a balance in treatment choices to minimize recurrence and maintain cosmetic integrity. A multidisciplinary approach, integrating clinical examination with dermoscopy and RCM and histological assessment, is essential for accurate diagnosis and effective LM management. Full article
(This article belongs to the Special Issue Melanoma: Clinical Updates and Perspectives)

Other

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10 pages, 1262 KiB  
Case Report
Impact of BRAF and MEK Inhibitors on Gingival Hyperplasia in Melanoma Patients—A Case Report
by Tanja Veljovic, Milanko Djuric, Ivana Gusic, Nada Vuckovic, Bojana Ramic and Jelena Mirnic
J. Clin. Med. 2025, 14(1), 65; https://doi.org/10.3390/jcm14010065 - 26 Dec 2024
Abstract
Background: Although BRAF inhibitors, such as vemurafenib, produce a marked response in patients with advanced melanoma with a BRAF V600 mutation, they eventually develop resistance to this treatment. To address this issue, vemurafenib is increasingly combined with the MEK inhibitor cobimetinib, leading to [...] Read more.
Background: Although BRAF inhibitors, such as vemurafenib, produce a marked response in patients with advanced melanoma with a BRAF V600 mutation, they eventually develop resistance to this treatment. To address this issue, vemurafenib is increasingly combined with the MEK inhibitor cobimetinib, leading to improved response rates and enhanced survival. However, this treatment modality is associated with numerous side effects. We present a case of gingival hyperplasia in a patient treated with vemurafenib, along with the strategy adopted for the management of this condition, and the impact of subsequent cobimetinib administration on its severity. Methods: The 59-year-old male patient in the focus of this report presented at the Department of Periodontology at the Medical Faculty, University of Novi Sad, in 2019, complaining of gingival overgrowth and bleeding. The patient reported persistent gum swelling during the preceding six months, which he ascribed to the use of vemurafenib, 960 mg twice daily, since 2018, when this medication was prescribed as a part of malignant melanoma treatment. Detailed clinical examination revealed significant gingival overgrowth around all present teeth, affecting the vestibular as well as the oral sides. The patient underwent thorough scaling and root planing, followed by the surgical removal of hyperplastic gingiva. After gingivectomy, the patient was scheduled for follow-up visits at one-month intervals. Six months after gingivectomy, vemurafenib dose was reduced to 720 mg twice daily, and cobimetinib was introduced at 60 mg per day. Results: The treatment protocol adopted in this study, combined with cobimetinib administration, stabilized the gingiva condition in this patient. However, due to his overall poor oral hygiene, gingiva remained inflamed and edematous, but was no longer hyperplastic and hyperkeratotic in appearance. Conclusions: This case underscores the importance of recognizing and adequately addressing this complication, as its adverse effect on a patient’s quality of life can potentially compromise treatment protocol adherence. Full article
(This article belongs to the Special Issue Melanoma: Clinical Updates and Perspectives)
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