Language：English   Publishing type：Research paper (scientific journal)  

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are fatal adverse skin reactions characterized by high fever, epidermal detachment, and mucositis. Selpercatinib is a highly selective inhibitor of tyrosine kinase, rearranged during transfection (RET), and is the first targeted therapy for solid tumors with RET gene alteration. The main adverse events of selpercatinib include hypertension, liver dysfunction, diarrhea, and QT prolongation on electrocardiograms. We present the case of 50-year-old male with medullary thyroid carcinoma who was treated with selpercatinib. On the 12th day of the treatment, he developed widespread erythema, which resulted in a referral to our department. Physical examination revealed disseminated erythematous macules, conjunctival congestion, and bloody crusting of the lips, and histopathological examination showed single-cell necrosis in epidermis. Based on these findings, he was diagnosed with SJS. After the discontinuation of selpercatinib and systemic administration of corticosteroids, his symptoms were improved. The patient showed positivity for selpercatinib in drug lymphocyte stimulation test, suggesting the diagnosis of SJS induced by selpercatinib. To the best of our knowledge, this is the first report of SJS caused by selpercatinib. We herein present and discuss this case to raise awareness.

DOI： 10.1111/1346-8138.17749

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. BCCs occur mainly in exposed areas, such as the face and scalp. Therefore, surgical resection with narrow margins is highly desirable. However, narrow margins may increase the risk of positive histopathological margins. Outcomes for such treatment might be unfavorable, but evidence for such a conclusion is lacking. METHODS: Between April 2015 and November 2023, a total of 230 Japanese cases with BCC which underwent surgical resection with 2-mm, 3-mm, or 5-mm margins were followed in our hospital. We conducted a retrospective review that focused on the recurrence rate and histopathological margins. RESULTS: Recurrence was recorded if the follow-up time was longer than 3 months. One of the 198 cases (0.5%) developed a recurrence. The mean lateral and deep histopathological margins were 2,525.4 μm (30.8-14,034.6 μm) and 3,409 μm (199.9-16,523.6 μm), respectively. Recurrence rate was associated with tumor size and clinical tumor border. However, histopathological margin was not associated with recurrence rate, even when it was less than 1,000 μm. CONCLUSIONS: A narrow histopathological margin is acceptable for surgical resection of BCC in Japanese patients.

DOI： 10.1272/jnms.JNMS.2024_91-308

PubMed

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DOI： 10.18888/hi.0000004913

CiNii Research

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Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I033872782

Language：Japanese   Publisher：東京 : 金原出版  

DOI： 10.18888/hi.0000004788

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Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I033780812

Language：Japanese   Publisher：The Medical Association of Nippon Medical School  

Case 1 was a 58-year-old man presenting with a dome-shaped elastic-soft nodule measuring 24 × 18 mm on the left buttock, which had developed five years previously. Case 2 was a 63-year-old woman with an elastic-soft subcutaneous nodule (18 × 22 mm) on the posterior side of the right thigh, which she had first noticed five years before. Case 3 was a 79-year-old man with an elastic-soft subcutaneous nodule (17 × 10 mm) on the lateral side of his left thigh, which he had become aware of four years previously. In all three cases, adipose tissue proliferation was observed between the dermal collagen fibers. Nevus lipomatosus cutaneous superficialis (NLCS) was diagnosed, with lipoma or soft fibroma considered in the differential diagnosis. All three nodules were excised. In case 3, the signal was not suppressed on magnetic resonance imaging (MRI) with fat-suppressed T1-weighted images. Since the excisional design for cases of NLCS is different from that of lipoma, MRI was considered useful in the preoperative diagnosis.

DOI： 10.1272/manms.20.15

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Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I033388545

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