Dermatología Oncológica

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Metastatic Spitzoid Melanoma in a Child: Case Report
(European Journal of Pediatric Dermatology, 2025-07-10) Paola Andrea Rojas angarita; Henry Santiago Leal Reina; Bladimir Rodriguez Lechtig; Xavier Rueda Cadena
Spitzoid melanoma is an extremely rare and aggressive melanocytic neoplasm in childhood, and is clinically and histopathologically difficult to differentiate from other Spitzoid lesions. We present the case of a 6-year-old girl diagnosed with BRAF V600E-mutated infantile Spitzoid melanoma, metastatic to regional lymph nodes. The patient was treated with pembrolizumab (anti-PD-1) and local cryosurgery for palliative purposes, with a good initial partial response. Subsequent disease progression prompted the indication of salvage targeted therapy. She remains under multidisciplinary follow-up, has well tolerated treatment, and has not experienced visceral progression to date.This case underscores the diagnostic complexity of Spitzoid melanocytic tumors in childhood and highlights the importance of integrating histological and molecular data to guide therapeutic decisions.
Inmunohistoquímica en cirugía micrográfica de Mohs: avances en el tratamiento del lentigo maligno en el Instituto Nacional de Cancerología de Colombia
(Revista Colombiana de Cancerología, 2025-09-09) Leal Reina Henry Santiago; Bravo Mora Catalina; Rojas Angarita Paola Andrea; Rocha Aguirre Juan Eduardo; González Cardona Lina Paola
Lentigo maligna is the most common type of melanoma in situ worldwide, characterized by significant subclinical extension and high recurrence rates following conventional surgery. For this reason, Mohs micrographic surgery is considered a first-line treatment. The use of immunohistochemistry in Mohs micrographic surgery for the treatment of lentigo maligna has proven to enhance outcomes not only in histologic evaluation but also in the speed of surgical sample processing, thereby increasing the precision and efficiency of the procedure. Consequently, its implementation began at the Functional Dermatology Unit of the Instituto Nacional de Cancerología (Colombia) (INC) in 2024. This article describes the application of this immunohistochemistry technique in Mohs micrographic surgery for the treatment of lentigo maligna at the INC.
Tratamiento de la micosis fungoide con terapia de haz de electrones de la piel total: experiencia real en un centro de excelencia para linfomas cutáneos en Bogotá, Colombia.
(2025-12-30) Henry Santiago, Leal Reina
Abstract: Introduction: Total Skin Electron Beam Therapy (TSEBT) has established itself as an effective option for the management of cutaneous lymphomas such as mycosis fungoides. This technique allows for uniform treatment of the entire skin surface, making it a key alternative for patients with extensive disease resistant to conventional treatments. Methods: A case series was conducted with 11 patients diagnosed with cutaneous lymphoma treated with TSEBT at a referral center. Demographic, clinical, and therapeutic variables, including clinical response, were analyzed with different tools such a Modified Severity-Weighted Assessment Tool (mSWAT) and the Pruritus Visual Analogue Scale (PVAS), toxicities, and early relapses. The information was obtained from clinical records between January 2023 and January 2025. Results: In this series of 11 cases treated with Total Skin Electron Beam Therapy (TSEBT), 63.63% of patients (7) achieved complete response (CR), 27,27% (3) partial response (PR) with improvement between 50 and 99% of the clinical picture, thus achieving an ORR of 90.9%, and 9.1% (1) disease progression. Relapses were documented in 63.6% of cases with a mean follow-up of 8 months. Of the cases with CR, 66.7% relapsed. The index of the mSWAT decreased on average of 67.5% in patients who were taken to this treatment, initially averaging an mSWAT of 69.3 and a final average of 22.5;and the PVAS score improved going from an average of an initial average of 8.1/10 to a final score of 2.7/10. TSEBT was well tolerated, with minor toxicities such as xerosis, transient alopecia, distal onycholysis, and erythema. These results highlight the treatment's efficacy and safety, although the relapse rate underscores the need for combined strategies and long-term follow-up. Conclusions: TSEBT has been shown to be an effective therapeutic option in patients with cutaneous T-cell lymphomas, achieving an ORR of 90.9% and significant reductions in tumor burden (average 65% on the mSWAT score). These results support its use, especially in settings where systemic therapies have shown limitations, and reinforce the effectiveness of TSEBT as a therapeutic modality even at moderate doses, although relapses remain common in advanced stages.
Supervivencia y factores pronósticos en pacientes con Melanoma lentiginoso acral en el Instituto Nacional de Cancerología en Colombia. Estudio de cohorte.
(Instituto nacional de cancerologia, 2026) Paola Andrea Rojas Angarita; John Alexander Nova; Alvaro Acosta; Xavier Rueda; Carolina Pozzobon; Leonardo Pulido; Lina Gonzalez; Luz Dary Gutierrez; Sebastian Gil; William Lopez
Aunque el melanoma representa solo el 4% de las neoplasias cutáneas, este tumor es el responsable del 75% de las muertes por cáncer de piel. El subtipo melanoma lentiginoso acral (MLA) corresponde a menos del 5% en población blanca, sin embargo, en latinoamericana es el subtipo de melanoma más frecuente. A pesarde esto, el melanoma lentiginoso acral ha sido poco estudiado; su abordaje y manejo sigue los parámetros establecidos para los otros subtipos de melanoma, sin tener certeza de que los factores pronósticos para el MLA sean los mismos que para otros subtipos de melanoma.

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