Skin Tumors and Reactions to Cancer Therapy in Children

In today’s era of genomic testing, targeted cancer therapies, and increased cancer survivorship, recognition and management of oncologic disease in children is becoming more important to address. This book familiarizes clinicians with the range of oncologic issues that pediatric dermatologists encounter, including the diagnosis and management of various skin tumors, cutaneous reactions to cancer therapies, and both acute and long term complications of cancer therapy. Written and edited by experts in the field, __Pediatric Skin Tumors and Cutaneous Reactions to Cancer Therapy__ explores these important topics, beginning with the discussion of various skin tumors, and associated genetic syndromes, followed by chapters on acute cutaneous reactions to traditional and targeted cancer therapies, graft versus host disease, and opportunistic skin infections. This book concludes with the discussion of both malignant and nonmalignant late effects of the skin in childhood cancer survivors. Preface 5 Acknowledgements 7 Contents 8 Contributors 9 1: Melanoma and Spitz Nevi in Children 11 Spitz Nevi 11 Clinical 12 Histology 12 Genetics 13 Management 13 Atypical Spitz Tumors 14 Clinical 14 Genetics 14 Histology 15 Molecular Analysis 16 Management 16 Pediatric Melanoma 17 Clinical 17 Risk Factors 18 Genetics 18 Management 18 Prognosis 20 Summary 21 References 21 2: Congenital Nevi 26 Background and Diagnosis 26 Overview 26 Pathogenesis 26 Genetics 27 Classification 27 Congenital Melanocytic Nevus Syndrome 28 Differential Diagnosis 30 Evolution and Complications 30 Benign Changes 30 Proliferative Nodules 30 Autoimmune Response 31 Secondary Cutaneous Processes 31 Musculoskeletal Effects 31 Neurocutaneous Melanocytosis (NCM) 32 Melanoma 34 Treatment 36 Treatment Options and Indications 36 Treatment Considerations 36 Psychosocial Considerations 37 References 38 Recommended Reading 42 3: Lymphoproliferative Disorders of the Skin 43 Cutaneous Lymphoid Hyperplasia/Pseudolymphoma 43 Pityriasis Lichenoides 45 Lymphomatoid Papulosis 48 Cutaneous T-Cell Lymphoma/Mycosis Fungoides 50 Cutaneous B-Cell Lymphoma 54 Primary Cutaneous Marginal Zone Lymphoma 54 Precursor B-Cell Lymphoblastic Lymphoma 55 References 56 Recommended Reading 59 4: Other Proliferative Disorders of the Skin 61 Mastocytosis 61 Introduction 61 Epidemiology 61 Natural History 62 Pathogenesis 62 Clinical Features 63 Diagnosis 64 Laboratory Findings 65 Treatment 65 Langerhans Cell Histiocytosis 66 Introduction 66 Epidemiology 67 Natural History 67 Pathogenesis 67 Clinical Features 68 Diagnosis 69 Treatment 69 References 69 Recommended Reading 72 5: Malignancy-Associated Genodermatoses 73 Genodermatoses Associated with Primary Cutaneous Malignancies 73 Introduction 73 Basal Cell Carcinoma 73 Nevoid Basal Cell Carcinoma Syndrome 74 Bazex Syndrome 75 Squamous Cell Carcinoma 75 Ferguson-Smith 75 Melanoma 76 Familial Atypical Multiple Mole- 76 Genodermatoses Associated with Photosensitivity and Increased Risk of Skin Cancer 77 Introduction 77 DNA Repair 77 Xeroderma Pigmentosum 77 Rothmund-Thomson 78 Bloom Syndrome 78 Cell Matrix Instability 79 Kindler Syndrome 79 Oculocutaneous Albinism 80 Genodermatoses Associated with Other Causes of Secondary Cutaneous Malignancies 80 Introduction 80 Epidermolysis Bullosa 80 Incontinentia Pigmenti 81 Epidermodysplasia Verruciformis 81 Genodermatoses Associated with Extracutaneous Malignancies 81 Introduction 81 Summary 85 References 85 Recommended Reading 87 6: Malignant Soft Tissue Tumors in Children 88 Introduction 88 Rhabdomyosarcomas 88 Epidemiology 88 Clinical Presentation 89 Risk Factors 89 Prognosis 90 Treatment 90 Embryonal RMS (Fusion Negative) 90 Alveolar RMS (Fusion Positive) 90 Undifferentiated RMS (Pleomorphic, Anaplastic) 90 Genetic Classification and Advances 90 Primary Cutaneous RMS 91 Non-rhabdomyosarcoma 91 Fibrous (Connective Tissue Tumors) 91 Fibrosarcoma 91 Epidemiology 91 Clinical Characteristics 92 Laboratory and Imaging Characteristics 92 Prognosis and Treatment 92 Dermatofibrosarcoma Protuberans 93 Epidemiology 93 Clinical Presentation 93 Laboratory and Imaging Tests 94 Prognosis and Treatment 94 Borderline or Malignant Vascular Tumors 94 Kaposi Sarcoma 94 Epidemiology 94 Clinical Characteristics 95 Laboratory and Imaging 95 Treatment and Prognosis 95 Kaposiform Hemangioendothelioma 95 Epidemiology 95 Clinical Presentation 96 Prognosis 97 Treatment 97 Neural 97 Malignant Peripheral Nerve Sheath Tumors (MPNSTs) (Synonyms Neurofibrosarcoma, Neurogenic Sarcoma, Malignant Schwannoma) 97 Epidemiology 97 Clinical Presentation 97 Laboratory and Imaging Studies 97 Prognosis and Treatment 98 Lipomatous 98 Liposarcoma 98 Epidemiology 98 Clinical Presentation 98 Prognosis 98 Treatment 98 Tumors of Unknown Origin 99 Malignant Rhabdoid Tumor (Atypical Teratoid/Rhabdoid Tumor) 99 Epidemiology 99 Risk Factors 99 Clinical Presentation 99 Prognosis 99 Treatment 99 Synovial Sarcoma 100 Epidemiology 100 Clinical Characteristics 100 Laboratory and Imaging 100 Treatment and Prognosis 100 Summary 100 References 102 Recommended Reading 106 7: Cutaneous Reactions to Traditional Chemotherapy and Radiation Therapy 107 Introduction 107 Antimetabolite Chemotherapeutic Agents 107 Purine Analogues 108 Mercaptopurine 108 Fludarabine 108 Cladribine 112 Pyrimidine Analogues 112 5-Fluorouracil and Capecitabine 112 Cytarabine 113 Gemcitabine 114 Folic Acid Antagonists 114 Methotrexate 114 Alkylating Agents 115 Cyclophosphamide 115 Ifosfamide 116 ThioTEPA 116 Melphalan 117 Busulfan 117 Hydroxyurea 117 Platinum-Based Antineoplastic Agents: Cisplatin and Carboplatin 118 Antitumor Antibiotics 119 Anthracycline Antitumor Antibiotics 119 Dactinomycin 120 Bleomycin 120 Topoisomerase Inhibitors 121 Topoisomerase I Inhibitors: Topotecan and Irinotecan 121 Topoisomerase II Inhibitors 122 Etoposide 123 Teniposide 123 Mitotic Inhibitors 124 Taxanes: Paclitaxel and Docetaxel 124 Vinca Alkaloids 125 Radiation Therapy 126 Mechanism of Action 127 Types of Ionizing Radiation Therapy 127 Methods of Delivery for Radiation Therapy 128 Uses 128 Adverse Effects 128 Treatment of Acute Radiation Dermatitis 130 Summary 130 References 131 Recommended Reading 143 8: Cutaneous Reactions to Targeted Anticancer Agents 144 Introduction: The Era of Targeted Anticancer Therapy 144 Special Implications in Children 145 EGFR Inhibitors 146 BRAF and MEK Inhibitors 149 mTOR Inhibitors 151 Tyrosine Kinase Inhibitors 152 Antiangiogenesis Agents 153 Summary 155 References 155 Recommended Reading 158 9: Pediatric Graft-Versus-Host Disease 159 Introduction to GVHD 159 Pathophysiology and Risk Factors for GVHD 159 Incidence of GVHD 161 Clinical Features of GVHD 162 Differential Diagnosis for GVHD 165 Histopathology and Laboratory Evaluation of GVHD 166 Classification of GVHD 167 Treatment of GVHD 167 Outcomes of GVHD 169 Summary 169 References 170 Recommended Reading 173 10: Opportunistic Skin Infections in Immunosuppressed Children 174 Introduction 174 Bacterial Infections 175 Aerobic Gram-Positive Bacteria 175 Aerobic Gram-Negative Bacteria 176 Anaerobic Infections 176 Viral Infections 177 Herpesviridae 177 Herpes Simplex Virus (HSV) 177 Varicella Zoster Virus (VZV) 178 Epstein-Barr Virus (EBV/HHV-4) 179 Human Herpesvirus 8 179 Human Papilloma Virus (HPV) 180 Molluscum Contagiosum 180 Human Polyomavirus 181 Fungal Infections 181 Dermatophyte Infections 181 Opportunistic Yeast Infections 181 Invasive Mold Disease 182 Mycobacterial Infections 183 Clinical Presentation 184 Vesicles and Bullae 184 Pustular Eruptions 184 Eschars and Ulcerations 185 Papules and Nodules 186 Summary 186 References 186 Recommended Reading 189 11: Skin Cancer and Other Late Effects of Cancer Therapy 190 Introduction 190 Skin Cancer 190 Non-Melanoma Skin Cancer 191 Posttransplant Lymphoproliferative Disorder 192 Kaposi’s Sarcoma 193 Permanent Alopecia 193 Autoimmune Disorders 194 Scars 195 Education and Anticipatory Guidance 195 Summary 196 References 197 Recommended Reading 200 Index 201 Front Matter ....Pages i-xii Melanoma and Spitz Nevi in Children (Catherine Warner, Melinda Jen)....Pages 1-15 Congenital Nevi (Johanna S. Song, Diana Bartenstein, Elena B. Hawryluk)....Pages 17-33 Lymphoproliferative Disorders of the Skin (Markus Boos, Sara Samimi)....Pages 35-52 Other Proliferative Disorders of the Skin (Emily A. Gurnee, Leslie P. Lawley)....Pages 53-64 Malignancy-Associated Genodermatoses (Sarah N. Robinson, Hannah Song, Jennifer T. Huang)....Pages 65-79 Malignant Soft Tissue Tumors in Children (Christina L. Boull, Sheilagh M. Maguiness)....Pages 81-99 Cutaneous Reactions to Traditional Chemotherapy and Radiation Therapy (Lucinda L. Kohn, Sonal D. Shah)....Pages 101-137 Cutaneous Reactions to Targeted Anticancer Agents (Sophie Vadeboncoeur, Nicole R. LeBoeuf)....Pages 139-153 Pediatric Graft-Versus-Host Disease (Valerie Carlberg, Emily Simons, Sophia Delano, Jennifer T. Huang)....Pages 155-169 Opportunistic Skin Infections in Immunosuppressed Children (James Treat, Elizabeth Heller)....Pages 171-186 Skin Cancer and Other Late Effects of Cancer Therapy (Carrie C. Coughlin)....Pages 187-197 Back Matter ....Pages 199-207 "In today's era of genomic testing, targeted cancer therapies, and increased cancer survivorship, recognition and management of oncologic disease in children is becoming more important to address. This book familiarizes clinicians with the range of oncologic issues that pediatric dermatologists encounter, including the diagnosis and management of various skin tumors, cutaneous reactions to cancer therapies, and both acute and long term complications of cancer therapy. Written and edited by experts in the field, Pediatric Skin Tumors and Cutaneous Reactions to Cancer Therapy explores these important topics, beginning with the discussion of various skin tumors, and associated genetic syndromes, followed by chapters on acute cutaneous reactions to traditional and targeted cancer therapies, graft versus host disease, and opportunistic skin infections. This book concludes with the discussion of both malignant and nonmalignant late effects of the skin in childhood cancer survivors."-- Provided by publisher Annotation In today's era of genomic testing, targeted cancer therapies, and increased cancer survivorship, recognition and management of oncologic disease in children is becoming more important to address. This book familiarizes clinicians with the range of oncologic issues that pediatric dermatologists encounter, including the diagnosis and management of various skin tumors, cutaneous reactions to cancer therapies, and both acute and long term complications of cancer therapy. Written and edited by experts in the field, Pediatric Skin Tumors and Cutaneous Reactions to Cancer Therapy explores these important topics, beginning with the discussion of various skin tumors, and associated genetic syndromes, followed by chapters on acute cutaneous reactions to traditional and targeted cancer therapies, graft versus host disease, and opportunistic skin infections. This book concludes with the discussion of both malignant and nonmalignant late effects of the skin in childhood cancer survivors