Publications by authors named "Addison M Demer"
Background: Dermatofibrosarcoma protuberans (DFSP) arising in the vulvar and perivulvar region poses unique challenges to the dermatologic surgeon. The potential for broad subclinical extension and involvement of deeper and high-risk functional structures requires a strong knowledge of relevant anatomy. Careful considerations are required for preoperative arrangements, surgical day preparations, and postoperative surveillance to improve treatment outcomes and patient experiences.
View Article and Find Full Text PDFRisk Factors for Ectropion After Lower Eyelid and Cheek Reconstruction Following Mohs Micrographic Surgery.
Plast Reconstr Surg Glob Open
February 2025
Background: Development of ectropion is a frequently reported complication after reconstruction of infraorbital Mohs defects. This study aimed to characterize preoperative and surgical factors contributing to ectropion development in patients undergoing reconstruction after Mohs micrographic surgery.
Methods: We conducted a retrospective single-center case-control study on patients undergoing reconstruction of Mohs micrographic surgery defects involving the nonmarginal lower eyelid and upper cheek from 2011 to 2023.
Background: Prior studies describe wide local excision and "slow Mohs" outcomes for periocular melanoma. Mohs micrographic surgery (MMS) with immunohistochemistry maximizes tissue preservation and offers same-day comprehensive margin evaluation, which facilitates expedited repair, and coordination of oculoplastic reconstruction when necessary.
Objective: To describe oncologic and reconstructive outcomes of invasive periocular cutaneous melanoma treated with immunohistochemistry-assisted MMS.
Article Synopsis
- The study reviews the increasing use of Mohs micrographic surgery with melanocytic immunostains (MMS-I) for treating cutaneous melanoma over a decade.
- It analyzed data from 352 patients, primarily older males, with most tumors classified as early-stage T1a/b and lentigo maligna subtype.
- The findings showed low rates of local recurrence (1.4%) and melanoma-specific deaths (0.9%), indicating that MMS-I is effective for T1a/b melanomas.
Article Synopsis
- Mohs micrographic surgery (MMS) is an effective treatment for melanoma in situ (MIS), but inconsistent surgical techniques make it hard to apply current data broadly.
- To standardize MMS techniques for MIS in future studies, a modified Delphi method was used, involving expert input through voting on various surgical approaches.
- The study generated 8 consensus recommendations, with five agreed upon in the first round and the others in the second, aimed at providing uniform guidelines to improve future clinical trials.
Background: National cancer reporting-based registry data, although robust, lacks granularity for incidence trends. Expert opinion remains conflicted regarding the possibility of melanoma overdiagnosis in the context of rising incidence without a corresponding rise in mortality.
Objective: To characterize 10- and 50-year trends in melanoma incidence and mortality.
Mohs Micrographic Surgery With Immunohistochemistry for the Treatment of Periocular Melanoma In Situ.
Ophthalmic Plast Reconstr Surg
January 2025
Purpose: Mohs micrographic surgery with immunohistochemistry allows for same-day comprehensive margin assessment of melanoma in situ prior to subspecialty reconstruction. This study describes the oncologic and reconstructive outcomes of eyelid and periorbital melanoma in situ and identifies risk factors for complex reconstructive demands.
Methods: Retrospective case series of all patients treated with Mohs micrographic surgery with immunohistochemistry for melanoma in situ affecting the eyelids or periorbital region from 2008 to 2018 at a single institution.
Background: Mohs micrographic surgery with melanocytic immunohistochemistry (MMS-I) is increasingly utilized for special site melanoma treatment. Yet, frequency and risk factors associated with upstaging of all-stage cutaneous melanomas treated with MMS-I remain undefined.
Objective: Determine upstaging frequency and factors associated with tumor upstaging for all-stage melanomas treated with MMS-I.
Background And Objectives: The prognosis of patients diagnosed with melanoma is highly dependent on staging, early detection, and early intervention. In this systematic review, the authors aimed to investigate the impact of surgical delay (time between diagnostic biopsy and definitive surgical excision) on melanoma-specific outcomes.
Material And Methods: A systematic review was conducted from Embase (1974-present), MEDLINE (1946-present), Cochrane Central Register of Controlled Trials (2005-present), Scopus, and Web of Science.
Background: Mohs micrographic surgery (MMS) is increasingly used to treat cutaneous melanoma. However, it is unclear whether intraoperative immunohistochemistry (IHC) improves surgical outcomes.
Objective: To determine whether intraoperative IHC during MMS and staged excision is associated with a decreased risk of poor surgical outcomes.
Background: Although advances have been made in the understanding of recurrence patterns in dermatofibrosarcoma protuberans, the current understanding of disease-specific mortality after surgical management is limited.
Objective: To understand disease-specific mortality rates associated with dermatofibrosarcoma protuberans treated with wide local excision (WLE) versus Mohs micrographic surgery (MMS).
Materials And Methods: A systematic literature search was conducted on March 6, 2023, to identify patients treated with MMS or WLE for dermatofibrosarcoma protuberans.