Jennifer Nam Choi

Melanoma-related TikTok content lacks adequate skin of color representation and comprehensive educational content. This study found that engagement differed by content type, with response-style videos performing best and educational videos performing worst; in multivariate analysis, patient-created videos were also associated with higher engagement, while educational depth was not associated with engagement, suggesting that format, relatability, and presentation style may influence audience engagement more than educational depth, highlighting potential opportunities to improve the reach and inclusivity of melanoma-related health communication.

Effective communication is essential for promoting appropriate skin cancer screening for the public. This study compares the readability of online resources and ChatGPT-generated responses related to the topic of skin cancer screening. We analyzed 60 websites and responses to five questions from ChatGPT-4.0 using five readability metrics: the Flesch-Kincaid Reading Ease, Flesch-Kincaid Grade Level, SMOG Index, Gunning Fog Index, and Coleman-Liau Index. Results showed that both websites and ChatGPT responses exceeded the recommended sixth grade reading level for health-related information. No significant differences were found between the readability for university-hosted versus non-university-hosted websites. However, across all readability metrics, ChatGPT responses were significantly more difficult to read. These findings highlight the need to enhance the accessibility of health information by aligning content with recommended literacy levels. Future efforts should focus on developing patient-centered, publicly accessible materials and refining AI-generated content to improve public understanding and encourage proactive engagement in skin cancer screenings.

In-transit metastases of malignant melanoma pose a significant clinical challenge, particularly in patients with contraindications to systemic therapies. While surgical excision and systemic immunotherapies remain standard treatments, localized therapies such as intralesional talimogene laherparepvec (T-VEC) and topical imiquimod, which stimulate tumor-specific T-cell responses, have garnered increasing attention for their potential efficacy and tolerability. Although the individual efficacy of these therapies is well-documented, their combined use and their synergistic effects have not been well-documented. This case series reports on five patients with in-transit melanoma metastases treated with T-VEC and imiquimod at Northwestern Memorial Hospital from November 2018 to May 2023. Patients received a median of 13 (range 8–20) T-VEC injections over a median of 6 months (range 5–9), of which 4 of those months were with concurrent T-VEC and imiquimod cream. Four of the five patients achieved complete response (CR) by the end of the treatment course. One patient developed systemic progression during therapy, leading to early cessation of treatment. All patients with CR elected to continue topical imiquimod applications as maintenance following T-VEC for a median of 6 months (range 2–14 months). Only one of the four patients who achieved CR developed metastatic nodal disease 10 months after the last T-VEC injection. The three other patients are free of cutaneous and systemic disease 2–57 months after their last injection. All patients tolerated treatment well with zero patients discontinuing treatment due to side effects. These findings suggest that the combination of intralesional T-VEC and topical imiquimod can be an effective and safe treatment of in-transit metastases of malignant melanoma.

Purpose There are limited treatment options available for hematopoietic stem-cell transplant patients (HSCT) with oral graft-versus-host disease (GVHD). Intraoral phototherapy is a novel, yet promising therapeutic regimen. Research question To assess the safety and effectiveness of intraoral narrowband UVB (nbUVB) phototherapy in the treatment of oral GVHD. Methods This case series evaluated 10 patients with refractory oral GVHD, who were treated at Northwestern Memorial Hospital with nbUVB between July 2019 and October 2023. Primary outcomes were to evaluate the safety and efficacy of phototherapy. Efficacy was measured by objective improvement in symptom scores and subjective improvement in patient reported symptoms. Safety was determined by the withdrawal due to adverse events. Total nbUVB exposure, number of treatments, and change in systemic immunosuppressive medications were also examined. Results The study cohort comprised 10 patients who developed oral GVHD at a median of 9.5 months after HSCT. The total median dose of nbUVB was 36 J/cm², and the median number of sessions was 55. All 10 patients demonstrated some degree of improvement in symptoms. Notably, there was a reduction in the number of patients who reported symptoms of oral pain (83%), bleeding (67%), xerostomia (50%), and oral sensitivity (78%) after initiating phototherapy. There was also a statistically significant decrease in the levels of pain, erythema, and edema (p ≤ 0.001, < 0.001, 0.01, respectively). Most patients tolerated phototherapy well, but 1 patient withdrew from treatment due to adverse effects. Seventy-five percent of patients who were on immunosuppressive medications were able to decrease or stop these medications. Conclusion This case series suggests that nbUVB phototherapy is well tolerated and efficacious in patients with oral GVHD.