Armando Nolasco Toledo

The integration of artificial intelligence (AI), wearable technologies, and digital health monitoring systems has significantly transformed modern healthcare by enabling continuous patient surveillance, personalized interventions, and improved access to medical services. Despite these advances, increasing evidence suggests that prolonged use of wearable devices may be associated with a variety of cutaneous manifestations that can affect patient comfort, treatment adherence, and overall healthcare outcomes. This review aimed to analyze the current scientific evidence regarding dermatological complications associated with wearable technologies, biosensors, adhesive monitoring systems, and AI-assisted healthcare platforms. A qualitative integrative review was conducted using the Scientific Method as a methodological framework. Scientific literature was identified through searches in PubMed/MEDLINE, Scopus, ScienceDirect, Web of Science, and Google Scholar. Evidence related to dermatological manifestations, immunological mechanisms, clinical implications, artificial intelligence applications, and preventive strategies was critically evaluated and synthesized. The findings indicate that allergic contact dermatitis, irritant contact dermatitis, medical adhesive-related skin injuries, erythema, pruritus, and pressure-associated lesions are the most frequently reported complications. Pathophysiological mechanisms involve adhesive exposure, epidermal barrier disruption, mechanical friction, humidity accumulation, and delayed hypersensitivity reactions. Artificial intelligence demonstrated considerable potential for lesion classification, teledermatology support, remote monitoring, and predictive risk assessment. The review concludes that while wearable technologies and AI provide substantial healthcare benefits, their successful implementation requires greater attention to dermatological safety, patient-centered device design, interdisciplinary collaboration, and preventive strategies aimed at minimizing cutaneous adverse effects.

Cutaneous oncology has entered a new phase defined by the integration of early detection strategies, molecular risk stratification, and biologically guided systemic therapies. Melanoma, although less frequent than keratinocyte cancers, remains the most lethal form of skin cancer, while basal cell carcinoma and Merkel-cell carcinoma contribute significantly to global oncologic burden. This review analyzes the contemporary transformation of cutaneous oncology within the precision medicine framework, focusing on three core domains: stage-based prognosis, genomic characterization, and targeted and immune-based therapeutic interventions. Evidence from landmark clinical trials demonstrates that BRAF-mutated melanoma benefits from combined BRAF/MEK inhibition, while immune checkpoint blockade—particularly PD-1–based regimens—achieves durable survival in advanced disease. Long-term survival data confirm sustained benefit in a subset of patients, redefining expectations for metastatic melanoma outcomes. In addition, immunotherapy has shown meaningful activity in other aggressive cutaneous malignancies such as Merkel-cell carcinoma. The integration of staging systems, molecular diagnostics, and systemic therapies illustrates a dual therapeutic paradigm in which tumor genotype and immune context guide treatment selection. From an international perspective, including healthcare systems in Mexico, Colombia, and Ecuador, the implementation of precision oncology requires structured integration of early detection, standardized pathology, essential genomic testing, and multidisciplinary therapeutic access. Cutaneous oncology in the precision era is therefore characterized by coordinated biological insight and clinical application, forming the basis for advanced academic instruction and evidence-based oncologic practice.

Advanced melanoma that progresses after immune checkpoint inhibitors (ICIs) such as anti–PD-1 and anti–CTLA-4 antibodies represents an urgent therapeutic challenge. Tumor-infiltrating lymphocyte (TIL) therapy, an adoptive cell therapy that re-infuses ex vivo–expanded autologous T cells, has shown renewed potential for overcoming immunotherapy resistance. Recent clinical trials, including lifileucel-based regimens, have reported encouraging response and survival outcomes in heavily pretreated populations. This systematic review aimed to evaluate the clinical efficacy, survival outcomes, safety, and feasibility of TIL therapy in patients with immunotherapy-refractory advanced melanoma. A comprehensive search was conducted across PubMed, Scopus, and Google Scholar for studies published between 2014 and 2025 using the terms tumor-infiltrating lymphocyte therapy, TIL therapy, advanced melanoma, and lifileucel. Eligible studies included phase I–III clinical trials, cohort studies, and systematic reviews reporting response rate (ORR), duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety outcomes. Across multiple phase II and III studies, lifileucel achieved objective response rates (ORRs) of 31–36% in immunotherapy-refractory cohorts, including complete responses in up to 12% of patients. The median DoR exceeded 36 months, and 31.3% of responders maintained responses at 5 years. Median PFS ranged from 4.1 to 7.2 months, and median OS from 13.9 to 25.8 months, with some patients achieving long-term disease control beyond five years. Predictors of improved response included lower tumor burden and normal LDH levels. TIL therapy exhibited a predictable and manageable safety profile, dominated by transient grade 3/4 hematologic toxicities related to lymphodepletion and IL-2. Manufacturing feasibility was high, with cryopreserved lifileucel products enabling consistent expansion and delivery across treatment centers. Continued research should refine patient selection, optimize production, and evaluate combination strategies to enhance long-term survival and broaden clinical accessibility.