@entity3852 : treatment with XXXX .

@entity1 @entity3852 @entity5 @entity1489 @entity2 @entity1732 @entity3 @entity791 @entity320
@entity3852 is the second most deadly form of @entity1489 after @entity320 , with a mortality rate of as high as 35 percent. It usually occurs as a deep red or purple dome-shaped @entity5 on sun-exposed skin of elderly @entity1 . Transplant recipients or @entity791 @entity1 have a higher incidence of this @entity5 than normal individuals. There is an association of a polyoma virus with this @entity5 that may explain the increased incidence in immunosuppression. Surgery, followed by radiation therapy is the standard of treatment. Sentinel node dissection is recommended because this @entity5 metastasizes often. Chemotherapy, such as is used for oat cell @entity2 , is advised for metastatic disease. However, systemic chemotherapy protocols have not been overly successful. We have treated four cases of @entity5 with surgery followed by intralesional @entity1732 and have followed these cases for up to five years with no evidence of recurrence or @entity3 . One case had radiation post operatively but the @entity5 recurred. Intralesional @entity1732 caused complete regression of this @entity5 with minimal scarring and long term cure. @entity1732 , besides being a potent chemotherapy agent, has direct antiviral effects that may explain why this drug is so effective in treating @entity3852 .
