Rotations 2.0 Episode 72 Rosacea

Episode 72 Rosacea

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Heartwide by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 71 Squamous Cell Carcinoma 

Question 1 

A 68‑year‑old patient presents to a family medicine clinic with a scaly, tender, hyperkeratotic plaque on the helix of the ear that has enlarged over 2 months. Shave biopsy confirms cutaneous squamous cell carcinoma (cSCC). The pathology report additionally notes tumor cells tracking along a nerve. The patient is otherwise healthy. Which is the most appropriate next step in management?

C. Arrange urgent dermatology (and/or head & neck) referral for high‑risk cSCC management planning

Question 2 

A researcher examines the tumor microenvironment of cSCC and finds abundant regulatory T cells (Tregs)associated with high extracellular adenosine, which suppresses local anti‑tumor immunity. The researcher asks how these Tregs generate adenosine in the extracellular space. Which mechanism best explains the increased extracellular adenosine production?

C. Tregs express ectoenzymes CD39 and CD73 that metabolize extracellular ATP → adenosine

Question 3 

A 79‑year‑old patient has locally advanced cSCC that is not amenable to curative surgery or radiation therapy. The oncology consultant recommends first‑line systemic therapy with a PD‑1 immune checkpoint inhibitor per evidence summarized in the review. Which regimen matches a PD‑1–targeted treatment dosing schedule described in the article?

B. Cemiplimab 350 mg IV every 3 weeks

Rosa, Ilenia, Lorenzo Pio Padula, Francesco Semeraro, Carlotta Marrangone, Antonio Inserra, Luisa De Risio, and Marta Boffa, et al. “Endocannabinoids, Depression, and Treatment Resistance: Perspectives on Effective Therapeutic Interventions.” Psychiatry Research 352 (2025): 116697.

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